1.
Excision of the gallbladder is commonly referred to as a :
Correct Answer
C. Cholecystectomy
Explanation
Cholecystectomy is the correct answer because it refers to the surgical removal of the gallbladder. The other options are not related to the gallbladder. Colectomy is the removal of all or part of the colon, choledochectomy is the removal of the common bile duct, and corpectomy is the removal of a vertebral body.
2.
What code best describes an ablation of a polyp in the colon?
Correct Answer
C. Cryosurgery
Explanation
Cryosurgery is the best code to describe the ablation of a polyp in the colon. Cryosurgery involves using extreme cold temperatures to freeze and destroy abnormal tissues, including polyps. This technique is often used in the removal of small polyps in the colon. The other options, such as bipolar cautery removal, snare, and hot biopsy forceps, involve different methods of removing polyps but are not specifically related to cryosurgery.
3.
Peritonitis is a condition that occurs in which system?
Correct Answer
C. Digestive
Explanation
Peritonitis is a condition that occurs in the digestive system. It is an inflammation of the peritoneum, which is the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs. This condition typically occurs when bacteria or other infectious agents enter the peritoneum, leading to infection and inflammation. Symptoms of peritonitis include severe abdominal pain, fever, nausea, and vomiting. Prompt medical attention is necessary to treat peritonitis and prevent complications.
4.
What type of infection is Helicobactor pylorus?
Correct Answer
A. Bacterial
Explanation
Helicobacter pylori is a type of bacterial infection. It is a spiral-shaped bacterium that infects the stomach lining and is known to cause various gastrointestinal diseases, including gastritis and peptic ulcers. This bacterium is usually transmitted through contaminated food or water and is one of the most common bacterial infections worldwide. Treatment typically involves a combination of antibiotics and acid-suppressing medications to eradicate the infection and promote healing of the affected tissues.
5.
Which following term describes a congenital absence of a limb?
Correct Answer
B. Ectromelia
Explanation
Ectromelia is the correct term to describe a congenital absence of a limb. It refers to a developmental abnormality where a limb is either partially or completely absent at birth. This condition can affect any limb, including arms or legs, and can vary in severity. Ectromelia is caused by genetic or environmental factors that disrupt the normal development of the limb buds during embryogenesis. It is important to differentiate ectromelia from amputation, which refers to the intentional removal of a limb, and the other two options, Hallux varus and Genu vagum, which are unrelated conditions.
6.
The patient presents with a laceration on the auricle pinna that needs a wound repair. What part of the body will the physician repair?
Correct Answer
B. Ear
Explanation
The physician will repair the laceration on the auricle pinna. The auricle pinna is the visible part of the external ear, which is commonly referred to as the "ear." Therefore, the correct answer is "Ear."
7.
The kidneys, bladder, and urethra make up what system?
Correct Answer
B. Urinary
Explanation
The kidneys, bladder, and urethra make up the urinary system. This system is responsible for filtering waste products from the blood, producing urine, and eliminating it from the body. The kidneys filter waste and excess water from the blood to produce urine, which is then stored in the bladder. The urethra is the tube that carries urine from the bladder out of the body. Therefore, the correct answer is Urinary.
8.
Complete the series : Frontal, Ethmoid, Maxillary, -------------------------------
Correct Answer
C. SpHenoid
Explanation
The given series follows a pattern of naming different sinuses in the skull. The frontal sinus is located in the forehead, followed by the ethmoid sinus located between the eyes, and then the maxillary sinus located in the cheekbones. Therefore, the next term in the series would be the sphenoid sinus, which is located behind the nose and between the eyes.
9.
A physician anesthetizes the brachial plexus nerves with an injection to provide pain control. These nerves are located :
Correct Answer
D. From the neck to the subclavicular.
Explanation
The brachial plexus nerves are a network of nerves that originate from the neck and extend down to the subclavicular region. Anesthetizing these nerves with an injection can provide pain control for the upper extremity, from the shoulder to the wrist.
10.
Adrenal glands are part of which anatomical system?
