Exercises from Medical Billing and Coding Lesson Group 11

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Medical Billing and Coding Lesson Group 11 SECTION 2.4 Maria Lugo (username: MC2101820) Attempt 1 Written: Feb 24, 2022 1:51 PM - Feb 24, 2022 2:25 PM Which CPT symbol is used to convey a revised code? Question options: A) Bullet B) Star C) Plus D) Triangle Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 A _______ is a 10-digit number assigned to providers to be used for identification purposes when submitting services to payers. Question options: A) NPI B) UPIN C) NIP D) NUIP Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1
Under which part of Medicare would home health visits be covered? Question options: A) Part B B) Part A C) Part A and B D) Neither Part A nor Part B Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 Sam, a four-year-old male, was brought to the emergency department by his mother, where Dr. Black, the emergency department physician, examined the child. Dr. Black has not provided service to this child in the past. During the history, the mother stated that the child has had a temperature of 101 degrees F for the past 24 hours, has been very fussy and crying, and has been pulling on his left ear. The child states, "It hurts." The physician examined the child during an expanded problem-focused examination, ear, NMT, and diagnosed acute suppurative otitis media, for which he prescribed a 10-day course of amoxicillin. MDM was of low complexity. What CPT code is assigned? Question options: A) 99283 B) 99282 C) 99324
D) 99288 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 Which of the following is the PRO not responsible for reviewing? Question options: A) Admission B) Coverage C) Diagnoses D) Discharge Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 If an established patient presented to the physician's office for simple suture removal after the postop period and the nurse provided the service, what CPT code would you assign for the service? Question options: A) 99239 B) 99213 C) 99211 D) 99212 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3
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The _______ issue of the Federal Register contains outpatient facility changes for CMS programs for the upcoming year. Question options: A) November/December B) November/August C) December/October D) October/November Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 Ignoring third-party payer rules, code the following: Discharge Report Patient: Patricia Lorez Physician: Bart Elders, MD Hospital Course: This 52-year-old white female was noted on chest x-ray to have a lesion in her right lung. It was followed for a short period of time and appeared to be somewhat denser. She was, therefore, submitted for a thoracic surgical consultation. After extensive preoperative evaluation by Dr. Green and Dr. Black, she was thought to be a suitable candidate for thoracotomy. On March 3, she underwent a right upper and right middle lobectomy for a stage 1 adenocarcinoma, which appeared to be in the right upper lobe with extension across the fissure to the right middle lobe. The patient was maintained overnight in the ICU, after which she was extubated and transferred to the ambulatory ward. The epidural was removed on the second postoperative day, and the chest tubes were removed on the fourth postoperative day. From that point on, with an episode of atrial fibrillation occurring the fifth day postoperatively, she
was treated with digoxin and diltiazem with resolution. She did have short bursts of atrial fibrillation, however, the day prior to discharge; therefore, she was begun on oral anticoagulation in anticipation that she may continue to have episodes of atrial fibrillation after discharge. On the seventh postoperative day, the patient was discharged home and given a return appointment in two weeks with a chest x-ray, rhythm strip, and protime. Medications at the time of discharge: 1. Digoxin 0.25 mg p.o. q.d. 2. Diltiazem 120 mg p.o. q.6h 3. Ipratropium bromide inhalers 4. Coumadin 5 mg p.o. q.d. 5. Percodan as needed for pain Final Diagnosis: Stage I adenocarcinoma, right upper lobe What CPT code is assigned? Question options: A) 99241 B) 99238 C) 99368 D) 99324 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 History, examination, and medical decision making are called Question options:
A) elements of an outpatient visit. B) coordination factors. C) key components. D) contributory factors. Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 Code 99070 is used to identify Question options: A) supplies and materials. B) materials. C) supplies. D) injections. Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Which CPT code set is assigned to a 4-year old patient when sedation is provided by the surgical physician? Question options: A) 9915599157 B) 0010000352 C) 9915199153
