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While cerclage removal is generally covered under the global period, CPT guidelines state that the cerclage removal may be coded if done under any
anesthesia, other than local.
A.
True
B.
False
Correct Answer
A. True
Explanation A procedure in which the cervical opening is closed with stitches to prevent or delay preterm birth
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2.
Traumatic hemarthrosis is a _______________
Correct Answer sprain
Explanation Traumatic hemarthrosis refers to bleeding into a joint cavity as a result of trauma or injury. A sprain, on the other hand, is an injury to a ligament, which is the tissue that connects bones to each other. While both conditions involve injury and can cause pain and swelling, they are different in terms of the specific tissues affected. Therefore, traumatic hemarthrosis is not a sprain.
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3.
When a malignant neoplasm of lymphoid tissue metastasizes beyond the
lymph nodes, a code from categories C81-C85 with a final character “9”
should be assigned identifying "______________ and solid organ sites”
Correct Answer extranodal
Explanation When a malignant neoplasm of lymphoid tissue spreads beyond the lymph nodes, it is referred to as extranodal. This means that the cancer has metastasized to other areas or organs outside of the lymph nodes. The code from categories C81-C85 with a final character "9" is used to identify this extranodal involvement of lymphoid tissue in solid organ sites.
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4.
If record states that pt is taking Coumadin regularly, don't forget to code LONG-TERM USE OF ________________
A.
Anti-hypertensive
B.
Anti-coagulant
C.
Anti-viral
D.
Anti-biotic
Correct Answer
B. Anti-coagulant
Explanation The correct answer is anti-coagulant. The question states that the patient is taking Coumadin regularly, which is a brand name for the medication warfarin, a commonly used anti-coagulant. Anti-coagulants are medications that help prevent blood clots from forming or getting larger, and they are often prescribed for long-term use in patients with certain medical conditions. Therefore, it is important to code for long-term use of anti-coagulants when the patient's record indicates regular use of Coumadin.
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5.
Unless a provider is subject to a state-based external cause code reporting
mandate or these codes are required by a particular payer, reporting of ICD-10-CM codes in Chapter 20, External Causes of Morbidity, is not required.
A.
True
B.
False
Correct Answer
A. True
Explanation The statement is saying that unless a provider is required to report external cause codes by a state-based mandate or a specific payer, they are not required to report ICD-10-CM codes in Chapter 20, which is about External Causes of Morbidity. Therefore, the correct answer is True, indicating that reporting these codes is not mandatory in most cases.
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6.
Lisinopril is _____________
A.
Anti-inflammatory
B.
Insulin
C.
Diuretic
D.
Anti-hypertensive
Correct Answer
D. Anti-hypertensive
Explanation Lisinopril is classified as an anti-hypertensive medication. This means that it is used to treat high blood pressure by helping to relax the blood vessels, allowing blood to flow more easily. It is not an anti-inflammatory, insulin, or diuretic medication.
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7.
If patient in question is pregnant and has AIDS/HIV, the "HIV complicating pregnancy" code comes __________ B20.
Correct Answer before
Explanation Do not forget to include a "complicating pregnancy code" for any other conditions if applicable.
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8.
If patient is admitted and later transferred, the initial reason for admittance is coded _____________.
Correct Answer second
Explanation The reason for the transfer is coded first
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9.
Patient presents with shortness of breath and is diagnosed with acute diastolic heart failure. The patient had a heart transplant about two years ago. Even though the heart failure developed long after the transplant of the heart, this is coded as a complication of the transplant.
A.
True
B.
False
Correct Answer
A. True
Explanation There are no timeframe restriction on complications of a transplanted organ.
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10.
Pain associated with devices, implants or grafts left in a surgical site (for
example painful hip prosthesis) is assigned to the appropriate code
found in Chapter 19, Injury, poisoning, and certain other consequences
of external causes.
Use additional code(s) from category G89 to identify acute or chronic pain due to presence of the device, implant or graft
A.
True
B.
