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Ccs Exam Flashcards

1
Q

What software computes the DRG (diagnosis related group)?

A

Grouper

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2
Q

What is data structure?

A

Dictionary of data elements

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3
Q

How to code incomplete procedure in CPT?

A

Modifier 52 reduced services

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4
Q

What are G codes?

A

Temporary codes for emerging procedures and professional services with no cpt code

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5
Q

When can you code Late Effect first?

A

When followed by manifestation

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6
Q

Compressive fracture of lumbar spine due to osteoporosis?

A

Pathological fracture 733.13 and 733.00

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7
Q

How to code induced abortion resulting in live born?

A

Early onset of delivery 644.21

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8
Q

What are J codes?

A

Codes for meds or drug code that cannot be self administered. Injectable drugs.

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9
Q

Test for Syphilis?

A

Wasserman or VDRL venereal disease research lab

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10
Q

How to code bilateral procedure in cpt?

A

Modifier 50

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11
Q

What is case mix?

A

Complexity of population of patients or types of patients treated

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12
Q

What is audit trail?

A

Chronological list of those who access the EHR (electronic health record) or EMD (electronic med record)

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13
Q

How can access to the network be controlled?

A

Identification authorization and authentication

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14
Q

Basis for HCPCS (healthcare common procedure coding system) level II modifiers?

A

Anatomical site

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15
Q

Treatment for gout?

A

Allopurinol or Colchicine

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16
Q

Term for full thickness removal of skin lesion?

A

Excision

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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.

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18
Q

Who maintains cpt book?

A

AMA

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19
Q

How to code incomplete procedure in ICD-9?

A

Code up to extent of the procedure

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20
Q

What enzymes are elevated in acute MI?

A

CPK-MB (creatine phosphokinase-mb) and Troponin

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21
Q

What are M codes?

A

Morphology codes for study of types of cell and behavior of neoplasm

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22
Q

Organ involved in Ossiculor chain reconstruction?

A

Middle ear

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23
Q

What are key factors/components of E&M (evaluation and management?

A

History, examination, and medical decision making

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24
Q

Treatment for CHF?

A

Lasix, Lanoxin, Digoxin

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25
Q

What is anemia due to bone marrow failure?

A

Aplastic anemia

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26
Q

What bones are involved in Epycondylar fracture?

A

Humerus and Femur

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27
Q

Modifier for discontinued outpatient procedure PRIOR to anesthesia administration?

A

Modifier 73

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28
Q

What is EMTALA?

A

Emergency medical treatment and labor act. All ER cases must be treated in ER even if patient is not financially capable

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29
Q

What takes precedence in the convention in coding or guidelines?

A

Convention in coding book and instructions

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30
Q

What is mutually exclusive edit?

A

Submission of 2 codes which are improbable or cannot be reasonable be performed at the same session

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31
Q

What is non excisional debridement?

A

Debridement using water, gauze, or a blunt instrument. Non surgical.

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32
Q

What is excisional debridement?

A

Debridement done either by physician nurse or therapist using a cutting instrument. Surgical removal cutting away.

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33
Q

What is being treated if patient is receiving potassium?

A

Hypokalemia

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34
Q

Treatment for high LDL cholesterol and low HDL?

A

Pravachol

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35
Q

In what part of med record would a physician write a note when the chart is already completed?

A

Addendum

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36
Q

What are 4 organizations that make up the cooperating parties for ICD-9 CM?

A

AHA AHIMA NCHS CMS

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37
Q

Treatment for genital herpes?

A

Acyclovir or Zovirax

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38
Q

What are Outliers?

A

Cases requiring more resources than usual or those who stay in hospital longer than average length of stay

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39
Q

Definition of principle diagnosis?

A

Condition established after study to be main reason for admission

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40
Q

What is DRG creep or up code fraud?

A

Coding of diagnosis or procedure which is not present or not documented in order to increase the DRG

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41
Q

What part of med report would you find size of lesion in excision?

A

Operative report

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42
Q

3 compartments of the knee

A

Medial
Lateral
Patelo-Femoral

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43
Q

What is benchmarking?

A

Process of comparing data to standard, peer group or another organization?

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44
Q

What is meaning of puerperium?

