1. What is the appropriate code for an inpatient consultation for a
patient with acute pancreatitis?
A. 99221
B. 99255
C. 99261
D. 99223
Answer: b) 99255
Rationale: CPT code 99255 is used for a high-complexity inpatient
consultation, appropriate for a case like acute pancreatitis.
2. What does the term "capitation" refer to in medical billing?
A. A payment method where providers receive a fixed payment per
patient per month
B. A method to track patient satisfaction
C. The coding of emergency medical procedures
D. The process of submitting claims for a single service
Answer: a) A payment method where providers receive a fixed
payment per patient per month
Rationale: Capitation refers to a payment arrangement where
healthcare providers are paid a set amount per patient, regardless
of the number of services provided.
,3. What modifier should be used to indicate a surgical procedure
performed on a patient who was not previously scheduled for
surgery?
A. -50
B. -22
C. -21
D. -58
Answer: b) -22
Rationale: Modifier -22 is used to indicate a service that was more
complex or difficult than usual, such as an unscheduled surgery.
4. What is the first step in the medical coding process?
A. Assigning the correct CPT code
B. Reviewing the medical record
C. Submitting the claim to the insurance
D. Verifying patient identity
Answer: b) Reviewing the medical record
Rationale: The first step in the coding process is to review the
medical record to determine the correct codes for diagnoses and
procedures.
, 5. Which of the following codes is used to report a bilateral
procedure?
A. Modifier -59
B. Modifier -50
C. Modifier -25
D. Modifier -51
Answer: b) Modifier -50
Rationale: Modifier -50 is used to indicate that a procedure was
performed bilaterally (on both sides of the body).
6. Which of the following describes a "global period" in medical
billing?
A. The time between the initial consultation and the final payment
B. The period of time in which follow-up visits for a specific
procedure are covered
C. The time needed to perform a procedure
D. The length of time before a diagnosis code becomes effective
Answer: b) The period of time in which follow-up visits for a
specific procedure are covered
Rationale: A global period refers to the time frame during which
all services related to a specific procedure, including follow-up
visits, are considered part of the same procedure and not
reimbursed separately.
patient with acute pancreatitis?
A. 99221
B. 99255
C. 99261
D. 99223
Answer: b) 99255
Rationale: CPT code 99255 is used for a high-complexity inpatient
consultation, appropriate for a case like acute pancreatitis.
2. What does the term "capitation" refer to in medical billing?
A. A payment method where providers receive a fixed payment per
patient per month
B. A method to track patient satisfaction
C. The coding of emergency medical procedures
D. The process of submitting claims for a single service
Answer: a) A payment method where providers receive a fixed
payment per patient per month
Rationale: Capitation refers to a payment arrangement where
healthcare providers are paid a set amount per patient, regardless
of the number of services provided.
,3. What modifier should be used to indicate a surgical procedure
performed on a patient who was not previously scheduled for
surgery?
A. -50
B. -22
C. -21
D. -58
Answer: b) -22
Rationale: Modifier -22 is used to indicate a service that was more
complex or difficult than usual, such as an unscheduled surgery.
4. What is the first step in the medical coding process?
A. Assigning the correct CPT code
B. Reviewing the medical record
C. Submitting the claim to the insurance
D. Verifying patient identity
Answer: b) Reviewing the medical record
Rationale: The first step in the coding process is to review the
medical record to determine the correct codes for diagnoses and
procedures.
, 5. Which of the following codes is used to report a bilateral
procedure?
A. Modifier -59
B. Modifier -50
C. Modifier -25
D. Modifier -51
Answer: b) Modifier -50
Rationale: Modifier -50 is used to indicate that a procedure was
performed bilaterally (on both sides of the body).
6. Which of the following describes a "global period" in medical
billing?
A. The time between the initial consultation and the final payment
B. The period of time in which follow-up visits for a specific
procedure are covered
C. The time needed to perform a procedure
D. The length of time before a diagnosis code becomes effective
Answer: b) The period of time in which follow-up visits for a
specific procedure are covered
Rationale: A global period refers to the time frame during which
all services related to a specific procedure, including follow-up
visits, are considered part of the same procedure and not
reimbursed separately.