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D) 9949599498 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 According to the Anesthesia Guidelines, what time is used to report the start of anesthesia time? Question options: A) Entering the operating room B) During the pre-anesthesia assessment C) When the anesthesiologist begins to prepare the patient for anesthesia D) Surgery start time Hide Feedback HCPCS Coding and Reimbursement Issues,Section 3 According to the Anesthesia Guidelines, the reporting of anesthesia services is appropriate by or under the responsible supervision of which of the following? Question options: A) Physician B) Anesthesiologist C) Any certified anesthesia professional D) CRNA Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3
Which modifier is used when reporting regional or general anesthesia provided by a physician also performing the service for which the anesthesia is being provided? Question options: A) -25 B) -47 C) -51 D) -52 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Which modifier may be used to indicate a procedure that isn't considered to be a component of another procedure but is a distinct, independent procedure? Question options: A) -27 B) -47 C) -91 D) - 59 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Read the following office visit details and assign the correct code. Office Visit
Patient: Milly Mortonson Physician: Donald Grossman, MD Chief Complaint: Hypothyroidism. Subjective: Milly is a 39-year-old established patient who is a married white female with a history of hypothyroidism. The TSH level done in May of 2000 was mildly elevated at 12.37. Since then, the patient has been taking an increased dose of Synthroid at 0.125 mcg daily. Except for her weight, she reports that she is feeling quite well. She is frustrated that she has gained weight over the summer. Objective: Weight is 180 pounds. No other examination is done today during this problem-focused encounter. Assessment: 1. Hypothyroidism, euthyroid on treatment 2. Weight gain Plan: She will continue on brand name Levothyroid (this is the brand carried by the hospital) 0.125 mcg daily. The patient was given some information on a weight loss and walking program put on through the Public Health Department. Medical decision making at a straightforward level. Return clinic visit p.r.n. What CPT code is assigned? Question options: A) 99213 B) 99214 C) 99212 THE ANSWER WAS MARKED AS INCORRECT D) 99202
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Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 A 65-year-old Medicare patient presents for a trivalent influenza vaccination, 0.25 mL, split virus, intramuscular injection. The HCPCS code assigned is G0008. Which CPT code is assigned? Question options: A) 90655 B) 90632 C) 90647 D) 90657 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 For code range _______, medical decision-making is only considered moderate to high with the initial face-to-face encounter. Question options: A) 9949799498 B) 9949299494 C) 9946099465 D) 9949599496 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3
During a hip replacement surgery, Dr. Smith asks the charge nurse to page Dr. Jones for assistance. Dr. Jones is in the operating room for 20 minutes. The surgery lasts 60 minutes. Which modifier should be appended to the surgery procedure code? Question options: A) 79 B) 81 C) 54 D) 80 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Which modifier explains multiple operations during the same operative session? Question options: A) -54 B) -50 C) - 51 D) -52 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Maria Lugo (username: MC2101820) Attempt 2
Written: Feb 24, 2022 2:43 PM - Feb 24, 2022 3:39 PM The attending physician for this inpatient requests a subsequent consultation from another physician who, earlier in the week, has provided an initial inpatient consultation. The consultant provides an interval history, which reveals a patient with continued diffuse abdominal pain, more pronounced in the upper quadrants. The patient has a feeling of fullness and tightness in that region. Pain is rated at 6–7 on a scale of 10. Patient acknowledges that she has now lost her appetite. She notes that urine is very dark in color and skin has felt very itchy. The patient also confirmed with her mother that there's no known liver disease in the family. A detailed examination is completed. The medical decision making was of high complexity. What CPT code is assigned? Question options: A) 99336 B) 99292 C) 99233 D) 99318 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 Which CPT symbol conveys codes which are modifier -51 exempt? Question options: A) Lightning bolt B) Number sign C) Circle D) Circle with a line Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2
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Which section of the CPT book is used to locate service/procedure terms and codes? Question options: A) Appendices B) Guidelines C) Index D) Tabular List Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Which of the following is the numeric designation for a group of providers that's used instead of the individual provider number? Question options: A) AUN B) GPN C) IPN D) PA Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 The full list of telemedicine services can be located in appendix Question options: A) A. B) D.
