Ccs Exam Flashcards
1
Q
What software computes the DRG (diagnosis related group)?
A
Grouper
2
Q
What is data structure?
A
Dictionary of data elements
3
Q
How to code incomplete procedure in CPT?
A
Modifier 52 reduced services
4
Q
What are G codes?
A
Temporary codes for emerging procedures and professional services with no cpt code
5
Q
When can you code Late Effect first?
A
When followed by manifestation
6
Q
Compressive fracture of lumbar spine due to osteoporosis?
A
Pathological fracture 733.13 and 733.00
7
Q
How to code induced abortion resulting in live born?
A
Early onset of delivery 644.21
8
Q
What are J codes?
A
Codes for meds or drug code that cannot be self administered. Injectable drugs.
9
Q
Test for Syphilis?
A
Wasserman or VDRL venereal disease research lab
10
Q
How to code bilateral procedure in cpt?
A
Modifier 50
11
Q
What is case mix?
A
Complexity of population of patients or types of patients treated
12
Q
What is audit trail?
A
Chronological list of those who access the EHR (electronic health record) or EMD (electronic med record)
13
Q
How can access to the network be controlled?
A
Identification authorization and authentication
14
Q
Basis for HCPCS (healthcare common procedure coding system) level II modifiers?
A
Anatomical site
15
Q
Treatment for gout?
A
Allopurinol or Colchicine
16
Q
Term for full thickness removal of skin lesion?
A
Excision
17
Q
What disposition will affect the post discharge transfer rule?
A
Patient transferred to home health within 3-5 days after discharge. Long term health care.
18
Q
Who maintains cpt book?
A
AMA
19
Q
How to code incomplete procedure in ICD-9?
A
Code up to extent of the procedure
20
Q
What enzymes are elevated in acute MI?
A
CPK-MB (creatine phosphokinase-mb) and Troponin
21
Q
What are M codes?
A
Morphology codes for study of types of cell and behavior of neoplasm
22
Q
Organ involved in Ossiculor chain reconstruction?
A
Middle ear
23
Q
What are key factors/components of E&M (evaluation and management?
A
History, examination, and medical decision making
24
Q
Treatment for CHF?
A
Lasix, Lanoxin, Digoxin
25
What is anemia due to bone marrow failure?
Aplastic anemia
26
What bones are involved in Epycondylar fracture?
Humerus and Femur
27
Modifier for discontinued outpatient procedure PRIOR to anesthesia administration?
Modifier 73
28
What is EMTALA?
Emergency medical treatment and labor act. All ER cases must be treated in ER even if patient is not financially capable
29
What takes precedence in the convention in coding or guidelines?
Convention in coding book and instructions
30
What is mutually exclusive edit?
Submission of 2 codes which are improbable or cannot be reasonable be performed at the same session
31
What is non excisional debridement?
Debridement using water, gauze, or a blunt instrument. Non surgical.
32
What is excisional debridement?
Debridement done either by physician nurse or therapist using a cutting instrument. Surgical removal cutting away.
33
What is being treated if patient is receiving potassium?
Hypokalemia
34
Treatment for high LDL cholesterol and low HDL?
Pravachol
35
In what part of med record would a physician write a note when the chart is already completed?
Addendum
36
What are 4 organizations that make up the cooperating parties for ICD-9 CM?
AHA AHIMA NCHS CMS
37
Treatment for genital herpes?
Acyclovir or Zovirax
38
What are Outliers?
Cases requiring more resources than usual or those who stay in hospital longer than average length of stay
39
Definition of principle diagnosis?
Condition established after study to be main reason for admission
40
What is DRG creep or up code fraud?
Coding of diagnosis or procedure which is not present or not documented in order to increase the DRG
41
What part of med report would you find size of lesion in excision?
Operative report
42
3 compartments of the knee
Medial
Lateral
Patelo-Femoral
43
What is benchmarking?
Process of comparing data to standard, peer group or another organization?
44
What is meaning of puerperium?
Postpartum after birth extending to 6 weeks
45
What is SNOMED?
Systematic NOmenclature of MEDicine.
It is a systematic computer processable collection of medical terminologies. It provides codes, terms, synonyms, and definitions.
46
What is OSHPD
Office of statewide health planning and development.
| Provides the state with an enhanced understanding of the structure and function of its healthcare delivery system
47
What condition is associated with SIADH (syndrome of inappropriate anti diuretic hormone)?
Hyponatremia (low sodium or sodium deficiency)
48
What is a complicated wound?
It is an infected wound with foreign body, delayed healing and delayed treatment.
49
What condition is associated with elevated HBNP? Human brain natriuretic peptide
Congestive heart failure
50
How would you check productivity of the coders?
Coders ID, number of charts coded, and me frame
51
In adverse effect of drug what is the principle diagnosis?
The manifestation code
52
Adjacent tissue transfer (includes excision of the lesion?
Z platsy
53
What condition is associated with high PSA (prostate specific antigen)?
Cancer of the prostrate (BPH benign prostatic hyperplasia)
54
What is stress fracture?
Fracture caused by repetition trauma?