Correct Answer
C. Endocrine
Explanation
The adrenal glands are part of the endocrine system. These small glands are located on top of the kidneys and are responsible for producing hormones such as adrenaline and cortisol. These hormones play a crucial role in regulating various bodily functions, including metabolism, blood pressure, and stress response. Therefore, the correct answer is endocrine.
11.
The basilic vein is located in the :
Correct Answer
D. Arm
Explanation
The basilic vein is located in the arm. It is a large vein that runs along the inner side of the arm, starting from the elbow and extending up to the shoulder. This vein is commonly used for medical procedures such as blood draws and intravenous access because of its accessibility and size.
12.
The small intestine is divided into what parts :
Correct Answer
D. Duodenum, Jejunum, Ileum
Explanation
The small intestine is divided into three main parts: the duodenum, jejunum, and ileum. The duodenum is the first part of the small intestine and receives partially digested food from the stomach. The jejunum is the middle part of the small intestine and is responsible for absorbing nutrients from the digested food. The ileum is the final part of the small intestine and completes the absorption process, as well as playing a role in the immune system.
13.
The right upper quadrant of the abdominal area contains which of the following?
Correct Answer
A. Gallbladder
Explanation
The gallbladder is located in the right upper quadrant of the abdominal area. It is a small organ that stores bile produced by the liver. When we eat, the gallbladder releases bile into the small intestine to help with digestion and the breakdown of fats. The other options listed, such as the appendix, pancreas, and stomach, are located in different areas of the abdomen and not in the right upper quadrant.
14.
How would you characterize oligomenorrhea?
Correct Answer
C. Infrequent menstruation
Explanation
Oligomenorrhea is characterized by infrequent menstruation. This means that a person with oligomenorrhea experiences longer gaps between their menstrual cycles than what is considered normal. It is different from the absence of menstruation (amenorrhea), irregular menstrual cycles, or bleeding unrelated to the menstrual cycle.
15.
A Cochlear implant is placed in the :
Correct Answer
B. Inner Ear
Explanation
A cochlear implant is a medical device that is surgically placed in the inner ear. It is designed to provide a sense of sound to individuals who are severely or profoundly deaf. The implant consists of an external microphone, speech processor, and transmitter that send electrical signals to an array of electrodes in the inner ear. These electrodes stimulate the auditory nerve, allowing the brain to perceive sound. Placing the implant in the inner ear allows for direct stimulation of the auditory system, bypassing any damaged or non-functioning parts of the ear.
16.
What is Sialadenitis?
Correct Answer
D. An inflammation of a salivary gland
Explanation
Sialadenitis refers to the inflammation of a salivary gland. This condition occurs when the salivary gland becomes infected or obstructed, leading to pain, swelling, and tenderness in the affected area. Common causes of sialadenitis include bacterial infections, salivary stones, and reduced saliva flow. Treatment typically involves antibiotics, warm compresses, and maintaining good oral hygiene.
17.
What is the meaning of the root word "myelo-"?
Correct Answer
C. Spinal Cord
Explanation
The root word "myelo-" refers to the spinal cord. This can be understood by looking at the other options: muscle, bone, and blood, which do not relate to the spinal cord. Therefore, the correct answer is spinal cord.
18.
Surgical repair on the levator muscle of the eyelid to correct drooping is called :
Correct Answer
A. BlepHaroptosis Repair.
Explanation
Blepharoptosis refers to the condition of drooping eyelids, and surgical repair of the levator muscle is the appropriate treatment for correcting this condition. Therefore, the correct answer is Blepharoptosis Repair. Conjunctivoplasty is a surgical procedure to repair the conjunctiva, not the levator muscle. Blepharoplasty is a cosmetic surgery procedure to improve the appearance of the eyelids, not specifically for correcting drooping. Canthotomy is a surgical procedure to release tension in the eyelid, not for repairing the levator muscle.
19.
