CDEO EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
A 75-year-old patient with a long history of age-related
osteoporosis trips on a rug at home and falls breaking her hip.
How is the diagnosis code reported?
A. Traumatic fracture
B. Pathologic fracture due to age related osteoporosis
C. Other fracture
D. Query provider to confirm the nature of the fractu Correct
Answers B. Pathologic fracture due to age related osteoporosis
The coding guidelines for coding fractures in patients with
osteoporosis states "A code from category M80, not a traumatic
fracture code, should be used for any patient with known
osteoporosis who suffers a fracture, even if the patient had a
minor fall or trauma, if that fall or trauma would not usually
break a normal, healthy bone."
A patient presents to the physician for evaluation of a suspicious
skin lesion on the right arm. The patient and physician discuss
treatment and agree to excise the lesion of the arm. The size of
the lesion is 3.0 cm. and is removed with a scalpel. Simple
suture repair is performed to close the wound which measured
3.5 cm. What are the CPT® and diagnosis codes?
A. 11403, D48.5
B. 11403, D49.2
C. 12002, 11403-51, D49.2
D. 11603, C44.602 Correct Answers B. 11403, D49.2
,The skin lesion is not documented as malignant reporting
Excision-Benign Lesion code 11403 (arm, 3.0 cm excised).
CPT® subsection guidelines indicate for excision of benign
lesions requiring more than simple closure, such as intermediate
closure (12031-12057) or complex closure (13100-13153) report
with the excision lesion removal code. Because a simple closure
is performed the repair is bundled.
Because there is not a pathology report to indicate if the skin
lesion is benign, malignant or uncertain behavior, report code
D49.2.
Clinical Documentation Improvement (CDI) programs can help:
I. Build effective documentation compliance policies
II. Capture clinical data required for continuity of care
III. Promote failures identified in documentation review
A. I and III
B. I, II and III
C. II and III
D. I and II Correct Answers I and II
I. Build effective documentation compliance policies
II. Capture clinical data required for continuity of care
An effective CDI program never emphasizes failures; it
promotes continuity of care and development of effective CDI
policies.
Determine the organ systems examined in the documentation
provided below:
Physical Exam:
Vitals: BP: 118/68 Pulse: 82 Respirations: 17 Temperature: 98.6
,NECK: nontender, without palpable lymph node. No carotid
bruit bilaterally.
CVS: Irregularly irregular w/ 1/6 SE murmur. No gallop or rub
Lungs: CTA bilaterally, no wheezing, rales, rhonchi
ABDOMEN: bowel sounds present, soft, nontender,
nondistended. No pulsatile mass or bruit noted.
Extremities: +1 pitting LE edema b/l with venous stasis changes.
Distal pulses palpable.
A. Constitutional, Eyes, ear/nose/throat, cardiovascular,
respiratory, gastrointestinal, musculoskeletal,
hematologic/lymphatic/immunologic (8 organ systems for a
complete exam)
B. Constitutional, cardiovascular, respiratory, musculoskeletal,
hematologic/lymphatic/immunologic (5 organ systems for a
detailed exam)
C. Constitutional, cardiovascular, respiratory, gastrointestinal,
hematologic/lymphat Correct Answers C. Constitutional,
cardiovascular, respiratory, gastrointestinal,
hematologic/lymphatic/immunologic (5 organ systems for a
detailed exam)
When using organ systems, you can use findings labeled under
the body areas to support organ system findings. In this case,
you can use neck findings to support the lymphatic organ
system. You can also use Abdomen findings to support the GI
organ system. You cannot, however, use extremity findings to
support the musculoskeletal system. All findings documented
further support the cardiovascular system.
, During an initial annual wellness visit, a 66-year-old Medicare
patient receives influenza and pneumonia vaccinations. The
patient is healthy with no complaints.
What procedure and diagnosis codes are reported?
A. G0438, 90471, 90472, 90656, 90732, Z00.00
B. G0438, G0008, G0009, 90656, 90732, Z00.00, Z23
C. 99387-25, G0008, G0009, 90656, 90732, Z00.00, Z23
D. G0008, G0009, 90656, 90732, Z23 Correct Answers A.
G0438, 90471, 90472, 90656, 90732, Z00.00
Initial AWV are reported with G0438. The initial AWV can be
billed once in a patient's lifetime. Subsequent AWV are reported
with G0439.
Because this patient is covered by Medicare, you report the
vaccine administration codes with G0008 and G0009. The
supply of the vaccines is reported with 90556 (Influenza virus
vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL
dosage, for intramuscular use) and 90732 (Pneumococcal
polysaccharide vaccine, 23-valent (PPSV23), adult or
immunosuppressed patient dosage, when administered to
individuals 2 years or older, for subcutaneous or intramuscular
use).
The patient is being seen for the AWV with no complaints
which is reported with Z00.00. Code Z23 is reported to
supported the vaccinations administered.
