Which HCPCS Level II code category allows for pass-through payment devices? CORRECT ANSWER C codes
Which is the correct statement regarding AAPC
... [Show More] members per AAPC's Code of Ethics? CORRECT ANSWER Conduct themselves in all professional activities in a manner consistent with ethical principles of professional conduct.
Which is the ICD-10-CM code for GERD? CORRECT ANSWER K21.9
Which is the unit of measurement for documenting the size of a skin graft? CORRECT ANSWER Square centimeters
Which is true about the role of a co-surgeon? CORRECT ANSWER Handles a particular area of expertise.
Which layer is the middle layer of the eyeball? CORRECT ANSWER Choroid
Which layer of the epidermis is normally found on the palms of the hands and the soles of the feet? CORRECT ANSWER Stratum Lucidum
Which layer of the heart covers the heart's outer surface? CORRECT ANSWER Epicardium
Which leukocyte does the body use to protect against allergic reactions and parasites? CORRECT ANSWER Eosinophils
Which leukocyte is the body's second line of defense against infection? CORRECT ANSWER Monocytes
Which leukocyte protects the body from viral infections? CORRECT ANSWER Lymphocytes
Which medical term refers to the cheek? CORRECT ANSWER Buccal
Which of the following are also known as the lesser vestibular glands? CORRECT ANSWER Skene's glands
Which of the following belongs to the appendicular skeleton as opposed to the axial skeleton? CORRECT ANSWER Pelvic Girdle
Which of the following best describes constituent components of the human lymphatic system? CORRECT ANSWER Lymph nodes, lymphatic vessels, spleen, thoracic duct
Which of the following charges are NOT excluded from Medicare payment based on statutory exclusions? CORRECT ANSWER Hip replacement
Which of the following conditions are NOT on the 2019 major complications and comorbidities list on the CMS website? CORRECT ANSWER D15.0 Benign neoplasm of thymus
Which of the following conditions are on the 2019 complications and comorbidities list on the CMS website? CORRECT ANSWER IO1.0 Acute rheumatic pericarditis
Which of the following describes "dystonia"? CORRECT ANSWER Neurologic movement disorder causing abnormal postures
Which of the following does NOT require documentation for a cause-and-effect relationship to be coded? (Reference guidelines I.C.9.a.2 and I.C.9.a.3) CORRECT ANSWER Hypertension and chronic kidney disease
Which of the following facilities must have no more than 25 inpatient beds? CORRECT ANSWER: CAH Rationale: CAHs can have no more than 25 inpatient beds used for either inpatient or swing bed services.
Which of the following is also referred to as the voice box? CORRECT ANSWER Larynx
Which of the following is an example of a DRG payment sys? CORRECT ANSWER All Pt Dx Related Groups (APDRG), Severity Diagnosis Related Groups (SDRG), Medicare Severity Diagnosis Related Groups (MSDRG)
Which of the following is not a cardiac valve? CORRECT ANSWER Intraventricular septum
Which of the following is not a cardiac valve? CORRECT ANSWER Intraventricular septum
Which of the following is not a cardiac valve? CORRECT ANSWER Intraventricular septum
Which of the following is NOT a packaged service? CORRECT ANSWER Anesthesia professional services Packaged items are: >Costs for operating room (OR), procedure room, treatment room, recovery room, and materials, including supplies and equipment for the administration and monitoring of anesthesia >Observation services Certain pharmaceuticals (except for transitional pass-through), drugs, and biologicals that function as supplies >Medical and surgical supplies and equipment other than those in which separate payment is allowed >Ancillary services >Clinical diagnostic laboratory tests >Procedures described by add-on codes >Implantable medical devices (such as pacemakers) >Inexpensive drugs under a per-day drug threshold packaging amount >Guidance services >Image processing services >Intraoperative services >Imaging supervision and interpretation services >Professional services, such as anesthesia professional services are paid by Part B under the Physician Fee Schedule (PFS).