Dislocation of the scaphoid bone is located in the :
Correct Answer
B. Foot
Explanation
The scaphoid bone is located in the wrist, specifically in the proximal row of carpal bones. It is one of the most commonly fractured carpal bones, usually resulting from a fall onto an outstretched hand. Dislocation of the scaphoid bone would therefore be located in the wrist, not in the shoulder, elbow, or knee.
20.
A patient who has been severely burned will be undergoing a skin xenograft for temporary wound closure. The xenograft harvests the skin from where?
Correct Answer
C. From a donor that is non-human.
Explanation
The correct answer is from a donor that is non-human. In a skin xenograft procedure, the skin is harvested from a donor that is not of the same species as the patient. This is often done using pig skin, as it is similar in structure and function to human skin. The xenograft is used as a temporary wound closure until the patient's own skin can be regenerated or a more permanent graft can be performed.
21.
Which of the code book volumes are used in a physician's office?
Correct Answer
D. Only A and B are used.
Explanation
In a physician's office, Volume 1 and Volume 2 of the code book are used. Volume 1 contains diagnosis codes for outpatient settings, while Volume 2 contains procedure codes. Volume 3, on the other hand, is used for inpatient hospital settings and is not typically used in a physician's office. Therefore, the correct answer is that only Volume 1 and Volume 2 are used in a physician's office.
22.
" ------------------------------- " is a reference that instructs coder to look up another term to locate a code for a particular condition.
Correct Answer
C. See condition
Explanation
The correct answer is "See condition". This answer suggests that when encountering the reference "See condition" in coding, the coder should look up another term to find the appropriate code for a specific condition. This implies that the coder should refer to additional information or guidelines to determine the appropriate code to use based on the given condition.
23.
--------------------------------------- is (are) used in both the index and Tabular List to enclose supplementary words that may be present or absent in the statement of a disease or procedure, without affecting the code assignment.
Correct Answer
D. Parentheses
Explanation
Parentheses are used in both the index and Tabular List to enclose supplementary words that may be present or absent in the statement of a disease or procedure, without affecting the code assignment. This allows for additional information to be included without changing the code that is assigned. The use of parentheses helps to clarify and provide additional context for the code assignment.
24.
Which statement is NOT true of inclusion terms?
Correct Answer
A. An "Inclusion note" under a code indicates that the terms excluded from the code are to be coded elsewhere.
Explanation
An inclusion note under a code indicates that the terms included in the code are to be coded elsewhere, not excluded from the code.
25.
The word(s) " ----------- " should be interpreted to mean either "and" or "or" when it appears in the title.
Correct Answer
D. And
Explanation
The word "and" should be interpreted to mean both "with" and "see" when it appears in the title.
26.
The most commonly used etiology/manifestation combinations are the codes for --------------------------, category 250.
Correct Answer
C. Diabetes mellitus.
Explanation
The most commonly used etiology/manifestation combinations are the codes for diabetes mellitus, category 250. This implies that diabetes mellitus is a frequently reported condition and its codes are commonly used in medical documentation.
27.
" -------------------------- " is used in the Alphabetic Index to provide guidance when two conditions are related or have a casual relationship.
Correct Answer
A. Due to
Explanation
"Due to" is used in the Alphabetic Index to indicate a causal relationship between two conditions or terms. It implies that one condition or term is the cause or reason for the other. This phrase helps provide guidance and clarify the relationship between the two conditions or terms listed in the index.
28.
When coding neoplasm (cancer) , "metastatic from" means?
Correct Answer
A. Primary site.
Explanation
"Metastatic from" refers to the primary site of the neoplasm or cancer. This term indicates that the cancer has spread from its original location to another part of the body. It helps in identifying the origin or source of the cancerous cells, which is crucial for determining the appropriate treatment and prognosis for the patient.
29.
EVALUATION AND MANAGEMENT :A 90-year-old patient asks for a second opinion when he was recently diagnosed with bilateral senile cataracts. His regular ophthalmologist has recommended implantation of lenses after surgical removal of the cataracts. The patient presents to the clinic stating that he is concerned about the necessity of the procedure. During the detailed history, the patient states that he has had decreasing vision over the last year or two but has always had excellent vision. He cannot recall a trauma to the eye in the past. The physician conducted a detailed visual examination and confirmed the diagnosis of the patient's ophthalmologist. The medical decision-making was of low complexity.