C) P. D) F. Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 The E/M guidelines list Question options: A) clinical examples. B) specific CPT codes. C) categories of service located in the E/M section. D) ROS only. Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 A brief history, extended review of systems, no past, family, and/or social history are classified as Question options: A) problem-focused history. B) detailed history. C) confidential history. D) expanded problem-focused history. Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 According to the E/M, there are five elements to the basic format of the services found in the E/M section. The first is the unique code number, the second is the place and/or type of service,
the third is the content of the service, and the fourth is the nature of the presenting problem. What is the fifth element? Question options: A) Time B) CC C) ROS D) Diagnosis Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 Read the following record of operation and select the correct anesthesia code. Record of Operation Patient: Ann Zantza Physician: Dennis Munoz, MD Preoperative Diagnosis: Cancer of right breast Postoperative Diagnosis: Cancer of right breast Surgeon: Morton Holden, MD History: This patient has cancer of the right breast. It was elected to do a right total mastectomy with an axillary dissection. Procedure: This patient was given a general anesthetic. The right arm was free draped, and she was prepped and draped in this position. We marked our superior and inferior skin incisions, and then we developed our superior flap and went down to the chest wall. We then developed the inferior flap and went down to the chest wall. We then removed the breast going from medial to lateral. We then marked it from pathological orientation. I then opened up the clavipectoral fascia. There was an easily palpable node in an area where I had felt palpable nodes before her neoadjuvant chemotherapy. I dissected this node out. This could be a sentinel node, but I obviously do not know that for sure. However, it is in the area where I felt palpable nodes, and I elected to send it for frozen section with the idea that if I saw a tumor within the node, then I would consider being more aggressive with my axillary dissection. We sent this for frozen section and it came back with no tumor. It could be that there was a tumor in this node and chemotherapy dealt with it. Either way, we continued with our axillary dissection, but we elected not to go after level II nodes because this was negative. We identified the axillary vein, the long thoracic nerve, and the thoracodorsal vessels and nerves, and then we did a formal axillary dissection going from below the axillary vein all the way down. We sent this for pathology. We had excellent hemostasis. We clipped multiple small vessels and lymphatics. We irrigated out the wound with fluid that had Ancef in it. We then put a Hemovac drain through a separate wound laterally inferiorly and put one limb in the axilla and one limb on the chest wall. We sutured
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these in place with silk sutures. We went ahead and closed the skin with interrupted Vicryl stitches, and then staples were placed in the skin. Telfa toppers and gauze were applied. The patient tolerated this very well and went to the recovery room in good condition. What CPT Anesthesia code is assigned? Question options: A) 00404 B) 00406 C) 00410 D) 00402 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 The CPT Anesthesia Guidelines indicate that the six levels of Physical Status Modifiers are consistent with the ranking of patient's physical status written by the Question options: A) AMA. B) ASA. C) AGA. D) AGP. Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 Read the following operative report and select the correct CPT Anesthesia code. Operative Report Patient: Patricia Ortez Physician: Harold Green, MD Preoperative Diagnosis: Left frozen shoulder
Postoperative Diagnosis: Left frozen shoulder Procedures Performed: 1. Arthroscopic debridement, left shoulder 2. Joint manipulation, left shoulder Clinical History: This 52-year-old lady presented with a history of progressive pain and discomfort of her left shoulder. The evaluation confirmed evidence of left frozen shoulder. After the risks and benefits of anesthesia and surgery were explained to the patient, the decision was made to undertake the procedure. Report of Operation: Under general anesthesia, the patient was laid in the beach-chair position on the operating room table. The left shoulder was prepped and draped in the usual fashion. A standard posterior arthroscopic portal was created, with the camera introduced into the back joint. We had excellent visualization. It was immediately apparent that there was substantial inflammation throughout the entirety of the joint. Using a switch stick technique, we created an anterior portal and brought in the 7-mm cannula from the front. With a 4.0 double-biter resector, the synovium was then debrided throughout the entirety