CCA Mock Examination 60 Questions

61 Questions  I  By Melodey23
CCA Mock Examination 60 Questions

  
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1.  An eighty-nine-year-old male is admitted from a nursing home with confusion, hypotension, temperature of 103.5, and obvious dehydration. Blood cultures were negative; however, urine culture was positive for E. coli. Physician documents final diagnosis as septicemia, septic shock, UTI due to E. coli, and dehydration. 03.9     Septicemia, unspecified 041.4   E. Coli 246.51    Dehydration 298.9      Psychosis, unspecified 458.9      Hypotension, unspecified 599.0      UTI, site not specified 780.60    Fever, unspecified 785.52    Septic shock 995.92    Severe sepsis
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2.  HPV or human papilloma virus
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3.  The physician listed the discharge diagnoses as congestive heart failure with acute pulmonary edema
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4.  D&C for missed abortion, first trimester. Provide appropriate CPT code(s). 59820  Treatment of missed abortion, completed surgically; first trimester 59840  Induced abortion, by dilation and curettage 59850  Induced abortion, by one or more intra-amniotic injections, (amniocenthesis-injections) including hospital admission and visits, delivery of fetus and secundines 59855  Induced abortion, by one or more vaginal suppositories (eg, prostaglandin), with or without cervical dilation, (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines
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5.  Male patient has been diagnosed with benign prostatic hypertrophy and undergoes a transurethral destruction of the prostate by radiofrequency thermotherapy. Provide appropriate ICD-9-CM and CPT codes. 600.00 Hypertrophy (benign of prostate) without urinary obstruction and other lower urinary tract symptoms (LUTS) 52601 Transurethral electrosurgical resection of prostate including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) 52648 Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transuteral transection of the prostate are including if performed.) 53850 Transurethral destruction of prostate tissue; by microwave thermotherapy 53852 Transurethral destruction of prostate tissue; by radiofrequency thermotherapy
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6.  Vaginal delivery of a full term live born infant. Patient undergoes episiotomy with repair and post delivery elective tubal ligation. Provide appropriate ICD-9-CM diagnosis and procedure codes. 648.91     Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth or puerperium, delivered with or without mention of antepartum condition 650           Normal delivery V25.2        Encounter for contraceptive mangement, sterilization V27.0        Single liveborn 66.32        Other bilateral ligation and division of fallopian tubes 73.59        Other manually assisted delivery 73.6           Episiotomy (with subsequent repair)
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7.  John has chronic ulcers of the calf and back. Both ulcers are excisionally debrided and the ulcer of the back has a split thicknes skin graft. Provide appropriate ICD-9-CM diagnosis and procedure codes. 707.12    Ulcer of calf 707.8      Chronic ulcer of other specified sites 86.22      Excisional debridement of wound, infection, or burn 86.69      Skin graft
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8.  What is the correct sequencing of the codes for a patient who is six weeks post mastectomy for carcinoma of the breast and is admitted for chemotherapy? 174.9  Malignant neoplasm of the female breast, unspecified site V10.3  Personal history of malignant neoplasm of breast V58.11 Encounter for antineoplastic chemotherapy V67.00  Follow-up examination following surgery, unspecified
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9.  Patient was admitted from the nursing home in acute respiratory failure that was due to congestive heart failure. Chest xray also showed acute pulmonary edema. Patient was intubated and placed on mechanical ventilation and expired the day after admission. 428.0     Congestive heart failure, unspecified 428.1     Left heart failure 518.4     Acute edema of lung, unspecified 518.81   Acute respiratory failure 518.84   Acute and chronic respiratory failure 96.04     Insertion of endotrachial tube 96.71     Continuous invasive mechanical ventilation for less than 96 consecutive hours
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10.  A(n) ________________ form is used to record the patient's diagnoses and the services performed for a particular visit. It also included codes (CPT, HCPCS, and ICD-9-CM) used specifically by that physician's office.
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11.  A PAR physician is one who:
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12.  The APC (Ambulatory Payment Classification) payment is based on what coding system(s)?
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13.  Which of the following is coded as an adverse effect in ICD-9-CM?
