A covered entity does NOT include
a. Healthcare providers
b. Health plans
c. Patients
d. Clearinghouses
c. Patients
What does MAC stands
... [Show More] for?
a. Medicare Administrative Contractor
b. Medicare Advisory Contractor
c. Medicaid Administrative Contractor
d. Medicaid Alert Contractor
a. Medicare Administrative Contractor
When are providers responsible for obtaining an ABN for a service NOT considered medically necessary?
a. After providing a service or item to a beneficiary.
b. Prior to providing a service or item to a beneficiary.
c. After a denial has been received from Medicare.
d. During a procedure or service.
b. Prior to providing a service or item to a beneficiary
AAPC credentialed coders have proven mastery of what information?
a. Code sets
b. Evaluation and management principles
c. Documentation guidelines
d. All of the above
d. All of the above
Local Coverage Determinations are administered by whom?
a. LMRPs
b. NCDs
c. State Law
d. Each regional MAC
d. Each regional MAC
Rationale: Each Medicare Administrative Contractor (MAC) is then responsible for interpreting national policies into regional policies
Which of the following best describes constituent components of the human lymphatic system?
a. Lymph nodes, lymphatic vessels, spleen, thoracic duct
b. Lymph nodes, lymphatic vessels, thymus gland, pancreas
c. Lymph nodes, lymphatic vessels, tonsils, liver
d. Lymph nodes, lymphatic vessels, bone marrow, kidneys
a. Lymph nodes, lymphatic vessels, spleen, thoracic duct
The term hemic specifically refers to what bodily fluid?
a. Bile interstitial fluid
b. Interstitial fluid
c. Blood
d. Lymph
c. Blood
Which part of the brain controls blood pressure, heart rate and respiration?
a. Cerebellum
b. Cerebrum
c. Cortex
d. Medulla
d. Medulla
The radiology term fluoroscopy is described as:
a. Use of high-frequency sound waves to image anatomic structures
b. An X-ray procedure allowing the visualization of internal organs in motion
c. Technique using magnetism, radio waves and a computer to produce images
d. A scan using an X-ray beam rotating around the patient
b. An X-ray procedure allowing the visualization of internal organs in motion
Which of the following characterizes the disorder dystonia?
a. Difficulty swallowing
b. Slowness of motion
c. Abnormal muscle tone causing abnormal postures and muscle spasm
d. Impairment of speech
c. Abnormal muscle tone causing abnormal postures and muscle spasm
In the ICD-10-CM Alphabetic Index what is the code next to the main term called?
a. Category Code
b. Default Code
c. Unspecified Code
d. Subcategory Code
b. Default Code
What is the ICD-10-CM code for eyestrain?
a. H53.10
b. H53.10, H53.10
c. H57.811, H57.812
d. H57.813
a. H53.10
What is the ICD-10-CM code for fatigue?
a. R29.898
b. F45.8
c. F48.8
d. R53.83
d. R53.83
A patient sees his primary care provider for chest pain and regurgitation. The provider's diagnosis for the patient is gastroesophageal reflux. What diagnosis code(s) should be reported?
a. K21.9
b. K21.9, R07.9, K21.9
c. R07.9, R11.10
d. R07.9, R11.10, K21.9
a. K21.9
A 45 year-old female with malignant Mullerian duct cancer is receiving her first treatment of chemotherapy. What diagnosis codes are reported?
a. C79.82, Z51.11
b. C57.7, Z51.11
c. Z51.11, D28.7
d. Z51.11, C57.7
d. Z51.11, C57.7
According to ICD-10-CM guidelines, when a patient is seen for management of anemia due to malignancy, how is it reported?
a. Anemia is the only condition reported.
b. The malignancy is the only condition reported.
c. Anemia is reported first, followed by the code for the malignancy.
d. The malignancy is reported first, followed by the code for the anemia.
d. The malignancy is reported first, followed by the code for the anemia.
What ICD-10-CM code is reported for a patient who is a habitual abuser of cannabis?
a. F12.159
b. F12.129
c. F12.121
d. F12.10
d. F12.10
A patient presents to the ED with weakness on the left side and aphasia. Tests are ordered and the patient is admitted with a cerebrovascular accident (CVA). What ICD-10-CM code(s) is/are reported?
a. I67.89
b. R53.1, R47.01
c. I63.50
d. I63.9
d.
A patient is admitted after being found unresponsive at home. The patient had right-sided hemiplegia and aphasia from a previous CVA. The provider documents a current cerebral infarction due to occlusion of the right middle cerebral artery as the final diagnosis and the patient is transferred for rehabilitation. What ICD-10-CM code(s) is/are reported?
a. I67.89, I69.959, I69.920
b. I65.319
c. I67.89, I69.954, R47.01
d. I63.511, I69.351, I69.320
d. I63.511, I69.351, I69.320
Response Feedback: Rationale: Refer to ICD-10-CM guideline I.C.9.d.2. Look in the ICD-10-CM Alphabetic Index for Infarct, infarction/cerebral/due to/occlusion NEC/cerebral arteries directing you to code I63.5-. Report I63.511 Cerebral infarct due to unspecified occlusion or stenosis of right middle cerebral artery. This patient has a history of CVA with right-sided hemiplegia and aphasia. Look in the Alphabetic Index for Sequelae (of)/infarction/cerebral/hemiplegia which directs the coder to I69.35-. Also look for Sequelae/infarction/cerebral/aphasia I69.320. Verify in the Tabular List I69.351 Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side.Per ICD-10-CM guideline I.C.9.d.1 because the right side was affected and we do not know the dominant side, the default for dominance is right
Four years post hepatic transplant, the patient is diagnosed with combined hepatocellular carcinoma and cholangiocarcinoma of the liver. What ICD-10-CM codes are reported?
