ExamVault

CPC EXAM D 1. Indication: Patient has a hypertrophic scar on the posterior side of the left leg, at the level of the knee. This has begun to restrict his mobility. His physical therapy trial was unsuccessful. Procedure: After the proper induction of anesthesia, the subcutaneous tissue of the patient's left leg beneath the scar was infiltrated with crystalloid solution containing epinephrine to minimize blood loss. The scar was then excised down to viable dermis. Hemostasis was obtain...

Which one of the following is an example of fraud? A. Reporting the code for ultrasound guidance when used to perform a liver biopsy B. Reporting a biopsy and excision performed on the same skin lesion during the same encounter C. Failing to append modifier 26 on an X-ray that is performed and interpreted in the physician's office D. Reporting a lab panel with an additional lab test that is not included in the lab panel - Answer- B. Reporting a biopsy and excision performed on the same sk...

A patient with coronary atherosclerosis underwent a PTCA in the left anterior descending and in the first diagonal of the LD. What CPT® code(s) is/are reported? - Answer- 92920-LD, 92921-LD A child with suspected sleep apnea was given an apnea monitoring device to use over the next month. The device was capable of recording and storing data relative to heart and respiratory rate and pattern. The pediatric pulmonologist reviewed the data and reported to the child's primary pediatrician. What...

If a ST elevation myocardial infarction (STEMI) converts to a non ST elevation myocardial infarction (NSTEMI) due to thrombolytic therapy, how is it reported, according to ICD-10-CM guidelines? A. As unspecified AMI B. As a subendocardial AMI C. As STEMI D. As a NSTEMI - Answer- C. As STEMI ICD-10-CM guidelines (Section I.C.9.e.1) indicate: If STEMI converts to NSTEMI due to thrombolytic therapy, it is still coded as STEMI. Which place of service code is reported on the physician's ...

What is the term for the total amount of covered medical expenses a policyholder must pay each year out-of-pocket before the health insurance company begins to pay any benefits? A. Copayment B. Deductible C. Secondary Payment D. Coinsurance - Answer- B. Deductible Which type of insurance covers physicians and other healthcare professionals for liability as to claims arising from patient treatment? A. Business liability B. Bonding C. Medical malpractice D. Workers' compens...

What document is referenced to when looking for potentialproblem areas identified by the government indicatingscrutiny of the services within the coming year?: A) OIG Compliance Plan Guidance B) OIG Security Summary C) OIG Work Plan D) OIG Investigation Plan - Answer- C (Rationale: Twice a year, the OIG releases a Work Plan outlining its priorities for the fiscal year ahead. Within the Work Plan, potential problem areas with claims submissions are listed and will be targeted with special scr...

Many coding professionals go on to find work as: - Answer- Consultant A medical record contains information on all but what areas? - Answer- Financial records Technicians who specialize in coding are called: - Answer- Coding specialists EHR stands for: - Answer- Electronic health record What type of provider goes through approximately 26.5 months of education and is licensed to practice medicine with the oversight of a physician? - Answer- Physician Assistant (PA) The Medicare pro...

What is the patient's right when it involves making changes in the personal medical record? A. Patient must work through an attorney to revise any portion of the personal medical information. B. They should be able to obtain copies of the medical record and request corrections of errors and mistakes. C. It is a violation of federal health care law to revise a patient medical record. D. Revision of the patient medical record depends solely on the facility's compliance program policy. - An...

What part of Medicare covers prescription drug services - Answer- Part D What is medical coding? - Answer- Translating medical documentation into codes. Which is NOT a covered entity of HIPAA... Medicare, Worker's Comp, Dentists, Pharmacies - Answer- Workers compensation What is an NCD (National Coverage Determination) interpreted at the MAC level considered? - Answer- LCD (Local Coverage Determinations) When should an ABN (Advance Beneficiary Notification) be signed? - Answer- when...

