Module 9 Flashcards
A 66-year-old patient was treated in the urgent care center for a fractured wrist. The patient said, “I was moving a cabinet for my boss when it fell over and hit my wrist.” The office billed Medicare and received reimbursement of $550. Which of the following would apply in this situation?
A. The office must give the $550 check to the patient, who should contact workers’ compensation.
The $550 payment must be returned to Medicare.
B. The office was appropriately reimbursed $550 by Medicare for the urgent care visit.
Medicare is not responsible for payment of work-related injuries requiring medical services.
C. The office should bill the employer’s workers’ compensation for only the Medicare coinsurance and deductible due after receiving payment from Medicare.
Full services should be billed to worker’s compensation for work-related injuries. The Medicare check will need to be returned.
D. The office is guilty of both fraud and abuse according to HIPAA because of accepting the $550 payment.
An office is guilty of fraud only when the act is an intentional deception or misrepresentation.
E. The office should have billed the employer’s workers’ compensation payer for the visit.
A claim should always be submitted to workers’ compensation when the injury is work related, regardless of any other insurance coverage. Medicare will need to be notified and the payment returned.
E. The office should have billed the employer’s workers’ compensation payer for the visit.
A claim should always be submitted to workers’ compensation when the injury is work related, regardless of any other insurance coverage. Medicare will need to be notified and the payment returned.
Exophthalmos is a sign of which of the following conditions?
A. Endometriosis
This is a disease of the female reproductive system and the primary symptom is dysmenorrhea.
B. Pancreatitis
Pancreatitis is a disease of the digestive system and may cause abdominal pain, nausea, vomiting and weight loss.
C. Hyperthyroidism
Outward protruding eyeballs, proptosis, caused by an increase in the volume of tissue behind the eyes is a common sign of an overactive thyroid gland.
D. Cholelithiasis
Cholelithiasis is calculi or gallstones found in the gallbladder or common duct which may cause abdominal pain.
E. Emphysema
This is a disease of the lungs and causes dyspnea.
C. Hyperthyroidism
Outward protruding eyeballs, proptosis, caused by an increase in the volume of tissue behind the eyes is a common sign of an overactive thyroid gland.
Which of the following is most likely to be included in the subjective portion of a SOAP chart note?
A. Pulse 60 bpm
This is verifiable by clinical findings and is objective.
B. Diazepam (Valium) 5 mg
This is verifiable objective information.
C. Normal sinus rhythm
This is verifiable by clinical examination and is objective information.
D. Retinal detachment
This is verifiable by clinical findings and is objective.
E. Dizziness for three days
This is reported by the patient and is subjective.
E. Dizziness for three days
This is reported by the patient and is subjective.
Which of the following routes of drug administration will permit the most rapid pharmacologic effect?
A. Intravenous
Intravenous medication provides a rapid method for administering medications and avoids absorption barriers, such as the GI tract and body tissue.
B. Subcutaneous
Absorption of medications from the subcutaneous tissue would take time.
C. Buccal
Although buccal administration of medications can have rapid onset, it takes time for absorption through the buccal mucosa.
D. Sublingual
Although sublingual administration of medications can have rapid onset, it takes time for absorption through the oral mucosa.
E. Intramuscular
Absorption of intramuscular medications from the muscles takes time.
A. Intravenous
Intravenous medication provides a rapid method for administering medications and avoids absorption barriers, such as the GI tract and body tissue.
Which of the following surgical procedures is performed as a method to prevent conception?
A. Conization
This is a surgical procedure of the cervix to remove abnormal cells.
B. Hysteroscopy
This is inspection of the inside of the uterus by using an endoscope.
C. Episiotomy
This is an incision of the perineum that can be performed during childbirth.
D. Tubal ligation
This is considered a permanent form of contraception.
E. Dilatation and curettage
This is a surgical procedure that expands the cervical canal so that the surface of the lining of the uterine wall can be scraped.
D. Tubal ligation
This is considered a permanent form of contraception.
Which of the following describes a billing system where statements are mailed at a certain time during the month based on alphabetic breakdown of accounts receivable?
A. Collection ratio
This is a measurement of fees collected relative to the total fees charged in a given period.
B. Reconciliation
This is a procedure that ensures the bank’s record of deposits, payments, and withdrawals matches the medical practice record.
C. Superbill
This is the encounter form that includes charges and procedure codes for services rendered.
D. Age analysis
This is the process of reviewing accounts by age from the first date of billing.
E. Cycle
This bills each patient once per month, but spreads the work of billing over the month.
E. Cycle
This bills each patient once per month, but spreads the work of billing over the month.
Which of the following is a laboratory test commonly performed on a specimen from a patient taking furosemide (Lasix)?
A. White blood count
This test is used in the diagnosis and prognosis of disease and would not be affected by furosemide.
B. C-Reactive protein
This test is an inflammatory marker.
C. Potassium level
Furosemide is a diuretic. Diuretics can affect the potassium. This is a common laboratory study for a patient taking furosemide (Lasix).
D. Hemoglobin analysis
This test is used to screen for anemia and would not be affected by furosemide.
E. Thyroid-stimulating hormone assay
This test is a measure of the pituitary hormone controlling thyroid function and would not be affected by furosemide.
C. Potassium level
Furosemide is a diuretic. Diuretics can affect the potassium. This is a common laboratory study for a patient taking furosemide (Lasix).
Which of the following best describes a function of the epiglottis?
A. Opens the aperture of the larynx during the act of swallowing
The epiglottis closes to prevent food from entering the larynx.
B. Prevents food from entering the larynx during the act of swallowing
This is the function of epiglottis.
C. Promotes salivary excretion from salivary glands
There is no relationship between the epiglottis and salivary excretion.
