Exam Prep for CCA (2024/2025) - Questions with Detailed Answers The nose, mouth, sinuses, pharynx, & larynx make up the? The upper respiratory tract
... [Show More] Mary Giovanni is in the hospital recovering from colon resection surgery. Based on her symptoms, her doctors are concerned about the possibility that she has developed a pulmonary embolism. Which of the following procedures will provide the definitive diagnosis? a) Chest X-ray b) Pulmonary angiography c) Lung scan d) None of the above A 32 year old patient has a colonoscopy with removal of 3 polyps by snare. Moderate sedation was used & provided by the physician. The intraservice time was 30 minutes. 45385 - colonoscopy with removal of tumor or polyps or other lesions by snare technique 99156-initial 15 minutes of intraservice time, patient 5 years or older. 99157-each additional 15 minutes of intraservice time (list separately in addition to code for primary service) The diagnosis is as follows: "Carcinoma of axillary lymph nodes & Lungs, metastatic from breast" what is the primary cancer site? a) Lungs b) Axillary lymph nodes c) Breast d) Both Axillary lymph nodes & Lungs Patient has a year history of mitral valve regurgitation (mitral insufficiency) and now presents for a mitral valve replacement with bypass (Code for physician using CPT procedure codes only). **(Valvuloplasty is a plastic repair of a valve) 33430 Replacement, mitralvalve, with cardiopulmonary bypass You are conducting an educational session on benchmarking. You tell your audience that the key to benchmarking is to use the comparison to? Improve your departments processes Your facility would like to improve physician documentation in order to allow improved coding. As a coding supervisor, you have found it very effective to provide the physicians with? Feedback on specific instances when improved documentation would improve coding. A patient is diagnosed with early onset Alzheimer's disease with dementia, how would this be coded? G30.0-Alzheimer's disease with early onset F02.80-Dementia in other diseases classified elsewhere. Without behavioral disturbance. An established patient was seen by a physician in her office for DTaP-IPV/Hib (DTap=Diphtheria, Tetanus, & Acellular Pertussis) (IPV=Inactivated Polio Vaccine) (Hib=Haemophilus influenzae type B vaccine) 90471-Immunization administration (includes percutaneous intradermal, subcutaneous, or intramuscular injections) 1 vaccine (single or combination vaccine/toxoid) 90698-Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenza type b, & inactivated poliovirus vaccine (DTaP-IPV/Hib) for intramuscular use. What CPT code is used for a high-energy ESW of the lateral humeral epicondyle (tennis elbow) using general anesthesia? 0102T-Extracorporeal shock wave, high energy, performed by a physician , requiring anesthesia other than local, involving lateral humeral epicondyle. Which of the following procedures can be identified as "destruction" of lesions: a) paring of hyperkeratotic lesion b) laser removal of condylomata (wart) c) shaving of skin lesion d) removal of skin tags The practice of using a code that results in a higher payment to the provider than the code that more accurately reflects the service provided is known as? Upcoding A ________is a collection of information or data that is organized in such a way that it's contents can be queried and relationships created Database A single lung transplant without cardiopulmonary bypass. (Code for physician using CPT procedure only) 32851 Lung transplant, single, without cardiopulmonary bypass A female with 6 months of stress incontinence. Laparoscopic urethral suspension was completed. choose the appropriate ICD-10-CM and CPT codes? N39.3- Stress incontinence (female) (male) 51990-Laparoscopy, surgical; urethral suspension for stress incontinence. The use of radioactive sources placed into a tumor-bearing area to generate high intensity radiation is termed? Brachytherapy External Beam Radiation The most common type of radiation therapy used for cancer treatment. A machine is used to aim high-energy rays (or beams) from outside the body into the tumor. (The machine most commonly used is called a linear accelerator or "linac.") What radiation therapy uses several beams of various intensities aimed at different angles to precisely target the tumor. Through the use of CT, MRI or other advanced imaging techniques to precisely map the position of the tumor. The images are used to design a four-dimensional, customized treatment plan that determines beam intensity and positioning. The goal is to deliver the highest possible dose to kill the cancer while minimizing exposure to healthy organs. Stereotactic body radiation therapy (SBRT) or Stereotactic ablative radiotherapy A machine called a synchrotron or cyclotron speeds up protons. The high speed of the protons creates high energy. This energy makes the protons travel to the desired depth in the body. The protons then give the targeted radiation dose in the tumor. There is less radiation dose outside of the tumor which minimizes damage to the surrounding healthy tissues & organs, which helps reduce side effects. Proton Beam Treatment Which of the following procedures would not be coded to "resection" when using ICD-10-PCS? a) Excision of sigmoid colon b) Excision of gallbladder c) Resection of the upper right lobe d) Partial resection of upper left lobe. During her hospitalization for her third delivery, Janet had a sterilization procedure performed. When the record is coded, the code for sterilization, Z30.2, is A. not used. B. used and sequenced as the principal diagnosis. C. used and sequenced as a secondary diagnosis. D. the only code used. A patient suffered dizziness as a result of taking prescribed phenobarbital. The patient took his medication with beer R42-Dizziness and Giddiness T42.3X1A-Poisoning by barbiturates accidental (unintentional). Initial