MEDICAL CODING AND BILLING FINAL
EXAM QUESTIONS AND ANSWERS
Which of the following is/was NOT a result of CMS' use of Recovery Audit
Contractors (RACs)? - Answer-Consolidation of Medicare parts A and B
This terminology is only used in an electronic health record. - Answer-SNOMED CT
This type of computer-assisted coding uses artificial intelligence and linguistics to
extract data from the record and convert it into medical codes. - Answer-Natural
language processing
ICD-10-CM Coding Guidelines - Answer-
Codes for signs and symptoms are reported when the provider has documented a
related definitive diagnosis. - Answer-false
There is no time frame defining when pain becomes chronic pain. The physician's
documentation should be used to determine if the pain is considered chronic. -
Answer-true
When a patient has an adverse drug reaction, code both the reaction and the code
from T36-T50. - Answer-true
Inoculation and vaccination Z codes can be reported as the first listed or additional
codes. - Answer-true
When the cause of an injury is suspected to be the result of terrorism, a code from
category Y38 should be assigned. - Answer-false
When a patient with a high-risk pregnancy is being seen for a routine prenatal
outpatient visit, the supervision of high-risk pregnancy code should be reported as
the first-listed diagnosis. - Answer-true
The second trimester is defined as 12 weeks 0 days to less than 28 weeks 0 days. -
Answer-false
When the physician documents suspected or possible avian influenza, a code from
category J09 should be reported. - Answer-false
ICD-10-CM Coding Scenarios - Answer-
A 10-year old male patient is seen in the emergency department for cough, difficulty
breathing and wheezing more severe than his baseline. He responds well to
treatment with nebulized albuterol and is discharged home with instructions to follow
up with his primary care provider. The final diagnosis is: Acute bronchitis
superimposed on COPD with asthma of severe persistent type with acute
exacerbation. - Answer-J44.1, J20.9, J45.51
,A patient presents with abdominal pain. After a complete work-up the patient is found
to have an obstructive diaphragmatic hernia with gangrene - Answer-K44.1
A 7-year-old child was seen in the emergency room for a dog bite on her left thigh.
She received an injection of rabies immunoglobulin since the dog was known to have
rabies. - Answer-S71.152A, Z20.3, W54.0XXA
The patient is a 13 yr. old type 1 diabetic with proliferative retinopathy of both eyes
who regularly uses insulin for control of blood sugar. - Answer-E10.3593
A 67-year-old male patient went to his physician's office for a visit for his chronic,
systolic CHF and hypertension. After examination, the physician determined the
patient's condition is stable and will keep his current medication regimen the same. -
Answer-I11.0, I50.22
A 14-year-old male patient was brought into the emergency room by his parents after
he injured his left knee from sliding into third base during a high school baseball
game. X-rays revealed a sprained anterior cruciate ligament. - Answer-S83.512A,
W21.89XA, Y92.320, Y93.64, Y99.8
Recurrent tonsillitis and chronic tonsillitis - Answer-J03.91, J35.01
A 48-year-old female patient was admitted for hemodialysis for acute renal failure.
The patient also has stage I chronic renal failure and hypertension. - Answer-N17.9,
I12.9, N18.1
Jean came into the office for concerns of frequent urination, and a migraine
headache with aura and associated facial pain which she has had for 3 days. She
has taken her migraine medicine with no relief. The physician performed a urinalysis
with microscopy, and a 2 view paranasal sinus x-ray. The urinalysis revealed gross
hematuria. The x-ray revealed acute maxillary sinusitis. Assessment: urinary tract
infection, intractable migraine with status migrainosus, and acute maxillary sinusitis. -
Answer-G43.111, J01.00, N39.0
A 17-year-old male patient was taken to the emergency room because of third
degree burns to his chest wall and abdomen. He also has third degree burns to both
upper arms and forearms. The patient fell into a bonfire - Answer-T21.31XA,
T21.32XA, T22.312A, T22.332A, T22.311A, T22.331A, X03.0XXA
A 33-year-old female patient comes into the office today with complaints of chronic
coughing and wheezing. The physician sends her to the hospital for chest x-rays.
