MEDICAL BILLING AND CODING FINAL
A 26-year-old female presented to the emergency department with complaints of severe
headaches of 10 hour duration. An expanded problem focused history and examination
were preferring the MDM was moderate complexity which of the following is the correct
evaluation and management code for the services provided? - answer-99283
A 43-year-old established patient presents to office for his annual visit. The physician
performed a comprehensive history and exam. The patient wrote a refill for chronic
condition of diabetes Mellitus to and hypertension. Which of the following is the correct
code assignment? - answer-99396, Z00.00, I10, E11.9
A 72-year-old patient is undergoing a corneal transplant. An anesthesiologist is
personally performing monitored anesthesia care. Which of the following modifiers
should be reported for the anesthesia? - answer--AA-AS
A Medicare patient has an 80/20 plan. The charge amount was $300. The amount
allowed was $100 which of the following is the patients co-insurance? - answer-$20
A Medicare patient presents to an outpatient hospital facility for a scheduled
hysterectomy. To which Medicare plan should the facility submit the claim? - answer-
Part B
A patient has a home health aide come to his home to clean and dress a burn on his
lower leg. The aid uses a special absorptive do you sterilize dressing to cover 20 sq. in.
area. She also covers 15 sq. in.² area with a self-adhesive sterilize gauze pad. Which of
the following is the correct HCPCS code assignment? - answer-A6204, A6219
A patient presents for excision on his arm. The lesion was 3 cm with 0.5 cm margins. It
was a full thickness removal and the pathology proved it to a benign lesion. The closure
was simple. Which of the following is the correct CPT code assignment? - answer-
11404
A patient presents to office with RUQ abdominal pain. The physician sends the patient
for HIDA scan to access for possible cholelithiasis. Which of the following is the correct
ICD 10 CM code assignment? - answer-R10.11
A patient presents to the ED with multiple stab wounds to the arm and chest. On
examination there are three deep lacerations to the arms measuring 1.2 cm 1.4 cm and
2.1 cm requiring complex closure and 2 superficial wounds measuring 1.3 cm and 2.4
cm requiring intermediate closure. Which of the following is the correct CPT code
assignment? - answer-13121, 12032-59
A patient presents with low back pain. The physician ordered an MRI and discover the
patient has L5/S1 spondylolisthesis. Which of the following is the correct ICD 10 CM
code assignment? - answer-M43.17
, A patient presents with symptoms for gastric reflux. The physician performed EGD
flexible transoral. The scope was advanced to the stomach but unable to advance to the
duodenum due to gastric bolus. Physician will return patient for second EGD after
course of treatment. Which of the following is the correct CPT code assignment? -
answer-43235-53
A patient was diagnosed with cancer in both breasts and was prepped for surgery
today. A simple bilateral mastectomy was preformed. Which of the following is the
correct CPT code assignment? - answer-19303-50
A third party payer made an error while adjudicating a claim. Which of the following
should the insurance and coding specialist do? - answer-Resubmit the claim with an
attachment explaining the error.
An established patient has an office visit for the removal of skin tags from the eye area.
During the examination the patient asks the physician to evaluate minor chest pain and
pressure. The physician preforms an expanded history and examination with low
medical decision making. Which of the following codes should be reported for today's
service? - answer-99213-25, 11200
An Insurance and coding specialist is reviewing a patient's encounter form that is
documented in the medical record prior to completing a CMS 1500 form. She noticed
that the position of coded the encounter form. The specialist has the ethical obligation to
first? - answer-Query the physician
Collecting statistics on the frequency of co-pay collection at the time of service is a step
in the process of? - answer-Managing A/R
Collecting statistics on the frequency of copay collection at time of service is a step in
the process of? - answer-Managing A/R
Developing an insurance claim begins? - answer-When the patient calls to schedule an
appointment
Hey patient has not had an alcoholic drink for two years but has been diagnosed with
alcoholic cirrhosis and ascities. Which of the following ICD 10 CM code should be
assigned? - answer-K70.31, F10.21
Hey patient presents for a right side hip injection the provider use palpitation for
guidance which of the following is an appropriate CPT code? - answer-20610-RT
Hey patient was seen in the office. Charges were recorded and submitted to the
patient's insurance and an EOB was received by the office with a payment of $70.89.
