4. Which one of the following statements accurately represents the practice known as unbundling?
A. Combination codes are assigned separately in ICD-10-CM. B. Codes that should be grouped into one code are broken into separate codes to maximize physician reimbursement. C. ICD-10-PCS codes are broken into separate codes for congruent assignment. D. Codes listed as separate procedures are assigned individually.
5. Placing a catheter into the aorta or directly into an artery or vein is called
A. brachiocephalic manipulation. B. third order placement. C. selective catheter placement. D. nonselective catheter placement.
6. What ICD-10-CM code would be assigned for a patient with acute tubule-interstitial nephritis?
A. L50.0 B. Z02.6 C. N10 D. B96.2
7. The suffix -sis means
A. inflammation. B. drooping. C. condition. D. process.
8. The concept of meaningful use pertains to
A. medical office protocol and document organization. B. electronic health record implementation. C. resource management in the inpatient setting. D. categorization of patient information.
9. In what CPT code range is Surgical Pathology found?
A. 88400–80499 B. 88000–80299 C. 88300–88309 D. 88515–88598
10. According to the CMS National Physician Fee Schedule, what is the conversion factor for basic life support mileage?
A. $32.4726 B. $34.5741 C. $28.8457 D. $36.0666
11. A patient who was involved in a motor vehicle accident is taken to the hospital by ambulance and admitted to the hospital in critical care. The physician sees the patient for 74 minutes in critical care. The physician leaves to attend to other patients in the ICU and the NICU of the same hospital. Five hours later, the physician returns to the patient and continues to treat the patient in critical care for an additional 30 minutes. The patient spends a total of 104 minutes in critical care. What codes are assigned?
A. 99291, 99292 B. 99292, 99293 C. 99291, 99291 D. 99292, 99292, 99293
12. The prefix endo- means
A. beneath. B. outside of. C. adjacent to. D. within.
13. What is the CPT code for a three-view x-ray of the mandible?
A. 70200 B. 70100 C. 70150 D. 70240
14. Rules of evidence control the
A. amount of evidence that may be admitted during a civil trial. B. processes and procedures for question and answer sessions. C. documents that can be considered during jury trial. D. length of criminal court proceedings, but not civil court proceedings.
15. The ampulla, isthmus, interstitium, and fimbria are examples of
A. implantation sites of ectopic pregnancy. B. incision sites for pacemaker insertion. C. membranes in the abdomen. D. bones in the ankle.
16. Code J9165 is assigned for intravenous diethylstilbestrol diphosphate. According to the code description, what dosage was administered?
A. 20 mg B. 50 mg C. Up to 0.5 mg D. 250 mg
17. Members of the uniformed services, their families and survivors, and retired members and their families qualify for
A. TRICARE. B. OIG Recovery. C. Medicare. D. Medicaid.
18. A patient comes to the emergency room complaining of abdominal pain. She was previously diagnosed with type I diabetes. She also complains of watery eyes, congestion, pressure in the sinuses, and difficulty breathing. Her final diagnoses are right lower quadrant abdominal pain, type I diabetes, acute sinusitis, and asthma. What CPT and ICD-10-CM codes are assigned?
A. 99222, R18.91, E16.9, J01.91, J45.919 B. 99221, R17.41, E17.9, J01.90, J45.909 C. 99221, R10.31, E10.9, J01.90, J45.909 D. 99223, R14.31, E15.9, J01.90, J45.929
19. Under HIPAA, health care facilities must
A. follow up with patients who repeatedly miss scheduled appointments for mandatory services. B. keep records of patients who refill prescriptions more than once within a three-month timeframe. C. maintain a clean, safe working environment. D. choose a privacy officer in accordance with HIPAA policies and procedures.
20. What is the ICD-10-CM code for unspecified acute pericarditis?
A. I30.89 B. I30.9 C. I30 D. I30.79
21. What is the full code description for 25515?
A. Open treatment of radial shaft fracture, includes internal fixation, when performed B. Closed treatment of ulnar shaft fracture; without manipulation C. Closed treatment of radial shaft fracture; without manipulation D. Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex
22. Which of the following anatomical locations would contain the diaphysis?
A. Metatarsal B. Diaphragm C. Septum D. Tibia
23. A patient recently became eligible for health insurance through her employer. Her health insurance is considered to be an 80-20 policy. Under the terms of an 80-20 policy, the insurer pays 80 percent and the insured pays 20 percent of expenses. This 80-20 policy is an example of
A. coinsurance. B. prospective payment. C. capitation. D. case management.
24. The Outpatient Prospective Payment System (OPPS) pays
A. an established rate for outpatient services in specific hospitals. B. a percentage of the national average for the same surgery performed in a different geographic location. C. 65% of the schedule C rate for all surgeries. D. subsidies to contain health care costs in rural facilities.
25. The study of disease is called
A. physiology. B. pathology. C. urology. D. neurology.
26. Superficial injuries such as abrasions or contusions are
A. not coded when associated with more severe injuries of the same site. B. queried to determine if the injuries are confined to the same site. C. coded when associated with more severe injuries of the same site. D. coded only when debridement is performed.
27. Another name for XXY syndrome is
A. Turner’s syndrome. B. Cooley’s anemia. C. Klinefelter syndrome. D. Huntington’s chorea.
28. The method that physicians use to bill for each service or visit individually rather than on a pre-paid basis is called
A. fee-for-service. B. capitation. C. pre-paid care. D. managed care.
29. A physician has a meeting with a pharmaceutical sales representative. During the course of the conversation, the physician reveals the diagnosis and past family, medical, and social history of a patient currently being treated with one of the medications that the sales representative is selling. In this situation, the doctor could be sued for
A. invasion of privacy. B. malfeasance. C. undue harm and fraud. D. malice.
30. A patient is prescribed a medication that narrows the blood vessels and raises her blood pressure. The medication is most likely a
A. tranquilizer. B. cardiogenic. C. vasoconstrictor. D. cardiotonic
31. Physicians typically refer to anatomical locations using directional terms, which are often
A. paired in opposites. B. used primarily by chiropractors. C. used to describe surgical incisions. D. referenced horizontally.
32. The study of tissue disease using macroscopic or microscopic analysis is called
A. immunology. B. histopathology. C. cytopathology. D. microbiology.
33. A physician obtains cells from the bone marrow cavity using a needle and a syringe. How would this procedure be coded?
A. 36575 B. 37328 C. 38220 D. 35092
34. What is Medicare Part D?
A. The component of Medicare Part A that covers outpatient surgeries B. Add-on coverage for prescription drugs provided through insurance companies approved by Medicare C. Supplemental coverage for war veterans and their dependents D. Add-on coverage for dental procedures
35. A female patient is seen for her annual gynecological examination. During the examination, the physician performs a test to detect cervical cancer. This test is called a/an
A. immunoassay test. B. Pap smear. C. carcinoembryonic antigen test. D. mycobacterial culture.
36. A physician is called to the intensive care unit for a patient with second-degree burns sustained on 55% of his body while cooking in the kitchen where he works. The physician sees the patient in the critical care unit for two hours, leaves the unit, and returns later the same day to provide an additional hour of critical care. What ICD-10-CM and CPT codes would be assigned?
A. L91.8, 99291 × 2, 99292 × 4 B. R53.81, 99291, 99293 × 5 C. Z30.09, 99293, 99294 × 2 D. T31.50, 99291, 99292 × 4
37. A change in the tissues and cells within a specific area on or in the body is called a
A. lesion. B. cyst. C. neoplasm. D. tumor.
38. Information about a patient can becan be released for research under the terms of HIPAA, only if
A. the patient signs an authorization immediately upon admission. B. the research is critical for technological development. C. the patient has authorized the release and only a limited amount of information is released. D. researchers obtain authorization from the admitting physician.
39. A patient is diagnosed with breast cancer and undergoes a partial mastectomy. What CPT code would be assigned?
A. 19305 B. 19307 C. 19304 D. 19301
40. To conform to the HIPAA Privacy Rule, which of the following safeguards must be maintained in health care facilities?
A. Immunization and injection safeguards B. Reasonable administrative, technical, and physical safeguards C. ICD-7 provisional safeguards D. Hazardous waste protection safeguards
41. A patient sustains a fracture of the femur while playing football in a nearby park. What ICD-10-CM code would be assigned?