D. Enhances digestion of solid foods
This is the function of the enzymes secreted in the stomach.
E. Prevents regurgitated foods and liquids from entering the pharynx
Regurgitated food enters back into the pharynx from the stomach through the esophagus.
B. Prevents food from entering the larynx during the act of swallowing
This is the function of epiglottis.
Checks received on account should be stamped for endorsement at which of the following times?
A. At the time they are entered in the deposit book
Deposits may not be made the same day the payment was received. This would not guard against lost or stolen checks.
B. After they are posted to the account
The check may not be posted to the account immediately and could be lost or stolen.
C. At the end of each day
This could allow checks to be misplaced before being endorsed.
D. When they are submitted to the bank
Checks could be lost or stolen before getting to the bank.
E. Immediately
This guards against lost or stolen checks being fraudulently cashed.
E. Immediately
This guards against lost or stolen checks being fraudulently cashed.
The criteria of establishing “duty owed, dereliction of duty, direct cause, and damages” are used in reference to which of the following situations?
A. Keeping a patient on life support systems
This refers to maintaining respirations and heartbeat by mechanical means based on a medical decision and is not related to negligence.
B. Revoking a medical license
This is the process of the licensing board taking away privileges to practice medicine.
C. Proving negligence
Plaintiffs must prove in a court of law that the “4 Ds” of negligence exist in a malpractice claim.
D. Providing emergency treatment to a comatose patient
This a medical decision related to patient care.
E. Terminating a physician-patient contractual relationship
This refers to the decision to stop medical care and can be initiated by either the physician or patient.
C. Proving negligence
Plaintiffs must prove in a court of law that the “4 Ds” of negligence exist in a malpractice claim.
When recording an electrocardiogram, the international standardization for amplitude is 1 millivolt (mv) and is equal to how many millimeters (mm)?
A. 10
The international standard is 1 mv = 10 mm.
B. 5
This would be set at half the international standard.
C. 20
This would be set at 2X the international standard.
D. 15
This would be greater than the international standard.
E. 25
This would be greater than the international standard.
A. 10
The international standard is 1 mv = 10 mm.
Which of the following blood tests is performed to monitor a patient’s response to Coumadin therapy and to aid in adjusting Coumadin dosage?
A. Fasting blood glucose
A fasting blood glucose is done to assist in the diagnosis and monitoring of diabetes mellitus and is not related to the amount of Coumadin in the blood.
B. Complete blood count (CBC)
A complete blood count generally includes a hemoglobin and hematocrit, red blood cell count for anemia determination, a white blood cell count for infection/inflammation monitoring, and a blood differential of the percentages of white blood cells. It does not measure clotting activity of the blood.
C. International Normalized Ratio (INR)
The INR is performed to help ensure that patients taking Coumadin are at the therapeutic level, which is typically between 2-3. If the INR is too low, the patient is at risk of a blood clot and if it is too high, the patient is at risk for excessive bleeding.
D. Hemoglobin A1c
The A1c test is performed to monitor the long-term glucose levels of the blood. A1c levels help diabetics monitor glucose control levels at typically 3 month intervals.
E. C-reactive protein
C-reactive protein is a test that measures the inflammatory response of the body, but it is not related to clotting factors in the blood.
C. International Normalized Ratio (INR)
The INR is performed to help ensure that patients taking Coumadin are at the therapeutic level, which is typically between 2-3. If the INR is too low, the patient is at risk of a blood clot and if it is too high, the patient is at risk for excessive bleeding.
According to Current Procedural Terminology (CPT) coding rules, a new patient is one who has not received professional services from the physician or a qualified health care professional in the practice of the exact same specialty and subspecialty for a MINIMUM of how many years?
A. 1 year
A patient seen within the past year is established.
B. 2 years
A patient seen within the past 2 years is an established patient.
C. 3 years
If it has been at least 3 years since the patient was seen, then the patient is considered new to the practice for coding purposes.
D. 4 years
At a minimum of 3 years the patient is considered new to the practice.
E. 5 years
At a minimum of 3 years the patient is considered new to the practice.
C. 3 years
If it has been at least 3 years since the patient was seen, then the patient is considered new to the practice for coding purposes.
Which of the following can only be detected in urine by microscopic examination?
A. Protein
Measurable amounts of protein are not normally found in urine. The presence of protein may indicate kidney damage. Protein may be detected by a chemical reaction on a urine test strip.
B. Ketones
This is a by-product of fat metabolism which may be elevated in uncontrolled diabetes mellitus or extreme dieting. Ketones may be detected by a chemical reaction on a urine test strip.
C. Bilirubin
This is a by-product of hemoglobin breakdown, which may be elevated in liver disease and may be detected by a chemical reaction on a urine test strip.
D. Casts
Casts can only be detected by microscopic examination. Casts most often correlate with a finding of protein in the urine, but their presence cannot be detected by a chemical reaction on a urine test strip.
E. Glucose
This is a monosaccharide elevated in hyperglycemia and may be detected by a chemical reaction on a urine test strip.
D. Casts
Casts can only be detected by microscopic examination. Casts most often correlate with a finding of protein in the urine, but their presence cannot be detected by a chemical reaction on a urine test strip.
Which of the following describes the method that completely destroys microorganisms?
A. Disinfection
This is a process that generally destroys pathogenic organisms.
B. Boiling
This is the process of heating a liquid to the vaporizing stage. It does not destroy all organisms.
C. Sanitization
This is a process to remove organic material from an article and thus reduces the number of microorganisms.
D. Fumigation
This is a process of exposure to fumes. It does not sterilize.
E. Sterilization
Sterilization destroys all microorganisms and spores.
E. Sterilization
Sterilization destroys all microorganisms and spores.