Correct Answer
C. 99203
Explanation
The correct answer is 99203. This code represents a new patient office visit with a detailed history, a detailed examination, and low complexity medical decision-making. In this scenario, the 90-year-old patient is seeking a second opinion for his bilateral senile cataracts. The physician conducts a detailed visual examination and confirms the diagnosis made by the patient's ophthalmologist. The patient's history of decreasing vision and lack of trauma to the eye suggests a progressive condition rather than an acute problem. The medical decision-making is considered low complexity because the diagnosis is confirmed and the treatment plan involves surgical removal of the cataracts with lens implantation.
30.
The attending physician requests a confirmatory consultation from an interventional radiologist for a second opinion about a 60-year-old male with abnormal areas within the liver. The recommendation for a CT guided biopsy is requested, which the attending has recommened be performed. During the comprehensive history, the patient reported right upper quadrant pain. His liver enzymes were elevated. Previous CT study revealed multiple low attenuation areas within the liver (infection not tumor). The laboratory studies were creatinine, 0.9; hemoglobin, 9.5; PT and PTT, 13.0/31.5 with an INR of 1.2. The comprehensive physical examination showed that the lungs were clear to auscultation and the heart had regular rate and rhythm. The mental status was oriented times three. Temperature, intermittent low-grade fever, up to 101 deg. fahrenheit, usually occurs at night. The CT-guided biopsy was considered appropriate for this patient. The medical decision making was of high complexity.
Correct Answer
A. 99223
Explanation
The correct answer is 99223 because the patient's condition is complex and requires a comprehensive evaluation and management. The attending physician has requested a second opinion from an interventional radiologist and a CT-guided biopsy is recommended. The patient has abnormal areas within the liver, elevated liver enzymes, and previous CT studies showing low attenuation areas. The patient also reports right upper quadrant pain and intermittent low-grade fever. All of these factors contribute to the complexity of the medical decision making in this case, justifying the use of code 99223.
31.
A cardiology consultation is requested for a 69-year-old inpatient for recent onset of dyspnea on exertion and chest pain. The comprehensive history reveals that the patient cannot walk three blocks without exhibiting retrosternal squeezing sensation with shortness of breath. A comprehensive physical examination reveals pleasant, elderly female in no apparent distress. The medical decision making complexity is high based on the various diagnosis options.
Correct Answer
C. 99255
Explanation
The correct answer is 99255 because the patient's symptoms of dyspnea on exertion and chest pain, along with the inability to walk three blocks without experiencing retrosternal squeezing sensation and shortness of breath, indicate a high level of medical decision making complexity. This complexity suggests that the patient's condition requires a comprehensive evaluation and management, which is captured by the code 99255.
32.
A new patient presents to the emergency department with an ankle sprain received when he fell while roller-blading. The physician completes an expanded problem focused history and examination. The medical decision making complexity is low.
Correct Answer
B. 99282
Explanation
The correct answer is 99282. This code represents a level 2 emergency department visit. The patient's presentation with an ankle sprain and the completion of an expanded problem focused history and examination indicate a moderate level of complexity. The medical decision making complexity is low, which aligns with a level 2 visit.
33.
A physician provides a service to a new patient in a custodial care center. The physician performed an expanded problem-focused history and examination. The medical decision making was of low complexity.
Correct Answer
B. 99325
Explanation
The correct answer is 99325. This code represents an initial evaluation and management service for a new patient in a custodial care center. The physician performed an expanded problem-focused history and examination, which means they gathered information about the patient's medical history and performed a limited examination. The medical decision making was of low complexity, indicating that the physician made straightforward decisions about the patient's care. This code accurately reflects the level of service provided by the physician in this scenario.
34.
