CPC Assessment M2

Question 1

The excision of foreign material or dead or damaged skin to promote healing is known as_______

1. fulguration.
2. dermabrasion.
3. debridement.
4. cryosurgery.

Answer 1

3. debridement.

Question 2

Erythrocytes refers to_______

1. lymphatic cells.
2. blood cells.
3. white blood cells.
4. red blood cells.

Answer 2

4. red blood cells.

Question 3

When documenting for burns of the skin, how is the total surface area recorded?

1. TBSA
2. FTSG
3. STSG
4. Epidermis vs dermis

Answer 3

1. TBSA

Question 4

Modifier -FA denotes

1. first toe, right foot.
2. first toe, left foot.
3. thumb, left hand.
4. thumb, right hand.

Answer 4

3. thumb, left hand.

Question 5

What part of the HIPAA guidelines pertain to coding?

1. no pre-existing conditions
2. standard code sets and standard claim forms
3. patient privacy
4. patient ability to request records

Answer 5

2. standard code sets and standard claim forms

Question 6

Which of the following is NOT part of the 7 federal guidelines for compliance plans?

1. conducting internal auditing
2. develop compliance and practice standards
3. develop practice E/M guidelines
4. conducting appropriate training

Answer 6

3. develop practice E/M guidelines

Question 7

Arthro pertains to which anatomical system?

1. musculoskeletal
2. nervous
3. digestive Disease/Gastrointestinal
4. integumentary

Answer 7

1. musculoskeletal

Question 8

An anastomosis would be defined as______

1. a surgical connection between two normally distinct structures.
2. reconnection of two normally connecting structures.
3. a surgical replacement of a joint.
4. fusion of two body structures

Answer 8

1. a surgical connection between two normally distinct structures.

Question 9

The acronym “LLQ” refers to what anatomical area/region?

1. left lower quadrant of the body
2. left lower quadrant of the abdominal area/cavity
3. left lower quadrant of an extremity
4. left lower quadrant of the head

Answer 9

2. left lower quadrant of the abdominal area/cavity

Question 10

A fracture of the distal end of the radius at the epiphysis is called a ________

1. comminuted fracture.
2. greenstick fracture.
3. compression fracture.
4. Colles’ fracture.

Answer 10

4. Colles’ fracture.

Question 11

What direct penalties may be imposed by the government for fraudulent activities?

1. exclusion from the Medicare program
2. inability to appeal claims to the Medicare program
3. suspension of medical license
4. exclusion from electronic funds transfer from Medicare

Answer 11

1. exclusion from the Medicare program

Question 12

The term “anterior” refers to what part of the body or anatomical part/structure?

1. medial
2. posterior
3. lateral
4. front

Answer 12

4. front

Question 13

The visible portion of the external ear is referred to as_____

1. ossicle
2. incus
3. auricle
4. malleus

Answer 13

3. auricle

Question 14

When fraudulent actions are taken by a provider, what penalties may be imposed by the government?

1. exclusion from electronic funds transfer from Medicare
2. possible imprisonment
3. inability to appeal claims to the Medicare program
4. revocation of medical license

Answer 14

2. possible imprisonment

Question 15

The uppermost part of the body or an anatomical structure is referred to as:

1. superior
2. uppermost
3. oblique
4. transverse

Answer 15

1. superior

Question 16

All employees, coding or other, should understand that the medical records are the property of whom?

1. the patient
2. only those entities as defined by legal advice
3. the practice/provider
4. the insurance carrier

Answer 16

3. the practice/provider

Question 17

One of the bones of the lower leg is called the ______

1. femur
2. tibia
3. patella
4. metatarsal

Answer 17

2. tibia

Question 18

This gland has two lobes and an isthmus that connects them.

1. pituitary gland
2. thyroid gland
3. adrenal gland
4. thymus gland

Answer 18

2. thyroid gland

Question 19

When Medicare services being provided are believed to not be covered under the Medicare program, what form should be secured and signed by the patient prior to services rendered?