A. S72.001A B. S72.009A C. S72.003A D. S49.006A
42. According to the guidelines for medical records outlined in the Health Insurance Portability and Accountability Act (HIPAA), patients
A. have the right to have errors reviewed by a hospital administrator. B. have the right to correct errors in identification data only. C. have the right to have errors in their medical records corrected. D. do not have the right to have errors corrected, as the data has been previously verified by the physician.
43. Modifier -23 indicates that
A. two surgeons performed a procedure. B. a procedure was performed bilaterally. C. a physician reviewed and interpreted a radiology procedure. D. the patient received general anesthesia for a procedure that would ordinarily be performed with local or no anesthesia.
44. The Health Insurance Portability and Accountability Act (HIPAA) was created for the purpose of
A. streamlining claims processing and reducing paperwork through electronic transmission. B. stabilizing administrative costs and productivity. C. decreasing employee turnover and reducing the volume of new hire paperwork. D. modifying legal and ethical issues surrounding medical records retention.
45. A patient is seen in the emergency room complaining of abdominal pain in the left lower quadrant. It’s determined that the patient is experiencing inflammation of the pancreas, which is also called
A. pancreaticoduodonal arcade. B. pancreatitis. C. pancreatolysis. D. pancreatonia.
46. A 55-year-old patient was injured while working as a carpenter on a construction site. While framing the roof of a two-story house, he fell and hit his head. He was diagnosed with a concussion to the left side of his head, and underwent a right frontal parietal craniotomy with removal of a subdural hematoma. During the patient’s period of recovery, he was given a medication that resulted in a rash on his abdomen. The physician conducted an expanded problem focused history and exam, with straightforward medical decision making. What CPT code(s) should be assigned?
A. 99251 B. 99252 C. 99292, 99291 D. 99253
47. Taking certain steps to protect PHI from being accidentally released to individuals who don’t need to know the information is called the
A. minimum necessary standard. B. privacy management statute. C. health information guardianship guideline. D. information provision standard.
48. The main term represents the most basic aspect of a disease or condition. For example, the main term of a diagnosis involving a broken arm is
A. broken. B. break. C. fracture. D. arm.
49. Performing a daily check for viruses and malware is one of the
A. requirements of the Help Desk. B. routine aspects of software maintenance. C. sensible guidelines for Internet use in health care facilities. D. functions of HIM encoders.
50. A coder overhears a confidential statement made outside of the court, and then, when called to testify, repeats the statement as being truth. This is an example of
A. cross-examination. B. hearsay. C. speculation. D. a direct quote.
51. A patient receives two venous pressure clamps for hemodialysis. What HCPCS Level II code is assigned?
A. A4751 B. A4751 × 2 C. A4918 × 2 D. A4918
52. The process of removing tissue for histopathology is called
A. shaving. B. debridement. C. excision. D. biopsy.
53. A coder would assign modifier -53 to report
A. dental procedures. B. repeat procedures. C. anesthesia administration. D. procedures cancelled due to the patient’s condition.
54. Alternative dispute resolution (ADR) allows
A. resolving medical malpractice suits by submitting pretrial depositions. B. lawyer-to-lawyer mediation during trial recess. C. mediating disputes with a judge in the presence of the bailiff. D. litigants to resolve disputes prior to or after the start of litigation.
55. Code range 99231–99233 pertains to
A. initial hospital care. B. subsequent hospital care. C. consultation services. D. hospital discharge services.
56. A patient comes to the emergency room complaining of abdominal pain, nausea, and intractable vomiting. Unable to pinpoint the source of the patient’s complaints, the physician decides to admit the patient to the hospital. After conducting a complete history and examination, the patient’s final diagnosis is determined to be chronic duodenal ulcer. The patient remains hospitalized for three days. The physician sees the patient on the day of discharge. What ICD-10 and CPT codes are assigned?
A. 99234, N17.9 B. 99223, I48.91 C. 99238, K26.7 D. 99291, D63.1
57. The specific guidelines that constitute a valid release of information under the HIPAA Privacy Rule are described as
A. OIG specifications. B. E/M levels. C. considerations in relation to risk management. D. core elements.
58. The suffix –centesis means
A. abnormal condition. B. calculus or stone. C. a surgical puncture for fluid removal. D. separation, breakdown, destruction.
59. The code for an ESWL would be found in the
A. Urinary and Male Genital Systems of CPT. B. Chemotherapy section of HCPCS. C. Digestive System of CPT. D. Cardiovascular System of CPT.
60. A female patient is diagnosed with breast cancer of the lower-inner quadrant of the right breast. The patient undergoes a modified radical mastectomy of the right breast in an attempt to circumvent the spread of the cancer to any secondary anatomical sites. The procedure was performed in three stages. In addition to the radical mastectomy, the physician also performed a right breast biopsy to treat the breast tumor in the lower-inner quadrant. What ICD-10-CM and CPT codes are assigned?
A. 19307-58-RT, 19101-59-RT, C50.311 B. 15852-58, Z48.01 C. 11602, 15240, C50.312 D. 19307-RT, 19101-RT, C50.211
61. A patient comes to the ambulatory surgery center for a fusion of the cervical spine. Prior to the beginning of the surgery, the patient suffers an allergic reaction to the anesthesia shortly after it’s administered. Because of this reaction, the surgery is not performed. What code would be assigned as the first-listed diagnosis?
A. The observation code B. The reason that the surgery was scheduled to be performed C. The allergy code D. The anesthesia administration
62. Anti-inflammatory drugs applied to the skin to relieve skin disorders are called
A. topical corticosteroids. B. antiseptics. C. keratolytics. D. astringents.
63. The _______ nerve sends visual data to the occipital lobe of the brain.
A. abducens B. trochlear C. optic D. oculomotor
64. The root word OBSTETR/O means
A. pregnancy. B. cesarean. C. midwife. D. birth.
65. The root word ENTER/O means
A. tooth. B. stomach. C. intestine. D. secretion.
66. What code would be assigned for gastropathy?
A. K29.7 B. K41.31 C. K31.9 D. K41.2
67. A patient comes to the physician’s office complaining of neck irritation. The physician examines her neck and notes that she has a 15 cm neck scar. Upon further examination, the physician notes that the neck scar requires extensive debridement and retention sutures. The physician performs a dermabrasion to treat the neck scar and then closes the complex wound with the sutures. What ICD-10 and CPT codes are assigned?
A. 13132, 13133 × 2, L90.5 B. 13132, 13133 × 3, H81.09, L92.9 C. 13133-51, 13131-79, L60.0 D. 13132, L76.82
68. The bulbourethral gland is found in the _______ system.
A. neurological B. cardiovascular C. male genital D. female genital
69. A tethered health record allows patients to
A. restructure insurance copayments. B. use a secure portal to access their own records. C. compare their health records to the records of patients with similar diagnoses. D. amend the diagnoses listed in the health record.
70. A patient is diagnosed with lymphocytic lymphoma. Another patient is seen several weeks later and is diagnosed with histiocytic lymphoma. Both of these diagnoses are examples of _______ lymphoma.
A. basic B. Hodgkin’s C. non-Hodgkin’s D. Burkitt’s
71. A patient receives a blood glucose monitor. What HCPCS Level II code would be assigned?
A. E0976 B. E0607 C. E0562 D. E4752
72. A good compliance program in the health care setting includes
A. HHS surveillance. B. regular tracking and monitoring of coding activities. C. meetings with compliance officers. D. regular audit consultations with trustees of the AAPC.
73. A patient with numerous symptoms is seen in the laboratory for a general health panel to gauge her overall physical well-being. What CPT code would be assigned for a general health panel?
A. 80051 B. 82136 C. 84135 D. 80050
74. Code 71030-TC indicates a/an
A. complete chest x-ray, four views, technical component only. B. incomplete chest x-ray, two views, technical and professional component. C. complete chest x-ray, two views, technical component only. D. incomplete chest x-ray, three views, technical and professional component
75. If patients choose to obtain copies of their medical records, under the terms of HIPAA, providers can
A. also fulfill requests for prescription data. B. reschedule office visits to allow time to update medical records. C. complete employee paperwork. D. charge a reasonable fee for providing copies of those records.
76. A patient comes to the clinic complaining of fever, diarrhea, nausea, and vomiting. The patient is diagnosed with salmonella meningitis. What ICD-10-CM code would be assigned?