The final diagnosis for the office visit is coughing/wheezing, rule out mild persistent
asthma. - Answer-R05, R06.2
Polyneuropathy secondary to rheumatoid arthritis of the right hand - Answer-
M05.541
A 32-year-old female patient was brought to the emergency department by her
husband for difficulty walking. They had been at a party at a friend's house where the
, wife had taken Valium as prescribed by her physician and consumed three martinis.
The patient was examined and monitored for 12 hours and then discharged. The
final diagnosis was documented as: Overdose secondary to abuse of Valium and
alcohol with resulting ataxia. - Answer-T42.4X1A, T51.0X1A, R27.0, F10.10, F13.10,
Y92.019
Impending myocardial infarction - Answer-I20.0
The patient is a newborn, delivered by cesarean section secondary to persistent
occiput posterior presentation with obstruction. Upon examination the patient was
normal with the exception of caput succedaneum secondary to sitting in the birth
canal for so long. - Answer-Z38.01, P12.81, P03.1
CPT/HCPCS Coding Guidelines - Answer-
Wound closure consisting of steri-strips alone is classified as a simple repair. -
Answer-false
The reporting of test results with medical interpretive judgment is considered a
clinical pathology consultation. - Answer-true
Services performed to manage postoperative complications are included in the
surgical package therefore they are not reported separately. - Answer-false
The codes 31233-31298 are used to report bilateral procedures unless otherwise
specified. - Answer-false
For excision of benign lesions requiring more than simple closure, an intermediate or
complex closure code should be reported in addition to the excision code. - Answer-
true
Routine postoperative followup care is not covered under the surgical global
package. - Answer-false
Capitation, global/prospective payment, and prospective payment are examples of
this type of reimbursement method. - Answer-Episode-of-care
Under this reimbursement method, a third-party payer contracts with a healthcare
provider to pay a flat fee per individual enrolled in the healthcare plan. - Answer-
Capitation
Dr. Johnson recommends a procedure for Mr. Thomas who is a Medicare patient.
The procedure is not reimbursed under Mr. Thomas' Medicare policy. In order to bill
Mr. Thomas for the procedure, Dr. Johnson's office must collect a(n)____ from Mr.
Thomas. - Answer-advance beneficiary notice of noncoverage
Which of the following is NOT an element of the healthcare reimbursement process?
- Answer-clinical documentation review
EXAM QUESTIONS AND ANSWERS
Which of the following is/was NOT a result of CMS' use of Recovery Audit
Contractors (RACs)? - Answer-Consolidation of Medicare parts A and B
This terminology is only used in an electronic health record. - Answer-SNOMED CT
This type of computer-assisted coding uses artificial intelligence and linguistics to
extract data from the record and convert it into medical codes. - Answer-Natural
language processing
ICD-10-CM Coding Guidelines - Answer-
Codes for signs and symptoms are reported when the provider has documented a
related definitive diagnosis. - Answer-false
There is no time frame defining when pain becomes chronic pain. The physician's
documentation should be used to determine if the pain is considered chronic. -
Answer-true
When a patient has an adverse drug reaction, code both the reaction and the code
from T36-T50. - Answer-true
Inoculation and vaccination Z codes can be reported as the first listed or additional
codes. - Answer-true
When the cause of an injury is suspected to be the result of terrorism, a code from
category Y38 should be assigned. - Answer-false
When a patient with a high-risk pregnancy is being seen for a routine prenatal
outpatient visit, the supervision of high-risk pregnancy code should be reported as
the first-listed diagnosis. - Answer-true
The second trimester is defined as 12 weeks 0 days to less than 28 weeks 0 days. -
Answer-false
When the physician documents suspected or possible avian influenza, a code from
category J09 should be reported. - Answer-false
ICD-10-CM Coding Scenarios - Answer-
A 10-year old male patient is seen in the emergency department for cough, difficulty
breathing and wheezing more severe than his baseline. He responds well to
treatment with nebulized albuterol and is discharged home with instructions to follow
up with his primary care provider. The final diagnosis is: Acute bronchitis
superimposed on COPD with asthma of severe persistent type with acute
exacerbation. - Answer-J44.1, J20.9, J45.51
,A patient presents with abdominal pain. After a complete work-up the patient is found
to have an obstructive diaphragmatic hernia with gangrene - Answer-K44.1
A 7-year-old child was seen in the emergency room for a dog bite on her left thigh.
