Mr. Valdez arrives in the emergency department with complaints of shortness of breath and wheezing.After study, he is found to have an exacerbation of COPD. He has a history of emphysema. ICD-10-CM code(s) are: A. R06.02, R06.2 B. J44.1 C. J44.1, J43.9 D. J43.9 Question 7 Ms. Gardose is a 75-year-old woman who presented to emergency department with sharp pain during inhalation. The physician diagnosed her with pneumonia and flare up of COPD. Diagnosis code(s) to report this patient’s condition are: A. J44.0, J18.9 B. J44.0, J18.9, J44.1 C. J44.1, J18.9 D. J18.9 Question 8 What documentation indicates a “rupture” when coding for an endovascular repair? A. Pseudoaneurysm B. Chronic rupture C. Dissection D. Acute hemorrhage Question 9 Code +34709 for placement of an extension may be assigned for which scenario? A. An extension is placed in the common iliac artery. B. A docking limb is placed in the common iliac artery. C. An extension is placed in the external iliac artery. D. A docking limb is placed in the external iliac artery. Question 10 Which diagnostic test or procedure can be used to diagnose a patient with CVS? A. Abdominal X-ray B. Abdominal ultrasound C. Upper GI endoscopy D. None of the above Question 11 What is the ICD-10-CM code for a diagnosis of “cyclic vomiting syndrome?” A. R11.2 B. R11.12 C. G43.A0 D. G43.A1 Question 12 Payer policies follow the indications for the drugs and what has been approved by the: A. FDA B. CMS C. OSHA D. None of the above. Question 13 A peer-to-peer prior authorization entails: A. A discussion between the ordering provider and nurse practitioner B. A discussion between the ordering provider and payer’s medical director or pharmacist C. A discussion between two providers in the same office D. A discussion between a pharmacist and pharmacy technician Question 14 Guard against insurance and patient check payment theft by: A. Using insurance company direct deposit options B. Using bank check scanners in your office for depositing checks C. Using a bank lock box to avoid checks coming to the office D. All of the above Question 15 What type of insurance plans do not include out-of-network benefits? A. HMO/EPO B. PPO C. POS D. Traditional Question 16 You may want to consider being an out-of-network provider if all of your referrals come from the following marketing sources: A. Word of mouth B. Other colleagues C. Independent marketing D. All of the above Question 17 A patient presents to the urgent care after accidently cutting two fingers with a bagel knife. The laceration on the index finger is 1 cm and the laceration on the middle finger is 2 cm. Simple repairs are performed on each laceration with 5-0 nylon. How should you code these repairs? A. 12001 x 2 B. 12001 C. 12002 D. 12042 Question 18 A patient presents with an abscess on his back that requires drainage. The procedure note indicates: I&D of abscess - complicated. Area injected with 1% lidocaine, anesthesia achieved. Area incised with #11 blade, frank pus expressed approx. 5 mL. Abscess probed to break loculations and wound irrigated and then packed with nugauze. Sterile dressing applied. How should you code? A. 10040 B. 10061 C. 10060 D. 10180 Question 19 The patient is a 49-year-old woman who presents to the ER with an acute onset of pain in her right wrist after falling while being chased by a dog. She fell onto an outstretched hand and struck it sharply against her front doorstep. X-rays of her right hand and wrist confirm she sustained a Colles distal radius fracture. The orthopedist on call places her in a short-arm cast and the visit is documented to Level 3. A. 25600-RT, 99283-57 B. 25600-RT, 29075-59-RT, 99283-57 C. 25605-RT, 29075-51-RT, 99283-25 D. 25605-RT, 99283 Question 20 A 68-year-old, Medicare patient was woodworking in his basement workshop in his single-family home, preparing a new finish to a coffee table. He lost his grip on a powered sander and suffered a crushing injury into the capitate and hamate bones of his right wrist as well as a Gustilo-Anderson Type I open fracture of the hamate body. In the hospital, an orthopedic surgeon performed a flexor tendon decompression fasciotomy with extensive debridement of muscle, nerve tissue and bone as well as a 2- bone carpectomy. An ORIF of the fracture was also done. The surgery took place in the hospital the day after admission at Level 2 subsequent hospital care. This procedure was actually done in consult, but Medicare does not pay for consultation CPT® codes. The patient is placed in an extension control cock- up wrist splint. Code the encounter. A. 25023-RT, 25628-51-RT, 25210-51-RT B. 25023-RT, 25628-51-RT, 25210-51-RT x 2 C. 25023-RT, 11012-51, 25645-51-RT, 25210-51-RT x 2 D. 25023-RT, 25645-51-RT, 25210-51-RT x 2, 99232-57 Grade You have failed 3 attempts. Please reread the publication and try in 1 hours. View Rationale Question 1 Atherosclerosis: A. Is a significant risk factor for AAA B. May cause muscle weakness in the legs C. May cause tears in the inner layer of the aorta D. Both a and b View Rationale Question 2 True or False: You can use a general diagnosis code (Z00.00) for an in-depth procedure test, such as TSH screening panel. A. True B. False View Rationale Question 3 A patient presents to the urgent care after accidently cutting two fingers with a bagel knife. The laceration on the index finger is 1 cm, and 2 cm on the middle finger. Simple repairs are performed on each laceration with 5-0 nylon. Which is proper coding? A. 12001 x 2 B. 12001 C. 12002 D. 12042 View Rationale Question 4 A patient presents with an abscess on his back that requires drainage. The procedure note is: I&D of abscess, complicated. Area injected with 1 percent lidocaine, anesthesia achieved. Area incised with #11 blade, frank pus expressed approx. 