a. T86.49, C80.2, C22.0, C22.1, Z94.4
b. C80.2, C22.0
c. C80.2, C22.0, C22.1, Z94.4
d. T86.49, C80.2, C22.0
d. T86.49, C80.2, C22.0
What is NOT an example of active treatment for pathological fractures?
a. Surgical treatment
b. Emergency department encounter
c. Evaluation and treatment by a new provider
d. Cast change
d. Cast change
A patient was admitted three weeks following a normal vaginal delivery with a postpartum breast abscess. What ICD-10-CM code is reported?
a. O91.12
b. O91.22
c. N61.1
d. O91.13
a. O91.12
What is/are the external cause code(s) for a passenger involved in an MVA that lost control on the highway and hit a guardrail?
a. Y92.411
b. V47.6XXA
c. V47.5XXA
d. V47.6XXA, Y92.411
a. Y92.411
A 7 year-old female patient was seen in the emergency department after being bitten by a dog. The child received treatment for the puncture wounds to her left leg. She also received a rabies vaccine because the dog was known to have rabies. What ICD-10-CM codes are reported?
a. S81.852A, Z20.3, Z23, W54.0XXA
b. S81.812A, Z20.3, Z23, W54.0XXA
c. S81.812A, A82.9, Z23, W54.0XXA
d. S81.852A, Z23, W54.0XXA
a. S81.852A, Z20.3, Z23, W54.0XXA
A male patient is here for his chemotherapy for metastatic carcinoma of the liver secondary to cancer of the right areola. What ICD-10-CM codes are reported?
a. C22.9, C50.019, Z51.11
b. Z51.11, C78.7, C50.021
c. Z51.11, C50.029, C78.7
d. C78.7, C50.021, Z51.11
b. Z51.11, C78.7, C50.021
Rationale: ICD-10-CM guideline I.C.2.e.2 states that if a patient admission/encounter is solely for the administration of chemotherapy, immunotherapy, or radiation therapy, assign code Z51.0 Encounter for antineoplastic radiation therapy, or Z51.11 Encounter for antineoplastic chemotherapy, or Z51.12 Encounter for antineoplastic immunotherapy as the first listed or principal diagnosis. In the ICD-10-CM Alphabetic Index look for Encounter (with health service) (for)/chemotherapy for neoplasm guiding you to code Z51.11. Next, look in the Alphabetic Index for Metastasis, metastatic/cancer/from specified site and you are directed to see Neoplasm, malignant, by site. In the ICD-10-CM Table of Neoplasms look for Neoplasm, neoplastic/liver and select the code from the Malignant Secondary column, guiding you to code C78.7. Next look for Neoplasm, neoplastic/areola and select the code from the Malignant Primary column or Neoplasm, neoplastic/breast/areola and select the code from the Malignant Primary column, guiding you to subcategory code C50.0-. In the Tabular List, the 5th character is reported for the sex of the patient. In this case the patient is a male resulting in a 5th character of 2. The 6th character is for laterality; 1 is for right. The complete code is C50.021 for primary cancer of the right male areola. When assigning breast cancer codes make sure to select for the correct sex of the patient. The secondary cancer is listed first because the chemotherapy is directed to the secondary site per ICD-10-CM guideline I.C.2.b. Verify code selection in the Tabular List.
What is the correct CPT® code for a complete, four-view, chest X-ray?
a. 71048
b. 71046 x 2
c. 71047
d. 71045 x 4
a. 71048
How many days does it take CMS to implement HCPCS Level II Temporary Codes that have been reported as added, changed or deleted?
a. 90
b. 30
c. 60
d. 365
a. 90
What codes are voluntarily reported to payers, provide evidence-based performance-measure data?
a. HCPCS Level II codes
b. CPT® Category I codes
c. CPT® Category III codes
d. CPT® Category II codes
d. CPT® Category II codes
HCPCS Level II includes code ranges that consist of what type of codes?
a. Permanent national codes, miscellaneous codes and temporary national codes
b. Permanent national codes, dental codes and category II codes
c. Category II codes, temporary national codes and miscellaneous codes
d. Dental codes, morphology codes, miscellaneous codes and permanent national codes
a. Permanent national codes, miscellaneous codes and temporary national codes
When procedures are "mandated" by third party payers, what modifier would you use?
a. 52
b. 26
c. 76
d. 32
d. 32
A patient is taken to surgery for removal of a squamous cell carcinoma of the right thigh. What is the correct diagnosis code for today's procedure?
a. C79.2
b. C79.89
c. C44.702
d. C44.722
d. C44.722
A 14 year-old boy was thrown against the window of the car on impact. The resulting injury was a star-shaped pattern cut to the top of his head. In the ED, the MD on call for plastic surgery was asked to evaluate the injury and repair it. The total length of the intermediate repair was 5+4+4+5 cm (18 cm total). The star-like shape allowed the surgeon to pull the wound edges together nicely in a natural Y-plasty in two spots. What CPT® code is reported for the repair?
a. 14041
b. 13121
c. 14040
d. 12035
d. 12035
A patient presents with a recurrent seborrheic keratosis of the left cheek. The area was marked for a shave removal. The area was infiltrated with local anesthetic, prepped and draped in a sterile fashion. The lesion measuring 1.8 cm was shaved using an 11-blade. Meticulous hemostasis was achieved using light pressure. The specimen was sent for permanent pathology. The patient tolerated the procedure well. What CPT® code is reported?
a. 11642
b. 11200
c. 11312
d. 11442
c. 11312 [Show Less]