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14.  Total transcervical thymectomy. Provide appropriate CPT code(s). 60200     Excision of cyst or adenoma of thyroid, or transection of isthmus 60240     Thyroidectomy, total or complete 60520     Thymectomy, partial or total; transcervical approach (separate procedure) 60540     Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure)
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15.  Pathological fracture of the femur due to metastatic bone cancer. Patient has a history of lung cancer. Only the fracture is treated. Provide the appropriate ICD-9-CM diagnostic code(s). 162.9      Primary malignancy lung and bronchus, unspecified 198.5     Secondary malignancy bone and bone marrow 733.13   Pathologic fracture neck of femur 821.00   Traumatic fracture femur, unspecified part V10.11   Personal history malignant neoplasm lung and bronchus
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16.  Thirty-two year old female known HIV positive was admitted with lessions of the anterior trunk. Excisional biopsies of the skin lesions were positive for Kaposi's sarcoma. Further examination revealed thrush. Provide appropriate ICD-9-CM and CPT codes. 042     Human immunodeficiency virus (HIV) disease 176.0 Kaposi's sarcoma, skin 686.00    Pyoderma, unspecified 112.0     Candidiasis of mouth 528.9     Other and unspecified disease of the oral soft tissues 86.11     Biopsy of the skin and subcutaneous tissue 86.22     Excisional debridement of the skin and subcutaneous tissue (wound, infection or burn)
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17.  According to CPT, a biopsy of the breast that involves removal of only a portion of the lesion for pathologic examination is:
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2 comments
18.  Which diagnostic technique records the patient heart rates and rhythms over a 24-hour period?
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19.  The physician has documented the final diagnoses as: acute myocardial infarction, COPD, CHF, hypertension, atrial fibrillation and status-post cholecystectomy. The following conditions should be reported using ICD-9-CM diagnostic codes. 401.1     Hypertension, benign 401.9     Hypertension, unspecified 402.91   Hypertensive, heart disease, unspecified with heart failure 410.91   Acute myocardial infarction, unspecified site, initial episode of care 427.31   Atrial fibrillation 428.0     Congestive heart failure, unspecified 496        Chronic obstructive pulmonary disease V45.79   Acquired absence of organ
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20.  In the CPT coding system, when there is no code to properly represent the work performed by the provider, the coder must use this code
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21.  A marked loss of bone density and increase in bone porosity is
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22.  The type of anemia caused by a failure of the bone marrow to produce red blood cells is:
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23.  The process of attaching a HCPCS code to a procedure so that the code will automatically be included on the patient's bill is known as:
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24.  The purpose of the Correct Coding Initiative is to:
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25.  Patient (inpatient) was admitted with chestpain. Doctor ordered EKG to rule out MI
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26.  Cesarean delivery with antepartum and postpartum care. Provide appropriate CPT code(s). 59400     Routine obstetric care, including antepartum care, vaginal delivery (with or without episiotomy and/or forcepts), and postpartum care 59510     Routine obstetric care including antepartum care, cesarean delivery, and postpartum care 59514     Cesarean delivery only 59610     Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy and/or forceps) and postpartum care, after previous cesarean delivery
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27.  Urinary frequency, urgency, nocturia, incontinence and hesitancy are all symptoms of:
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28.  If any part of a combination code was not "present on admission" (POA) assign the POA  indicator of:
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29.  The patient was admitted due to increasing severe pain in his right arm, shoulder and neck for the past 6 weeks. MRI tests showed herniation of the C5-C6 disc. Patient underwent cervical laminotomy and diskectomy C5-C6 disc. The patient is currently being treated for COPD and CAD with a history of a PTCA. Provide appropriate ICD-9-CM diagnosis and procedure codes. 722.0      Displacement of cervical intervertebral disc without myelopathy 722.71    Intervertebral disc disorder with myelopathy, cervical region 492.8     Other emphysema 496         Chronic airway obstruction, not elsewhere classified 414.01    Coronary atheroscierosis of native coronary artery 414.00     Coronary atherosclerosis of unspecified type of vessel, native or graft V45.82     Percutaneous transluminal coronary angioplasty status 80,.51      Excision of intervertebral disc 03.09     Other exploration and decompression of spinal canal (Decompression, laminotomy) 
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30.  In order to correctly code a hernia repair, the coder needs to know all of the following except:
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31.  Chronic otitis media with bilateral myringotomy and tube insertion using local anesthesia. Provide appropriate ICD-9-CM and CPT codes. 381.00     Acute nonsuppurative otitis media, unspecified 381.05     Acute allergic mucoid otitis media 382.9       Unspecified otitis media 69400     Eustachian tube inflation, transnasal; with catheterization 69405     Eustachian tube catheterization, transtympanic 69420     Myringotomy including aspiration and/or eustachian tube inflation 69433     Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia
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32.  CMS delegates its daily operations of the Medicare and Medicaid programs to:
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33.  Chip is an unfortunate 35 year old who has been previously diagnosed with lung cancer. He has been receiving chemotherapy and radiation. He develops seizures and is admitted. Work up revealed metastasis of the lung cancer to the brain. Provide appropriate ICD-9-CM diagnosis codes. V10.11   Personal history of malignant neoplasm of the bronchus and lung V10.85   Personal history of malignant neoplasm of the brain 162.9     Malignant neoplasm of the bronchus/lung, unspecified site 191.9     Malignant neoplasm of the brain, unspecified 197.0     Secondary malignant neoplasm of the lung 198.3     Secondary malignant neoplasm of the brain and spinal cord 780.39   Other convulsions (seizures, not otherwise specified)
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34.  Which of the following could influence a facility's case mix?