Which of the following is NOT used to determine the MS-DRG? CORRECT ANSWER Services billed by the Physician
Which of the following is the normal pacemaker in the heart? CORRECT ANSWER SA node
Which of the following is true about the typmpanic membrane? CORRECT ANSWER It separates the external ear from the middle ear
Which of the following is true of the stratum germinativum? CORRECT ANSWER It lies on top of the dermis and has access to a rich supply of blood
Which of the following procedures is the removal of the gallbladder? CORRECT ANSWER Cholecystectomy
Which of the following providers are in their first year after graduation from medical school? CORRECT ANSWER: Intern Rationale: Interns are usually in their first year following graduation from medical school and are completing a one-year rotation in various departments of the teaching facility departments of the hospital that depend on specialties. Residents are licensed physicians and depending the specialty, have two to five years of training in that specialty.
Which of the following services can be billed as observation services to Medicare? CORRECT ANSWER Patients undergoing same-day procedures that have a complication arise from the procedure that requires monitoring beyond the usual recovery room period.
Which of the following should be on each page of the patient's medical record? CORRECT ANSWER Patient's name or ID number.
Which of the following statements does NOT describe the Medicare Outpatient Prospective Payment System? CORRECT ANSWER Multiple surgical services are not reimbursed separately. Rationale: Although multiple surgical services may be discounted, the procedures are reimbursed separately unless it is a composite payment.
Which of the following statements is NOT true about Medicare payment for hospice services. CORRECT ANSWER The payment is $50 of charges
Which of the following statements is true regarding an ED encounter? CORRECT ANSWER Answer: Two claims are generated: one for the facility and one for the physician. Rationale: When providers perform procedures in the outpatient facility, two bills (claims) are generated. One claim is for the physician services, which are submitted on a CMS-1500 claim form. The other is for the facility services, which are submitted on a UB-04 claim form. This includes emergency department services.
Which of the following statements is true regarding ASCs? CORRECT ANSWER Answer: Independent ASCs are privately funded Rationale: Independent ASCs are privately funded, usually from a private investor, and are not associated directly with a hospital.
Which one of the following defines cost-to-charge ratio (CCR)? CORRECT ANSWER A ratio of the hospital's costs divided by the charges. Rationale: Cost-to-Charge Ratio (CCR)—A ratio of the cost divided by the charges. An APC is a method by which a hospital is reimbursed based on procedures performed instead of a cost-to-charge ratio (a ratio of the hospital's expenses [costs] divided by what the hospital charges [charges]).
Which one of the following is a requirement of Type B EDs? CORRECT ANSWER It is held out to the public as a place for emergency care without requiring a scheduled appointment.
Which option is NOT included in a written plan for care for outpatient therapy? CORRECT ANSWER CPT® codes.
Which organ produces bile to assist in digestion? CORRECT ANSWER Liver
Which part is considered the foundation of a word? CORRECT ANSWER Root
Which part of the brain controls blood pressure, heart rate and respiration? CORRECT ANSWER Medulla
Which part of the large intestine is between the hepatic flexure and the splenic flexure? CORRECT ANSWER Transverse colon
Which payment indicator is assigned to ASC services to indicate a packaged service/item and no separate payment is made? CORRECT ANSWER N1
Which procedures are approved by OPPS to be performed as outpatient hospital procedures? CORRECT ANSWER Hysteroscopies
Which regulation marked the congressional request for an OPPS to be developed? CORRECT ANSWER The Omnibus Budget Reconciliation Act of 1986 Rationale: The Omnibus Budget Reconciliation Act of 1986 (OBRA 86) marked the congressional request for an outpatient prospective payment system to be developed. The Balanced Budget Act included the CMS requirement to move from a cost-based reimbursement for hospital outpatient services to the implementation of an OPPS.
Which respiratory structure is comprised of cartilage and ligaments? CORRECT ANSWER Trachea
Which service is reimbursed based on the APC payment method? CORRECT ANSWER Patient X-ray of left foot in the outpatient department Rationale: The APC system is a payment methodology for outpatient, or ambulatory, facility services. It does not include the professional component of ambulatory care, which is paid under the Resource-Based Relative Value Scale (RBRVS) methodology. Also it does not include services and procedures that require inpatient care and/or procedures paid under an existing fee schedule. [Show Less]