MEDICAL BILLING AND CODING FINAL
EXAM Q&A
A five-year-old was brought to the emergency department after falling from a
climbing wall and sustaining scrapes and bruises. No sutures were required. The
visit involved an expanded problem-focused history and physical exam with decision
making of moderate complexity. What is the correct CPT code? - Answer-99283
What does the HCPCS Level II coding classification system provide to medical
providers and suppliers? - Answer-Codes for reporting procedures, services, medical
equipment, and supplies not included in CPT.
Using the Table of Drugs and Biologicals in the HCPCS Level II codebook, what is
the code for a 10 mg injection of morphine sulfate? - Answer-J2270
The durable medical equipment dealer supplied the patient with a non-heated
humidifier to be used with his CPAP device. What is the correct HCPCS Level II
code? - Answer-E0561
Following surgery, the patient was provided with below-knee-length surgical
stockings. What is the correct HCPCS Level II code? - Answer-A4500
The surgeon amputated the patient's right lower extremity. His physician assistant
(PA) actively assisted the surgeon in this surgical procedure. What is the correct
HCPCS Level II modifier used for the PA's role in this procedure? - Answer-AS
What is the fastest but also most dangerous route of drug administration? - Answer-
Intravenous
What is a chemically equivalent, lower-cost version of a brand name drug? - Answer-
generic
Where are the names, dosages, and reasons for all drugs that a patient currently
takes documented in a medical record? - Answer-Medication List
What is a written request to a physician to clarify or complete the information in
clinical documentation to ensure accurate health records? - Answer-Physician query
A test that screens for antibodies in the blood would be reported on what medical
report? - Answer-Laboratory Report
Which of the following is one reason why clinical documentation improvement (CDI)
efforts are necessary? - Answer-It provides an opportunity for physicians to
demonstrate the quality of care that was provided.
The patient was referred for a bone scan to check for metastatic disease. Which
diagnosis would support medical necessity for this procedure? - Answer-Breast
cancer
, What is the physical location where healthcare services are provided to patients? -
Answer-Place of service
What is the standard, unique health identifier that is mandated by HIPAA for each
healthcare provider and used for claims processing, patient eligibility inquiries,
claims inquiries, patient referrals, and generation of remittance advices? - Answer-
National Provider Identifier (NPI)
What is the term for two or more physicians who share space, equipment, supplies,
and personnel and may represent a single specialty or multiple specialties? -
Answer-Group practice
What is health insurance issued by private companies? - Answer-Commercial
Which of the following allows employees to continue healthcare coverage beyond
the benefit termination date? - Answer-Consolidated Omnibus Budget Reconciliation
Act (COBRA)
What is defined as the amount commonly charged for a particular medical service by
providers within a certain geographic area. - Answer-Usual, customary, and
reasonable (UCR)
Where are BCBS claims submitted for processing? - Answer-The local BCBS plan
where the services were provided
What is a review by BCBS that grants prior approval for reimbursement of a
healthcare service? - Answer-Preauthorization
What is any information that can link a specific individual to medical records? -
Answer-Protected Health Information (PHI)
Which of the following is an example of consent? - Answer-The patient allows
insurance benefits to be paid directly to the provider.
The HIPAA Security Rule provides standards for health information maintained or
transmitted in what format? - Answer-electronic
Which of the following is an example of fraud? - Answer-Falsifying patient records to
justify the medical necessity of services.
Which of the following is true concerning the release of patient information? -
Answer-Original records should never be released.
What is the "main term" for primary pancreatic neoplasm of the head of the
pancreas? - Answer-Neoplasm
The ICD-10-CM code book is updated annually on what date? - Answer-October 1
EXAM Q&A
A five-year-old was brought to the emergency department after falling from a
climbing wall and sustaining scrapes and bruises. No sutures were required. The
visit involved an expanded problem-focused history and physical exam with decision
making of moderate complexity. What is the correct CPT code? - Answer-99283
What does the HCPCS Level II coding classification system provide to medical
providers and suppliers? - Answer-Codes for reporting procedures, services, medical
equipment, and supplies not included in CPT.
Using the Table of Drugs and Biologicals in the HCPCS Level II codebook, what is
the code for a 10 mg injection of morphine sulfate? - Answer-J2270
The durable medical equipment dealer supplied the patient with a non-heated
humidifier to be used with his CPAP device. What is the correct HCPCS Level II
code? - Answer-E0561
Following surgery, the patient was provided with below-knee-length surgical
stockings. What is the correct HCPCS Level II code? - Answer-A4500
The surgeon amputated the patient's right lower extremity. His physician assistant
(PA) actively assisted the surgeon in this surgical procedure. What is the correct
HCPCS Level II modifier used for the PA's role in this procedure? - Answer-AS
What is the fastest but also most dangerous route of drug administration? - Answer-
Intravenous
What is a chemically equivalent, lower-cost version of a brand name drug? - Answer-
generic
Where are the names, dosages, and reasons for all drugs that a patient currently
takes documented in a medical record? - Answer-Medication List
What is a written request to a physician to clarify or complete the information in
clinical documentation to ensure accurate health records? - Answer-Physician query
A test that screens for antibodies in the blood would be reported on what medical
report? - Answer-Laboratory Report
Which of the following is one reason why clinical documentation improvement (CDI)
efforts are necessary? - Answer-It provides an opportunity for physicians to
demonstrate the quality of care that was provided.
The patient was referred for a bone scan to check for metastatic disease. Which
diagnosis would support medical necessity for this procedure? - Answer-Breast
cancer
, What is the physical location where healthcare services are provided to patients? -
Answer-Place of service
What is the standard, unique health identifier that is mandated by HIPAA for each
healthcare provider and used for claims processing, patient eligibility inquiries,
claims inquiries, patient referrals, and generation of remittance advices? - Answer-
National Provider Identifier (NPI)
What is the term for two or more physicians who share space, equipment, supplies,
and personnel and may represent a single specialty or multiple specialties? -
Answer-Group practice
What is health insurance issued by private companies? - Answer-Commercial
Which of the following allows employees to continue healthcare coverage beyond
the benefit termination date? - Answer-Consolidated Omnibus Budget Reconciliation
Act (COBRA)
What is defined as the amount commonly charged for a particular medical service by
providers within a certain geographic area. - Answer-Usual, customary, and
reasonable (UCR)
Where are BCBS claims submitted for processing? - Answer-The local BCBS plan
where the services were provided
What is a review by BCBS that grants prior approval for reimbursement of a
healthcare service? - Answer-Preauthorization
What is any information that can link a specific individual to medical records? -
Answer-Protected Health Information (PHI)
Which of the following is an example of consent? - Answer-The patient allows
insurance benefits to be paid directly to the provider.
The HIPAA Security Rule provides standards for health information maintained or
transmitted in what format? - Answer-electronic
Which of the following is an example of fraud? - Answer-Falsifying patient records to
justify the medical necessity of services.
Which of the following is true concerning the release of patient information? -
Answer-Original records should never be released.
What is the "main term" for primary pancreatic neoplasm of the head of the
pancreas? - Answer-Neoplasm
The ICD-10-CM code book is updated annually on what date? - Answer-October 1