A. A23.24 B. A02.21 C. A05.26 D. A07.21
77. A patient comes to the emergency room complaining of right knee pain. He states that he was playing baseball the previous evening and accidentally fell when sliding into first base. The physician obtains an expanded problem focused history and examination, as well as a two-view x-ray of the right knee. The physician reviews the x-ray, as well as the notes in the medical record, and renders a diagnosis of osteoarthritis of the knee. The physician performs a patellofemoral arthroplasty to repair the knee. What ICD-10-CM and CPT codes are assigned?
A. 27477, M17.12 B. 27506-RT, N17.11 C. 27477-RT, D17.39 D. 27447-RT, M17.11
78. Provision of security against a hurt, loss, or damage with specific cash payments is called
A. copayment. B. protection. C. indemnity. D. secured loss.
79. HCPCS modifier –E2 indicates that the patient had a surgical procedure performed on the
A. lower left eyelid. B. upper left eyelid. C. upper right eyelid. D. lower right eyelid.
80. When is code 58120 assigned?
A. The code is assigned for permanent pacemaker insertion. B. The code has been deleted and cannot be assigned. C. The code is assigned for a patient undergoing dilatation and curettage. D. The code is assigned as an add-on code.
81. Epithelial tissue that secretes its products directly into the bloodstream is made of
A. extracellular matrix. B. endocrine gland cells. C. endoplasmic reticulum. D. columnar epithelial cells.
82. Which of the following modifiers would be assigned for a moribund patient?
A. P4 B. P1 C. P5 D. P3
83. The anatomical location of the calyx is the
A. spine. B. brain. C. arm. D. kidney.
84. Which one of the following requirements is outlined in the guidelines established in HIPAA’s Privacy Rule?
A. Hospital administrators must encrypt data within older data files. B. Physicians must not disclose patient information to consulting physicians. C. Patients must receive notice if their information will be used or disclosed to third parties. D. Managers must secure medical records immediately following patient admission.
85. The I-10 helps coders classify patient
A. morbidity and mortality. B. management information. C. evaluation files. D. reimbursement data.
86. During a routine examination, a male patient is diagnosed with an elevated PSA. The physician performs a biopsy of the prostate with a rectal ultrasound to pinpoint the source of the problem. Which CPT and ICD-10-CM codes would be assigned?
A. 55725, 76000-26, R93.6 B. 55700, 76872-26, R97.2 C. 55734, 73200-26, R97.2 D. 55720, 74000-26, R97.3
87. Health care practitioners must maintain records of privacy policy practices and procedures for
A. 20 years. B. 10 months. C. 2 years. D. 6 years.
88. A patient comes to the emergency department of a rural hospital. He complaints of problems sleeping, foot swelling, and insomnia. After a detailed review of the patient’s history and a detailed examination, the patient is diagnosed with chronic renal insufficiency, nephrotic syndrome, and anemia, based on the values listed in his blood test. The patient undergoes a biopsy of the left and right kidneys under physician guidance. A CT scan is also used for guidance and needle placement. A follow-up CT scan with physician review and interpretation is also performed. What ICD-10 and CPT codes are assigned?
A. 50500-73, 51200-LT, C79.2, C61 B. 50200-RT-LT, 50310-RT, 51252-26, E46, N18.9, N04.9 C. 51000, 50310-59-LT, J90, Z90.12, E85.4 D. 50200-50, 50200-59-RT, 77012.26, N18.9, N04.9, D64.9
89. Data stored in a health care facility must
A. comply with HIPAA rules and must be maintained securely. B. adhere to OIG policies and procedures. C. be organized in accordance with state standards for electronic data interchange. D. conform to the physician’s expectations for data storage.
90. Health care practitioners who submit fraudulent bills to increase reimbursement may
A. be blacklisted according to geographic location. B. be listed in the Coding Directory of Fraudulent Billing published annually by the Department of Health and Human Services. C. be reported to the Office of the Attorney General. D. face financial penalties or, in some cases, imprisonment.
91. Which of the following anesthesia modifiers indicates a normal, healthy patient?
A. P3 B. P1 C. P4 D. P2
92. When coding burns, coders should
A. classify all burns as acute burns. B. assign separate codes for each burn site. C. assign the code for third-degree burns. D. assign the code for chronic burns.
93. A 65-year-old patient is admitted to the hospital for 48 hours to receive treatment from her physician. This patient would be covered under
A. Medicare Part D. B. Medicare Part A. C. Medicare Part B. D. Medicare Part C.
94. A patient comes to the clinic complaining of ongoing headaches. The headaches began one week prior and have persisted ever since. A lumbar spinal tap is performed to pinpoint the source of the patient’s headaches. What CPT and ICD-10-CM codes are assigned?
A. 62270, G44.1 B. 62270, G74.3 C. 62141, G46.8 D. 62272, G46.9
95. What code would be assigned for a tube pericardiostomy?
A. 33210 B. 33026 C. 33015 D. 33050
96. What is the code description for 65101-LT?
A. Removal of ocular implant performed laterally B. Fine needle aspiration of orbital contents on the left third of the orbit C. Biopsy of cornea performed on the lower third of the cornea D. Enucleation of eye, without implant, performed on the left side of the body
97. Another name for diazepam is
A. Flexeril. B. Valium. C. Norflex. D. Myolastan.
98. The gatekeeper concept refers to the operation of
A. prospective payment organizations. B. retrospective payment organizations. C. ambulatory payment surgery centers. D. health maintenance organizations.
99. The CPT code for thrombolysis is
A. 93000. B. 92975. C. 92920. D. 93797.
100. According to HIPAA, a patient’s information may be released for
A. paternity testing. B. research. C. determining premiums based on a patient’s past medical history. D. transferring electronic medical records to remote locations.
101. Which of the following statements is true of the Affordable Care Act?
A. It includes a provision for military service members who served in Afghanistan. B. It requires health care facilities to maintain health records for at least 10 years. C. It makes it mandatory for patients to carry health insurance. D. It offers parents supplementary coverage for dependents with chronic illness
102. A patient is seen in the physician’s office after the results of an earlier mammogram demonstrated microcalcification in the right breast as well as a breast lesion. The lesion is excised using needle localization. The patient’s final diagnosis is fibrosclerosis of the right breast. What CPT and ICD-10-CM codes are assigned?
A. 19120-RT, L10.11 B. 19125-RT, N60.31 C. 19126-LT, M25.1 D. 19123-RT, H16.11
103. A coder would assign a Q code as a temporary code for
A. holistic treatments for spinal procedures. B. durable medical equipment only. C. procedures or services only. D. procedures, services, and supplies
104. Which of the following forms is used to bill outpatient charges?
A. HCFA-1350 or CMS-650 B. HCFA-1400 or CMS-1540 C. AMA-14 or UCF-1250 D. CMS-1500 or UCF-1500.
105. During a routine examination, a patient indicates that she is taking an antihypertensive medication that causes her kidneys to excrete more urine. These antihypertensive medications are called
A. calcium-channel blockers. B. anticoagulants. C. beta blockers. D. diuretics.
106. A patient comes to the emergency room complaining of postnasal drip, frequent nosebleeds, headaches, and difficulty breathing. She is diagnosed with a deviated nasal septum, hypertrophy of the turbinate, and inflammation of the ethmoid sinuses. The physician performs an endoscopic ethmoidectomy of the left nasal sinus, septoplasty, and turbinate excision. What ICD-10-CM and CPT codes are assigned?
A. 31255, 30520, 30130, J34.2, J34.3, J32.2 B. 31255-LT, 30520-51, 30130-51, J34.2, J34.3, J32.2 C. 31230, 30520, J34.2, J34.3, J32.2 D. 31230-51, 30520-LT, J34.2
107. A physician is analyzing specific organs in a particular region of the patient’s body. In her notes, she refers to the transverse or cross-sectional plane, which divides the body
A. inferiorly. B. vertically. C. horizontally. D. bilaterally.
108. A patient comes to the emergency room after having dinner at a restaurant, where she began to experience chest tightness during the meal. She is seen for a cardiology consultation in the outpatient setting for a diagnosis of chest tightness. Which CPT and ICD-10-CM codes would be assigned?
A. 99245, R07.89 B. 99244, R07.59 C. 99242, R17.52 D. 99243, R25.96
109. Providers that receive reimbursement after health care services have been provided are being compensated under the _______ system.
