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1. Phacoemulsification of left cataract with IOL implant and subconjunctival injection.
(Code ICD-10-CM for diagnosis and CPT for procedures.) - CORRECT ANSWER A. H26.9,
66983, 68200
B. H26.9, 66984-LT
C. H26.9, 66940-LT
D. H26.9, 66984-LT, 68200-LT
Answer is B
2. The required method for the submission of health care claims to third-party payers must
be electronic unless the facility has acquired a - CORRECT ANSWER A. non-digital release
of submission.
B. contract with a clearinghouse.
C. note from the IT department.
D. waiver from the payer to submit paper claims.
Answer is D
3. The following data is required to be included in a patient health record, EXCEPT -
CORRECT ANSWER A. immunization dates.
B. vital signs.
C. copies of all claims submitted.
D. diagnoses.
Answer is C
4. The _______ has the duty to adjust the MS-DRGs if necessary at the beginning of every
fiscal year beginning _____________. - CORRECT ANSWER A. CMS, October 1
B. IG, October 1
C. AHA, January 1
, D. CMS, January 1
Answer is A
5. If the same condition is described as both acute and chronic and separate subentries
exist in the ICD-10-CM alphabetic index at the same indentation level - CORRECT
ANSWER A. only the acute condition should be coded.
B. only the chronic condition should be coded.
C. they should both be coded, acute sequenced first.
D. they should both be coded, chronic sequenced first.
Answer is C
6. In reviewing a medical record for coding purposes, the coder notes that the discharge
summary has not yet been transcribed. In its absence, the best place to look for the
patient's response to treatment and documentation of any complications that may have
developed during this episode of care is in the - CORRECT ANSWER A. doctors' progress
note section.
B. history and physical.
C. doctors' orders.
C. operative report.
Answer is A
7. CMS delegates its daily operations of the Medicare and Medicaid programs to - CORRECT
ANSWER A. the National Center for Vital and Health Statistics.
B. the PRO in each state.
C. Medicare administrative contractor (MAC).
D. the office of Inspector General.
Answer is C
8. The Master Patient Index, __________, which can be used to access data for analysis. -
CORRECT ANSWER A. lists all physicians within one facility on one specific date
B. is the same as Case Mix Index
C. collates patient information from separate systems
D. catalogs patients by principal diagnosis code
Answer is C
,9. Patient self-reported documentation may also be used to assign codes for social
determinants of health, with the requirement that - CORRECT ANSWER A. lab reports
confirm that patient's story.
B. a nurse or other clinician witness the patient's story.
C. the physician includes these details in the encounter documentation.
D. the patient has the report notarized.
Answer is C
10. CAC software is used to analyze health care documents and produce appropriate
medical codes. This may be used by some health care facilities when there are an
insufficient number of certified medical coding candidates. CAC stands for - CORRECT
ANSWER A. Computed Axial Classification.
B. Certified Alcohol Counselor.
C. Computer-Assisted Coding.
D. Cost Analysis Coding.
Answer is C
11. Patient presents to the GI lab for a colonoscopy. During the colonoscopy, polyps were
discovered in the ascending colon and in the transverse colon. Polyps in the ascending
colon were removed via hot biopsy forceps, and the polyps in the transverse colon were
removed by snare technique. - CORRECT ANSWER A. D12.3, 45355, 45383-59
B. D12.2, D12.3, 45384, 45385-59
C. D12.2, 44392, 44394-59
D. D12.2, D12.3, 45355
Answer is B
12. The patient was seen by the physician on September 30. By the time the documentation
reached the medical coder, it was October 2. The code set required to report the
appropriate diagnosis is - CORRECT ANSWER A. the 2022 ICD-10-CM code set.
B. the coder may choose which code set to use.
C. the third-party payer will choose which code set to use.
D. the 2023 ICD-10-CM code set.
Answer is A
, 13. Provide the CPT code(s) for anesthesia services for the transvenous insertion of a
pacemaker. - CORRECT ANSWER A. 00530
B. 33206, 00560
C. 33202, 00530
D. 00560
Answer is A
14. The patient was admitted through the Emergency Department and she is anxious about
notifying her spouse and her sister. Her spouse is out of town on business and her sister
lives in another state. The patient is worried about how they can get updates when she
is in surgery, when they cannot prove how they are related to her to clear HIPAA
limitations. You tell her not to worry, because - CORRECT ANSWER A. the hospital can
assign special pass codes.
B. the hospital can use facial recognition.
C. they will need to wait until she is out of surgery.
D. the hospital can use voice recognition.
Answer is A
SAMPLE MS-DRG REPORT
MS-DRG IDENTIFIER: A, B, C ,D
RELATIVE WEIGHT: 1.234, 3.122, 2.165, 5.118
NUMBER OF PATIENTS WITH THIS MS-DRG: 12, 10, 19, 16
Based on the sample MS-DRG report above, what is the case-mix index for this facility? -
CORRECT ANSWER A. 2.965807
B. 42.26275
C. 11.639
D. 2.90975
Answer is A