MO METRIX CCS EXAM PRACTICE
TEST QUESTIONS AND ANSWERS
a. The Centers for Disease Control and Prevention - Correct Answers -Which of the
following is not a covered entity in the HIPAA Privacy rule?
a. The Centers for Disease Control and Prevention
b. Employer-sponsored health plan
c. Third-party billing agency
d. Healthcare provider
d. Hierarchical condition category (HCC) coding - Correct Answers -Which of the
following is a risk adjustment model used by Medicare to predict health care costs and
resource consumption of specific patient populations over time?
a. Risk adjustment factor (RAF)
b. Diagnosis-related groups
c. Outcome and Assessment information set
d. Hierarchical condition category (HCC) coding
d. The two codes can be billed together with an appropriate modifier - Correct Answers -
CPT cod 20650 is a column 2 code that has a National Correct Coding Initiative (NCCI)
edit of 1 when paired with CPT code 21813. How would this be interpreted?
a. The two codes are inclusive of each other and can never be billed together.
b. If being billed together, only report one unit of each
c. The two codes are exclusive of each other and can never be billed together
d. The two codes can be billed together with an appropriate modifier
c. Moderate complexity - Correct Answers -Based on the following documentation, what
would the overall medical decision-making be?
Numbered of diagnosis or management options: Minimal
Amount and complexity of data: Moderate
Level of risk: Moderate
a. Straightforward
b. Low complexity
c. Moderate complexity
,d. High complexity
a. 58301-53 - Correct Answers -A patient was seen by her gynecologist to remove her
intrauterine device. The removal was attempted but terminated due to excessive
bleeding. How should the gynecologist report the encounter?
a. 58301-53
b. 58301-52
c. 99212-25, 58301
d. 99212, 58301-59
c. 76536
no modifier - Correct Answers -A technician performs an ultrasound of a patient's
thyroid at a privately owned family practice immediately following her annual health
screening. The primary care physician determines that the images are normal and
advises the patient to return in one year. How should the primary care physician report
the ultrasound?
a. 76536-26
b. 76536-TC
c. 76536
d. 76536-TC, 26
a. Medically unlikely edits - Correct Answers -Which type of edit identifies the maximum
number of units that may be reported for a CPT/HCPCS code that relates to an
individual patient?
a. Medically unlikely edits
b. Add-on-code edits
c. Correspondence edits
d. Procedure-to-procedure coding edits
d. Two or more unrelated diseases occurring at the same time. - Correct Answers -
Which statement best describes a comorbidity?
a. Two or more life-threatening illnesses occurring at the same time
b. Three or more minor injuries occurring at the same time
c. Three or more chronic illness occurring at the same time
d. Two or more unrelated diseases occurring at the same time.
a. Protect privacy and confidentiality; protect personal health information; and use
technology, data, and information resources in the way they are intended. - Correct
Answers -A healthcare employee happens to meet a well-known actor during a lunch
break. Unknown to the employee, the actor is currently admitted in the hospital and has
chosen to eat in the cafeteria to not feel cooped up any longer. The employee takes a
, photo and shares it with his co-workers and social media. Which AHIMA standard(s) of
Ethical Coding has been violated?
a. Protect privacy and confidentiality; protect personal health information; and use
technology, data, and information resources in the way they are intended.
b. Respect the dignity of every person, put the welfare of persons before self-interest.
c. Refuse to participate in unethical practices, privacy and confidentiality, respect the
dignity of every person
d. None, the act was unintentional
d. Social history - Correct Answers -The smoking status of a patient should generally be
found in which section of a medical record?
a. Chief complaint
b. Plan
c. Examination
d. Social history
c. Family history - Correct Answers -Which of the following is not a data element
required by the uniform Hospital Discharge Data set (UHDDS)
a. Location of residence
b. Provider name
c. Family history
d. Total charges for services rendered.
b. Mentor colleagues to strengthen the professional workforce - Correct Answers -A
hospital director repeatedly refuses to accept residents due to a tight budget that limits
training time for students. Which AHIMA Standard(s) of ethical Coding has been
violated?
a. Put the welfare of persons before self-interest
b. Mentor colleagues to strengthen the professional workforce
c. Respect the worth of every person.
d. Represent the profession to the public in a positive manner.
c. 33533, 33517 - Correct Answers -A physician performs a coronary artery bypass
grafting using the left internal mammary artery to the right coronary, and a saphenous
vein graft to the circumflex. Which CPT code(s)
a. 33533, 33510
b. 33534
c. 33533, 33517
d. 35600, 33517
TEST QUESTIONS AND ANSWERS
a. The Centers for Disease Control and Prevention - Correct Answers -Which of the
following is not a covered entity in the HIPAA Privacy rule?
