medical office chapter 3

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Blue shield is a government sponsored insurance plan.

False

Septicemia is an infection in the blood stream caused by a virus

False, bacteria

Digital block anesthesia is a type of regional anesthesia

true

DRGs are important for hospital charges.

true

One of the three key E&M components, Examination, has 4 levels of service: Problem focused, Expanded problem focused, Detailed, and Comprehensive.

true

The history component of E&M contains: Chief Complaints, History of Present Illness, Review of Symptoms, and Past, Family and/or Social History (PFSH).

true

Coding for wound closures requires the following information: location, size (length), and type of closure

true

When coding for therapeutic services sequence the appropriate V code first for patients receiving chemotherapy, radiation therapy,or rehabilitation services

true

A bronchoplasty is the surgical repair of the bridge of the nose.

false, the bronchus

Strabismus is commonly known as crossed eyes.

true

CPT is the property of the World Health Organization

false, American Medical Association

Parkinson's Disease is known as eponym.

true

Prior hospitalizations are part of a patient's past history.

true

Current Procedural Terminology, Fourth Edition, is a coding system.

true

The hypoglossal nerve controls the facial muscles.

false, tongue muscles

Part of the nature of presenting problem includes allergies.

false, does not

CPT stands for Current Procedural Terminology.

true

ICD-9 was developed by the HCFA to track conditions of disease.

false,World Health Organization to track morbidity and mortality statistics

ICD-9-CM stands for Internal Classification for Diseases, Ninth Revision, Clarical Modification.

false, International Classification for Diseases, Ninth Revision, Clinical Modification

DRG stands for Diagnostic Radiology Groups

false, Diagnosis-Related Groups

The modifiers are the major section of the CPT.

false, not

The organization that maintains and updates the diagnosis portion of the ICD-9-CM codes is the NCHS.

true

Face-to-Face Time includes obtaining a history, performing and examination, and counseling the patient.

true

Concurrent care is when two surgeons operate on the same patient at the same time.

false, similiar services provided by one or more physicians on the same day

Unbundling is th assigning of multiple CPT codes when one CPT code would fully describe the service or procedure.

true

A late effect is the residual effect that remains from the acute phase of an injury or illness.

true

Counseling, Coordination of Care, the Nature of the Presenting Problem and Time are not key E&M components

true

All established patient E&M codes, for a particular level of service, require a minimum of 2 of the 3 key elements.

true

Fragmenting is another term for bundling and unbundling.

true

Basic CPT codes use four digits.

false, five

There are two types of CPT codes one is (add on) the other is______.
A. Adjustment
B. Stand-alone
C. additions
D. single digit

B. Stand-alone

Basic CPT codes use how many digits?
A. 2 digits
B. 3 digits
C. 4 digits
D. 5 digits

D. 5 digits

Services provided by a specialist such as neurosurgeons and intensive care units would be termed as what type of care?
A. Skilled care
B. Binary care
C. Tertiary care
D. Primary care

C. Tertiary care

Which of the following is not a government sponsored insurance plan?
A. Blue Shield
B. Medicare
C. Medicaid
D. TriCare

A. Blue Shield

How often is the Physicians' Current Procedural Terminology (CPT) revised?
A. never
B. every six months
C. annually
D. every two years

C. annually

A summary form listing key components of Evaluation and Management codes is called a/an ____.
A. crib sheet
B. claim form
C. insurance form
D. processing form

A. crib sheet

All CPT codes, descriptions and their two digit modifiers are copyrighted by___.
A. Insurance company
B. the American Medical Association
C. Hospital Association
D. Underwriters Association

B. the American Medical Association

When a code used on a claim form does not match the system used by the insurance company,_____ is likely to occur.
A. downcoding
B. upcoding
C. uncoding
D. duplication

A. downcoding

Deliberate manipulation of CPT codes for increased payment is called______.
A. misconduct
B. malpractice
C. downloading
D. upcoding

D. upcoding

A two or five digit number added to the CPT codes to supply more specific information about the services provided to the patient is called____.
A. key
B. modifier
C. code
D. secret

B. modifier

Procedures that are considered unusual, experimental, or new and do not have a specific code number assigned; unlisted procedure code are located at the end of the subsection and can be used to identify any procedure that lacks a code.
A. Unlisted procedures
B. Practice codes
C. Uncertain codes
D. Experimental code

A. Unlisted procedures

The assigning of multiple CPT codes when one CPT code would fully describe the service or procedure is called ______.
A. unprofessional
B. unbundling
C. bungling
D. Temporary coding