55
What auxiliary procedure is fixed in cabg?
39.61 extra corporeal circulation or cardio pulmonary bypass machine
56
What is blood transfusion hepatitis?
Hepatitis C?
57
What diagnosis is an indication for EPS? Electrophysiological study)
Sinus node dysfunction?
58
What type of hernia requires additional code for mesh?
Incisional or ventral?
59
What condition is associated with elevated ammonia in the blood?
Alcoholic encephalopathy
60
Code for normal delivery?
650 and V27.0
61
If physician excised 2 lesions with 1 incision how is this coded?
2 excision codes with modifier 51 on the last
62
What are E codes?
Codes used to identify the cause of injury, poisoning and other adverse effects
63
Reimbursement system for outpatient
APC ambulatory payment classification
64
What is a significant procedure?
Defined as one that is surgical in nature, carries a procedural/surgical risk or anesthetic risk or requires specialized training.
65
What bones are involved in trimallear fracture?
Tibia and fibula ( ankle)
66
What is serum hepatitis?
Hepatitis B
67
What is case mix index?
Severity
Prognosis
Treatment
Avg DRG weight
68
Treatment for hypothyroidism?
Synthroid or Levothyroxine
69
What are V codes?
Codes used to document conditions with no actual disease
70
Terms synonymous with Open fracture
```
Compound
Missile
Gunshot
Puncture
Infected
Foreign body
```
71
Types of endoscopy
Diagnostic and surgical
72
What condition is associated with Epstein Barr virus EBV?
Infectious mononucleosis
73
What is endoscopy?
Insertion of scope into natural body passageways
74
What is a separate procedure?
Part of comprehensive procedure
75
Test level for anticoagulant?
PTT (prothrombin time) and INR (international normalized ratio)
76
What is surgical package?
It includes pre-operative, operative, and post operative care services
77
Treatment for Thrush or Oral Candidiasis/Candida?
Nystatin/Fungicidin
78
What is spontaneous fracture?
This is considered pathological fracture, fragility fracture, compression fracture, or fatigue or insufficiency fracture.
79
What is principle procedure?
Procedure done for definitive treatment (not for diagnostic or exploratory purposes)
80
Skin graft from patient himself?
autograft
81
In poisoning with drug, what is the principal diagnosis?
The Poisoning Code
82
Which procedure will go to surgical DRG?
CRPT (Cardiac Resynchronization Therapy Pacemaker)
83
Test for Hepatitis B?
Hepatitis B Surface Antigen
84
How would you code Italicized Codes?
Secondary
85
What hospital department is involved in EMTALA?
Risk Management
86
What is Pathalogical Fracture?
Fracture of the bone because of bone disease such osteoporosis/ or cancer of the bone as multiple myeloma.
87
What is spontaneous fracture?
This is considered pathological fracture, fragility fracture, compression fracture, or fatigue or insufficiency fracture.
88
What is principal procedure?
Procedures done for definitive treatment (not for diagnostic of exploratory purposes)
89
What condition does a patient with Polydipsia, Polyuria, Polyphagia symptoms have?
DM Type II
90
What is a skin graft taken from a different species ex PIG
Xenograft
91
What is unbundling?
submission of 2 codes: one of which is a component of the comprehensive code.
92
How would you improve the function and check the performance of the medical records?
audit and monitoring
93
What is debulking?
partial excision of surgical removal of tumor, done if cancer is unresectable. It is surgical removal or part of a malignant tumor which cannot be completely excised so as to enhance the effectiveness of radiation or chemotherapy.
94
What is called infectious Hepatitis?
Hepatitis A
95
What condition is associate with high TSH (Thryoid stimulating hormone)?
Hypothyroidism
96
If they did both diagnostic and surgical endoscopy, which one are you going to code?
surgical only
97
Code for positive serology for AIDS adult?
V08
98
Code for positive serology for AIDS/HIV in a 7 month old baby?
795.71 Inconclusive Positive Serology for AIDS
99
Keyword in the index when you look for TURP.
Prostatectomy
100
In what instances the acute respiratory failure is NOT the principal diagnosis?
```
When it is due to:
Sepsis
AIDS
Pregnancy
Poisoning
Newborn/Neonate
```
101
How to code EGD up to the ileum?
44376 Small intestinal endoscopy
102
Patient was admitted with chest pain due to unstable angina and CAD. What is correct sequence?
CAD and Unstable Angina
103
If the physician performs debridement, how will you code it?
Query the physician wether it is excisional or non-excisional
104
In aspergillosis pneumonia what is coded first?
Aspergillosis
105
What is the purpose of a physician query?
To clarify documentation
106
Modifier if patient is seen in the ER by a cardiologist and podiatrist?
Modifier 27 (multiple outpatient hospital E/M encounters on the same date)
107
What is CLO Test?
EGD with Biopsy
108
What is required to obtain a copy of the patient's medical record?
Signed consent of release of medical information
109
Who allows insurance companies to transfer patients' information to another facility with patient's consent?
HIPPA
110
How to code bilateral procedures in ICD-9?
Code twice
111
Who investigates coding fraud?