A

Postpartum after birth extending to 6 weeks

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45
Q

What is SNOMED?

A

Systematic NOmenclature of MEDicine.
It is a systematic computer processable collection of medical terminologies. It provides codes, terms, synonyms, and definitions.

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46
Q

What is OSHPD

A

Office of statewide health planning and development.

Provides the state with an enhanced understanding of the structure and function of its healthcare delivery system

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47
Q

What condition is associated with SIADH (syndrome of inappropriate anti diuretic hormone)?

A

Hyponatremia (low sodium or sodium deficiency)

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48
Q

What is a complicated wound?

A

It is an infected wound with foreign body, delayed healing and delayed treatment.

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49
Q

What condition is associated with elevated HBNP? Human brain natriuretic peptide

A

Congestive heart failure

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50
Q

How would you check productivity of the coders?

A

Coders ID, number of charts coded, and me frame

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51
Q

In adverse effect of drug what is the principle diagnosis?

A

The manifestation code

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52
Q

Adjacent tissue transfer (includes excision of the lesion?

A

Z platsy

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53
Q

What condition is associated with high PSA (prostate specific antigen)?

A

Cancer of the prostrate (BPH benign prostatic hyperplasia)

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54
Q

What is stress fracture?

A

Fracture caused by repetition trauma?

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55
Q

What auxiliary procedure is fixed in cabg?

A

39.61 extra corporeal circulation or cardio pulmonary bypass machine

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56
Q

What is blood transfusion hepatitis?

A

Hepatitis C?

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57
Q

What diagnosis is an indication for EPS? Electrophysiological study)

A

Sinus node dysfunction?

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58
Q

What type of hernia requires additional code for mesh?

A

Incisional or ventral?

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59
Q

What condition is associated with elevated ammonia in the blood?

A

Alcoholic encephalopathy

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60
Q

Code for normal delivery?

A

650 and V27.0

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61
Q

If physician excised 2 lesions with 1 incision how is this coded?

A

2 excision codes with modifier 51 on the last

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62
Q

What are E codes?

A

Codes used to identify the cause of injury, poisoning and other adverse effects

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63
Q

Reimbursement system for outpatient

A

APC ambulatory payment classification

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64
Q

What is a significant procedure?

A

Defined as one that is surgical in nature, carries a procedural/surgical risk or anesthetic risk or requires specialized training.

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65
Q

What bones are involved in trimallear fracture?

A

Tibia and fibula ( ankle)

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66
Q

What is serum hepatitis?

A

Hepatitis B

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67
Q

What is case mix index?

A

Severity
Prognosis
Treatment

Avg DRG weight

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68
Q

Treatment for hypothyroidism?

A

Synthroid or Levothyroxine

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69
Q

What are V codes?

A

Codes used to document conditions with no actual disease

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70
Q

Terms synonymous with Open fracture

A 
Compound
Missile
Gunshot
Puncture
Infected
Foreign body
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71
Q

Types of endoscopy

A

Diagnostic and surgical

72
Q

What condition is associated with Epstein Barr virus EBV?

A

Infectious mononucleosis

73
Q

What is endoscopy?

A

Insertion of scope into natural body passageways

74
Q

What is a separate procedure?

A

Part of comprehensive procedure

75
Q

Test level for anticoagulant?

A

PTT (prothrombin time) and INR (international normalized ratio)

76
Q

What is surgical package?

A

It includes pre-operative, operative, and post operative care services

77
Q

Treatment for Thrush or Oral Candidiasis/Candida?

A

Nystatin/Fungicidin

78
Q

What is spontaneous fracture?

A

This is considered pathological fracture, fragility fracture, compression fracture, or fatigue or insufficiency fracture.

79
Q

What is principle procedure?

A

Procedure done for definitive treatment (not for diagnostic or exploratory purposes)

80
Q

Skin graft from patient himself?

A

autograft

81
Q

In poisoning with drug, what is the principal diagnosis?

A

The Poisoning Code

82
Q

Which procedure will go to surgical DRG?

A

CRPT (Cardiac Resynchronization Therapy Pacemaker)

83
Q

Test for Hepatitis B?

A

Hepatitis B Surface Antigen

84
Q

How would you code Italicized Codes?