She received an injection of rabies immunoglobulin since the dog was known to have
rabies. - Answer-S71.152A, Z20.3, W54.0XXA
The patient is a 13 yr. old type 1 diabetic with proliferative retinopathy of both eyes
who regularly uses insulin for control of blood sugar. - Answer-E10.3593
A 67-year-old male patient went to his physician's office for a visit for his chronic,
systolic CHF and hypertension. After examination, the physician determined the
patient's condition is stable and will keep his current medication regimen the same. -
Answer-I11.0, I50.22
A 14-year-old male patient was brought into the emergency room by his parents after
he injured his left knee from sliding into third base during a high school baseball
game. X-rays revealed a sprained anterior cruciate ligament. - Answer-S83.512A,
W21.89XA, Y92.320, Y93.64, Y99.8
Recurrent tonsillitis and chronic tonsillitis - Answer-J03.91, J35.01
A 48-year-old female patient was admitted for hemodialysis for acute renal failure.
The patient also has stage I chronic renal failure and hypertension. - Answer-N17.9,
I12.9, N18.1
Jean came into the office for concerns of frequent urination, and a migraine
headache with aura and associated facial pain which she has had for 3 days. She
has taken her migraine medicine with no relief. The physician performed a urinalysis
with microscopy, and a 2 view paranasal sinus x-ray. The urinalysis revealed gross
hematuria. The x-ray revealed acute maxillary sinusitis. Assessment: urinary tract
infection, intractable migraine with status migrainosus, and acute maxillary sinusitis. -
Answer-G43.111, J01.00, N39.0
A 17-year-old male patient was taken to the emergency room because of third
degree burns to his chest wall and abdomen. He also has third degree burns to both
upper arms and forearms. The patient fell into a bonfire - Answer-T21.31XA,
T21.32XA, T22.312A, T22.332A, T22.311A, T22.331A, X03.0XXA
A 33-year-old female patient comes into the office today with complaints of chronic
coughing and wheezing. The physician sends her to the hospital for chest x-rays.
The final diagnosis for the office visit is coughing/wheezing, rule out mild persistent
asthma. - Answer-R05, R06.2
Polyneuropathy secondary to rheumatoid arthritis of the right hand - Answer-
M05.541
A 32-year-old female patient was brought to the emergency department by her
husband for difficulty walking. They had been at a party at a friend's house where the
, wife had taken Valium as prescribed by her physician and consumed three martinis.
The patient was examined and monitored for 12 hours and then discharged. The
final diagnosis was documented as: Overdose secondary to abuse of Valium and
alcohol with resulting ataxia. - Answer-T42.4X1A, T51.0X1A, R27.0, F10.10, F13.10,
Y92.019
Impending myocardial infarction - Answer-I20.0
The patient is a newborn, delivered by cesarean section secondary to persistent
occiput posterior presentation with obstruction. Upon examination the patient was
normal with the exception of caput succedaneum secondary to sitting in the birth
canal for so long. - Answer-Z38.01, P12.81, P03.1
CPT/HCPCS Coding Guidelines - Answer-
Wound closure consisting of steri-strips alone is classified as a simple repair. -
Answer-false
The reporting of test results with medical interpretive judgment is considered a
clinical pathology consultation. - Answer-true
Services performed to manage postoperative complications are included in the
surgical package therefore they are not reported separately. - Answer-false
The codes 31233-31298 are used to report bilateral procedures unless otherwise
specified. - Answer-false
For excision of benign lesions requiring more than simple closure, an intermediate or
complex closure code should be reported in addition to the excision code. - Answer-
true
Routine postoperative followup care is not covered under the surgical global
package. - Answer-false
Capitation, global/prospective payment, and prospective payment are examples of
this type of reimbursement method. - Answer-Episode-of-care
Under this reimbursement method, a third-party payer contracts with a healthcare
provider to pay a flat fee per individual enrolled in the healthcare plan. - Answer-
Capitation
Dr. Johnson recommends a procedure for Mr. Thomas who is a Medicare patient.
The procedure is not reimbursed under Mr. Thomas' Medicare policy. In order to bill
Mr. Thomas for the procedure, Dr. Johnson's office must collect a(n)____ from Mr.
Thomas. - Answer-advance beneficiary notice of noncoverage
Which of the following is NOT an element of the healthcare reimbursement process?
- Answer-clinical documentation review