encounter T51.8X1A-Toxic effect of other alcohols. Accidental (unintentional). Initial encounter Some ICD-10-CM codes are exempt from POA reporting because they? Are always present on admission & represent circumstances regarding the health care encounter or factors influencing health status that do not represent a current disease or injury CMS delegates its daily operations of the Medicare and Medicaid programs to: A. the office of Inspector General B. the PRO in each state C. the National Center for Vital and Health Statistics D. Medicare administrative contractor (MAC) Which diagnosis should be listed first when sequencing inpatient codes using the UHDDS? (Uniform Hospital Discharge Data Set) Principal diagnosis Male patient has been diagnosed with benign prostatic hypertrophy & undergoes a transurethral destruction of the prostate by radiofrequency thermotherapy. (Code ICD-10-CM for diagnosis & CPT for procedure) N40.0-Benign prostatic hyperplasia without lower urinary tract symptoms 53852-Transurethral destruction of prostate tissue, by radiofrequency thermotherapy As part of a concurrent record review, you need to locate the initial plan of action based on the attending physician's initial assessment of the patient. You can expect to find this documentation either within the body of the history and physical or in the a. doctor's admitting progress note b. nurse's admit note c. review of systems d. discharge summary Lumbar laminectomy (one segment) for decompression of spinal cord. (Code CPT for procedures) 63005-Laminectomy, with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy foraminotomy, or discectomy (eg. spinal stenosis), one or two vertebral segments; lumbar except for spondylolisthesis. The ________are the organizations that contract with medicare to perform reviews of medical records with the corresponding Medicare claims to detect & correct improper payments Recovery Audit Contractors (RAC's) Patient has a breast carcinoma and is now undergoing complete axillary lymphadenectomy. (Code for physician using CPT procedure codes only) 38745-Axillary lymphadenectomies; complete Which of the following could influence a facility's case mix? a) Changes in the services offered by a facility b) Accuracy of coding c) Changes in DRG weights d) All answers apply Excision 2 cm subcutaneous soft tissue lipoma of the back. (code for diagnoses using ICD-9-CM. Code for procedure using CPT.) D17.1-Benign lipomatous neoplasm of skin & subcutaneous tissue of trunk 21930-Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm The Joint Commission requires that all medical records be completed within ______ following Patient discharge? 30 Days Provide the CPT code for a patient that had a complicated removal of a wrist prosthesis. 25251-Removal of wrist prosthesis; complicated, including total wrist If the same condition is described as both acute and chronic and separate subentries exist in the ICD-10-CM alphabetic index at the same indentation level? They should both be coded, acute sequenced first. Patient presents to the GI Lab for a colonoscopy, during the colonoscopy, adenomatous polyps were discovered in the acending colon & the transverse colon. Polyps in the ascending colon were removed via biopsy forceps, & the polyps in the transverse colon were removed by snare technique. D12.2-Benign neoplasm of ascending colon D12.3-Benign neoplasm of the transverse colon 45384-Colonoscopy with removal of polyps, hot biopsy forceps. 45385-Colonoscopy with removal of polyps, snare technique. -59 Distinct procedural service What legal term is used in describing sexual harassment in reference to unwelcome sexual advances, request for sexual favors, & verbal or physical conduct of a sexual nature made in return for job benefits? Quid Pro Quo CPT code(s) for a laparoscopic takedown of the splenic flexure & a partial colectomy with anastomosis? 44204-Colectomy, partial, with anastomosis. 44213-Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy _______ is a system for documenting the extent or spread of cancer? Staging Which of these conditions are always considered "present on admission" (POA)? a) Congenital conditions b) Possible, probable, or suspected conditions c) Acute conditions d) Z codes Patient came to the hospital ambulatory surgical center for repair of incisional inguinal hernia. This is the second time the patient has developed this problem. The hernia was repaired with Gore-Tex graft. Choose the appropriate ICD-10-CM and CPT codes? K40.91-Inguinal hernia, without obstruction or gangrene, recurrent. 49565-Repair recurrent incisional or ventral hernia, reducible (flatens out when you lie down or press it) 49568-Implantation of mesh or other prosthesis for incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection. Robert Thompson was seen in the outpatient department with a chronic cough and the record states, "rule out lung cancer." What should be coded as the patient's diagnosis? Chronic cough A patient presents with dermatitis due to prescription topical antibiotic cream used as directed by physician L25.1-Unspecified contact dermatitis due to drugs in contact with skin. T49.0X5A-Adverse effect of local antifungal, anti-infective & anti-inflamatory drugs. Patient with carpal tunnel comes in for an open carpal tunnel release, right hand. (Code ICD-9-CM for diagnoses & CPT for procedures. G56.01-Carpal tunnel syndrome, right upper limb 64721-Neuroplasty and/or transposition; median nerve at carpal tunnel. MS-Drg Relative # of Patients Identifier Weight with MS- A 1.234 x 12 = 14.808 B 3.122 x 10 = 31.22 C 2.165 x 19 = 41.135 D 5.118 x 16 = 81.888 total = 169.051/57 = (2.965807) 12+10+19+16=57 Based on the sample MS-DRG report above, what is the case mix index for this facility. This facility. a) 42.26275 b) 2.965807 c) 2.90975 d) 11.639 2.965807 (RW x #PWMS) A thru D =169.051 /57 Total #PWMS [Show Less]