Question 1

Analysis of the connection between the diagnostic and procedural information on a claim is called ____.

Accepted Answer

A)  code verification 
B)  code analysis 
C)  claim processing 
D)  code linkage 
E)  claim association 
A)  code verification 
B)  code analysis 
C)  claim processing 
D)  code linkage 
E)  claim association

Question 2

You have consulted the index in the CPT and discovered that a dressing for a burn is found in procedure codes 16010-16030. To correctly code the dressing for the burn, you should ____.

Accepted Answer

A)  check each code in the range to choose the correct code 
B)  use the codes 16010 and 16030 
C)  use the code 16010 
D)  choose any code within this code range 
E)  use the code 16030 
A)  check each code in the range to choose the correct code 
B)  use the codes 16010 and 16030 
C)  use the code 16010 
D)  choose any code within this code range 
E)  use the code 16030

Question 3

Which of the following statements about surgical coding for the musculoskeletal system is not true?

Accepted Answer

A)  Fracture repair assumes and includes cast application. 
B)  If a diagnostic procedure becomes a therapeutic procedure, only the therapeutic procedure is coded. 
C)  Cast application is coded only when the physician applying the cast did not initially treat the fracture. 
D)  A fracture treatment is closed unless stated otherwise. 
E)  Musculoskeletal subheadings begin with the foot and toes and work their way up to the head. 
A)  Fracture repair assumes and includes cast application. 
B)  If a diagnostic procedure becomes a therapeutic procedure, only the therapeutic procedure is coded. 
C)  Cast application is coded only when the physician applying the cast did not initially treat the fracture. 
D)  A fracture treatment is closed unless stated otherwise. 
E)  Musculoskeletal subheadings begin with the foot and toes and work their way up to the head.

Question 4

The ________ of the medical decision making is a key factor in determining the level of E/M codes selected.

Accepted Answer

The answer of The ________ of the medical decision making...

Question 5

The CPT contains codes that represent medical ________, such as surgery and diagnostic tests, and medical services, such as an examination to evaluate a patient's condition.

Accepted Answer

The answer of The CPT contains codes that represent medical...

Question 6

To ensure reimbursement at the highest allowed level, CPT codes must ____.

Accepted Answer

A)  include codes and modifiers that reflect the services performed 
B)  include only the modifiers 
C)  include all of the unbundled procedures 
D)  reflect a procedure or service higher than what was actually performed 
E)  reflect a procedure or service lower than what was actually performed 
A)  include codes and modifiers that reflect the services performed 
B)  include only the modifiers 
C)  include all of the unbundled procedures 
D)  reflect a procedure or service higher than what was actually performed 
E)  reflect a procedure or service lower than what was actually performed

Question 7

Which subsection of the surgery section include procedures on the spleen and bone marrow?

Accepted Answer

A)  Cardiovascular System 
B)  Digestive System 
C)  Hemic/Lymphatic Systems 
D)  Endocrine System 
E)  Laboratory Procedures 
A)  Cardiovascular System 
B)  Digestive System 
C)  Hemic/Lymphatic Systems 
D)  Endocrine System 
E)  Laboratory Procedures

Question 8

When a patient has no symptoms of a disease and the provider performs the tests for that disease at the patient's request, the provider has committed which of these fraudulent coding and billing practices?

Accepted Answer

A)  Reporting services that were not performed 
B)  Reporting services at a higher level than was carried out 
C)  Performing procedures not related to the patient's condition 
D)  Billing separately for services that are bundled in a single procedure code 
E)  Reporting the same service twice 
A)  Reporting services that were not performed 
B)  Reporting services at a higher level than was carried out 
C)  Performing procedures not related to the patient's condition 
D)  Billing separately for services that are bundled in a single procedure code 
E)  Reporting the same service twice

Question 9

Any code that includes more than one procedure in its description is considered a(n) ________ code.

Accepted Answer

The answer of Any code that includes more than one...

Question 10

Nathan is in the medical office today complaining of a sore throat and fever. After ruling out strep throat, the practitioner diagnoses a common cold and tells Nathan to take over-the-counter medications for symptom relief. In which category does Nathan's chief complaint fall?