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35.  Tom is admitted with acute chest pain. Final diagnoses listed include; acute pulmonary edema with congestive heart failure, subendocardial anterior wall myocardial infarction, hypertensive heart disease and chronic obstructive pulmonary disease. Provide appropriate ICD-9-CM diagnosis code(s). 410.11     Acute myocardial infarction, of other anterior wall, initial episode of care 410.71     Acute subendocardial infarction, initial episode of care 402.90     Hypertensive heart disease without heart failure unspecified benign or malignant 402.91     Hypertensive heart disease with heart failure unspecified benign or malignant 428.0       Congestive  heart failure, unspecified 428.1       Left heart failure 496          Chronic airway obstruction, not elsewhere classified 518.4       Acute edema of lung, unspecified
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36.  The ________________ are the organizations that contract with Medicare to perform reviews of medical records with the corresponding Medicare claim to detect and correct improper payments.
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37.  Hysteroscopy with D&C and polypectomy. Provide the appropriate CPT code(s). 58100 Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) 58120 Dilation and curettae, diagnostic and/or therapeutic (nonobstetrical) 58555 Hysteroscopy, diagnostic (separate procedure) 58558 Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C 58563 Hysteroscopy, surgical: with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
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38.  When a patient is admitted because of a primary neoplasm with metastasis and treatment is directed toward the secondary neoplasm only
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39.  A patient initially consulted with Dr. Vasseur at the request of Dr. Meche, the patient's primary care physician. Dr. Vasseur examined the patient, prescribed edication, and ordered tests. Additional visits to Dr. Vasseur's office for continuing care would be assigned from which E&M section?
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40.  Aunt Elsie is brought to the hospital for increased confusion. She is subsequently diagnosed with Alzheimer's disease with dementia and cerebral atherosclerosis. Aunt Elsie is also treated for hypertension and hypothyroidism. Provide appropriate ICD-9-CM diagnosis codes. 244.9    Unspecified acquired hypothyroidism 294.10  Dementia in conditions classified elsewhere without behavioral disturbance (manifestation) 294.11  Dementia in conditions classified elsewhere with behavioral disturbance (manifestation) 331.0    Alzheimer's disease 401.9    Essential hypertension, unspecified benign or malignant 437.0   Cerebral atherosclerosis
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2 comments
41.  What is the term used to describe the adjusting of the dollar amount due from the patient or insurance company to reflect a zero balance due on the claim?
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42.  Incomplete abortion complicated by excessive hemorrhage; dilation and curettage performed. Provide appropriate ICD-9-CM diagnosis and procedure codes. 285.1     Acute blood los anemia 634.11   Spontaneous abortion complicated by delayed or excessive hemorrhage, incomplete 634.12   Spontaneous abortion complicated by delayed or excessive hemorrhage, complete 634.91   Spontaneous abortion without complication, incomplete 69.02     Dilation and curettage following delivery or abortion 69.09     Other dilation and curettage
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43.  Patient has bilateral inguinal hernias, the left is indirect and the right is direct. He has repair of both hernias with mesh prosthesis. Provide appropriate ICD-9-CM diagnosis and procedure codes. 550.90  Inguinal without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent) 550.91  Inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified, recurrent 550.92  Inguinal hernia, without mention of obstruction or gangrene, bilateral (not specified as recurrent) 53.01  Other and open unilateral repair of direct inguinal hernia 53.16  Other and open bilateral repair of inguinal hernia, one direct and one indirect, with graft or prosthesis 
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44.  A co-worker complained of the sudden onset of chest pain and was admitted. A myocardial infarction was ruled out. You would code
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45.  Phacoemulsification of left cataract with IOL implant and subconjunctival injection. Provide appropriate ICD-9-CM and CPT codes. 366.9 Unspecified cataract 66940 Removal of lens material; extracapsular 66983 Intracapsular cataract extraction with insertion of intraocular lens prosthesis (one stage procedure) 66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis, (one stage procedure) manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification) 68200 Subconjunctival injection
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1 comment
46.  The physician's office note states: "counseling visit, 15 minutes counseling in follow-up with a patient newly diagnosed with diabetes." If the physician reports code 99214, which piece of documentation is missing to substantiate this code?