of the rotator cuff over the surface of the biceps and the anterior ligamentous structures, as well as irrigated to remove any blood. The articular surfaces were inspected and found to be normal. The attachment of the biceps was normal, although it had been covered with synovium. Anterior ligamentum structures were free from the subscapularis. The joint was then infiltrated with 80 mg of Depo-Medrol and 12 cc of Marcaine. The instruments were removed. The arthroscopic portal was closed with absorbable sutures and Steri-strips. The joint was then manipulated. Prior to manipulation, we had about 90 degrees of elevation passively. Post manipulation evaluation was free up to 180 degrees, and external rotation in an abducted position was possible to 90 degrees, as was internal rotation. Extension was possible to 40 degrees, and adduction was possible to 50 degrees. The wounds were then dressed with Myopore dressing. The patient was then placed in a CryoCuff sling, awakened and placed on her hospital bed and taken to the recovery room in good condition. Which CPT Anesthesia code is assigned? Question options: A) 01634 B) 01650 C) 01630 D) 01622 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2
Time must be documented in the medical record to select from which code range? Question options: A) 9922199239 B) 9929199292 C) 9930499306 D) 99339-99340 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 Summary of Additions, Deletions, and Revisions are located in appendix _______ of the CPT code book. Question options: A) A B) D C) B D) E Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 An established patient is seen in a nursing facility by the physician because the patient, who is a diabetic, has developed a stage 2 decubitus ulcer with cellulitis. The patient has no complaint of fever or chills and no other skin issues at this time. The physician performs a history and detailed examination. The medical decision making complexity is moderate. The physician revises the patient's medical care plan. What CPT code is assigned? Question options: A) 99366
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B) 99242 C) 99309 D) 99304 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 The Medicare program is supported by money gained through what source? Question options: A) Employer payments B) Property taxes C) Social Security taxes D) Employee contributions Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 What is the Medicare and beneficiary payment of PAR-covered services? Question options: A) 80/20 B) 70/30 C) 50/50 D) 90/10
Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 Which part of Medicare covers the hospital portion? Question options: A) Part B B) Part C C) Part D D) Part A Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 _______ anesthesia isn't coded separately because it's included in the surgery. Question options: A) MAC B) Regional C) Local D) General Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 During a surgical procedure, the physician decides the patient would have to return to the OR in three days for an additional procedure. Which modifier(s) will be appended to the surgical procedure code? Question options: A) 58
B) 58 and 78 C) 56 D) 78 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 A patient visits her primary care physician's office in January of 2019. The physician schedules a one-year followup to be conducted via Skype. What is the CPT code for this visit? Question options: A) 99203 B) 99423 C) 99220 D) 99224 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 Maria Lugo (username: MC2101820) Attempt 3 Written: Mar 30, 2022 12:33 PM - Mar 30, 2022 1:10 PM
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Which modifier should not be reported by anesthesiologists? Question options: A) -53 B) -59 C) -23 D) -47 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 According to the E/M Guidelines, when counseling and/or coordination of care dominates more than _______ percent of the physician/patient and/or family encounter, time is considered to be the key or controlling factor to quality for a particular level of service. Question options: A) 60 B) 10 C) 50 D) 30 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 A surgical procedure is performed by a general surgeon and an orthopedist. Both surgeons dictate the procedure and
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submit encounters for billing. Which modifier should be appended to the surgical procedure code? Question options: A) -62 B) -81 C) -82 D) -80 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Which of the following is an organized set of health care services for a specific geographic area? Question options: A) Medicaid B) Health Maintenance Organization (HMO) C) Private Insurance D) Preferred Provider Organization (PPO) Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 Some of the procedures or services listed in CPT that are commonly carried out as an integral component of a total service or procedure have been identified by Question options: A) any additional.
