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1. When the physician does not specify the method used to remove a lesion
during an endoscopy, what is the appropriate procedure?
a. Assign the removal by snare technique code.
b. Assign the removal by hot biopsy forceps code.
c. Assign the ablation code.
d. Query the physician as to the method used. - CORRECT ANSWER Correct
Answer: D
It is not appropriate for the coder to assume the removal was done by either
snare or hot biopsy forceps. The ablation code is only assigned when a lesion is
completely destroyed and no specimen is retrieved. The coding professional must
query the physician to assign the appropriate code (AHIMA 2012a, 607).
2. What is the best reference tool to determine how CPT codes should be
assigned?
a. Local coverage determination from Medicare
b. American Medical Association's CPT Assistant newsletter
c. American Hospital Association's Coding Clinic
d. CMS website - CORRECT ANSWER Correct Answer: B
, CPT Assistant provides additional CPT coding guidance on how to assign a
CPT code by providing intent on the use of the code and explanation of
parenthetical instructions. The American Medical Association publishes the
guidance monthly (AMA 2012b).
3. Identify the appropriate ICD-9-CM diagnosis code(s) for right and left bundle
branch block.
a. 426.3, 426.4
b. 426.53
c. 426.4, 426.53
d. 426.52 - CORRECT ANSWER Correct Answer: B
Index Block, left, with right bundle branch block. Right and left bundle branch
block is inclusive of one code. It is inappropriate to assign a code for right (426.4)
and left (426.3) bundle branch block when a combination code includes both the
right and left (Schraffenberger 2012, 201-207).
3. A software interface is a:
a. Device to enter data
b. Protocol for describing data
c. Program to exchange data
d. Standard vocabulary - CORRECT ANSWER Correct Answer: C
A software interface is a computer program that allows different applications to
communicate and exchange data (Johns 2011, 137).
, 4. What did the Centers of Medicare and Medicaid Services develop to
promote national correct coding methodologies and to control improper
coding leading to inappropriate payment in Part B claims?
a. Outpatient Perspective Payment System (OPPS)
b. National Correct Coding Initiative (NCCI)
c. Ambulatory Payment Classifications (APCs)
d. Comprehensive Outpatient Rehab Facilities (CORFs) - CORRECT ANSWER
Correct Answer: B
CMS developed the NCCI to control improper coding practices leading to
inappropriate payments in Part B claims (CMS 2012a).
5. Identify the appropriate diagnostic and/or procedure ICD-9-CM code(s) for
reprogramming of a cardiac pacemaker.
a. V53.31
b. 37.85
c. V53.02
d. V53.31, 37.85 - CORRECT ANSWER Correct Answer: A
Index Fitting (of) pacemaker (cardiac). No procedure code exists in ICD-9-CM to
describe reprogramming (Schraffenberger 2012, 204-205).
6. Which of the following hospitals are excluded from the Medicare acute-care
prospective payment system?
a. Children's
, b. Small community
c. Tertiary
d. Trauma - CORRECT ANSWER Correct Answer: A
Children's hospitals are excluded from PPS because the PPS diagnosis-related
groups do not accurately account for the resource costs for the types of patients
treated (Johns 2011, 321).
7. Which of the following programs has been in place in hospitals for years
and has been required by the Medicare and Medicaid programs and
accreditation standards?
a. Internal DRG audits
b. Peer review
c Managed care
d. Quality improvement - CORRECT ANSWER Correct Answer: D
Quality improvement (QI) programs have been in place in hospitals for years and
have been required by the Medicare/Medicaid programs and accreditation
standards. QI programs have covered medical staff as well as nursing and other
departments or processes (LaTour and Eichenwald Maki 2010, 33).
8. Identify the code for a patient with a closed transcervical fracture of the
epiphysis.
a. 820.09
b. 820.02
c. 820.03