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47.  Which of the following is the term describing a woman who has delivered one child?
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48.  Newborn infant born with cleft palate 749.20 Cleft palate with cleft lip, unspecified V30.00 Single liveborn, born in hospital, without mention of c-section 27.54 Repair of cleft lip 27.62 Correction of cleft palate
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49.  A document which acknowledges patient responsibility for payment if Medicare denies the claim is a(n):
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50.  A patient is seen in the emergency department following an accident. The physician documents that the wound required multiple layers and extensive undermining.  According to CPT definitions, this type of repair would be classified as:
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51.  Patient with carpal tunnel comes in for an open carpal tunnel release. Provide appropriate ICD-9-CM and CPT codes. 354.0     Carpal tunnel syndrome 64721    Neuroplasty and/or transposition; median nerve at carpal tunnel 64892    Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length 64905    Nerve pedicle transfer; first stage 64999    Unlisted procedure, nervous system
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52.  _______________ is a defect characterized by four anatomical abnormalities within the heart that results in poorly oxygenated blood being pumped to the body.
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53.  The patient sees a PAR provider and has a procedure performed after meeting the annual deductible. If the Medicare-approved amount is $200, how much is the patient's out-of-pocket expense?
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54.  The blood disorder in which red blood cells lack of the normal ability to produce hemoglobin is called
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55.  Down's syndrome, Edward's syndrome and Patau's syndrome are all examples of ___________ defects:
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56.  Mitch was admitted directly from his physician's office for dehydration. Mitch had gastroenteritis for several days prior to this illness that has resulted in dehydration and requires intravenous hydration. Mitch also has chronic kidne disease and is at high risk for acute on chronic kidney failure. Two days following admission, Mitch develops acute renal failure. Mitch also has hypertension. Provide appropriate ICD-9-CM diagnosis codes. 276.51     Dehydration 401.9       Essential hypertension, unspecified benign or malignant 403.90     Hypertensive chronic kidney disease stage I through state IV, or unspecified benign or malignant 403.91     Hypertensive chronic kidney disease stage V or end-stage renal disease, unspecified benign or malignant 584.9       Acute kidney failure, unspecified
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1 comment
57.  The practice of using a code that results in a higher payment to the provider than the code that more accuratelyu reflects the service provided is known as:
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58.  The Emergency Medical Treatment and Active Labor Act is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA).
59.  ???????? Lumbar laminectomy (one segment) for decompression of spinal cord. Provide appropriate CPT code(s). 62263 Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (including contrast when administered), multiple adhesiolysis sessions; 2 or more days 63005 Laminectomy, with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or diskectomy (eg, spinal stenosis), one or two vertebral segments; lumbar except for spondylolisthesis 63030 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial  facetectomy, foraminotomy, and/or excision of herniated intervertebral disk including open and endoscopically-assisted approaches; one interspace, lumbar 63170 Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic or thoracolumbar
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1 comment
60.  Diverticulitis large bowel with abscess; right hemicolectomy with colostomy performed. Provide appropriate ICD-9-CM diagnosis and procedure codes. 562.10 Diverticulosis of colon (without mention of hemorrhage) 562.11 Diverticulitis of colon (without mention of hemorrhage) 569.5 Abscess of intestine 45.73 Open and other right hemicolectomy 45.74 Open and other resection of transverse colon 46.03 Exteriorization of large intestine (loop colostomy) 46.10 Colostomy, not otherwise specified 46.11 Temporary colostomy
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61.  Patient was admitted for cholecystectomy with exploratory of common duct, when the abnormal cavity was entered extensive metastic malignancy involving the stomach and duodendum with primary neoplasm in the pancreas was found. The procedure was discontinued, and the operative wound was closed. The coder reports:
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