False
Correct Answer
A. True
Explanation The statement is true because pain associated with devices, implants, or grafts left in a surgical site is assigned a code found in Chapter 19, which deals with injuries, poisoning, and certain other consequences of external causes. In addition, category G89 is used to identify whether the pain is acute or chronic due to the presence of the device, implant, or graft. Therefore, the correct answer is true.
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11.
Manipulation of condyle indexes to Reposition, ________________
Correct Answer humeral shaft
12.
What diagnosis code(s) are used for a hemorrhage post elective abortion.
A.
O04.6, Delayed or excessive hemorrhage following (induced) termination of pregnancy.
B.
O72.1, Other immediate postpartum hemorrhage
C.
O04.6 AND z33.2, Encounter for elective termination of pregnancy
D.
O72.1 and z33.2
Correct Answer
A. O04.6, Delayed or excessive hemorrhage following (induced) termination of pregnancy.
Explanation Do not assign code Z33.2, , when the patient experiences a complication post elective abortion.
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13.
A patient is admitted with acute gastritis. On the second day of admission, the patient has hematemesis. The patient is also being treated for long-standing
hypertension and diabetes, along with recently diagnosed hypothyroidism. Which of the patient's diagnoses will have a POA indicator of N?
A.
Acute Gastritis
B.
Hematemesis
C.
Hypertension AND Diabetes
D.
Hypothyroidism
Correct Answer
A. Acute Gastritis
Explanation The acute gastritis will warrant a POA indicator of N since there is a combination code for the gastritis with bleeding and the bleeding did not occur until after admission
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14.
Bypass procedures (except for coronary bypasses) are coded by identifying the body part bypassed __________ (4th character) and the body part bypassed ________ (7th character)
A.
To ; from
B.
From ; to
Correct Answer
A. To ; from
Explanation Coronary artery bypass procedures are coded differently. The body part identifies the number of coronary arteries bypassed TO, and the qualifier specifies the vessel bypassed FROM.
Example: Aortocoronary artery bypass of the left anterior descending coronary artery and
the obtuse marginal coronary artery is classified in the body part axis of classification as
two coronary arteries, and the qualifier specifies the aorta as the body part bypassed from.
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15.
Excessive thirst polydipsia and increased urination are common signs and symptoms of ___________________
Correct Answer diabetes
Explanation Excessive thirst, known as polydipsia, and increased urination are classic symptoms of diabetes. In diabetes, the body either does not produce enough insulin or cannot effectively use the insulin it produces. This leads to high blood sugar levels, causing the kidneys to work harder to eliminate the excess sugar through urine. As a result, the body becomes dehydrated, triggering excessive thirst. Increased urination occurs as the body tries to remove the excess sugar. Therefore, excessive thirst and increased urination are common signs and symptoms of diabetes.
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16.
In an ASC (ambulatory surgery center) case, _______________codes are used
Correct Answer CPT
Explanation In an ASC (ambulatory surgery center) case, CPT codes are used. CPT (Current Procedural Terminology) codes are a standardized system of medical codes used to describe specific procedures and services provided by healthcare professionals. These codes help in accurately documenting and billing for services rendered in an ASC setting. They provide a common language for communication among healthcare providers, insurance companies, and regulatory agencies.
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17.
Using IPPS (inpatient prospective payment system), what can be used to measure the cost of care for inpatients?
A.
OPPS
B.
Case-mix Index
C.
HCPCS
D.
Divider rules
Correct Answer
B. Case-mix Index
Explanation The Case Mix Index (CMI) is the average relative DRG weight of a hospital's inpatient discharges, calculated by summing the Medicare Severity-Diagnosis Related Group (MS-DRG) weight for each discharge and dividing the total by the number of discharges
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18.
Fusion of a vertebral joint using a bone dowel interbody fusion device made of cadaver bone and packed with a mixture of local morsellized bone and demineralized bone matrix is coded to the device _________________.
A.
Autologous tissue substitue
B.
Autologous bone substitute
C.
Interbody Fusion Device
Correct Answer
C. Interbody Fusion Device
Explanation Fusion of a vertebral joint using a cage style interbody fusion device
containing morsellized bone graft is coded to the device Interbody Fusion Device
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19.