A. prospective payment B. retrospective payment C. capitation D. UCR
110. The regulations in HIPAA apply to three groups of individual and corporate entities, each involved in electronic medical records transfer. These groups are collectively referred to as
A. health care administrators. B. covered entities. C. provisional health care data collectors. D. protected personnel.
111. The largest salivary glands are called the _______ glands.
A. amylase B. parotid C. sublingual D. submandibular
112. Which modifier indicates a staged or related procedure performed during the postoperative period?
A. -59 B. -57 C. -58 D. -54
113. The voluntary program that’s financed through a combination of payments from general federal revenues and premiums paid by beneficiaries who elect to participate is called
A. CHAMPVA. B. Medicare Part B. C. Medicaid. D. TRICARE.
114. What is the full code description for 33536?
A. Repair of postinfarction ventricular septal defect, with or without myocardial resection B. Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts C. Repair of double outlet right ventricle with intraventricular tunnel repair D. Closure of atrioventricular valve (mitral or tricuspid) by suture or patch
115. Categorically needy and medically needy patients may qualify for
A. Medicaid. B. CHAMPVA. C. Champus. D. Medicare Advantage
116. ICD-10-CM code S50.351A indicates that the patient has a superficial foreign body of the right elbow. The A indicates that
A. code S50.351A should be assigned to page 1 of the medical record, but not subsequent pages. B. this is the patient’s first encounter. C. this is the patient’s second encounter for the same original diagnosis. D. code S50.351A should be sequenced before secondary codes.
117. The foramen ovale is found in which anatomical location?
A. Fibula B. Heart C. Pancreas D. Liver
118. A new patient is seen in a clinic for complaints of shortness of breath, fever, difficulty swallowing, runny nose, and cough. The physician performs a detailed history, detailed examination, and medical decision making of low complexity. The physician also obtains a chest x-ray and lab workup. Based on the results of the diagnostic tests, the physician renders a diagnosis of upper respiratory tract infection and lymphadenopathy. What ICD-10 and CPT codes are assigned?
A. 99203, J06.9, R59.0 B. 99202, D63.1, J45.909 C. 99213, R06.82, F10.229 D. 99215, M19.011, R13.10
119. A patient has a disorder in which the bone marrow produces an overabundance of white blood cells. What is this disorder called?
A. Leukemia B. Hemophilia C. Coagulation D. Septicemia
120. A patient is diagnosed with acne. What ICD-10-CM code would be assigned?
A. L74.2 B. L72.3 C. L70.0 D. L73.1
121. A coder assigns a HCPCS Level II code to a patient’s medical record. The code description reads as follows: Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape. Based on this description, which HCPCS Level II code was assigned?
A. B4072 B. B4125 C. B4034 D. B4278
122. The Health Insurance Portability and Accountability Act (HIPAA) standards were developed to
A. ensure that coders could easily access each medical record. B. determine the structure of insurance carrier payments for health care practitioners. C. protect patient confidentiality when health information is transferred electronically. D. define XLTM standards for health records management.
123. Another name for third-party contractors who have access to medical information is
A. business associates. B. insurance administrators. C. healthcare vendors. D. covered entities.
124. Bones inside the nose are called
A. maxillae. B. turbinates. C. ethmoids. D. septal mucosa.
125. The atrioventricular (tricuspid) valve is located in the
A. fibula. B. lung. C. heart. D. brain.
126. Another term for disease evolution is
A. exacerbation. B. remission. C. pathogenesis. D. morphology.
127. The vitreous humor can be found in the
A. ear. B. tongue. C. nose. D. eye.
128. The codes for pacemakers and implantable defibrillators would be found in what section of CPT?
A. 33202–33273 B. 33200–33205 C. 33437–33537 D. 33533–33799
129. The HIPAA Privacy Rule indicates that
A. practitioners should disclose only the minimum amount of health information necessary for the purpose of the disclosure. B. physicians may release medical information at their own discretion. C. restrictions on information disclosure exist only for patients with life-threatening illnesses. D. the level of information disclosure permitted is based on the nature of the procedure.
130. The abbreviation INH indicates what route of drug administration?
A. Inhaled and intrathecal administration B. Inhaled and intravenous administration C. Intrathecal injection D. Inhalant solution
131. A patient comes to the clinic complaining of nausea, vomiting, fever, dizziness, and intermittent confusion. The physician conducts a detailed history and examination and reviews the patient’s lab results. The patient is diagnosed with pyelonephritis and is scheduled for an ultrasound to review the state of the kidneys and other organs. What CPT and ICD-10-CM codes are assigned?
A. 76775-TC, N15 B. 76775-26, N10 C. 73256-TC, M11 D. 71010-26, B12
132. What happens when HIPAA rules conflict with state law?
A. Conflicting state rules are overridden by federal law. B. The interpretation of HIPAA rules is left to the physician’s discretion. C. State laws overrule federal law. D. The Supreme Court’s decision becomes final in binding arbitration
133. Which of the following statements is true of the olfactory nerve?
A. It’s susceptible to erosion due to Peyronie’s disease. B. It’s located in the mitral valve and helps to circulate blood throughout the heart. C. It conveys the fluid from lymph glands to other areas of the body. D. It’s found in the nose and allows the senses to detect and distinguish odors.
134. The first step in EHR implementation is
A. structuring the timeline for EHR implementation. B. analyzing the content of the traditional medical record. C. conducting an assessment of the goals, needs, and financial stability of the health care practice. D. reviewing the list of established patients currently being seen in the practice.
135. The outcome of delivery code should be
A. omitted from the maternal record for stillborn delivery. B. assigned to the newborn record only. C. assigned to the maternal record when a delivery occurs. D. assigned to both the maternal and newborn records.
136. A patient is seen in the office for complaints of dizziness and insomnia. The physician records a chronological description of specific elements of the patient’s condition. This chronological description is called the
A. history of present illness. B. examination. C. review of systems. D. chief complaint.
137. What is the CPT code description for 64483?
A. Injection(s) anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level B. Injection, anesthetic agent, sphenopalatine ganglion C. Injection(s) anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, multiple levels D. Transforaminal epidural injection under ultrasound guidance
138. Releasing genetic information is forbidden under the terms of HIPAA because it may
A. allow immediate family members to have access to a patient’s medical records. B. require physicians to fulfill contractual obligations for treatments provided in ambulatory surgery centers. C. indicate susceptibility to a future illness, without the patient actually being diagnosed with the condition. D. not be successfully transmitted to all health care facilities.
139. Prescribing combination drugs that contain multiple medications to cut down on the number of pills
patients take on a daily basis
A. compounds the drugs’ effectiveness. B. increases the likelihood of compliance. C. decreases the frequency of drug interactions. D. supports good body function.
140. A patient who has paralysis of all four limbs is called
A. quadriplegic. B. paraplegic. C. tetraplegic. D. hemiplegic.
141. Which of the following is true about HIPAA national standards?
A. The national standards apply to any electronic data interchange. B. The national standards apply only to data exchange within a specified geographical region. C. The national standards do not apply to surgical procedures in the inpatient setting. D. The national standards do not apply to data exchanged within a claim clearinghouse.
142. A patient undergoes an appendectomy and later returns to the operating room for a related procedure the same day. Which modifier should be assigned to the CPT code?
A. -51 B. -AA C. -78 D. -76
143. The portion of health insurance that an insured pays before he or she is entitled to receive benefits from an insurance plan is called the
A. deductible. B. OPPS reimbursement. C. capitation. D. coinsurance.
144. A patient is seen in follow-up two weeks after undergoing cholecystectomy. During the follow-up examination, the physician notes that the abdominal wound has not yet healed. The patient undergoes a split-thickness autograft due to a nonhealing left lower abdominal wound that’s 10 square centimeters. Which CPT and ICD-10-CM codes would be assigned?
A. 15350, L52.64 B. 15250, L34.74 C. 15200, L85.64 D. 15100, L76.82
145. The Female Genital System subsection covers which CPT code range?
A. 56203–56303 B. 56607–56809 C. 56300–56499 D. 56405–58999
146. What ICD-10-CM code would be assigned for unilateral primary osteoarthritis of the right hip?
A. M16.12 B. M16.30 C. M16.11 D. M16.10
147. Which of the following anatomical locations would contain the superior vena cava?
A. Hip B. Nose C. Lungs D. Heart
148. A patient receives an injection of nandrolone decanoate. What HCPCS Level II code would be assigned?
A. J2323 B. J3530 C. J2320 D. J2300
149. The suffix –stasis means
A. breakdown. B. stopping and controlling. C. kinetic. D. flow.
150. A patient undergoes a sigmoidoscopy. The coder would assign CPT code
A. 45852. B. 45330. C. 45397. D. 45919.
4. Which one of the following statements accurately represents the practice known as unbundling?
A. Combination codes are assigned separately in ICD-10-CM. B. Codes that should be grouped into one code are broken into separate codes to maximize physician reimbursement. C. ICD-10-PCS codes are broken into separate codes for congruent assignment. D. Codes listed as separate procedures are assigned individually.