Accepted Answer

A)  Minimal complaint 
B)  Self-limited complaint 
C)  Low-severity complaint 
D)  Moderate-severity complaint 
E)  High-severity complaint 
A)  Minimal complaint 
B)  Self-limited complaint 
C)  Low-severity complaint 
D)  Moderate-severity complaint 
E)  High-severity complaint

Question 11

Medical offices usually have a(n) ____ to help minimize the risk of fraud by discovering and correcting coding and billing problems.

Accepted Answer

A)  quality assurance program 
B)  billing software program 
C)  financial management plan 
D)  compliance plan 
E)  external auditor 
A)  quality assurance program 
B)  billing software program 
C)  financial management plan 
D)  compliance plan 
E)  external auditor

Question 12

A(n) ________ patient is one that has been seen by any providers in the same specialty of the medical practice within the past three years.

Accepted Answer

The answer of A(n) ________ patient is one that has...

Question 13

When coding CPT procedures, an add-on code will describe ____.

Accepted Answer

A)  special circumstances that apply to a procedure 
B)  surgical or other supplies that were used during a procedure 
C)  other procedures done in addition to a main procedure 
D)  medications used during a procedure 
E)  the type of anesthetic that was used during a procedure 
A)  special circumstances that apply to a procedure 
B)  surgical or other supplies that were used during a procedure 
C)  other procedures done in addition to a main procedure 
D)  medications used during a procedure 
E)  the type of anesthetic that was used during a procedure

Question 14

Dr. Breckell is scheduled to perform a cyst removal on Haley's right hand. After he begins the procedure, he notices that the cyst is much larger than anticipated and is involved with nerves and ligaments in the right thumb. Complete cyst removal takes 30 minutes longer than expected. Which modifier would you use to describe this special circumstance?

Accepted Answer

A)  22: Increased Procedural Services 
B)  26: Professional Component 
C)  TC: Technical Component 
D)  50: Bilateral Procedure 
E)  51: Multiple Procedures 
A)  22: Increased Procedural Services 
B)  26: Professional Component 
C)  TC: Technical Component 
D)  50: Bilateral Procedure 
E)  51: Multiple Procedures

Question 15

_______ codes are the most frequently used of all CPT codes because they are used by all physicians in any medical specialty.

Accepted Answer

E/M Evalua

Question 16

A medical provider bills separately for a comprehensive metabolic panel and a quantitative glucose test, which is normally included in the metabolic panel. This is an example of which of the following fraudulent coding and billing practices?

Accepted Answer

A)  Reporting services that were not performed 
B)  Reporting services at a higher level than was carried out 
C)  Performing procedures not related to the patient's condition 
D)  Billing separately for services that are bundled in a single procedure code 
E)  Reporting the same service twice 
A)  Reporting services that were not performed 
B)  Reporting services at a higher level than was carried out 
C)  Performing procedures not related to the patient's condition 
D)  Billing separately for services that are bundled in a single procedure code 
E)  Reporting the same service twice

Question 17

Billing for a moderate level evaluation and management service when only a simple BP check and injection were carried out is an example of ____.

Accepted Answer

A)  Reporting services that were not performed 
B)  Reporting services at a higher level than was carried out 
C)  Performing procedures not related to the patient's condition 
D)  Billing separately for services that are bundled in a single procedure code 
E)  Reporting the same service twice 
A)  Reporting services that were not performed 
B)  Reporting services at a higher level than was carried out 
C)  Performing procedures not related to the patient's condition 
D)  Billing separately for services that are bundled in a single procedure code 
E)  Reporting the same service twice

Question 18

An example of a Category II code is a code used for ____.

Accepted Answer

A)  weight reduction counseling 
B)  annual physical examinations 
C)  fracture management 
D)  total replacement heart systems 
E)  pain management 
A)  weight reduction counseling 
B)  annual physical examinations 
C)  fracture management 
D)  total replacement heart systems 
E)  pain management

Question 19

Which of the following items is not required for a service to be considered a consultation?