B. unbundling

ICD-9-CM stands for:
A. International Classification of Diseases, Ninth Revision, Clinical Modification
B. Internal Classification of Diseases, Ninth Revision, Clarical Modification
C. Internation Clarafication of disease, Ninth Revision, Clarical Modification
D. Internal Clarafication of Diseases, Ninth Revision, Clinical Modification

A. International Classification of Diseases, Ninth Revision, Clinical Modification

A code that is used to describe the main reason for the patient's visit in cases whre the patient is not sick is called a/an _____code.
A. V
B. E
C. M
D. C

A. V

CPT stands for_______.
A. Case Procedural Terminology
B. Current Procedural Terminology
C. Current Patient Transcripts
D. Case Procedural Transcripts

B. Current Procedural Terminology

The organization that maintains and updates the diagnosis portion of the ICD-9-CM codes is:
A. AAMA
B. NCHS
C. AMA
D. CDC

B. NCHS

M codes are found in the alphabetic index and used primarily by what type of patients?
A. Cancer
B. OB
C. Diabetic
D. Asthma

A. Cancer

All but which of the following is a general group of procedure codes?
A. summation
B. calculated care
C. emergency care
D. concurrent care

A. summation

A term used in ICD-9-CM for codes when insufficient information is available for a more specific code is called _____.
A. NOS-- not otherwise specified
B. NEC-- not elsewhere classified
C. NR -- not rated
D. NOC--not otherwise counted

B. NEC-- not elsewhere classified

Which of the following choices indicates a known error on the billing form?
A. no HCPCS code required
B. total charges are wrong
C. required additional ICD-9 code not listed
D. required additional CCPT code not listed

C. required additional ICD-9 code not listed

A bronchoplasty is the surgical repair of the ____.
A. bronchus
B. bridge of the nose
C. blood vessel
D. none of the above

A. bronchus

The surgical breaking of a bone is called______.
A. costectomy
B. osteoclasis
C. ablution
D. hypoglossal

B. osteoclasis

Strabismus is commonly known as______.
A. cross eyes
B. warts
C. headache
D. scabies

A. cross eyes

The hypoglossal nerve controls_____.
A. facial muscles
B. the tongue muscles
C. the eye muscles
D. the lip muscles

B. the tongue muscles

Where do you find HCPCS level II codes?
A. they are in the back of the ICD-9 book
B. they are in their own book: HCPCS level II
C. they are in the appendix of the CPT book
D. they are only available from medicare

B. they are in their own book: HCPCS level II

The term -emia means_____.
A. deficiency
B. excess of
C. blood condition
D. death of

C. blood condition

The term -pnea means_______.
A. break
B. swallowing
C. breathing
D. circulation

C. breathing

Which component below is not a part of the nature of the presenting problem?
A. Symptom
B. Sign
C. Complaint
D. Allergies

D. Allergies

Which below is not a part of past history?
A. Occupational history
B. Current medications
C. Allergies
D. Prior hospitalizations

A. Occupational history

Concurrent care is:
A. Similar services provided by one or more physicians on the same day
B. When two surgeons operate on a patient at the same time
C. When a patient is being treated for more than one condition, simultaneously (concurrently)
D. Services rendered by a physician to provide ongoing review and revision of a patient's plan of care which involves multidisciplinary or complex care modalities

A. Similar services provided by one or more physicians on the same day

What are the three key E&M components?
A. History, exam, and medical decision making
B. Review of systems, nature of presenting problem, and exam
C. History, medical decision making, and review of systems
D. Time, counseling, and coordination of care

A. History, exam, and medical decision making

What are the four E&M contributory factors?
A. Time, counseling, coordination of care, and history
B. Time, counseling, coordination of care, and the nature the the presenting problem
C. Exam, counseling, coordination of care, and the nature of the presneting problem
D. History, exam, medical decision making, time

B. Time, counseling, coordination of care, and the nature the the presenting problem

What is not a descriptive component for emergency department levels of E&M services?
A. time
B. the nature of the presenting problem
C. coordination of care
D. history

A. time

What is a major component differentiating between past history and social history?
A. Past history is anything that happened over 30 days ago
B. Social history is anything that has to do with interaction with other people
C. Past history is concerned only with the patient's past experiences with illnesses, injuries, and treatments
D. Occupational history is past history; current employment is social history