5. Placing a catheter into the aorta or directly into an artery or vein is called
A. brachiocephalic manipulation. B. third order placement. C. selective catheter placement. D. nonselective catheter placement.
6. What ICD-10-CM code would be assigned for a patient with acute tubule-interstitial nephritis?
A. L50.0 B. Z02.6 C. N10 D. B96.2
7. The suffix -sis means
A. inflammation. B. drooping. C. condition. D. process.
8. The concept of meaningful use pertains to
A. medical office protocol and document organization. B. electronic health record implementation. C. resource management in the inpatient setting. D. categorization of patient information.
9. In what CPT code range is Surgical Pathology found?
A. 88400–80499 B. 88000–80299 C. 88300–88309 D. 88515–88598
10. According to the CMS National Physician Fee Schedule, what is the conversion factor for basic life support mileage?
A. $32.4726 B. $34.5741 C. $28.8457 D. $36.0666
11. A patient who was involved in a motor vehicle accident is taken to the hospital by ambulance and admitted to the hospital in critical care. The physician sees the patient for 74 minutes in critical care. The physician leaves to attend to other patients in the ICU and the NICU of the same hospital. Five hours later, the physician returns to the patient and continues to treat the patient in critical care for an additional 30 minutes. The patient spends a total of 104 minutes in critical care. What codes are assigned?
A. 99291, 99292 B. 99292, 99293 C. 99291, 99291 D. 99292, 99292, 99293
12. The prefix endo- means
A. beneath. B. outside of. C. adjacent to. D. within.
13. What is the CPT code for a three-view x-ray of the mandible?
A. 70200 B. 70100 C. 70150 D. 70240
14. Rules of evidence control the
A. amount of evidence that may be admitted during a civil trial. B. processes and procedures for question and answer sessions. C. documents that can be considered during jury trial. D. length of criminal court proceedings, but not civil court proceedings.
15. The ampulla, isthmus, interstitium, and fimbria are examples of
A. implantation sites of ectopic pregnancy. B. incision sites for pacemaker insertion. C. membranes in the abdomen. D. bones in the ankle.
16. Code J9165 is assigned for intravenous diethylstilbestrol diphosphate. According to the code description, what dosage was administered?
A. 20 mg B. 50 mg C. Up to 0.5 mg D. 250 mg
17. Members of the uniformed services, their families and survivors, and retired members and their families qualify for
A. TRICARE. B. OIG Recovery. C. Medicare. D. Medicaid.
18. A patient comes to the emergency room complaining of abdominal pain. She was previously diagnosed with type I diabetes. She also complains of watery eyes, congestion, pressure in the sinuses, and difficulty breathing. Her final diagnoses are right lower quadrant abdominal pain, type I diabetes, acute sinusitis, and asthma. What CPT and ICD-10-CM codes are assigned?
A. 99222, R18.91, E16.9, J01.91, J45.919 B. 99221, R17.41, E17.9, J01.90, J45.909 C. 99221, R10.31, E10.9, J01.90, J45.909 D. 99223, R14.31, E15.9, J01.90, J45.929
19. Under HIPAA, health care facilities must
A. follow up with patients who repeatedly miss scheduled appointments for mandatory services. B. keep records of patients who refill prescriptions more than once within a three-month timeframe. C. maintain a clean, safe working environment. D. choose a privacy officer in accordance with HIPAA policies and procedures.
20. What is the ICD-10-CM code for unspecified acute pericarditis?
A. I30.89 B. I30.9 C. I30 D. I30.79
21. What is the full code description for 25515?
A. Open treatment of radial shaft fracture, includes internal fixation, when performed B. Closed treatment of ulnar shaft fracture; without manipulation C. Closed treatment of radial shaft fracture; without manipulation D. Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex
22. Which of the following anatomical locations would contain the diaphysis?
A. Metatarsal B. Diaphragm C. Septum D. Tibia
23. A patient recently became eligible for health insurance through her employer. Her health insurance is considered to be an 80-20 policy. Under the terms of an 80-20 policy, the insurer pays 80 percent and the insured pays 20 percent of expenses. This 80-20 policy is an example of
A. coinsurance. B. prospective payment. C. capitation. D. case management.
24. The Outpatient Prospective Payment System (OPPS) pays
A. an established rate for outpatient services in specific hospitals. B. a percentage of the national average for the same surgery performed in a different geographic location. C. 65% of the schedule C rate for all surgeries. D. subsidies to contain health care costs in rural facilities.
25. The study of disease is called
A. physiology. B. pathology. C. urology. D. neurology.
26. Superficial injuries such as abrasions or contusions are
A. not coded when associated with more severe injuries of the same site. B. queried to determine if the injuries are confined to the same site. C. coded when associated with more severe injuries of the same site. D. coded only when debridement is performed.
27. Another name for XXY syndrome is
A. Turner’s syndrome. B. Cooley’s anemia. C. Klinefelter syndrome. D. Huntington’s chorea.
28. The method that physicians use to bill for each service or visit individually rather than on a pre-paid basis is called
A. fee-for-service. B. capitation. C. pre-paid care. D. managed care.
29. A physician has a meeting with a pharmaceutical sales representative. During the course of the conversation, the physician reveals the diagnosis and past family, medical, and social history of a patient currently being treated with one of the medications that the sales representative is selling. In this situation, the doctor could be sued for
A. invasion of privacy. B. malfeasance. C. undue harm and fraud. D. malice.
30. A patient is prescribed a medication that narrows the blood vessels and raises her blood pressure. The medication is most likely a
A. tranquilizer. B. cardiogenic. C. vasoconstrictor. D. cardiotonic
31. Physicians typically refer to anatomical locations using directional terms, which are often
A. paired in opposites. B. used primarily by chiropractors. C. used to describe surgical incisions. D. referenced horizontally.
32. The study of tissue disease using macroscopic or microscopic analysis is called
A. immunology. B. histopathology. C. cytopathology. D. microbiology.
33. A physician obtains cells from the bone marrow cavity using a needle and a syringe. How would this procedure be coded?
A. 36575 B. 37328 C. 38220 D. 35092
34. What is Medicare Part D?
A. The component of Medicare Part A that covers outpatient surgeries B. Add-on coverage for prescription drugs provided through insurance companies approved by Medicare C. Supplemental coverage for war veterans and their dependents D. Add-on coverage for dental procedures
35. A female patient is seen for her annual gynecological examination. During the examination, the physician performs a test to detect cervical cancer. This test is called a/an
A. immunoassay test. B. Pap smear. C. carcinoembryonic antigen test. D. mycobacterial culture.
36. A physician is called to the intensive care unit for a patient with second-degree burns sustained on 55% of his body while cooking in the kitchen where he works. The physician sees the patient in the critical care unit for two hours, leaves the unit, and returns later the same day to provide an additional hour of critical care. What ICD-10-CM and CPT codes would be assigned?
A. L91.8, 99291 × 2, 99292 × 4 B. R53.81, 99291, 99293 × 5 C. Z30.09, 99293, 99294 × 2 D. T31.50, 99291, 99292 × 4
37. A change in the tissues and cells within a specific area on or in the body is called a
A. lesion. B. cyst. C. neoplasm. D. tumor.
38. Information about a patient can becan be released for research under the terms of HIPAA, only if
A. the patient signs an authorization immediately upon admission. B. the research is critical for technological development. C. the patient has authorized the release and only a limited amount of information is released. D. researchers obtain authorization from the admitting physician.
39. A patient is diagnosed with breast cancer and undergoes a partial mastectomy. What CPT code would be assigned?
A. 19305 B. 19307 C. 19304 D. 19301
40. To conform to the HIPAA Privacy Rule, which of the following safeguards must be maintained in health care facilities?
A. Immunization and injection safeguards B. Reasonable administrative, technical, and physical safeguards C. ICD-7 provisional safeguards D. Hazardous waste protection safeguards
41. A patient sustains a fracture of the femur while playing football in a nearby park. What ICD-10-CM code would be assigned?