When a patient has a blood test for HIV that is inconclusive, what ICD-10-CM code is assigned a. Z21 b. R75 c. B20 d. Z11.4 - Answer- b. R75 What does MRSA stand for a. Methicillin Resistant Staphylococcus Aureus b. Methicillin Resistant Streptococcus Aureus c. Moderate Resistance Susceptible Aureus d. Mild Resistance Steptococcus Aureus - Answer- a. Methicillin Resistant Staphylococcus Aureus What does the forth character in diabetes mellitus diabetes codes indicate? a. The...

Surgical removal - Answer- The suffix -ectomy means Magnetic Resonance Imaging - Answer- MRI stands for The removal of the fallopian tubes and ovaries - Answer- The term "Salpingo-Oophorectomy" refers to Freezing - Answer- Cryopreservation is a means of preserving something through Paracentesis - Answer- Which of the following describes the removal of fluid from a body cavity Gastrotomy - Answer- If a surgeon cuts into a patient's stomach he has performed a Muscle - Answer- ...

abdomin/o - Answer- abdomen -agon - Answer- assemble -22 - Answer- Increase procedural services When should an ABN be signed? - Answer- When a service is not expected to be covered by Medicare. acetabul/o - Answer- hip socket -78 - Answer- Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative procedure -algesia - Answer- pain sensation ABG...

Blephar/o - Answer- Eyelid Bucc/o - Answer- Cheek Cholecyst/o - Answer- Gallbladder Colp/o - Answer- Vagina Cyst/o - Answer- A fluid sac or pouch, urinary bladder Derm/o - Answer- Skin Encephal/o - Answer- Brain Enter/o - Answer- Intestines Hem/o, Hemat/o - Answer- Blood My/o - Answer- Muscle Myel/o - Answer- Spinal cord, bone marrow Onych/o - Answer- Nail Oste/o - Answer- Bone Phleb/o - Answer- Vein Pulm/o - Answer- Lungs Synov/i - Answer- Synovial f...

When coding in operative report what action would NOT be recommended? - Answer- Coding from the header with out reading the body of the report If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient who determines coverage? - Answer- Medicare administrative contractor (MAC) MAC stands for what!? - Answer- Medicare administrative contractor What is the definition of coding? - Answer- Translating documentation into numerical/alphabetical codes used to o...

Local Coverage Determinations are administered by whom? a. State Law b. NCDs c. Each regional MAC d. LMRPs - Answer- c. Each regional MAC ABN stands for _____. a. Advanced Benefits Notification b. Advisory Beneficial Notice c. Admitting Beneficiary Notice d. Advance Beneficiary Notice - Answer- d. Advance Beneficiary Notice What type of health insurance provides coverage for low-income families? a. Commercial HMO b. Medicaid c. Medicare d. Commercial PPO - Answer- b. ...

Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he has coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he have to do? - Answer- He will have to enroll in Part B. Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. What should she be aware of when considering enrollment in a Medicare Advantage (MA) plan? - Answer- She cannot enroll in an MA Medical Savings Account (MS...

Mr. Carlini has heard that Medicare prescription drug plans are only offered through private companies under a program known as Medicare Advantage (MA), not by the government. He likes Original Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage. What should you tell him? - Answer- b. Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug plan through a private company that has contracted with the government t...

Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what type of plan designs are available through this program. What should you tell him about the types of health plans that are available through the Medicare Advantage program? - c. They are Medicare health plans such as HMOs, PPOs, PFFS, and MSAs. Correct Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage. What would be a correct descriptio...

The Supreme Court's Brown vs. Board of Education decision of 1954 - Answer- ordered the racial desegregation of public schools A person who votes based on what a candidate says he or she will do in the future is said to be - Answer- engaging in prospective voting Should presidential candidates receive an equal number of electoral votes, the election is decided by - Answer- the House of Representatives enter graph here***** - Answer- "A form of government in which the people (defin...

NAFTA - Answer- North American Free Trade Agreement; signed by US, Canada and Mexico in 1993. Tariff rates are falling or disappearing ICC - Answer- Interstate Commerce Commission; created in 1887 to regulate railroads that moved goods and services between states Each state sends __________ Senators to the United States Senate. A) 2 B) 4 C) 6 D) a number in proportion to the population of the state - Answer- A) 2 The states in the US system of government enjoy ______...