OIG (Office of Inspector General)
112
Principle diagnosis for patient admitted with acute gastroenteritis and dehydration?
Dehydration
113
What is principle diagnosis: pregnancy or dehydration?
Pregnancy
114
What is meaning of anemia?
Low red blood cells
115
What is it called when coders code s diagnosis which is not present?
Up coding or DRG creep
116
When coding residual and late effect which is codes first?
Late effect
117
What is significance of high TSH and low T4?
Hypothyroidism
118
Modifier NOT applicable to hospital outpatient?
Modifier 51
119
CPT code for unlisted procedure?
Ending in 99
120
Treatment for Hypokalemia
K Dur
121
How to code fracture of bone due to multiple myeloma or osteoporosis?
Pathological
122
Enzymes in pancreatitis?
Amylase and Lipase
123
What is treatment for Pnuemonia?
Rocephin or Zithromax
124
What will go to DRG?
CRT-P Cardiac Resyncronization Therapy Pacemaker
125
What is the name of the software that produces ICD9?
Encoder
126
What is the hepatitis enzyme?
Transamine
127
If claim is rejected what must be done?
Review and recode
128
What do you do with unfilled charts?
Check if coded and code if not
129
A CT was requested but claim was denied. Why?
Diagnosis did not match the procedure
130
What is required for a CT scan?
Diagnosis
131
What is paid under APC (Ambulatory Payment Classification)
Partial hospitalization
132
What is NOT pain under APC?
Laboratory
133
What is EPS?
Electrophysiological study
134
What is the name of the inpatient reimbursement system?
DRG (Diagnosis Related Group)
135
How do you code an outpatient rule out?
No Code.
136
What is the principal diagnosis for a patient with respiratory failure due to alcohol intake with medication?
Poisoning
137
What is the purpose of the network?
Allows access to everyone
138
Which gets coded when concerning fracture and dislocation
fracture
139
Malunion of fracture of femur is considered what?
Late Effect
140
What causes Hypokalemia?
Low potassium/potassium deficiency
141
What do you do when there is a breach in email confidentiality or unauthorized access of medical records?
Notify immediate supervisor
142
What must the coder do to prevent unauthorized access to confidential information?
Sign in and out
143
How can documentation be improved?
Feedback
144
Is it adverse effect or poisoning if the patient developed a reaction after synergistic effect from drug?
Adverse effect
145
When a fracture is caused by a disease, how is it coded?
Pathological
146
What is hypoglycemia linked to?
Low Calcium
147
What is HAC?
Hospital Acquired Condition. An undesirable situation or condition that affects a patient that arose during a hospital stay or medical facility
148
Tia vs Stroke?
Both are coded as primary and symptoms are coded as secondary
149
What is used for external data storage?
USB flash drive
150
Controlling factor in selection of E/M code when counseling and coordination of care dominates more than 50% of time spent by physician to a patient encounter
Face to Face time
151
How do you code DM with nephropathy?
DM with Renal Manifestation
152
Where will you find the sphincter of Oddi?
Common bile duct
153
What organ produces Amylase?
Pancreas
154
Sponge was left inside patient after surgery. Who do you contact?
Risk Management
155
What is the first screening test for AIDS?
ELISA (Enzyme-Linked Immunosorbent Assay)
156
How would you code 2 lacerations of the cheek-intermediate and 1 laceration of the forehead -simple?
2 codes. Add cheek and code simply separately
157
What is acute alcoholism?
Patient who has hallucinations due to alcohol intake (severe form)
158
Medication for hypertension?
Lotensin, Lopressor, and Norvasec
159
What kind of infection is Aspergillosis?
Fungal Infection
160
What kind of infection is Candidiasis?
Fungal Infection
161
An interventional radiology bill for common angioplasty has not been paid by the insurance company. What is a possible reason for denial?
Coder did not submit the appropriate modifier
162
A hospital need to bill $25K to $28K in account. Which one will you code first?
The one that will expire first.
163
Modifier that is NOT applicable to hospital outpatient or modifier used when a physician performed multiple surgeries/services on the same day, during the same surgical session?
Modifier 51
164
Modifier for discontinued procedure AFTER administration of anesthesia?
Modifier 74
165
What disposition affects MSDRG?
Skilled nursing facility
166
3 conditions that are always presumed to be due to diabetes without cause and effect relationship unless there is a stated cause?
1. Hypoglycemia
2. Osteomyelitis
3. Gangrene
167
What is NCCI?
National Correct Coding Initiative. Prevents billing errors (over/under payments) for Medicare Part B
168
What is charge master?
List of all charges to insurance
169
What is fluid loss due to burn?
Intravascular
170
What is central data repository?
Common data base
171
Modifier to use if you submit 2 codes that usually are not submitted together?
Modifier 59
172
Codes ending in 99
Unlisted procedures
173
How to code bilateral procedure in CPT?
Modifier 50
174
What agreement does OIG have?
Federal Compliance Agreement
175
What bones have epicondyle?
Humerus and Femur
176
What conditions are presumed to be diabetes related?
Hypoglycemia
Osteomyelitis
Gangrene
