EXAM PREPARATION QUESTIONS
AND ACCURATE SOLUTIONS
**The CPK elevation with MB enzymes elevated and the EKG ST changes denote a possible MI (Leon-
Chisen 2017, 386-392).
Generally, data quality is defined as:
a. Ensuring the greatest amount of data possible is obtained from the medical record
b. Ensuring the accuracy and completeness of an organization's data
c. Ensuring accuracy of the case-mix index
d. Ensuring the optimal reimbursement for each encounter ✅✅ANSW-b. Ensuring the accuracy
and completeness of an organization's data
**Data quality may have slightly different meanings because there are several disciplines that work
with data in healthcare. Generally, ensuring the accuracy and completeness of an organization's data
is a definition that can be agreed upon by the organization
The information provided shows that:
a. The payment is higher for patients with DRG 191
b. There are more patients with DRG 191
c. The case-mix index could be increased if more patients in DRG 193 were admitted
d. The case mix would not increase if more patients in DRG 193 were admitted ✅✅ANSW-a. The
payment is higher for patients with DRG 191
**The MS-DRG weight is higher than the other MS-DRG weights and therefore the associated MS-
DRG pays the most (Castro and Forrestal 2015, 115).
The billing department has requested that copies of the final coding summary with associated code
meanings for Medicare be printed remotely in the admission department. Currently they request the
summaries only when there is an unspecified procedure. Each time the coding supervisor goes to the
,admission department, the coding summaries have been left on a table near the patient entrance.
Of the actions presented here, what would be the best action for the coding supervisor to take?
a. Comply with the request.
b. Refuse to undertake this without further explanation.
c. Ignore the request.
d. Explain to the billing department supervisor that leaving the coding summary in public view
violates the patient's right to privacy. ✅✅ANSW-d. Explain to the billing department supervisor
that leaving the coding summary in public view violates the patient's right to privacy.
**Health information should not be left in public view
Databases utilize data models and data dictionaries. Which of the statements below are true for
these two important tools?
a. Data models are entities that store individual data; data dictionaries are an alphabetic index of all
data values
b. Data models are used for relational databases only; data dictionaries are used for objectoriented
databases
c. Data models provide the conceptual and graphical framework that helps define the entity and its
attributes; data dictionaries provide details on each data element
d. Data models represent a standard model of a database; data dictionaries provide a listing of all
data elements along with their attributes ✅✅ANSW-c. Data models provide the conceptual and
graphical framework that helps define the entity and its attributes; data dictionaries provide details
on each data element
**Data models provide a conceptual framework and graphical representation that help in defining
data elements. Data dictionaries are documents that explain in detail all data elements and their
corresponding attributes.
A 12-year-old boy was seen in an ambulatory surgical center for pain in his right arm. The x-ray
showed fracture of ulna. Patient underwent closed reduction of fracture right proximal ulna. What
diagnostic and procedure codes should be assigned?
S52.101A Unspecified fracture of upper end of right radius, initial encounter for closed fracture
,S52.101B Unspecified fracture of upper end of right radius, initial encounter for open fracture
S52.001A Unspecified fracture of upper end of right ulna, initial encounter for closed fracture
S52.001B Unspecified fracture of upper end of right ulna, initial encounter for open fracture
0PSH0ZZ Reposition right radius, open approach
0PSK0ZZ Reposition right ulna, open approach
24670 Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process(es) );
without manipulation
24675 Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process
✅✅ANSW-d. S52.001A, 24675
S52.001A: Unspecified fracture of upper end of right ulna, initial encounter for closed fracture.
24675: Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process(es) );
with manipulation
**The patient has a fracture of the right proximal ulna and closed reduction is necessary. In the ICD-
10-CM codebook, under Fracture, ulna, proximal, the coder is referred to Fracture, ulna, upper end.
The term "manipulation" is used to indicate reduction in CPT (AMA CPT Professional Edition 2017,
104). [Note: Since this is an ambulatory surgery center case, CPT codes are assigned, rather than ICD-
10-PCS codes.]
Authentication of health record entries means to:
a. Create facsimiles of documents
b. Prove authorship of documents
c. Develop documents
d. Use a rubber stamp on random sets of documents ✅✅ANSW-b. Prove authorship of
documents
**Authentication is the act of verifying a claim of identity (Brickner 2016, 89). In order to prove
authorship of documents they are required to be authenticated by a signature
A patient is admitted with hemoptysis. A bronchoscopy with transbronchial biopsy of the lower lobe
was undertaken that revealed squamous cell carcinoma of the right lung. Which conditions should
be identified as present on admission?
, C34.30 Malignant neoplasm of lower lobe, unspecified bronchus or lung
C34.31 Malignant neoplasm of lower lobe, right bronchus or lung
P26.9 Unspecified pulmonary hemorrhage originating in the perinatal period
R04.2 Hemoptysis
a. C34.30
b. R04.2
c. C34.31, R04.2
d. C34.30, P26.9, R04.2 ✅✅ANSW-c. C34.31, R04.2
C34.31: Malignant neoplasm of lower lobe, right bronchus or lung
R04.2: Hemoptysis
**The diagnosis after study (lung cancer) was present on admission as well as the symptom
(hemoptysis). Code P26.9 would not be assigned because it is not diagnosed and only applies to the
perinatal period (HHS 2017, Appendix I, 109-114).
Current Procedural Terminology (CPT) defines a separate procedure as which of the following?
a. When performed in conjunction with another service, is considered an integral part of the major
service
b. Provision of anesthesia
c. Joint aspiration is required
d. Pre-operative evaluation is not required ✅✅ANSW-a. When performed in conjunction with
another service, is considered an integral part of the major service
**When a procedure is designated as a separate procedure in the CPT codebook and it is performed
in conjunction with another service, it is considered an integral part of the major service. The CPT
code description includes "separate procedure." The intention is not to provide payment for a
procedure that is already integral to any given procedure (Smith 2016, 58; AMA CPT Professional
Edition 2017, 66).