1. patient release
2. Advance Beneficiary Notice (ABN)
3. Waiver form
4. Assignment of benefits

Answer 19

2. Advance Beneficiary Notice (ABN)

Question 20

The combining form pyelo refers to ______

1. the renal pelvis
2. urinary system
3. the kidneys
4. the ureters

Answer 20

1. the renal pelvis

Question 21

Common name for qui tam action is_______

1. Flase Claims Act
2. Whistleblower
3. Stark Law
4. Social Security

Answer 21

2. Whistleblower

Question 22

A new physician has joined the practice, and an application for a Medicare provider number has been submitted to Medicare for this provider. In the interim, how should the Medicare billing be handled for this new provider?

1. Bill the services under the group provider number only.
2. Bill the patient for the services.
3. Bill the services under another provider’s number in the practice.
4. Hold charges until a Medicare provider number has been assigned.

Answer 22

4. Hold charges until a Medicare provider number has been assigned.

Question 23

Additional authoritative ICD-10 coding information can be found in what publication(s)?

1. APC Briefing
2. AHA Coding Clinic
3. Medicare website
4. CPT Assistant

Answer 23

2. AHA Coding Clinic

Question 24

An individual episode of disturbed brain function is referred to as _______

1. A seizure
2. ischemia
3. a stroke or CVA
4. Alzheimer’s disease

Answer 24

1. A seizure

Question 25

Carcino refers to _______ 1. tumor 2. mass 3. cancer 4. disease

Answer 25

3. cancer

Question 26

NCD/LCD refers to: 1. edits that indicate whether a diagnosis is considered medically necessary. 2. edits that indicate whether a service is covered by the Medicare program 3. edits that indicate frequency procedures can be performed 4. all of the selections

Answer 26

4. all of the selections

Question 27

When a coder suspects fraud/abuse, what is the first action that should be taken? 1. report to supervisor 2. tell your spouse 3. call your attorney. 4. resign

Answer 27

1. report to supervisor

Question 28

A provider has set a standing office policy that states EKGs should be ordered and performed on all patients over the age of 35 regardless of their medical condition or complaint. What would be the common denial for this scenario? 1. lack of a referring physician 2. lack of medical necessity 3. lack of an appropriate NPI number 4. inappropriate place of service

Answer 28

2. lack of medical necessity

Question 29

The three layers that comprise the skin are referred to as _______ 1. the dermis, epidermis, and fascia. 2. the first layer, second layer, and third layer. 3. the dermis, epidermis, and subcutaneous. 4. split thickness and full thickness.

Answer 29

3. the dermis, epidermis, and subcutaneous.

Question 30

What is one factor of the federal guidelines for compliance programs? 1. Always be trustworthy. 2. Do not divulge any information to federal entities. 3. The organization has communicated standards and procedures to employees and agents. 4. Make sure the practice engages the use of an attorney.

Answer 30

3. The organization has communicated standards and procedures to employees and agents.

Question 31

The nose, nasal cavity, pharynx and larynx constitute the _____ 1. upper respiratory tract. 2. respiratory system. 3. lungs. 4. lower respiratory tract.

Answer 31

1. upper respiratory tract.

Question 32

During the physician's absence in the office, a patient is seen by the nurse, vital signs are taken, a urinalysis is performed, and the nurse calls in a prescription for medication for a UTI under the physician's name, who is usually in the office. What services, if any, are appropriate for this encounter? 1. Office Visit 99211 and Urinalysis are codable/billable. 2. No service may be coded/billed 3. Office visit 99211 would be appropriate with countersignature of physician that indicates concurrence with the services rendered by the nurse. 4. Office visit 99211 would be appropriate.