These transaction should be recorded in the? - answer-Patient ledger
A 26-year-old female presented to the emergency department with complaints of severe
headaches of 10 hour duration. An expanded problem focused history and examination
were preferring the MDM was moderate complexity which of the following is the correct
evaluation and management code for the services provided? - answer-99283
A 43-year-old established patient presents to office for his annual visit. The physician
performed a comprehensive history and exam. The patient wrote a refill for chronic
condition of diabetes Mellitus to and hypertension. Which of the following is the correct
code assignment? - answer-99396, Z00.00, I10, E11.9
A 72-year-old patient is undergoing a corneal transplant. An anesthesiologist is
personally performing monitored anesthesia care. Which of the following modifiers
should be reported for the anesthesia? - answer--AA-AS
A Medicare patient has an 80/20 plan. The charge amount was $300. The amount
allowed was $100 which of the following is the patients co-insurance? - answer-$20
A Medicare patient presents to an outpatient hospital facility for a scheduled
hysterectomy. To which Medicare plan should the facility submit the claim? - answer-
Part B
A patient has a home health aide come to his home to clean and dress a burn on his
lower leg. The aid uses a special absorptive do you sterilize dressing to cover 20 sq. in.
area. She also covers 15 sq. in.² area with a self-adhesive sterilize gauze pad. Which of
the following is the correct HCPCS code assignment? - answer-A6204, A6219
A patient presents for excision on his arm. The lesion was 3 cm with 0.5 cm margins. It
was a full thickness removal and the pathology proved it to a benign lesion. The closure
was simple. Which of the following is the correct CPT code assignment? - answer-
11404
A patient presents to office with RUQ abdominal pain. The physician sends the patient
for HIDA scan to access for possible cholelithiasis. Which of the following is the correct
ICD 10 CM code assignment? - answer-R10.11
A patient presents to the ED with multiple stab wounds to the arm and chest. On
examination there are three deep lacerations to the arms measuring 1.2 cm 1.4 cm and
2.1 cm requiring complex closure and 2 superficial wounds measuring 1.3 cm and 2.4
cm requiring intermediate closure. Which of the following is the correct CPT code
assignment? - answer-13121, 12032-59
A patient presents with low back pain. The physician ordered an MRI and discover the
patient has L5/S1 spondylolisthesis. Which of the following is the correct ICD 10 CM
code assignment? - answer-M43.17
, A patient presents with symptoms for gastric reflux. The physician performed EGD
flexible transoral. The scope was advanced to the stomach but unable to advance to the
duodenum due to gastric bolus. Physician will return patient for second EGD after
course of treatment. Which of the following is the correct CPT code assignment? -
answer-43235-53
A patient was diagnosed with cancer in both breasts and was prepped for surgery
today. A simple bilateral mastectomy was preformed. Which of the following is the
correct CPT code assignment? - answer-19303-50
A third party payer made an error while adjudicating a claim. Which of the following
should the insurance and coding specialist do? - answer-Resubmit the claim with an
attachment explaining the error.
An established patient has an office visit for the removal of skin tags from the eye area.
During the examination the patient asks the physician to evaluate minor chest pain and
pressure. The physician preforms an expanded history and examination with low
medical decision making. Which of the following codes should be reported for today's
service? - answer-99213-25, 11200
An Insurance and coding specialist is reviewing a patient's encounter form that is
documented in the medical record prior to completing a CMS 1500 form. She noticed
that the position of coded the encounter form. The specialist has the ethical obligation to
first? - answer-Query the physician
Collecting statistics on the frequency of co-pay collection at the time of service is a step
in the process of? - answer-Managing A/R
Collecting statistics on the frequency of copay collection at time of service is a step in
the process of? - answer-Managing A/R
Developing an insurance claim begins? - answer-When the patient calls to schedule an
appointment
Hey patient has not had an alcoholic drink for two years but has been diagnosed with
alcoholic cirrhosis and ascities. Which of the following ICD 10 CM code should be
assigned? - answer-K70.31, F10.21
Hey patient presents for a right side hip injection the provider use palpitation for
guidance which of the following is an appropriate CPT code? - answer-20610-RT
Hey patient was seen in the office. Charges were recorded and submitted to the
patient's insurance and an EOB was received by the office with a payment of $70.89.
These transaction should be recorded in the? - answer-Patient ledger