C. Past history is concerned only with the patient's past experiences with illnesses, injuries, and treatments

Face-to-Face Time includes:
A. Obtaining a history, performing an examination, and counseling a patient
B. Phone calls from the patient, performing an examination, and counseling a patient
C. Obtain a history, office administrative time, and counseling a patient
D. Meeting with the patient's family, phone time, and office time

A. Obtaining a history, performing an examination, and counseling a patient

Volume 3 of ICD-9-CM is most useful to:
A. In-patient hospital coders
B. Nurses, physical therapists, chiropractors, and other non-physician providers
C. Surgeons only; primary car physicians would have no use for it
D. Physician-based reimbursement specialists

A. In-patient hospital coders

Which of the following is not a major section of CPT?
A. Anesthesiology
B. Laboratory
C. Surgery
D. Modifiers

D. Modifiers

The guidelines for using the index of the CPT book tells you to begin with_____first.
A. Condition
B. Organ or anatomical site
C. Procedure or service
D. Abbreviations

C. Procedure or service

Digital block anesthesia is a type of regional anesthesia.
A. that's true
B. that's false
C. True when anesthesia is applied to the patient's finger
D. It depends on which region of the USA he anesthesia is given

A. that's true

If a physician documents in the patient's record the level of Medical Decision Making (MDM) as straightforward, low, moderate, or high complexity, that is sufficient to warrant the appropriate level of decision making.
A. No, the documentation must support the level and complexity of the MDM
B. No, straightforward is not a valid level of MDM
C. Yes, that would be sufficient
D. Yes, but only if the nature of the presenting problem supports the level

A. No, the documentation must support the level and complexity of the MDM

CPT is the property of which organization?
A. World Health Organization
B. Medicare
C. HCFA
D. American Medical Association

D. American Medical Association

ICD-9 was orginally developed:
A. By HCFA to track conditions and diseases
B. By the World Health Organization to track morbidity and mortality statistics
C. To assist Medicare, Medicaid, and private insurances with a coding system for payment
D. By the American Medical Association

B. By the World Health Organization to track morbidity and mortality statistics

Tinea Corporis is commonly known as:
A. Ringworm
B. Herpes Simplex
C. Body lice
D. Dermatitis

A. Ringworm

Parkinson's Disease is known as a(n):
A. Homonym
B. Synonym
C. Eponym
D. Anagram

C. Eponym

Which of the following is not listed as a dependency in ICD-9?
A. Coffee
B. Glue
C. Tobacco
D. Absinthe

A. Coffee

Which of the following are not a group specifically identified in ICD-9 as susceptible to extrinsic allergic alveolitis?
A. Pigeon fanciers
B. Coffee workers
C. Cheese washers
D. Tuna fishermen

D. Tuna fishermen

If, in the physician's notes, the patient's diastolic blood pressure is consistently higher than 120 and is experiencing renal failure, the coder should consult the physician to determine if this person's hypertension is:
A. Benign
B. Malignant
C. Unspecified
D. None of the above

B. Malignant

E codes are used to indicate:
A. Where an accident occurred
B. How an accident occurred
C Whether a drug overdose was accidental or on purpose
D. All of the above

D. All of the above

Late effects are:
A. The residual effect that remains from the acute phase of an injury or illness
B. An E code to describe a late hit during a football game
C. Categorized according to th Statue of Limitations (time limit) of the disease, condition, or injury
D. Are common in insomniacs, and always coded from the psychiatric portion of ICD-9; and always coded alon

A. The residual effect that remains from the acute phase of an injury or illness

Septicemia:
A. Is caused by the septicemia bacterialus
B. Is always a viral infection
C. Is an infection that invades the blood stream
D. None of the above

C. Is an infection that invades the blood stream

HCPCS level II codes includes what services not represented in CPT?
A. Ambulance services, durable medical equipment, and Chiropractic services
B. Chemotherapy treatment, durable medical equipment, and specific supplies
C. Ambulance services, Neurological testing, and specific supplies
D. Ambulance services, durable medical equipment, and specific supplies

D. Ambulance services, durable medical equipment, and specific supplies

HCPCS level II codes main difference with CPT codes is:
A. HCPCS codes can have from 3 to 6 digits
B. HCPCS level II codes begin with a letter
C. HCPCS level II codes do not accept any modifiers
D HCPCS level II codes end with a letter

B. HCPCS level II codes begin with a letter

HCPCS codes are:
A. Used to bill for supplies such as splints and surgical trays
B. The Health Care Financing Administration (HCFA) Common Procedure Coding System
C. Used to report injections (the drug that is injected)
D. All of the above

D. All of the above

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