Answer 32

2. No service may be coded/billed

Question 33

What is one of the primary advantages of implementing a compliance program? 1. Make more money 2. Male more work 3. Satisfy corporate entities 4. identification of potential problems before identified by third-party carries

Answer 33

4. identification of potential problems before identified by third-party carries

Question 34

LUL is an acceptable acronym/abbreviation for what region/anatomical area? 1. left lower quadrant of the abdomen 2. left upper lobe of the lung 3. left lower leg 4. left lower lung

Answer 34

2. left upper lobe of the lung

Question 35

In a teaching setting, what documentation must be present for resident services to be coded/billed for an initial hospital admission by the teaching physician? 1. documentation by the resident of history, exam, and MDM components as well as countersignature by the attending/teaching physician 2. documentation by the resident of history, exam, and MDM components as well as notation "agree and concur" with resident evaluation by attending/teaching physician 3. personal notation entered by teaching/attending physician documenting their participation and presence during the encounter 4. documentation by resident of the history, exam, and MDM components

Answer 35

3. personal notation entered by teaching/attending physician documenting their participation and presence during the encounter

Question 36

Which federal agency publishes the Annual Work Plan? 1. Social Security 2. Medicaid Program 3. Health Care Administration 4. Office of the Inspector General

Answer 36

4. Office of the Inspector General

Question 37

Presenting a claim on behalf of a person excluded from the Medicare program is an example of what? 1. Underbilling 2. Fraud 3. Overbilling 4. Abuse

Answer 37

2. Fraud

Question 38

The function of which organ is to absorb water, produce certain vitamins, and form and expel feces? 1. small intestine 2. duodenum 3. large intestine 4. stomach

Answer 38

3. large intestine

Question 39

What program was created through the Medicare Modernization Act of 2003 (MMA) to identify and recover improper Medicare payments paid to health care providers under fee-for-service (FFS) Medicare plans? 1. Medicare Integrity Program 2. Medicare False Claim Program 3. Medicare Anti-Trust Act 4. Recovery Audit Contractors (RAC)

Answer 39

4. Recovery Audit Contractors (RAC)

Question 40

The process of urination is also known as ______ 1. Dysuria 2. Incontinence 3. Micturition 4. Polyuria

Answer 40

3. Micturition

Question 41

Filing claims for services deemed not medically necessary is an example of _____ 1. overbilling 2. underbilling 3. abuse 4. fraud

Answer 41

3. abuse

Question 42

Which of the following blood types is considered the universal donor? 1. Blood Type O 2. Blood Type AB 3. Blood Type A 4. Blood Type B

Answer 42

1. Blood Type O

Question 43

L1 refers to which anatomical part? 1. first cervical vertebra 2. any lumbar vertebra 3. first lumbar vertebra 4. first thoracic vertebra

Answer 43

3. first lumbar vertebra

Question 44

The surgical creation of an opening is called _______ 1. ostomy 2. otomy 3. ectomy 4. plasty

Answer 44

1. ostomy

Question 45

Modifier -59 should be appended in what circumstances? 1. for all subsequent surgical procedures 2. when secondary surgical procedures are separate and distinct 3. for all secondary procedures in order for them to be considered for payment 4. when secondary procedures are designated as "separate procedure" in CPT

Answer 45

2. when secondary surgical procedures are separate and distinct

Question 46

The inflammation of diverticula in the intestines is known as _________ 1. diverticulosis 2. appendicitis 3. colitis 4. diverticulitis

Answer 46

4. diverticulitis

Question 47

ORIF stands for ________ 1. only reduction without fixation 2. open reduction with fixation 3. open reduction with internal fixation 4. none of those listed

Answer 47

3. open reduction with internal fixation

Question 48

Productivity for coding staff should be based on ______ 1. AHIMA standards only. 2. MGMA standards only. 3. AAPC standards only. 4. industry standards as well as the unique work for the practice.

Answer 48

4. industry standards as well as the unique work for the practice.

Question 49

A provider submits the following E/M services to the third-party carrier: Level 1 99211 10%, Level 2 99212 20%, Level 3 99213 40%, Level 4 99214 20%, Level 5 99215 10%. What is the common terminology when the carrier reviews levels of service to determine the appropriateness of the distribution levels? 1. bell curve 2. dome effect 3. linear distribution 4. level effect

Answer 49

1. bell curve

Question 50

Modifier -RT should be assigned to denote ______ 1. right anatomical site 2. right index finger 3. right thumb 4. right toe

Answer 50

1. right anatomical site