If a catheter is placed for chemo, code the INSERTION of the _______________
Correct Answer nonbiological appliance
Explanation Type 2 diabetes requires a code for long term insulin use if applicable.
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20.
Prolonged pregnancy extends beyond
A.
38
B.
36
C.
37
D.
42
Correct Answer
D. 42
Explanation Prolonged pregnancy is defined as a pregnancy that extends beyond the normal gestational period of 40 weeks. The correct answer, 42, is the only option provided that exceeds the expected duration of pregnancy. This suggests that a prolonged pregnancy is one that lasts longer than 42 weeks.
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21.
Exploratory laparotomy with general inspection of abdominal contents is coded to the _____________ cavity body part value
Correct Answer peritoneal
Explanation Exploratory laparotomy involves making an incision in the abdomen to visually examine the abdominal contents. During this procedure, the surgeon inspects the peritoneal cavity, which is the space within the abdomen that contains organs such as the liver, intestines, and stomach. Therefore, exploratory laparotomy with general inspection of abdominal contents is coded to the peritoneal cavity body part value.
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22.
The cystic duct from the gallbladder joins the common ______________ duct to form the common bile duct.
Correct Answer hepatic
Explanation The cystic duct from the gallbladder joins the common hepatic duct to form the common bile duct. The hepatic duct is responsible for carrying bile from the liver, while the cystic duct carries bile from the gallbladder. When these two ducts join together, they form the common bile duct, which then transports bile to the small intestine for digestion.
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23.
The common bile duct passes through the ________________and ends in the small intestine.
Correct Answer pancreas
Explanation The common bile duct passes through the pancreas and ends in the small intestine. The pancreas is an organ located in the upper abdomen, behind the stomach. It plays a crucial role in digestion by producing enzymes that help break down food and hormones that regulate blood sugar levels. The common bile duct carries bile, a substance produced by the liver, to the small intestine to aid in the digestion of fats.
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24.
Bile is made by the ________ and stored in the gallbladder.
Correct Answer liver
Explanation Bile is a digestive fluid that helps in the breakdown and absorption of fats. It is produced by the liver and then stored in the gallbladder. From there, it is released into the small intestine to aid in the digestion process.
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25.
A musculocutaneous flap transfer is coded to the appropriate body part value in the body system ____________.
A.
Integumentary
B.
Skin
C.
Subcutaneous tissue
D.
Muscles
Correct Answer
D. Muscles
Explanation For procedures involving transfer of multiple tissue layers including skin, subcutaneous
tissue, fascia or muscle, the procedure is coded to the body part value that describes the
deepest tissue layer in the flap, and the qualifier can be used to describe the other tissue
layer(s) in the transfer flap.
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26.
A device is coded only if a device remains after the procedure is completed. If no device remains, the device value No Device is coded.
A.
True
B.
False
Correct Answer
A. True
Explanation The given statement is true. It states that a device is coded only if it remains after the procedure is completed. If no device remains, then the value "No Device" is coded. This implies that coding is only done for devices that are present, and if there are no devices, a specific value is assigned.
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27.
If a patient admission/encounter is for the insertion or implantation of
radioactive elements, code the malignancy as the principal diagnosis. Code
Z51.0 should not be assigned.
A.
True
B.
False
Correct Answer
A. True
Explanation When a patient is admitted or encounters a healthcare facility for the purpose of inserting or implanting radioactive elements, the principal diagnosis should be the malignancy being treated. This means that the primary reason for the patient's admission or encounter is the malignancy itself, not the radioactive elements. Therefore, code Z51.0, which is used for encounters for other specific procedures and aftercare involving radiation therapy, should not be assigned in this case.
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28.
Medical conditions due to substance use, abuse, and dependence ARE or ARE NOT classified as substance-induced disorders.
A.
ARE
B.
ARE NOT
Correct Answer
B. ARE NOT
Explanation Assign the diagnosis code for the medical condition as directed by the Alphabetical Index along with
the appropriate psychoactive substance use, abuse or dependence code.
