Chapter 10 Coding Compliance Programs, CDI, and Coding for
Medical Necessity Test Questions and Answers
A patient undergoes a laparoscopic
cholecystectomy. Which code would support
medical necessity for this procedure? - The patient was treated in the office for urinary
ANSWER -k81.0 frequency with dysuria, sore throat with cough,
and headaches. The urinalysis was negative, and
the rapid strep test was positive for
A patient with a displaced supracondylar fracture, Streptococcus infection. The patient was placed
left humerus, undergoes closed reduction with on antibiotics and was scheduled to be seen in
manipulation and casting. Select the appropriate 10 days. Select the appropriate ICD-10-CM and
ICD-10-CM and CPT codes. - ANSWER - CPT codes. - ANSWER -R35.0, R30.0,
S42.412A, 24577-LT B95.5, 81000, 86403
A surgeon performs neuroplasty of the median Which code would be supported as a medical
nerve at the carpal tunnel, right hand. Which necessity for a male patient with a diagnosis of
code would support medical necessity for this hypercholesterolemia? - ANSWER -80061
procedure? - ANSWER -G56.01
A 43-year-old man presents to the emergency
The patient was seen in the office for abdominal department complaining of severe pain in his
cramping. A hemoccult test was positive for lower back. He states his "back hurt a little bit last
blood in the stool. The patient underwent night after doing some heavy lifting at work, but
proctosigmoidoscopy with biopsy two days later, this morning the pain was terrible." After a
and carcinoma of the colon was diagnosed. problem-focused history and exam, the physician
Select the appropriate ICD-10-CM and CPT diagnoses him with lumbar sprain. Select the
codes to be reported on the proctoscopy claim. - appropriate ICD-10-CM and CPT codes. -
ANSWER -C18.9, 82270, 45305 ANSWER -S33.5xxA, 99281
The term medically managed means that even The patient was treated in the office to rule out
though a diagnosis may not receive direct pneumonia. She had been experiencing
treatment during an encounter: - wheezing and congestion, and her respirations
ANSWER -it must be considered when were labored. The chest x-ray done in the office
determining treatment for other conditions was positive for pneumonia. Select the
appropriate ICD-10-CM and CPT codes. -
ANSWER -J18.9, 71045
The nurse practitioner orders a urinalysis. Which
code would support medical necessity for this
procedure? - ANSWER -N15.9 Which code would be supported as a medical
necessity for a diagnosis of osteoporosis? -
ANSWER -77081
Which code would be supported as a medical
necessity for a diagnosis of fracture of the
femoral neck? - ANSWER -27230 A patient complained of pain and swelling in his
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Medical Necessity Test Questions and Answers
A patient undergoes a laparoscopic
cholecystectomy. Which code would support
medical necessity for this procedure? - The patient was treated in the office for urinary
ANSWER -k81.0 frequency with dysuria, sore throat with cough,
and headaches. The urinalysis was negative, and
the rapid strep test was positive for
A patient with a displaced supracondylar fracture, Streptococcus infection. The patient was placed
left humerus, undergoes closed reduction with on antibiotics and was scheduled to be seen in
manipulation and casting. Select the appropriate 10 days. Select the appropriate ICD-10-CM and
ICD-10-CM and CPT codes. - ANSWER - CPT codes. - ANSWER -R35.0, R30.0,
S42.412A, 24577-LT B95.5, 81000, 86403
A surgeon performs neuroplasty of the median Which code would be supported as a medical
nerve at the carpal tunnel, right hand. Which necessity for a male patient with a diagnosis of
code would support medical necessity for this hypercholesterolemia? - ANSWER -80061
procedure? - ANSWER -G56.01
A 43-year-old man presents to the emergency
The patient was seen in the office for abdominal department complaining of severe pain in his
cramping. A hemoccult test was positive for lower back. He states his "back hurt a little bit last
blood in the stool. The patient underwent night after doing some heavy lifting at work, but
proctosigmoidoscopy with biopsy two days later, this morning the pain was terrible." After a
and carcinoma of the colon was diagnosed. problem-focused history and exam, the physician
Select the appropriate ICD-10-CM and CPT diagnoses him with lumbar sprain. Select the
codes to be reported on the proctoscopy claim. - appropriate ICD-10-CM and CPT codes. -
ANSWER -C18.9, 82270, 45305 ANSWER -S33.5xxA, 99281
The term medically managed means that even The patient was treated in the office to rule out
though a diagnosis may not receive direct pneumonia. She had been experiencing
treatment during an encounter: - wheezing and congestion, and her respirations
ANSWER -it must be considered when were labored. The chest x-ray done in the office
determining treatment for other conditions was positive for pneumonia. Select the
appropriate ICD-10-CM and CPT codes. -
ANSWER -J18.9, 71045
The nurse practitioner orders a urinalysis. Which
code would support medical necessity for this
procedure? - ANSWER -N15.9 Which code would be supported as a medical
necessity for a diagnosis of osteoporosis? -
ANSWER -77081
Which code would be supported as a medical
necessity for a diagnosis of fracture of the
femoral neck? - ANSWER -27230 A patient complained of pain and swelling in his
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