MA 300 Study Outline #1 UPDATED
ACTUAL Exam Questions and CORRECT
Answers
Who created the first comprehensive disease classification system in the United States in 1869? -
CORRECT ANSWER - the American Medical Association (AMA) as the American
Nomenclature of Disease.
What are the main reasons to use procedure coding? - CORRECT ANSWER - 1. To
justify medical services to insurance companies by correlating procedures to diagnosis
2. To collect statistics about the outcome and effectiveness of treatments
3. To help physicians and hospitals set fees based on the amount of time and skill required to
provide a specific service
How often are level I codes updated? - CORRECT ANSWER - Updated Annually
Who updates and publishes the CPT manual? - CORRECT ANSWER - American Medical
Association (AMA)
HCPCS level II codes include what services that are not in the PT system and may not be
covered by insurance? - CORRECT ANSWER - procedures, injections, and durable
medical equipment covered by Medicare Part B
How often should updated code books be purchased? - CORRECT ANSWER - every year.
CPT manual contains codes which are usually how many digits long? - CORRECT
ANSWER - 5-digits
What is a modifier? - CORRECT ANSWER - is an addition to a procedure code that
indicates unusual circumstances related to the procedure, such as a more extensive procedure or
two procedures performed in the same session
,How many digits are in a Modifier? - CORRECT ANSWER -2
What pieces of information may be significant when choosing the correct code for a procedure? -
CORRECT ANSWER - • Location
• Size of lesion or repair
• Method of performing the procedure, test, or surgery
• Number of minutes allotted for a treatment (e.g., acupuncture)
• Complexity of the procedure or service
What are the two types of CPT codes? - CORRECT ANSWER - Stand-alone & Indented
If a patient comes in for an exam and has an electrocardiogram done, per the physician's orders,
is this billed under the examination or separately, under its own code? - CORRECT
ANSWER - The code 93005 would be used if the ECG tracing is made in one office, but
insurance should not be billed for the interpretation because it will be done by another physician
and billed from another office
What type of services and providers would find their appropriate codes in the E/M section? -
CORRECT ANSWER - primary care practitioners and specialists.
Define established patient. - CORRECT ANSWER - one who has been seen in the
previous 3 years
Define new patient. - CORRECT ANSWER - one who has not had services performed by
any provider in the medical office in the previous 3 years
Define inpatient. - CORRECT ANSWER - a patient who has been formally admitted to a
health care facility'
, Define outpatient - CORRECT ANSWER - one who has not been admitted to a health care
facility
What is problem-focused history? - CORRECT ANSWER - is one that addresses the chief
complaint, with a brief history of the illness or problem.
It would be used for a straightforward problem, such as a sore throat.
What is expanded problem-focused history? - CORRECT ANSWER - addresses the chief
complaint, a brief history of the present illness or problem, and a review of systems that have to
do with the chief complaint.
It might be used for a somewhat more complicated problem, or a single diagnosis that involves
more than one body system or location, such as a patient with an established diagnosis of
psoriasis who now has new lesions on the elbows, an itchy scalp, and thickening and
discolorations of the fingernails.
What is detailed history? - CORRECT ANSWER - an extended history of the present
illness, and a review of body systems, including other systems beyond those related to the chief
complaint.
Family history is also reviewed as it relates to the present problem. If a patient has more
complicated medical problems and/or multiple problems, it may be necessary to obtain a detailed
history.
What is comprehensive history? - CORRECT ANSWER - an extended history of the
present illness; a review of all body systems, especially those directly related to the present
problem; and a complete family history.
This type of history is taken when a patient has a severe, acute medical condition or serious
changes in a long-term condition.
ACTUAL Exam Questions and CORRECT
Answers
Who created the first comprehensive disease classification system in the United States in 1869? -
CORRECT ANSWER - the American Medical Association (AMA) as the American
Nomenclature of Disease.
What are the main reasons to use procedure coding? - CORRECT ANSWER - 1. To
justify medical services to insurance companies by correlating procedures to diagnosis
2. To collect statistics about the outcome and effectiveness of treatments
3. To help physicians and hospitals set fees based on the amount of time and skill required to
provide a specific service
How often are level I codes updated? - CORRECT ANSWER - Updated Annually
Who updates and publishes the CPT manual? - CORRECT ANSWER - American Medical
Association (AMA)
HCPCS level II codes include what services that are not in the PT system and may not be
covered by insurance? - CORRECT ANSWER - procedures, injections, and durable
medical equipment covered by Medicare Part B
How often should updated code books be purchased? - CORRECT ANSWER - every year.
CPT manual contains codes which are usually how many digits long? - CORRECT
ANSWER - 5-digits
What is a modifier? - CORRECT ANSWER - is an addition to a procedure code that
indicates unusual circumstances related to the procedure, such as a more extensive procedure or
two procedures performed in the same session
,How many digits are in a Modifier? - CORRECT ANSWER -2
What pieces of information may be significant when choosing the correct code for a procedure? -
CORRECT ANSWER - • Location
• Size of lesion or repair
• Method of performing the procedure, test, or surgery
• Number of minutes allotted for a treatment (e.g., acupuncture)
• Complexity of the procedure or service
What are the two types of CPT codes? - CORRECT ANSWER - Stand-alone & Indented
If a patient comes in for an exam and has an electrocardiogram done, per the physician's orders,
is this billed under the examination or separately, under its own code? - CORRECT
ANSWER - The code 93005 would be used if the ECG tracing is made in one office, but
insurance should not be billed for the interpretation because it will be done by another physician
and billed from another office
What type of services and providers would find their appropriate codes in the E/M section? -
CORRECT ANSWER - primary care practitioners and specialists.
Define established patient. - CORRECT ANSWER - one who has been seen in the
previous 3 years
Define new patient. - CORRECT ANSWER - one who has not had services performed by
any provider in the medical office in the previous 3 years
Define inpatient. - CORRECT ANSWER - a patient who has been formally admitted to a
health care facility'
, Define outpatient - CORRECT ANSWER - one who has not been admitted to a health care
facility
What is problem-focused history? - CORRECT ANSWER - is one that addresses the chief
complaint, with a brief history of the illness or problem.
It would be used for a straightforward problem, such as a sore throat.
What is expanded problem-focused history? - CORRECT ANSWER - addresses the chief
complaint, a brief history of the present illness or problem, and a review of systems that have to
do with the chief complaint.
It might be used for a somewhat more complicated problem, or a single diagnosis that involves
more than one body system or location, such as a patient with an established diagnosis of
psoriasis who now has new lesions on the elbows, an itchy scalp, and thickening and
discolorations of the fingernails.
What is detailed history? - CORRECT ANSWER - an extended history of the present
illness, and a review of body systems, including other systems beyond those related to the chief
complaint.
Family history is also reviewed as it relates to the present problem. If a patient has more
complicated medical problems and/or multiple problems, it may be necessary to obtain a detailed
history.
What is comprehensive history? - CORRECT ANSWER - an extended history of the
present illness; a review of all body systems, especially those directly related to the present
problem; and a complete family history.
This type of history is taken when a patient has a severe, acute medical condition or serious
changes in a long-term condition.