A. S72.001A B. S72.009A C. S72.003A D. S49.006A
42. According to the guidelines for medical records outlined in the Health Insurance Portability and Accountability Act (HIPAA), patients
A. have the right to have errors reviewed by a hospital administrator. B. have the right to correct errors in identification data only. C. have the right to have errors in their medical records corrected. D. do not have the right to have errors corrected, as the data has been previously verified by the physician.
43. Modifier -23 indicates that
A. two surgeons performed a procedure. B. a procedure was performed bilaterally. C. a physician reviewed and interpreted a radiology procedure. D. the patient received general anesthesia for a procedure that would ordinarily be performed with local or no anesthesia.
44. The Health Insurance Portability and Accountability Act (HIPAA) was created for the purpose of
A. streamlining claims processing and reducing paperwork through electronic transmission. B. stabilizing administrative costs and productivity. C. decreasing employee turnover and reducing the volume of new hire paperwork. D. modifying legal and ethical issues surrounding medical records retention.
45. A patient is seen in the emergency room complaining of abdominal pain in the left lower quadrant. It’s determined that the patient is experiencing inflammation of the pancreas, which is also called
A. pancreaticoduodonal arcade. B. pancreatitis. C. pancreatolysis. D. pancreatonia.
46. A 55-year-old patient was injured while working as a carpenter on a construction site. While framing the roof of a two-story house, he fell and hit his head. He was diagnosed with a concussion to the left side of his head, and underwent a right frontal parietal craniotomy with removal of a subdural hematoma. During the patient’s period of recovery, he was given a medication that resulted in a rash on his abdomen. The physician conducted an expanded problem focused history and exam, with straightforward medical decision making. What CPT code(s) should be assigned?
A. 99251 B. 99252 C. 99292, 99291 D. 99253
47. Taking certain steps to protect PHI from being accidentally released to individuals who don’t need to know the information is called the
A. minimum necessary standard. B. privacy management statute. C. health information guardianship guideline. D. information provision standard.
48. The main term represents the most basic aspect of a disease or condition. For example, the main term of a diagnosis involving a broken arm is
A. broken. B. break. C. fracture. D. arm.
49. Performing a daily check for viruses and malware is one of the
A. requirements of the Help Desk. B. routine aspects of software maintenance. C. sensible guidelines for Internet use in health care facilities. D. functions of HIM encoders.
50. A coder overhears a confidential statement made outside of the court, and then, when called to testify, repeats the statement as being truth. This is an example of
A. cross-examination. B. hearsay. C. speculation. D. a direct quote.
51. A patient receives two venous pressure clamps for hemodialysis. What HCPCS Level II code is assigned?
A. A4751 B. A4751 × 2 C. A4918 × 2 D. A4918
52. The process of removing tissue for histopathology is called
A. shaving. B. debridement. C. excision. D. biopsy.
53. A coder would assign modifier -53 to report
A. dental procedures. B. repeat procedures. C. anesthesia administration. D. procedures cancelled due to the patient’s condition.
54. Alternative dispute resolution (ADR) allows
A. resolving medical malpractice suits by submitting pretrial depositions. B. lawyer-to-lawyer mediation during trial recess. C. mediating disputes with a judge in the presence of the bailiff. D. litigants to resolve disputes prior to or after the start of litigation.
55. Code range 99231–99233 pertains to
A. initial hospital care. B. subsequent hospital care. C. consultation services. D. hospital discharge services.
56. A patient comes to the emergency room complaining of abdominal pain, nausea, and intractable vomiting. Unable to pinpoint the source of the patient’s complaints, the physician decides to admit the patient to the hospital. After conducting a complete history and examination, the patient’s final diagnosis is determined to be chronic duodenal ulcer. The patient remains hospitalized for three days. The physician sees the patient on the day of discharge. What ICD-10 and CPT codes are assigned?
A. 99234, N17.9 B. 99223, I48.91 C. 99238, K26.7 D. 99291, D63.1
57. The specific guidelines that constitute a valid release of information under the HIPAA Privacy Rule are described as
A. OIG specifications. B. E/M levels. C. considerations in relation to risk management. D. core elements.
58. The suffix –centesis means
A. abnormal condition. B. calculus or stone. C. a surgical puncture for fluid removal. D. separation, breakdown, destruction.
59. The code for an ESWL would be found in the
A. Urinary and Male Genital Systems of CPT. B. Chemotherapy section of HCPCS. C. Digestive System of CPT. D. Cardiovascular System of CPT.
60. A female patient is diagnosed with breast cancer of the lower-inner quadrant of the right breast. The patient undergoes a modified radical mastectomy of the right breast in an attempt to circumvent the spread of the cancer to any secondary anatomical sites. The procedure was performed in three stages. In addition to the radical mastectomy, the physician also performed a right breast biopsy to treat the breast tumor in the lower-inner quadrant. What ICD-10-CM and CPT codes are assigned?
A. 19307-58-RT, 19101-59-RT, C50.311 B. 15852-58, Z48.01 C. 11602, 15240, C50.312 D. 19307-RT, 19101-RT, C50.211
61. A patient comes to the ambulatory surgery center for a fusion of the cervical spine. Prior to the beginning of the surgery, the patient suffers an allergic reaction to the anesthesia shortly after it’s administered. Because of this reaction, the surgery is not performed. What code would be assigned as the first-listed diagnosis?
A. The observation code B. The reason that the surgery was scheduled to be performed C. The allergy code D. The anesthesia administration
62. Anti-inflammatory drugs applied to the skin to relieve skin disorders are called
A. topical corticosteroids. B. antiseptics. C. keratolytics. D. astringents.
63. The _______ nerve sends visual data to the occipital lobe of the brain.
A. abducens B. trochlear C. optic D. oculomotor
64. The root word OBSTETR/O means
A. pregnancy. B. cesarean. C. midwife. D. birth.
65. The root word ENTER/O means
A. tooth. B. stomach. C. intestine. D. secretion.
66. What code would be assigned for gastropathy?
A. K29.7 B. K41.31 C. K31.9 D. K41.2
67. A patient comes to the physician’s office complaining of neck irritation. The physician examines her neck and notes that she has a 15 cm neck scar. Upon further examination, the physician notes that the neck scar requires extensive debridement and retention sutures. The physician performs a dermabrasion to treat the neck scar and then closes the complex wound with the sutures. What ICD-10 and CPT codes are assigned?
A. 13132, 13133 × 2, L90.5 B. 13132, 13133 × 3, H81.09, L92.9 C. 13133-51, 13131-79, L60.0 D. 13132, L76.82
68. The bulbourethral gland is found in the _______ system.
A. neurological B. cardiovascular C. male genital D. female genital
69. A tethered health record allows patients to
A. restructure insurance copayments. B. use a secure portal to access their own records. C. compare their health records to the records of patients with similar diagnoses. D. amend the diagnoses listed in the health record.
70. A patient is diagnosed with lymphocytic lymphoma. Another patient is seen several weeks later and is diagnosed with histiocytic lymphoma. Both of these diagnoses are examples of _______ lymphoma.
A. basic B. Hodgkin’s C. non-Hodgkin’s D. Burkitt’s
71. A patient receives a blood glucose monitor. What HCPCS Level II code would be assigned?
A. E0976 B. E0607 C. E0562 D. E4752
72. A good compliance program in the health care setting includes
A. HHS surveillance. B. regular tracking and monitoring of coding activities. C. meetings with compliance officers. D. regular audit consultations with trustees of the AAPC.
73. A patient with numerous symptoms is seen in the laboratory for a general health panel to gauge her overall physical well-being. What CPT code would be assigned for a general health panel?
A. 80051 B. 82136 C. 84135 D. 80050
74. Code 71030-TC indicates a/an
A. complete chest x-ray, four views, technical component only. B. incomplete chest x-ray, two views, technical and professional component. C. complete chest x-ray, two views, technical component only. D. incomplete chest x-ray, three views, technical and professional component
75. If patients choose to obtain copies of their medical records, under the terms of HIPAA, providers can
A. also fulfill requests for prescription data. B. reschedule office visits to allow time to update medical records. C. complete employee paperwork. D. charge a reasonable fee for providing copies of those records.
76. A patient comes to the clinic complaining of fever, diarrhea, nausea, and vomiting. The patient is diagnosed with salmonella meningitis. What ICD-10-CM code would be assigned?