A new patient is admitted to the observation unit of the local hospital after a 10 foot fall from a ladder. The physician completed a comprehensive history and physical examination. The medical decision making is moderately complex. Also code for Code for a subsequent observation, one day, Expanded problem-focused history, Expanded problem-focused exam and Moderate Medical Decision Making. What is noteworthy about the subsequent day observation codes?
Correct Answer
B. 99219; 99225; They are Out of Order Codes
Explanation
The subsequent day observation codes 99219 and 99225 are considered "Out of Order Codes" because they do not follow the E & M (Evaluation and Management) rules of the three key components. These codes are used when a patient is admitted for observation after a previous visit or procedure and the subsequent day requires a more comprehensive evaluation and management. These codes are used to accurately bill for the services provided on the subsequent day, even though they may not follow the usual order of E & M codes.
35.
An established patient is admitted to the hospital by his attending physician after a car accident in which the patient hit the steering wheel of the automobile with significant enough force to fold the wheel backward. After a detailed history and physical examination, the physician believed the patient may have sustained a right rotator cuff injury. The medical decision was straightforward in complexity.
Correct Answer
D. 99221
Explanation
The correct answer is 99221 because the patient is an established patient who was admitted to the hospital after a car accident. The physician performed a detailed history and physical examination and determined that the patient may have sustained a right rotator cuff injury. The medical decision-making was straightforward in complexity, indicating that a lower level of service is appropriate. Therefore, 99221, which represents an initial hospital visit for a new or established patient, is the correct code.
36.
An established patient is seen in a nursing facility by the physician because the patient, who is a diabetic, has developed a stage II decubitus ulcer with cellulitis. The physician performs a detailed history and examination. The medical decision making complexity is moderate.
Correct Answer
B. 99309
Explanation
In this scenario, the physician is seeing an established patient in a nursing facility who has developed a stage II decubitus ulcer with cellulitis. The physician performs a detailed history and examination, indicating a higher level of complexity in medical decision making. The correct answer, 99309, is an evaluation and management code for a detailed examination and a moderate level of medical decision making.
37.
Observation Codes 99218, 99219 and 99220 have estimated times of :
Correct Answer
B. 30, 50 and 70 minutes, respectively
Explanation
The correct answer is 30, 50 and 70 minutes, respectively. This is because the question states that Observation Codes 99218, 99219, and 99220 have estimated times, and these times are given as 30, 50, and 70 minutes respectively.
38.
A 60-year-old male presents for a complete physical. There are no new complaints since my previous examination on June 9 of last year. On physical examination, the patient is a well-developed, well-nourished male.The physician continues and provides a complete examination of the patient lasting 45 minutes.
Correct Answer
A. 99396
Explanation
The correct answer is 99396 because it is the appropriate code for a comprehensive preventive medicine evaluation and management (E/M) service for an established patient, 65 years or older. This code is used for a complete physical examination, which includes an assessment of the patient's overall health, as well as counseling and anticipatory guidance. The fact that the examination lasted 45 minutes also supports the use of this code, as it falls within the time range specified for code 99396.
39.
ANESTHESIA :The physical status for a patient who had a mild systemic disease would be?
Correct Answer
B. P2
Explanation
The physical status for a patient who had a mild systemic disease would be P2. This indicates that the patient has a mild systemic disease but is otherwise healthy. P1 represents a patient who is healthy with no underlying diseases, P3 represents a patient with severe systemic disease, and P4 represents a patient with severe systemic disease that is a constant threat to life.
40.
The qualifying circumstances code indicates a 75-year-old male.
Correct Answer
A. 99100
41.
This type of sedation decreases the level of patient's alertness but allows the patient to cooperate during the procedure.
Correct Answer
D. Conscious
Explanation
Conscious sedation is the correct answer because it is a type of sedation that reduces the patient's level of alertness while still allowing them to cooperate during a medical procedure. This type of sedation is commonly used for procedures such as dental work or minor surgeries, where the patient needs to be relaxed and comfortable but still able to follow instructions. Conscious sedation can be achieved through the administration of medications that induce a state of relaxation and drowsiness, but the patient remains conscious and can respond to stimuli.