Hematocrit (Hct): Correct Answers percentage of whole blood
occupied by RBCs
SOLUTIONS
A 75-year-old patient with a long history of age-related
osteoporosis trips on a rug at home and falls breaking her hip.
How is the diagnosis code reported?
A. Traumatic fracture
B. Pathologic fracture due to age related osteoporosis
C. Other fracture
D. Query provider to confirm the nature of the fractu Correct
Answers B. Pathologic fracture due to age related osteoporosis
The coding guidelines for coding fractures in patients with
osteoporosis states "A code from category M80, not a traumatic
fracture code, should be used for any patient with known
osteoporosis who suffers a fracture, even if the patient had a
minor fall or trauma, if that fall or trauma would not usually
break a normal, healthy bone."
A patient presents to the physician for evaluation of a suspicious
skin lesion on the right arm. The patient and physician discuss
treatment and agree to excise the lesion of the arm. The size of
the lesion is 3.0 cm. and is removed with a scalpel. Simple
suture repair is performed to close the wound which measured
3.5 cm. What are the CPT® and diagnosis codes?
A. 11403, D48.5
B. 11403, D49.2
C. 12002, 11403-51, D49.2
D. 11603, C44.602 Correct Answers B. 11403, D49.2
,The skin lesion is not documented as malignant reporting
Excision-Benign Lesion code 11403 (arm, 3.0 cm excised).
CPT® subsection guidelines indicate for excision of benign
lesions requiring more than simple closure, such as intermediate
closure (12031-12057) or complex closure (13100-13153) report
with the excision lesion removal code. Because a simple closure
is performed the repair is bundled.
Because there is not a pathology report to indicate if the skin
lesion is benign, malignant or uncertain behavior, report code
D49.2.
Clinical Documentation Improvement (CDI) programs can help:
I. Build effective documentation compliance policies
II. Capture clinical data required for continuity of care
III. Promote failures identified in documentation review
A. I and III
B. I, II and III
C. II and III
D. I and II Correct Answers I and II
I. Build effective documentation compliance policies
II. Capture clinical data required for continuity of care
An effective CDI program never emphasizes failures; it
promotes continuity of care and development of effective CDI
policies.
Determine the organ systems examined in the documentation
provided below:
Physical Exam:
Vitals: BP: 118/68 Pulse: 82 Respirations: 17 Temperature: 98.6
,NECK: nontender, without palpable lymph node. No carotid
bruit bilaterally.
CVS: Irregularly irregular w/ 1/6 SE murmur. No gallop or rub
Lungs: CTA bilaterally, no wheezing, rales, rhonchi
ABDOMEN: bowel sounds present, soft, nontender,
nondistended. No pulsatile mass or bruit noted.
Extremities: +1 pitting LE edema b/l with venous stasis changes.
Distal pulses palpable.
A. Constitutional, Eyes, ear/nose/throat, cardiovascular,
respiratory, gastrointestinal, musculoskeletal,
hematologic/lymphatic/immunologic (8 organ systems for a
complete exam)
B. Constitutional, cardiovascular, respiratory, musculoskeletal,
hematologic/lymphatic/immunologic (5 organ systems for a
detailed exam)
C. Constitutional, cardiovascular, respiratory, gastrointestinal,
hematologic/lymphat Correct Answers C. Constitutional,
cardiovascular, respiratory, gastrointestinal,
hematologic/lymphatic/immunologic (5 organ systems for a
detailed exam)
When using organ systems, you can use findings labeled under
the body areas to support organ system findings. In this case,
you can use neck findings to support the lymphatic organ
system. You can also use Abdomen findings to support the GI
organ system. You cannot, however, use extremity findings to
support the musculoskeletal system. All findings documented
further support the cardiovascular system.
, During an initial annual wellness visit, a 66-year-old Medicare
patient receives influenza and pneumonia vaccinations. The
patient is healthy with no complaints.
What procedure and diagnosis codes are reported?
A. G0438, 90471, 90472, 90656, 90732, Z00.00
B. G0438, G0008, G0009, 90656, 90732, Z00.00, Z23
C. 99387-25, G0008, G0009, 90656, 90732, Z00.00, Z23
D. G0008, G0009, 90656, 90732, Z23 Correct Answers A.
G0438, 90471, 90472, 90656, 90732, Z00.00
Initial AWV are reported with G0438. The initial AWV can be
billed once in a patient's lifetime. Subsequent AWV are reported
with G0439.
Because this patient is covered by Medicare, you report the
vaccine administration codes with G0008 and G0009. The
supply of the vaccines is reported with 90556 (Influenza virus
vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL
dosage, for intramuscular use) and 90732 (Pneumococcal
polysaccharide vaccine, 23-valent (PPSV23), adult or
immunosuppressed patient dosage, when administered to
individuals 2 years or older, for subcutaneous or intramuscular
use).
The patient is being seen for the AWV with no complaints
which is reported with Z00.00. Code Z23 is reported to
supported the vaccinations administered.
Hematocrit (Hct): Correct Answers percentage of whole blood
occupied by RBCs