A

Secondary

85
Q

What hospital department is involved in EMTALA?

A

Risk Management

86
Q

What is Pathalogical Fracture?

A

Fracture of the bone because of bone disease such osteoporosis/ or cancer of the bone as multiple myeloma.

87
Q

What is spontaneous fracture?

A

This is considered pathological fracture, fragility fracture, compression fracture, or fatigue or insufficiency fracture.

88
Q

What is principal procedure?

A

Procedures done for definitive treatment (not for diagnostic of exploratory purposes)

89
Q

What condition does a patient with Polydipsia, Polyuria, Polyphagia symptoms have?

A

DM Type II

90
Q

What is a skin graft taken from a different species ex PIG

A

Xenograft

91
Q

What is unbundling?

A

submission of 2 codes: one of which is a component of the comprehensive code.

92
Q

How would you improve the function and check the performance of the medical records?

A

audit and monitoring

93
Q

What is debulking?

A

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
Q

What is called infectious Hepatitis?

A

Hepatitis A

95
Q

What condition is associate with high TSH (Thryoid stimulating hormone)?

A

Hypothyroidism

96
Q

If they did both diagnostic and surgical endoscopy, which one are you going to code?

A

surgical only

97
Q

Code for positive serology for AIDS adult?

A

V08

98
Q

Code for positive serology for AIDS/HIV in a 7 month old baby?

A

795.71 Inconclusive Positive Serology for AIDS

99
Q

Keyword in the index when you look for TURP.

A

Prostatectomy

100
Q

In what instances the acute respiratory failure is NOT the principal diagnosis?

A 
When it is due to:
Sepsis
AIDS
Pregnancy
Poisoning
Newborn/Neonate
101
Q

How to code EGD up to the ileum?

A

44376 Small intestinal endoscopy

102
Q

Patient was admitted with chest pain due to unstable angina and CAD. What is correct sequence?

A

CAD and Unstable Angina

103
Q

If the physician performs debridement, how will you code it?

A

Query the physician wether it is excisional or non-excisional

104
Q

In aspergillosis pneumonia what is coded first?

A

Aspergillosis

105
Q

What is the purpose of a physician query?

A

To clarify documentation

106
Q

Modifier if patient is seen in the ER by a cardiologist and podiatrist?

A

Modifier 27 (multiple outpatient hospital E/M encounters on the same date)

107
Q

What is CLO Test?

A

EGD with Biopsy

108
Q

What is required to obtain a copy of the patient’s medical record?

A

Signed consent of release of medical information

109
Q

Who allows insurance companies to transfer patients’ information to another facility with patient’s consent?

A

HIPPA

110
Q

How to code bilateral procedures in ICD-9?

A

Code twice

111
Q

Who investigates coding fraud?

A

OIG (Office of Inspector General)

112
Q

Principle diagnosis for patient admitted with acute gastroenteritis and dehydration?

A

Dehydration

113
Q

What is principle diagnosis: pregnancy or dehydration?

A

Pregnancy

114
Q

What is meaning of anemia?

A

Low red blood cells

115
Q

What is it called when coders code s diagnosis which is not present?

A

Up coding or DRG creep

116
Q

When coding residual and late effect which is codes first?

A

Late effect

117
Q

What is significance of high TSH and low T4?

A

Hypothyroidism

118
Q

Modifier NOT applicable to hospital outpatient?

A

Modifier 51

119
Q

CPT code for unlisted procedure?

A

Ending in 99

120
Q

Treatment for Hypokalemia

A

K Dur

121
Q

How to code fracture of bone due to multiple myeloma or osteoporosis?

A

Pathological

122
Q

Enzymes in pancreatitis?

A

Amylase and Lipase

123
Q

What is treatment for Pnuemonia?

A

Rocephin or Zithromax

124
Q

What will go to DRG?

A

CRT-P Cardiac Resyncronization Therapy Pacemaker

125
Q

What is the name of the software that produces ICD9?

A

Encoder

126
Q

What is the hepatitis enzyme?

A

Transamine

127
Q

If claim is rejected what must be done?

A

Review and recode

128
Q

What do you do with unfilled charts?

A

Check if coded and code if not

129
Q

A CT was requested but claim was denied. Why?