For example, for alcoholic pancreatitis due to alcohol dependence, assign
the appropriate code from subcategory K85.2, Alcohol induced acute
pancreatitis, and the appropriate code from subcategory F10.2, such as
code F10.20, Alcohol dependence, uncomplicated.
It would not be appropriate to assign code F10.288, Alcohol dependence with other
alcohol-induced disorder.
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29.
MOD _____ is used for surgical or other invasive procedures done on the wrong body part
Correct Answer 13 to 26
30.
The default for post-thoracotomy and other postoperative pain not
specified as acute or chronic is the code for the ___________ form.
Correct Answer acute
Explanation Routine or expected postoperative pain immediately after surgery should not be coded.
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31.
Petechia not coded if thrombocytopenia, or another blood-clot disorder, is a diagnosis
Patients with inconclusive HIV serology, but no definitive diagnosis or manifestations of the illness, may be assigned code R75, _______________ laboratory evidence of human immunodeficiency virus
Correct Answer inconclusive
Explanation • If the left side is affected, the default is non-dominant.
• If the right side is affected, the default is dominant.
ambidextrous is dominant
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33.
An exception to the B20 guideline is if the reason for admission is ____________ syndrome associated with HIV disease. Assign code D59.31, followed by code B20
Correct Answer hemolytic-uremic
Explanation If the reason for admission is hemolytic-uremic syndrome associated with HIV disease, an exception to the B20 guideline is made. In this case, the code D59.31 should be assigned first, followed by code B20. This exception indicates that when hemolytic-uremic syndrome is present in a patient with HIV disease, it takes precedence over the B20 guideline, which is the code used for HIV disease.
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34.
The goal of information management is___________
A.
Increase the accuracy of your coding
B.
To support decision making
C.
To provide the most up to date coding rules to your team
D.
Make sure physicians are filling out accurate notes
Correct Answer
B. To support decision making
Explanation The goal of information management is to support decision making. This involves organizing and managing information in a way that allows for easy access and analysis, ultimately aiding in the decision-making process. By having accurate and up-to-date information readily available, decision-makers can make informed choices and take appropriate actions.
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35.
Medicare A is for inpatient care and Medicare B is for outpatient care
A.
True
B.
False
Correct Answer
A. True
Explanation Medicare A is designated for covering inpatient care, which includes hospital stays, skilled nursing facility care, and some home health care services. On the other hand, Medicare B is specifically designed to cover outpatient care, such as doctor visits, preventive services, and medical supplies. Therefore, the statement that Medicare A is for inpatient care and Medicare B is for outpatient care is true.
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36.
The UHDDS definition of principal diagnosis doesn't apply to ___________ as these are considered outpatient services.
A.
Provider-based office visits
B.
ASC services
C.
Emergency room visits
D.
A and C
Correct Answer
D. A and C
Explanation The Uniform Hospital Discharge Data Set (UHDDS) definition of principal diagnosis does not apply to hospital-based outpatient services OR provider-based office visits.
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37.
The CMS "FINAL RULE" on OPPS is that it established APC's by dividing outpatient services into fixed-payment groups
A.
True
B.
False
Correct Answer
A. True
Explanation On July 29, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2023.
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38.
Modified Barium Swallow (MBS) is a fluoroscopic procedure designed to determine whether food or liquid is entering a person's lungs, also known as _____________________
Correct Answer aspiration
Explanation The Modified Barium Swallow (MBS) is a procedure used to determine if food or liquid is entering a person's lungs, which is known as aspiration.
Explanation The correct answer is antineoplastic. Luteinizing hormone releasing hormone agonist therapy is a type of hormonal therapy used in the treatment of certain types of cancer, such as prostate cancer. It works by suppressing the production of certain hormones that can stimulate the growth of cancer cells. Antineoplastic refers to drugs or treatments that are used to inhibit or destroy the growth of cancer cells. Therefore, the infusion of luteinizing hormone releasing hormone agonist therapy can be considered as a form of antineoplastic treatment.
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