a. The Centers for Disease Control and Prevention
b. Employer-sponsored health plan
c. Third-party billing agency
d. Healthcare provider
d. Hierarchical condition category (HCC) coding - Correct Answers -Which of the
following is a risk adjustment model used by Medicare to predict health care costs and
resource consumption of specific patient populations over time?
a. Risk adjustment factor (RAF)
b. Diagnosis-related groups
c. Outcome and Assessment information set
d. Hierarchical condition category (HCC) coding
d. The two codes can be billed together with an appropriate modifier - Correct Answers -
CPT cod 20650 is a column 2 code that has a National Correct Coding Initiative (NCCI)
edit of 1 when paired with CPT code 21813. How would this be interpreted?
a. The two codes are inclusive of each other and can never be billed together.
b. If being billed together, only report one unit of each
c. The two codes are exclusive of each other and can never be billed together
d. The two codes can be billed together with an appropriate modifier
c. Moderate complexity - Correct Answers -Based on the following documentation, what
would the overall medical decision-making be?
Numbered of diagnosis or management options: Minimal
Amount and complexity of data: Moderate
Level of risk: Moderate
a. Straightforward
b. Low complexity
c. Moderate complexity
,d. High complexity
a. 58301-53 - Correct Answers -A patient was seen by her gynecologist to remove her
intrauterine device. The removal was attempted but terminated due to excessive
bleeding. How should the gynecologist report the encounter?
a. 58301-53
b. 58301-52
c. 99212-25, 58301
d. 99212, 58301-59
c. 76536
no modifier - Correct Answers -A technician performs an ultrasound of a patient's
thyroid at a privately owned family practice immediately following her annual health
screening. The primary care physician determines that the images are normal and
advises the patient to return in one year. How should the primary care physician report
the ultrasound?
a. 76536-26
b. 76536-TC
c. 76536
d. 76536-TC, 26
a. Medically unlikely edits - Correct Answers -Which type of edit identifies the maximum
number of units that may be reported for a CPT/HCPCS code that relates to an
individual patient?
a. Medically unlikely edits
b. Add-on-code edits
c. Correspondence edits
d. Procedure-to-procedure coding edits
d. Two or more unrelated diseases occurring at the same time. - Correct Answers -
Which statement best describes a comorbidity?
a. Two or more life-threatening illnesses occurring at the same time
b. Three or more minor injuries occurring at the same time
c. Three or more chronic illness occurring at the same time
d. Two or more unrelated diseases occurring at the same time.
a. Protect privacy and confidentiality; protect personal health information; and use
technology, data, and information resources in the way they are intended. - Correct
Answers -A healthcare employee happens to meet a well-known actor during a lunch
break. Unknown to the employee, the actor is currently admitted in the hospital and has
chosen to eat in the cafeteria to not feel cooped up any longer. The employee takes a
, photo and shares it with his co-workers and social media. Which AHIMA standard(s) of
Ethical Coding has been violated?
a. Protect privacy and confidentiality; protect personal health information; and use
technology, data, and information resources in the way they are intended.
b. Respect the dignity of every person, put the welfare of persons before self-interest.
c. Refuse to participate in unethical practices, privacy and confidentiality, respect the
dignity of every person
d. None, the act was unintentional
d. Social history - Correct Answers -The smoking status of a patient should generally be
found in which section of a medical record?
a. Chief complaint
b. Plan
c. Examination
d. Social history
c. Family history - Correct Answers -Which of the following is not a data element
required by the uniform Hospital Discharge Data set (UHDDS)
a. Location of residence
b. Provider name
c. Family history
d. Total charges for services rendered.
b. Mentor colleagues to strengthen the professional workforce - Correct Answers -A
hospital director repeatedly refuses to accept residents due to a tight budget that limits
training time for students. Which AHIMA Standard(s) of ethical Coding has been
violated?
a. Put the welfare of persons before self-interest
b. Mentor colleagues to strengthen the professional workforce
c. Respect the worth of every person.
d. Represent the profession to the public in a positive manner.
c. 33533, 33517 - Correct Answers -A physician performs a coronary artery bypass
grafting using the left internal mammary artery to the right coronary, and a saphenous
vein graft to the circumflex. Which CPT code(s)
a. 33533, 33510
b. 33534
c. 33533, 33517
d. 35600, 33517