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B) separate procedure. C) each additional. D) related procedure. Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 _______ modifiers help to show complexity of service but are not accepted by Medicare. Question options: A) Qualifying circumstances B) Physical status C) Base unit D) Anesthesia Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Surgery performed on an infant weighing six pounds requires which modifier? Question options: A) -62 B) -59 C) -63
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D) -66 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 The _______ is assigned the daily operation of the Medicare program by CMS. Question options: A) RBRVS B) IP C) FM D) MAC Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 Which physician is legally responsible for overseeing inpatient care? Question options: A) Referring provider B) Attending physician C) Resident physician D) Hospitalist Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3
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Dr. Robertson provided the first month of care planning oversight for a home health agency's home care of a 64-year- old male patient with advanced pancreatic cancer. The physician developed a plan that included home oxygen, intravenous diuretics, pain control management by means of intravenous morphine, review of records and lab studies, and communication with the agency. The time spent in oversight for the month was 45 minutes. What CPT code is assigned? Question options: A) 99220 B) 99380 C) 99360 D) 99375 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 The servicing provider information is placed in box _______ on the CMS 1500 claim form. Question options: A) 27 B) 24j C) 17b D) 32 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2
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According to the Medicine Guidelines, some of the listed procedures are commonly carried out in addition to the Question options: A) primary surgical procedure. B) primary procedure performed. C) secondary surgical procedure. D) principal diagnostic procedure. Hide Feedback HCPCS Coding and Reimbursement Issues, Section 4 Medical documentation for an established patient's office visit outlines a minor problem, no labs, and minimal risk. Which E/M code is assigned? Question options: A) 99202 B) 99214 C) 99212 D) 99213 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 Which modifier explains multiple operations during the same operative session? Question options: A) -52
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B) -50 C) -54 D) -51 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Which of the following is the numeric designation for a group of providers that's used instead of the individual provider number? Question options: A) GPN B) PA C) AUN D) IPN Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 Which CPT code set is assigned to a 4-year old patient when sedation is provided by the surgical physician? Question options: A) 9915599157 B) 0010000352
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C) 9949599498 D) 9915199153 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 What is the Medicare and beneficiary payment of PAR-covered services? Question options: A) 80/20 B) 70/30 C) 90/10 D) 50/50 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 1 Read the following office visit details and assign the correct code. Office Visit Patient: Milly Mortonson Physician: Donald Grossman, MD Chief Complaint: Hypothyroidism. Subjective: Milly is a 39-year-old established patient who is a married white female with a history of hypothyroidism. The TSH level done in May of 2000 was mildly elevated at 12.37. Since then, the patient has been taking an increased dose of Synthroid at 0.125 mcg daily. Except for her weight, she reports that she is feeling quite well. She is frustrated that she has gained weight over the summer. Objective: Weight is 180 pounds. No other examination is done
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today during this problem-focused encounter. Assessment: 1. Hypothyroidism, euthyroid on treatment 2. Weight gain Plan: She will continue on brand name Levothyroid (this is the brand carried by the hospital) 0.125 mcg daily. The patient was given some information on a weight loss and walking program put on through the Public Health Department. Medical decision making at a straightforward level. Return clinic visit p.r.n. What CPT code is assigned? Question options: A) 99212 B) 99213 C) 99214 D) 99202 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 3 Which CPT symbol is used to convey a revised code? Question options: A) Plus B) Bullet C) Triangle
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D) Star Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2 Which modifier is used when reporting regional or general anesthesia provided by a physician also performing the service for which the anesthesia is being provided? Question options: A) -47 B) -52 C) -51 D) -25 Hide Feedback HCPCS Coding and Reimbursement Issues, Section 2
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