1.
Identify the CPT code for a 42-year-old diagnosed with ESRD who requires home dialysis for
the month of April.
a. 90965
b. 90964
c. 90966
d. 90970
CORRECT ANSWER
Correct Answer: C
Dialysis, end-stage renal disease. Code 90966 is for end-stage renal disease (ESRD)
related services for home dialysis per full month for patients 20 years of age and older
(Smith 2012, 227).
2.
Exceptions to the consent requirement include:
a. Medical emergencies
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,b. Provider discretion
c. Implied consent
d. Informed consent
CORRECT ANSWER
Correct Answer: A
The law permits a presumption of consent during emergency situations, regardless of
whether the patient is an adult or minor (Brodnik et al. 2009, 99).
3.
An 80-year-old female is admitted with fever, lethargy, hypotension, tachycardia, oliguria,
and elevated WBC. The patient has more than 100,000 organisms of Escherichia coli per cc
of urine. The attending physician documents "urosepsis." How should the coder proceed to
code this case?
a. Code sepsis as the principal diagnosis with urinary tract infection due to E. coli as
secondary diagnosis.
b. Code urinary tract infection with sepsis as the principal diagnosis.
c. Query the physician to ask if the patient has septicemia because of the symptomatology.
d. Query the physician to ask if the patient had septic shock so that this may be used as the
principal diagnosis.
CORRECT ANSWER
Correct Answer: C
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, The term "urosepsis" is a nonspecific term. If that is the only term documented, only
code 599.0 should be assigned based on the default for the term in the ICD-9-CM index,
in addition to the code for the causal organism, if known. Septicemia results from the
entry of pathogens into the bloodstream. Symptoms include spiking fever, chills, and skin
eruptions in the form of petechiae or purpura. Blood cultures are usually positive;
however, a negative culture does not exclude the diagnosis of septicemia. Several other
clinical indications and symptomology could indicate the diagnosis of septicemia. Only
the physician can diagnose the condition based on clinical indications. Query the
physician when the diagnosis is not clear to the coder (Schraffenberger 2012, 79-81, 251).
4.
What is the correct CPT code assignment for destruction of internal hemorrhoids with use of
infrared coagulation?
a. 46255
b. 46930
c. 46260
d. 46945
CORRECT ANSWER
Correct Answer: B
Index main term: Destruction, hemorrhoid, thermal. Thermal includes infrared
coagulation (Kuehn 2012, 27, 163).
5.
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, Identify the two-digit modifier that may be reported to indicate a physician performed the
postoperative management of a patient, but another physician performed the surgical
procedure.
a. -22
b. -54
c. -32
d. -55
CORRECT ANSWER
Correct Answer: D
Modifiers are appended to the code to provide more information or to alert the payer
that a payment change is required. Modifier -55 is used to identify the physician
provided only postoperative care services for a particular procedure (Kuehn 2012, 292,
295).
6.
Which of the following organizations is responsible for updating the procedure classification
of ICD-9-CM?
a. Centers for Disease Control (CDC)
b. Centers for Medicare and Medicaid Services (CMS)
c. National Center for Health Statistics (NCHS)
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Identify the CPT code for a 42-year-old diagnosed with ESRD who requires home dialysis for
the month of April.
a. 90965
b. 90964
c. 90966
d. 90970
CORRECT ANSWER
Correct Answer: C
Dialysis, end-stage renal disease. Code 90966 is for end-stage renal disease (ESRD)
related services for home dialysis per full month for patients 20 years of age and older
(Smith 2012, 227).
2.
Exceptions to the consent requirement include:
a. Medical emergencies
1
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,b. Provider discretion
c. Implied consent
d. Informed consent
CORRECT ANSWER
Correct Answer: A
The law permits a presumption of consent during emergency situations, regardless of
whether the patient is an adult or minor (Brodnik et al. 2009, 99).
3.
An 80-year-old female is admitted with fever, lethargy, hypotension, tachycardia, oliguria,
and elevated WBC. The patient has more than 100,000 organisms of Escherichia coli per cc
of urine. The attending physician documents "urosepsis." How should the coder proceed to
code this case?
a. Code sepsis as the principal diagnosis with urinary tract infection due to E. coli as
secondary diagnosis.
b. Code urinary tract infection with sepsis as the principal diagnosis.
c. Query the physician to ask if the patient has septicemia because of the symptomatology.
d. Query the physician to ask if the patient had septic shock so that this may be used as the
principal diagnosis.
CORRECT ANSWER
Correct Answer: C
2
@https://www.stuvia.com/user/thestudyvault
, The term "urosepsis" is a nonspecific term. If that is the only term documented, only
code 599.0 should be assigned based on the default for the term in the ICD-9-CM index,
in addition to the code for the causal organism, if known. Septicemia results from the
entry of pathogens into the bloodstream. Symptoms include spiking fever, chills, and skin
eruptions in the form of petechiae or purpura. Blood cultures are usually positive;
however, a negative culture does not exclude the diagnosis of septicemia. Several other
clinical indications and symptomology could indicate the diagnosis of septicemia. Only
the physician can diagnose the condition based on clinical indications. Query the
physician when the diagnosis is not clear to the coder (Schraffenberger 2012, 79-81, 251).
4.
What is the correct CPT code assignment for destruction of internal hemorrhoids with use of
infrared coagulation?
a. 46255
b. 46930
c. 46260
d. 46945
CORRECT ANSWER
Correct Answer: B
Index main term: Destruction, hemorrhoid, thermal. Thermal includes infrared
coagulation (Kuehn 2012, 27, 163).
5.
3
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, Identify the two-digit modifier that may be reported to indicate a physician performed the
postoperative management of a patient, but another physician performed the surgical
procedure.
a. -22
b. -54
c. -32
d. -55
CORRECT ANSWER
Correct Answer: D
Modifiers are appended to the code to provide more information or to alert the payer
that a payment change is required. Modifier -55 is used to identify the physician
provided only postoperative care services for a particular procedure (Kuehn 2012, 292,
295).
6.
Which of the following organizations is responsible for updating the procedure classification
of ICD-9-CM?
a. Centers for Disease Control (CDC)
b. Centers for Medicare and Medicaid Services (CMS)
c. National Center for Health Statistics (NCHS)
4
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