Accepted Answer

A)  Request from another physician 
B)  Documentation of the findings 
C)  Record of recommendations 
D)  Revision of the initial diagnosis 
E)  Report to the referring physician 
A)  Request from another physician 
B)  Documentation of the findings 
C)  Record of recommendations 
D)  Revision of the initial diagnosis 
E)  Report to the referring physician

Question 20

If a code description has changed since the last revision of the CPT manual, what symbol is placed next to the CPT code?

Accepted Answer

A)  Green arrows 
B)  Lightning bolt 
C)  Red dot 
D)  Blue triangle 
E)  Pound (#) sign 
A)  Green arrows 
B)  Lightning bolt 
C)  Red dot 
D)  Blue triangle 
E)  Pound (#) sign

Exam 19: Procedure Coding

Analysis of the connection between the diagnostic and procedural information on a claim is called ____.

You have consulted the index in the CPT and discovered that a dressing for a burn is found in procedure codes 16010-16030. To correctly code the dressing for the burn, you should ____.

Which of the following statements about surgical coding for the musculoskeletal system is not true?

The ________ of the medical decision making is a key factor in determining the level of E/M codes selected.

The CPT contains codes that represent medical ________, such as surgery and diagnostic tests, and medical services, such as an examination to evaluate a patient's condition.

To ensure reimbursement at the highest allowed level, CPT codes must ____.

Which subsection of the surgery section include procedures on the spleen and bone marrow?

When a patient has no symptoms of a disease and the provider performs the tests for that disease at the patient's request, the provider has committed which of these fraudulent coding and billing practices?

Any code that includes more than one procedure in its description is considered a(n) ________ code.

Nathan is in the medical office today complaining of a sore throat and fever. After ruling out strep throat, the practitioner diagnoses a common cold and tells Nathan to take over-the-counter medications for symptom relief. In which category does Nathan's chief complaint fall?

Medical offices usually have a(n) ____ to help minimize the risk of fraud by discovering and correcting coding and billing problems.

A(n) ________ patient is one that has been seen by any providers in the same specialty of the medical practice within the past three years.

When coding CPT procedures, an add-on code will describe ____.

_______ codes are the most frequently used of all CPT codes because they are used by all physicians in any medical specialty.

A medical provider bills separately for a comprehensive metabolic panel and a quantitative glucose test, which is normally included in the metabolic panel. This is an example of which of the following fraudulent coding and billing practices?

Billing for a moderate level evaluation and management service when only a simple BP check and injection were carried out is an example of ____.

An example of a Category II code is a code used for ____.

Which of the following items is not required for a service to be considered a consultation?

If a code description has changed since the last revision of the CPT manual, what symbol is placed next to the CPT code?

Introduction to Medical Assisting

Healthcare and the Healthcare Team

Professionalism and Success

Interpersonal Communication

Legal and Ethical Issues

Infection Control Fundamentals

Safety and Patient Reception

Office Equipment and Supplies

Examination and Treatment Areas

Written and Electronic Communication

Medical Records and Documentation

Electronic Health Records

Managing Medical Records

Telephone Techniques

Patient Education

Schedule Management

Insurance Billing

Diagnostic Coding

Patient Collections and Financial Management

Organization of the Body

The Integumentary System

The Skeletal System

The Muscular System

The Cardiovascular System

The Blood

The Lymphatic and Immune Systems

The Respiratory System

The Nervous System

The Urinary System

The Reproductive Systems

The Digestive System

The Endocrine System

Special Senses

Infection Control Practices

Patient Interview and History

Vital Signs and Measurements

Assisting With a General Physical Exam

Assisting in Reproductive and Urinary Specialties

Assisting in Pediatrics

Assisting in Geriatrics

Assisting in Other Medical Specialties

Assisting in Eye and Ear Care

Assisting in Minor Surgery

Orientation to the Lab

Microbiology and Disease

Processing and Testing Urine and Stool Samples

Collecting, Processing, and Testing Blood Specimens

Electrocardiography and Pulmonary Function Testing

Diagnostic Imaging

Principles of Pharmacology

Math and Dosage Calculations

Medication Administration

Physical Therapy and Rehabilitation

Nutrition and Health

Practice Management

Emergency Preparedness

Preparing for the World of Work

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