ADVANCE CODING MIDTERM 7 EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026/2027

ADVANCE CODING MIDTERM 7 EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026/2027 Outpatient--Emergency Department (Injury) Patient Name: Jarrid Foust Diagnosis: Closed fracture of lower end of right radius and ulna Procedures: Fracture manipulation, forearm x-ray, cast application A 7-year-old male patient presented to the emergency department (ED) after falling off his bicycle. Superficial scrapes were noted on his right forearm, and he complained of pain in his right forearm. He said that as he hit the ground, his right arm struck a large rock. The ED physician provided Level 2 evaluation and management services and ordered an x-ray of the right forearm. X-ray of the right forearm, two views, with interpretation and report, revealed a closed fracture of the distal end of the radius and ulna. The ED physician called the on-call orthopedic surgeon for consultation, and the patient was prepared for surgery. After the anesthesiologist administered general anesthesia to this otherwise healthy child, - Answers A4580, 99282-57, 25565-RT, 73090-RT, 01820-P1-AA, S52.501A, S52.601A, W17.89XA, Y92.9, Y93.55 HCPCS level II codes are considered------ codes. - Answers national HCPCS level II codes describe procedures, services, and ,------ ----- ---- ----- ----- ----- abbreviated------- . - Answers durable medical equipment, prosthetics, orthotics, supplies (DMEPOS) CPT codes are included as HCPCS level------- codes. - Answers I HCPCS level II national codes are----- characters in length. - Answers five HCPCS level II national codes begin with the letters-----to------ . - Answers A TO V HCPCS level II codes are developed and maintained by the ------ ------------Workgroup. - Answers CMS HCPCS Services and procedures that are reimbursed by a MAC can be found in the ----- ---- ---- abbreviated----- - Answers Medicare Carriers Manual (MCM) Whether a service is covered or excluded under the Medicare program can be found in the Medicare----- ------ ----- Manual. - Answers National Coverage Determinations HCPCS level II permanent codes are maintained by the ---- ----Workgroup. - Answers CMS HCPCS HCPCS level II and CPT codes and multiple modifiers are reported on the------ same line of Block 24D on the claim, such as 26010 FA F1. - Answers CMS-1500 HCPCS level II miscellaneous codes are reported when a(n)------ ------- submits a claim for a product or service for which there is no existing HCPCS level II national code. - Answers DMEPOS dealer HCPCS level II temporary codes allow payers the flexibility to establish codes that are needed before the next January 1------ update. - Answers annual identify the modifier that is added to a code when a procedure is performed by a registered dietician - Answers -AE Modifier-------- is added to codes for procedures that are performed on both sides during the same operative session. - Answers -50 HCPCS level II-------- are added to HCPCS level I (CPT) and level II (national) codes. - Answers modifiers Some services must be reported by assigning both a CPT and a HCPCS code; the most common scenario uses a CPT code for administration of a(n)------ and the HCPCS code to identify the------ . - Answers infusion, medication If a drug is administered in a 100-mg dose and the HCPCS level II code description states "per 50 mg," the quantity billed is - Answers two If just 10 mg of a drug were administered and the HCPCS level II code description stated "up to 15 mg," the quantity billed is - Answers one The charge for office visit or procedure usually includes------- used to perform the procedure or service. - Answers supplies Although CMS developed this system, some HCPCS levels I and II services are not payable by - Answers Medicare Some HCPCS level II coding manuals include a table of drugs that lists J codes assigned to - Answers medications If you have difficulty locating the service or procedure in the HCPCS level II index, review the ------- -------- -------- to locate the code section and read the code descriptions very carefully before selecting a code. - Answers table of contents Codes sections in HCPCS level II are identified by a(n) - Answers alphabetical first character CMS developed the level II codes for Medicare, but------ ------- also adopted them. - Answers commercial payers If no code exists for a procedure or service, report the proper"unlisted procedure" -------code from and submit documentation explaining the procedure or service. - Answers CPT The specific---- ----- ----- code determines whether the claim is sent to the primary MAC that processes provider claims or the DME MAC that processes DMEPOS dealer claims. - Answers HCPCS level II Providers and DMEPOS dealers obtain annual lists of valid level II national codes, which include------ instructions for services. - Answers billing CMS decided to have all DME claims processed by only four DME MACs to reduce------ claims. - Answers fraudulent When a physician treats a Medicare patient for a fractured femur and supplies the patient with crutches, two claims are generated. The physician's claim for the fracture care is sent to the------ ,------- and the claim for the crutches is sent to the-------- -------- - Answers primary MAC, DME MAC For certain items or services reported on a claim submitted to the DME MAC, the DMEPOS dealer must receive a signed------ ------- ------- -------- , abbreviated------- - Answers certificate of medical necessity (CMN) Which would be assigned to report DMEPOS on insurance claims? - Answers HCPCS level II codes Which provides suppliers and manufacturers with assistance in determining HCPCS codes to be reported? - Answers PDAC Which temporary codes are reported to all payers? - Answers G codes and Q codes When both a CPT code and a HCPCS level II code are available for a procedure, service, or supply, the coder should assign the: - Answers code according to payer instructions.