Chapter Review Questions - CPC
2022-2023
Which Z code can only be reported as a first listed code?
a) Z37.9
b) Z79.890
c) Z87.710
d) Z00.129 -
... [Show More] ANS-d) Z00.129
RATIONALE: In the ICD-10-CM guidelines I.C.21.c.16, there is a list of Z codes that can
only be reported as first-listed diagnosis code.
When coding for a patient who has had a primary malignancy of the thyroid gland that
was completely excised a year ago, and there is no current treatment directed at that
site, which of the following statements is TRUE?
a) When no further treatment is provided and there is no evidence of any existing
primary malignancy, code Z85.850.
b) When further treatment is provided and there is evidence of an existing metastasis,
code first Z85.50 and then C23.3.
c) Any mention of extension, invasion, or metastasis to another site is coded as a
D49.1.
d) When further treatment is provided and there is evidence of an existing metastasis,
code first C78.39. - ANS-a) When no further treatment is provided and there is no
evidence of any existing primary malignancy, code Z85.850.
Rationale: According to the ICD-10-CM guidelines I.C.2.d., when the patient has
completed treatment for cancer and there is not an existing malignancy, select a
personal history of malignancy by site. From the ICD-10-CM alphabetic Index, look for
History/personal (of)/malignant neoplasm(of)/thyroid. Verify code selection in the
Tabular List.
Which anatomic site would you look under in the CPT Index to find carinal
reconstruction?
a) Breast
b) Chest
c) Esophagus
d) Trachea - ANS-d) Trachea
Rationale: To find this code in the CPT Index, it is important to know the carina is part of
the trachea. Look in the index under Trachea/Reconstruction/Carina
When the entry point for a catheterization is the aorta, what order would the right
brachial artery be considered when using Appendix L?
a) First Order
b) Second Order Branch
c) Third Order Branch
d) Beyond Third Order Branch - ANS-c) Third order Branch
Rationale: In Appendix L, the vascular families are given based on the assumption the
aorta is the starting point for the catheterization. The R. Brachial is a third order branch
to the Innominate.
According to the National Correct Coding Initiative, what edit is placed on codes 11042
and 10060? (Refer to the NCCI table provided in the chapter, page 71 of the 2022
Official Study Guide CPC Certification)
a) CCM 0; a modifier will not bypass the edit
b) CCM 1; a modifier will bypass the edit
c) CCM 9; a modifier will not bypass the edit
d) CCM 9; a modifier will bypass the edit - ANS-b) CCM1; a modifier will bypass the edit
Rationale: Refer to the NCCI Table provided in this chapter. The edit for 11042 and
10060 has a modifier indicator of 1 listed next to the edit, indicating a modifier is allowed
if supported by the documentation and will bypass the edit.
When coding for a surgical service, which of the following is NOT included in the global
surgical package?
a) Digital block
b) General anesthesia
c) Talking with the family
d) E/M encounter on the date immediately prior to a major procedure - ANS-b) General
anesthesia
Rationale: a digital block or topical anesthesia, talking with the family and other
physicians, and the E/M prior to a major surgery and during the postoperative care are
all considered included in a CPT surgical code. General anesthesia would be reported
separately.
How often does CMS release updates for HCPCS Level II codes?
a) Monthly
b) Quarterly
c) Semi-Annually
d) Annually - ANS-b) Quarterly
Rationale: HCPCS Level II codes are maintained by CMS and are released quarterly on
the CMS website.
When a service having both a technical and professional component (e.g., X-ray) is
performed in the hospital, which modifier would be used by the physician?
a) 26
b) 47
c) TC
d) AM - ANS-a) 26
Rationale: When a service having both a technical and professional component is
performed in the hospital, the physician may bill for the professional component only.
Modifier 26 represents the professional component.