A

Diagnosis did not match the procedure

130
Q

What is required for a CT scan?

A

Diagnosis

131
Q

What is paid under APC (Ambulatory Payment Classification)

A

Partial hospitalization

132
Q

What is NOT pain under APC?

A

Laboratory

133
Q

What is EPS?

A

Electrophysiological study

134
Q

What is the name of the inpatient reimbursement system?

A

DRG (Diagnosis Related Group)

135
Q

How do you code an outpatient rule out?

A

No Code.

136
Q

What is the principal diagnosis for a patient with respiratory failure due to alcohol intake with medication?

A

Poisoning

137
Q

What is the purpose of the network?

A

Allows access to everyone

138
Q

Which gets coded when concerning fracture and dislocation

A

fracture

139
Q

Malunion of fracture of femur is considered what?

A

Late Effect

140
Q

What causes Hypokalemia?

A

Low potassium/potassium deficiency

141
Q

What do you do when there is a breach in email confidentiality or unauthorized access of medical records?

A

Notify immediate supervisor

142
Q

What must the coder do to prevent unauthorized access to confidential information?

A

Sign in and out

143
Q

How can documentation be improved?

A

Feedback

144
Q

Is it adverse effect or poisoning if the patient developed a reaction after synergistic effect from drug?

A

Adverse effect

145
Q

When a fracture is caused by a disease, how is it coded?

A

Pathological

146
Q

What is hypoglycemia linked to?

A

Low Calcium

147
Q

What is HAC?

A

Hospital Acquired Condition. An undesirable situation or condition that affects a patient that arose during a hospital stay or medical facility

148
Q

Tia vs Stroke?

A

Both are coded as primary and symptoms are coded as secondary

149
Q

What is used for external data storage?

A

USB flash drive

150
Q

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

A

Face to Face time

151
Q

How do you code DM with nephropathy?

A

DM with Renal Manifestation

152
Q

Where will you find the sphincter of Oddi?

A

Common bile duct

153
Q

What organ produces Amylase?

A

Pancreas

154
Q

Sponge was left inside patient after surgery. Who do you contact?

A

Risk Management

155
Q

What is the first screening test for AIDS?

A

ELISA (Enzyme-Linked Immunosorbent Assay)

156
Q

How would you code 2 lacerations of the cheek-intermediate and 1 laceration of the forehead -simple?

A

2 codes. Add cheek and code simply separately

157
Q

What is acute alcoholism?

A

Patient who has hallucinations due to alcohol intake (severe form)

158
Q

Medication for hypertension?

A

Lotensin, Lopressor, and Norvasec

159
Q

What kind of infection is Aspergillosis?

A

Fungal Infection

160
Q

What kind of infection is Candidiasis?

A

Fungal Infection

161
Q

An interventional radiology bill for common angioplasty has not been paid by the insurance company. What is a possible reason for denial?

A

Coder did not submit the appropriate modifier

162
Q

A hospital need to bill $25K to $28K in account. Which one will you code first?

A

The one that will expire first.

163
Q

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?

A

Modifier 51

164
Q

Modifier for discontinued procedure AFTER administration of anesthesia?

A

Modifier 74

165
Q

What disposition affects MSDRG?

A

Skilled nursing facility

166
Q

3 conditions that are always presumed to be due to diabetes without cause and effect relationship unless there is a stated cause?

A
  1. Hypoglycemia
  2. Osteomyelitis
  3. Gangrene
167
Q

What is NCCI?

A

National Correct Coding Initiative. Prevents billing errors (over/under payments) for Medicare Part B

168
Q

What is charge master?

A

List of all charges to insurance

169
Q

What is fluid loss due to burn?

A

Intravascular

170
Q

What is central data repository?

A

Common data base

171
Q

Modifier to use if you submit 2 codes that usually are not submitted together?

A

Modifier 59

172
Q

Codes ending in 99

A

Unlisted procedures

173
Q

How to code bilateral procedure in CPT?

A

Modifier 50

174
Q

What agreement does OIG have?

A

Federal Compliance Agreement

175
Q

What bones have epicondyle?

A

Humerus and Femur

176
Q

What conditions are presumed to be diabetes related?

A

Hypoglycemia
Osteomyelitis
Gangrene

Ccs (2 decks)

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