42.
What publication is the National Unit Values published?
Correct Answer
B. RVG by ASA
Explanation
The correct answer is RVG by ASA. RVG stands for "Real Estate Valuation Guidelines," which is a publication that provides guidelines and standards for real estate appraisals. ASA refers to the "American Society of Appraisers," an organization that promotes professional excellence in the field of appraisals. Therefore, the National Unit Values are published in the RVG by ASA, indicating that the guidelines for real estate valuation are provided by the American Society of Appraisers.
43.
To calculate the unit value of services for two procedures performed on the same patient during the same operative session you would do the following to report anesthesia services.
Correct Answer
A. Report only the units for the highest unit value procedure.
Explanation
When calculating the unit value of services for two procedures performed on the same patient during the same operative session, it is recommended to report only the units for the highest unit value procedure. This means that the anesthesia services should be reported based on the procedure with the highest unit value, rather than combining or subtracting the units of the two procedures. By doing so, it ensures that the anesthesia services are accurately reported and billed based on the procedure that requires the most resources and time.
44.
Code anesthesia service provided for an anterior cervical discectomy with decompression of a single interspace of the spinal cord and nerve roots and including osteophytectomy.
Correct Answer
D. 00600
Explanation
The correct answer is 00600. This code represents the anesthesia service provided for an anterior cervical discectomy with decompression of a single interspace of the spinal cord and nerve roots, including osteophytectomy.
45.
Per CPT guidelines, anesthesia time ends :
Correct Answer
B. When the anesthesiologist is no longer in personal attendance on the patient.
Explanation
According to CPT guidelines, anesthesia time ends when the anesthesiologist is no longer personally attending to the patient. This means that once the anesthesiologist has completed their duties and is no longer directly involved in the patient's care, the anesthesia time is considered to have ended. It is not dependent on the patient leaving the operating room or the post anesthesia care unit, or fulfilling recovery criteria.
46.
A physical status anesthesia modifier of P4 means that a patient has :
Correct Answer
C. Has a severe systemic disease that is a constant threat to life.
Explanation
A physical status anesthesia modifier of P4 indicates that the patient has a severe systemic disease that poses a constant threat to their life. This means that the patient's overall health is significantly compromised and their condition requires careful monitoring and management during anesthesia.
47.
Qualifying circumstances anesthesia codes are used :
Correct Answer
D. All of the above.
Explanation
Anesthesia codes are used to not only describe the anesthesia itself, but also to indicate any qualifying circumstances that may impact the nature of the anesthesia or the provision of anesthesia under difficult circumstances. Therefore, all of the options listed - in addition to the anesthesia, circumstances impacting the character of the anesthesia, and provision of anesthesia under difficult circumstances - are reasons for using qualifying circumstances anesthesia codes.
48.
Anesthesia time starts when :
Correct Answer
C. When the radiologist prepares the patient for induction ---- preoperative
Explanation
The correct answer is when the radiologist prepares the patient for induction - preoperative. This is because anesthesia time typically starts when the patient is being prepared for the induction of anesthesia, which includes activities such as positioning the patient, applying monitoring devices, and administering preoperative medications. Meeting the family or administering drugs may be part of the anesthesia process, but they do not mark the start of anesthesia time.
49.
RADIOLOGY :A 60-year-old female comes to the clinic with shortness of breath. The doctor orders a chest x-ray, frontal and lateral.
Correct Answer
D. 71020, 786.05
Explanation
The correct answer is 71020, 786.05. The reason for this is that the question states that a chest x-ray, both frontal and lateral, is ordered. The code 71020 represents a chest x-ray, and the modifier 26 is not mentioned in the question, which means that the professional component is not being billed separately. The diagnosis code 786.05 is for shortness of breath, which matches the patient's symptoms.
50.
A patient presents for an MRI of the pelvis with contrast materials.
Correct Answer
C. 72196