5 mL. Abscess probed to break loculations, wound is irrigated, and then packed with Nu Gauze. Sterile dressing applied. Which code reports this procedure? A. 10040 B. 10061 C. 10060 D. 10180 View Rationale Question 5 A 9-year-old female presents to this office today with continued bed wetting. She is here with her mom, who states the child has never been able to go through the night without wetting the bed. She has used alarms, cutting off fluids at 6 p.m., and using bathroom before bed. Denies dysuria or frequency. Mom states the urine is often dark. Which is the ICD-10-CM code to report this condition? A. N39.4 B. N39.41 C. N39.44 D. N39.498 View Rationale Question 6 A 27-year-old male presents for evaluation of left elbow pain. It started two weeks ago after picking up a heavy box. There is no snapping or popping. Pain is aching, located on the left lateral elbow. It’s worse with gripping. He has never experienced this pain before, and there are no alleviating/aggravating factors. He has been putting heat on the area with short term relief. Proper diagnosis is: A. M77.0 B. M77.02 C. M77.11 D. M77.12 View Rationale Question 7 CMS changed the rule regarding teaching physicians re-documenting medical students’ physical examinations because: A. They want less documentation for auditors to review. B. They want to reduce the reimbursement for E/M services. C. They want to reduce administrative burdens for teaching physicians. D. They intend to change evaluation and management CPT® codes in 2019. View Rationale Question 8 Dr. Torrey is a teaching physician in a large metropolitan medical center. She has four medical students attached to her services. Resident Dr. Colavito performed an E/M service in the pediatric clinic, carefully documenting all encounter data in the EHR. The service was performed on 2/1/2018 at 9:30 a.m. Dr. Torrey reviewed his work and agreed with the findings on 2/2/2018 at 10 a.m. Does this meet CMS’ requirements for billing E/M services? A. Yes: The EHR automatically adds her name and date stamp. B. No: The teaching physician must be present at the time the patient is examined. View Rationale Question 9 When coding an adverse effect for a drug that was correctly prescribed and properly administered, what should be coded first? A. The drug B. The underlying condition treated C. The side effect of the drug D. The activity the patient was involved in when the drug was taken View Rationale Question 10 From a documentation standpoint, which is most useful in determining whether a patient has a true drug allergy or just a drug intolerance? A. The underlying condition treated B. The place of occurrence C. The activity the patient was involved in when the drug was taken D. The reaction the patient experienced and the drug that caused the reaction View Rationale Question 11 OP-25 is the measure for Safe Surgery Checklist Use (outpatient). Which should be done to ensure patient safety? A. Mark the site of the body area to be operated on. B. Confirm the patient’s identity before initiating the procedure. C. Identify the allergy(ies) the patient has prior to initiating the procedure. D. All of the above. View Rationale Question 12 A patient admitted for left hip replacement has a medical history of COPD, with hospitalization six months ago due to acute exacerbation, diabetes with neuropathy, appendicitis s/p RT appendectomy 1997, and a history of prostate cancer s/p TURP, radiation and chemotherapy, no NED and no medications noted. Considering the importance of capturing comorbidities in the inpatient setting, which conditions should the providers document and address as active conditions for accurate code reporting during this admission? A. Appendicitis, COPD, and diabetic neuropathy B. COPD and diabetic neuropathy C. COPD with exacerbation and diabetic neuropathy D. COPD, diabetic neuropathy, and prostate cancer View Rationale Question 13 Local Coverage Determinations (LCDs) are: A. Applicable across the United States B. Issued by CMS C. Contain information about standards for “reasonable and necessary” items and services D. Not enforceable by the Medicare administrative contractor (MAC) View Rationale Question 14 The Sessions and Brand memos are: A. New policies on how the DOJ should proceed regarding agency guidance B. Effective upon their date of issue C. Applied to guidance documents such as LCDs, CMS’ Medicare manuals, and OIG advisory opinions D. All the above View Rationale Question 15 A progress note with one to three elements of HPI for a new patient office visit will result in an E/M level no higher than: A. 99203 B. 99214 C. 99202 D. 99213 View Rationale Question 16 When comparing the review of systems and physical examination to the chief complaint and HPI in an EHR, the auditor is looking for: A. A comprehensive level B. A detailed level C. The number of HPI elements D. Agreement View Rationale Question 17 ____________________ is an example of a disease interaction. A. Hypertension and osteoporosis B. PVD and CHF C. Diabetes with macular degeneration D. Diabetes and respirator dependence View Rationale Question 18 All Medicare Advantage plan members are assigned an RAF by which entity? A. AMA B. CMS C. AARP D. ACA View Rationale Question 19 A patient has a panniculectomy, as well as a coring out and relocation of the umbilicus. Which is correct coding assignment for this surgery? A. 15830 B. 15830, 14301, 14302 C. 15380, 15847 D. 15380, 15877 View Rationale Question 20 UOD excludes all of the following, except: A. Hospice member B. Sickle cell disease patient C. 18 years and older who received prescription opioids for 15 days or more during the measurement year at a high dose D. Cancer patient Grade
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