A. A23.24 B. A02.21 C. A05.26 D. A07.21
77. A patient comes to the emergency room complaining of right knee pain. He states that he was playing baseball the previous evening and accidentally fell when sliding into first base. The physician obtains an expanded problem focused history and examination, as well as a two-view x-ray of the right knee. The physician reviews the x-ray, as well as the notes in the medical record, and renders a diagnosis of osteoarthritis of the knee. The physician performs a patellofemoral arthroplasty to repair the knee. What ICD-10-CM and CPT codes are assigned?
A. 27477, M17.12 B. 27506-RT, N17.11 C. 27477-RT, D17.39 D. 27447-RT, M17.11
78. Provision of security against a hurt, loss, or damage with specific cash payments is called
A. copayment. B. protection. C. indemnity. D. secured loss.
79. HCPCS modifier –E2 indicates that the patient had a surgical procedure performed on the
A. lower left eyelid. B. upper left eyelid. C. upper right eyelid. D. lower right eyelid.
80. When is code 58120 assigned?
A. The code is assigned for permanent pacemaker insertion. B. The code has been deleted and cannot be assigned. C. The code is assigned for a patient undergoing dilatation and curettage. D. The code is assigned as an add-on code.
81. Epithelial tissue that secretes its products directly into the bloodstream is made of
A. extracellular matrix. B. endocrine gland cells. C. endoplasmic reticulum. D. columnar epithelial cells.
82. Which of the following modifiers would be assigned for a moribund patient?
A. P4 B. P1 C. P5 D. P3
83. The anatomical location of the calyx is the
A. spine. B. brain. C. arm. D. kidney.
84. Which one of the following requirements is outlined in the guidelines established in HIPAA’s Privacy Rule?
A. Hospital administrators must encrypt data within older data files. B. Physicians must not disclose patient information to consulting physicians. C. Patients must receive notice if their information will be used or disclosed to third parties. D. Managers must secure medical records immediately following patient admission.
85. The I-10 helps coders classify patient
A. morbidity and mortality. B. management information. C. evaluation files. D. reimbursement data.
86. During a routine examination, a male patient is diagnosed with an elevated PSA. The physician performs a biopsy of the prostate with a rectal ultrasound to pinpoint the source of the problem. Which CPT and ICD-10-CM codes would be assigned?
A. 55725, 76000-26, R93.6 B. 55700, 76872-26, R97.2 C. 55734, 73200-26, R97.2 D. 55720, 74000-26, R97.3
87. Health care practitioners must maintain records of privacy policy practices and procedures for
A. 20 years. B. 10 months. C. 2 years. D. 6 years.
88. A patient comes to the emergency department of a rural hospital. He complaints of problems sleeping, foot swelling, and insomnia. After a detailed review of the patient’s history and a detailed examination, the patient is diagnosed with chronic renal insufficiency, nephrotic syndrome, and anemia, based on the values listed in his blood test. The patient undergoes a biopsy of the left and right kidneys under physician guidance. A CT scan is also used for guidance and needle placement. A follow-up CT scan with physician review and interpretation is also performed. What ICD-10 and CPT codes are assigned?
A. 50500-73, 51200-LT, C79.2, C61 B. 50200-RT-LT, 50310-RT, 51252-26, E46, N18.9, N04.9 C. 51000, 50310-59-LT, J90, Z90.12, E85.4 D. 50200-50, 50200-59-RT, 77012.26, N18.9, N04.9, D64.9
89. Data stored in a health care facility must
A. comply with HIPAA rules and must be maintained securely. B. adhere to OIG policies and procedures. C. be organized in accordance with state standards for electronic data interchange. D. conform to the physician’s expectations for data storage.
90. Health care practitioners who submit fraudulent bills to increase reimbursement may
A. be blacklisted according to geographic location. B. be listed in the Coding Directory of Fraudulent Billing published annually by the Department of Health and Human Services. C. be reported to the Office of the Attorney General. D. face financial penalties or, in some cases, imprisonment.
91. Which of the following anesthesia modifiers indicates a normal, healthy patient?
A. P3 B. P1 C. P4 D. P2
92. When coding burns, coders should
A. classify all burns as acute burns. B. assign separate codes for each burn site. C. assign the code for third-degree burns. D. assign the code for chronic burns.
93. A 65-year-old patient is admitted to the hospital for 48 hours to receive treatment from her physician. This patient would be covered under
A. Medicare Part D. B. Medicare Part A. C. Medicare Part B. D. Medicare Part C.
94. A patient comes to the clinic complaining of ongoing headaches. The headaches began one week prior and have persisted ever since. A lumbar spinal tap is performed to pinpoint the source of the patient’s headaches. What CPT and ICD-10-CM codes are assigned?
A. 62270, G44.1 B. 62270, G74.3 C. 62141, G46.8 D. 62272, G46.9
95. What code would be assigned for a tube pericardiostomy?
A. 33210 B. 33026 C. 33015 D. 33050
96. What is the code description for 65101-LT?
A. Removal of ocular implant performed laterally B. Fine needle aspiration of orbital contents on the left third of the orbit C. Biopsy of cornea performed on the lower third of the cornea D. Enucleation of eye, without implant, performed on the left side of the body
97. Another name for diazepam is
A. Flexeril. B. Valium. C. Norflex. D. Myolastan.
98. The gatekeeper concept refers to the operation of
A. prospective payment organizations. B. retrospective payment organizations. C. ambulatory payment surgery centers. D. health maintenance organizations.
99. The CPT code for thrombolysis is
A. 93000. B. 92975. C. 92920. D. 93797.
100. According to HIPAA, a patient’s information may be released for
A. paternity testing. B. research. C. determining premiums based on a patient’s past medical history. D. transferring electronic medical records to remote locations.
101. Which of the following statements is true of the Affordable Care Act?
A. It includes a provision for military service members who served in Afghanistan. B. It requires health care facilities to maintain health records for at least 10 years. C. It makes it mandatory for patients to carry health insurance. D. It offers parents supplementary coverage for dependents with chronic illness
102. A patient is seen in the physician’s office after the results of an earlier mammogram demonstrated microcalcification in the right breast as well as a breast lesion. The lesion is excised using needle localization. The patient’s final diagnosis is fibrosclerosis of the right breast. What CPT and ICD-10-CM codes are assigned?
A. 19120-RT, L10.11 B. 19125-RT, N60.31 C. 19126-LT, M25.1 D. 19123-RT, H16.11
103. A coder would assign a Q code as a temporary code for
A. holistic treatments for spinal procedures. B. durable medical equipment only. C. procedures or services only. D. procedures, services, and supplies
104. Which of the following forms is used to bill outpatient charges?
A. HCFA-1350 or CMS-650 B. HCFA-1400 or CMS-1540 C. AMA-14 or UCF-1250 D. CMS-1500 or UCF-1500.
105. During a routine examination, a patient indicates that she is taking an antihypertensive medication that causes her kidneys to excrete more urine. These antihypertensive medications are called
A. calcium-channel blockers. B. anticoagulants. C. beta blockers. D. diuretics.
106. A patient comes to the emergency room complaining of postnasal drip, frequent nosebleeds, headaches, and difficulty breathing. She is diagnosed with a deviated nasal septum, hypertrophy of the turbinate, and inflammation of the ethmoid sinuses. The physician performs an endoscopic ethmoidectomy of the left nasal sinus, septoplasty, and turbinate excision. What ICD-10-CM and CPT codes are assigned?
A. 31255, 30520, 30130, J34.2, J34.3, J32.2 B. 31255-LT, 30520-51, 30130-51, J34.2, J34.3, J32.2 C. 31230, 30520, J34.2, J34.3, J32.2 D. 31230-51, 30520-LT, J34.2
107. A physician is analyzing specific organs in a particular region of the patient’s body. In her notes, she refers to the transverse or cross-sectional plane, which divides the body
A. inferiorly. B. vertically. C. horizontally. D. bilaterally.
108. A patient comes to the emergency room after having dinner at a restaurant, where she began to experience chest tightness during the meal. She is seen for a cardiology consultation in the outpatient setting for a diagnosis of chest tightness. Which CPT and ICD-10-CM codes would be assigned?
A. 99245, R07.89 B. 99244, R07.59 C. 99242, R17.52 D. 99243, R25.96
109. Providers that receive reimbursement after health care services have been provided are being compensated under the _______ system.