Muscle is attached to bone by what method?
a) Tendons, ligaments, and directly to bone
b) Ligaments and aponeuroses
c) Tendons, aponeuroses and directly to bone
d) Tendons, ligaments, aponeuroses, and directly to bone - ANS-c) Tendons,
aponeuroses and directly to bone
Rationale: Tendons are white bands attaching muscle to bone. Aponeuroses are flat,
wide bands holding muscle to the bone covering. Muscle is attached directly to bone.
Ligaments attach bones to bones.
What is affected by myasthenia gravis?
a) Neuromuscular junction
b) Muscle belly
c) Muscle/bone connection
d) Bone - ANS-a) Neuromuscular junction
Rationale: Myasthenia gravis is characterized by weakness and muscle fatigue of
muscles under voluntary control. It is and autoimmune disorder caused by abnormal
destruction of the acetylcholine receptors at the neuromuscular junction.
Melanocytes exits in which layer of the skin?
a) Stratum Lucidum
b) stratum Granulosum
c) Stratum Spinosum
d) Stratum Basale (Stratum Germinativum) - ANS-d) Stratum Basale (Stratum
Germinativum)
Rationale: The stratum germinativum is the deepest layer of the skin and contains
melanocytes. Melanocytes produce pigment called melanin, which is responsible for
skin pigmentation
Which of the following best describes psoriasis?
a) An inflammatory condition characterized by redness, pustular and vesicular lesions,
crusts, and scales
b) A contagious infection of the skin generally caused by the Staphylococcus bacterium
c) A chronic condition characterized by lesions that are red, dry, elevated, and covered
by silvery scales
d) An allergic reaction characterized by wheals and generally accompanied by pruritus -
ANS-c) A chronic condition characterized by lesions that are red, dry, elevated, and
covered by silvery scales.
Rationale: Psoriasis is a common chronic, autoimmune condition characterized by the
eruption of reddish, silvery-scaled maculopapules.
The term "pneumomediastinum" describes what condition?
a) Inflammation of the mediastinum
b) Puncture of the alveoli of the lungs
c) Presence of a cyst or tumor in the mediastinum
d) The presence of air in the mediastinum - ANS-d) The presence of air in the
mediastinum.
Rationale: The prefix "pneumo-" means air. Pneumomediastinum is air in the
mediastinum.
A respiratory disease characterized by over expansion and destruction of the alveoli is
identified as:
a) Cystic fibrosis
b) Pneumoconiosis
c) Emphysema
d) Respiratory distress syndrome - ANS-c) Emphysema
Rationale: Emphysema is the loss of lung function due to overexpansion and
destruction of the alveoli. Since alveoli are the primary units for the exchange of oxygen
and carbon dioxide in the lungs, breathing becomes increasingly rapid, shallow, and
difficult.
Which vessel does the tip of a central venous catheter terminate in?
a) Basilic vein
b) Subclavian vein
c) Aorta
d) Pulmonary artery - ANS-b) Subclavian vein
Rationale: A central venous catheter terminates into a vein, not an artery. CPT
guidelines for Central Venous Access procedures state, "To qualify as a central venous
access catheter or device, the tip of the catheter or device must terminate in the
subclavian, brachiocephalic (innominate) or iliac veins, the superior or inferior vena
cava, or the right atrium."
Which chamber of the heart is the most muscular?
a) Right atria
b) Left atria
c) Right ventricle
d) Left ventricle - ANS-d. Left ventricle
Rationale: The left ventricle, which forces oxygen-rich blood into the body, is the most
muscular chamber of the heart.
The splenic (left colic) flexure lies in the upper-left quadrant, between what two portions
of the large intestine?
a) The cecum and ascending colon
b) The descending and sigmoid colon
c) The transverse and descending colon
d) The ascending and transverse colon - ANS-c) The transverse and descending colon
Rationale: The Splenic (left colic) flexure lies in between the transverse and descending
colon. It is where the colon bends sharply near the spleen.
A surgical procedure that creates an opening into the jejunum is defined as a:
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