A. prospective payment B. retrospective payment C. capitation D. UCR
110. The regulations in HIPAA apply to three groups of individual and corporate entities, each involved in electronic medical records transfer. These groups are collectively referred to as
A. health care administrators. B. covered entities. C. provisional health care data collectors. D. protected personnel.
111. The largest salivary glands are called the _______ glands.
A. amylase B. parotid C. sublingual D. submandibular
112. Which modifier indicates a staged or related procedure performed during the postoperative period?
A. -59 B. -57 C. -58 D. -54
113. The voluntary program that’s financed through a combination of payments from general federal revenues and premiums paid by beneficiaries who elect to participate is called
A. CHAMPVA. B. Medicare Part B. C. Medicaid. D. TRICARE.
114. What is the full code description for 33536?
A. Repair of postinfarction ventricular septal defect, with or without myocardial resection B. Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts C. Repair of double outlet right ventricle with intraventricular tunnel repair D. Closure of atrioventricular valve (mitral or tricuspid) by suture or patch
115. Categorically needy and medically needy patients may qualify for
A. Medicaid. B. CHAMPVA. C. Champus. D. Medicare Advantage
116. ICD-10-CM code S50.351A indicates that the patient has a superficial foreign body of the right elbow. The A indicates that
A. code S50.351A should be assigned to page 1 of the medical record, but not subsequent pages. B. this is the patient’s first encounter. C. this is the patient’s second encounter for the same original diagnosis. D. code S50.351A should be sequenced before secondary codes.
117. The foramen ovale is found in which anatomical location?
A. Fibula B. Heart C. Pancreas D. Liver
118. A new patient is seen in a clinic for complaints of shortness of breath, fever, difficulty swallowing, runny nose, and cough. The physician performs a detailed history, detailed examination, and medical decision making of low complexity. The physician also obtains a chest x-ray and lab workup. Based on the results of the diagnostic tests, the physician renders a diagnosis of upper respiratory tract infection and lymphadenopathy. What ICD-10 and CPT codes are assigned?
A. 99203, J06.9, R59.0 B. 99202, D63.1, J45.909 C. 99213, R06.82, F10.229 D. 99215, M19.011, R13.10
119. A patient has a disorder in which the bone marrow produces an overabundance of white blood cells. What is this disorder called?
A. Leukemia B. Hemophilia C. Coagulation D. Septicemia
120. A patient is diagnosed with acne. What ICD-10-CM code would be assigned?
A. L74.2 B. L72.3 C. L70.0 D. L73.1
121. A coder assigns a HCPCS Level II code to a patient’s medical record. The code description reads as follows: Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape. Based on this description, which HCPCS Level II code was assigned?
A. B4072 B. B4125 C. B4034 D. B4278
122. The Health Insurance Portability and Accountability Act (HIPAA) standards were developed to
A. ensure that coders could easily access each medical record. B. determine the structure of insurance carrier payments for health care practitioners. C. protect patient confidentiality when health information is transferred electronically. D. define XLTM standards for health records management.
123. Another name for third-party contractors who have access to medical information is
A. business associates. B. insurance administrators. C. healthcare vendors. D. covered entities.
124. Bones inside the nose are called
A. maxillae. B. turbinates. C. ethmoids. D. septal mucosa.
125. The atrioventricular (tricuspid) valve is located in the
A. fibula. B. lung. C. heart. D. brain.
126. Another term for disease evolution is
A. exacerbation. B. remission. C. pathogenesis. D. morphology.
127. The vitreous humor can be found in the
A. ear. B. tongue. C. nose. D. eye.
128. The codes for pacemakers and implantable defibrillators would be found in what section of CPT?
A. 33202–33273 B. 33200–33205 C. 33437–33537 D. 33533–33799
129. The HIPAA Privacy Rule indicates that
A. practitioners should disclose only the minimum amount of health information necessary for the purpose of the disclosure. B. physicians may release medical information at their own discretion. C. restrictions on information disclosure exist only for patients with life-threatening illnesses. D. the level of information disclosure permitted is based on the nature of the procedure.
130. The abbreviation INH indicates what route of drug administration?
A. Inhaled and intrathecal administration B. Inhaled and intravenous administration C. Intrathecal injection D. Inhalant solution
131. A patient comes to the clinic complaining of nausea, vomiting, fever, dizziness, and intermittent confusion. The physician conducts a detailed history and examination and reviews the patient’s lab results. The patient is diagnosed with pyelonephritis and is scheduled for an ultrasound to review the state of the kidneys and other organs. What CPT and ICD-10-CM codes are assigned?
A. 76775-TC, N15 B. 76775-26, N10 C. 73256-TC, M11 D. 71010-26, B12
132. What happens when HIPAA rules conflict with state law?
A. Conflicting state rules are overridden by federal law. B. The interpretation of HIPAA rules is left to the physician’s discretion. C. State laws overrule federal law. D. The Supreme Court’s decision becomes final in binding arbitration
133. Which of the following statements is true of the olfactory nerve?
A. It’s susceptible to erosion due to Peyronie’s disease. B. It’s located in the mitral valve and helps to circulate blood throughout the heart. C. It conveys the fluid from lymph glands to other areas of the body. D. It’s found in the nose and allows the senses to detect and distinguish odors.
134. The first step in EHR implementation is
A. structuring the timeline for EHR implementation. B. analyzing the content of the traditional medical record. C. conducting an assessment of the goals, needs, and financial stability of the health care practice. D. reviewing the list of established patients currently being seen in the practice.
135. The outcome of delivery code should be
A. omitted from the maternal record for stillborn delivery. B. assigned to the newborn record only. C. assigned to the maternal record when a delivery occurs. D. assigned to both the maternal and newborn records.
136. A patient is seen in the office for complaints of dizziness and insomnia. The physician records a chronological description of specific elements of the patient’s condition. This chronological description is called the
A. history of present illness. B. examination. C. review of systems. D. chief complaint.
137. What is the CPT code description for 64483?
A. Injection(s) anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level B. Injection, anesthetic agent, sphenopalatine ganglion C. Injection(s) anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, multiple levels D. Transforaminal epidural injection under ultrasound guidance
138. Releasing genetic information is forbidden under the terms of HIPAA because it may
A. allow immediate family members to have access to a patient’s medical records. B. require physicians to fulfill contractual obligations for treatments provided in ambulatory surgery centers. C. indicate susceptibility to a future illness, without the patient actually being diagnosed with the condition. D. not be successfully transmitted to all health care facilities.
139. Prescribing combination drugs that contain multiple medications to cut down on the number of pills
patients take on a daily basis
A. compounds the drugs’ effectiveness. B. increases the likelihood of compliance. C. decreases the frequency of drug interactions. D. supports good body function.
140. A patient who has paralysis of all four limbs is called
A. quadriplegic. B. paraplegic. C. tetraplegic. D. hemiplegic.
141. Which of the following is true about HIPAA national standards?
A. The national standards apply to any electronic data interchange. B. The national standards apply only to data exchange within a specified geographical region. C. The national standards do not apply to surgical procedures in the inpatient setting. D. The national standards do not apply to data exchanged within a claim clearinghouse.
142. A patient undergoes an appendectomy and later returns to the operating room for a related procedure the same day. Which modifier should be assigned to the CPT code?
A. -51 B. -AA C. -78 D. -76
143. The portion of health insurance that an insured pays before he or she is entitled to receive benefits from an insurance plan is called the
A. deductible. B. OPPS reimbursement. C. capitation. D. coinsurance.
144. A patient is seen in follow-up two weeks after undergoing cholecystectomy. During the follow-up examination, the physician notes that the abdominal wound has not yet healed. The patient undergoes a split-thickness autograft due to a nonhealing left lower abdominal wound that’s 10 square centimeters. Which CPT and ICD-10-CM codes would be assigned?
A. 15350, L52.64 B. 15250, L34.74 C. 15200, L85.64 D. 15100, L76.82
145. The Female Genital System subsection covers which CPT code range?
A. 56203–56303 B. 56607–56809 C. 56300–56499 D. 56405–58999
146. What ICD-10-CM code would be assigned for unilateral primary osteoarthritis of the right hip?
A. M16.12 B. M16.30 C. M16.11 D. M16.10
147. Which of the following anatomical locations would contain the superior vena cava?
A. Hip B. Nose C. Lungs D. Heart
148. A patient receives an injection of nandrolone decanoate. What HCPCS Level II code would be assigned?
A. J2323 B. J3530 C. J2320 D. J2300
149. The suffix –stasis means
A. breakdown. B. stopping and controlling. C. kinetic. D. flow.
150. A patient undergoes a sigmoidoscopy. The coder would assign CPT code
A. 45852. B. 45330. C. 45397. D. 45919.
