AAPC IDC 10. American Academy of Professional Coders. All Exams TEST BANK.

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AAPC IDC 10 Exam (All Exams) Test Bank - American Academy of Professional Coders Physician Coding for CPC Preparation (Q-S) Review Test Submission: Chapter 1 Quiz Course 2019 Physician Coding ... for CPC Preparation (Q-S) Test Chapter 1 Quiz Started 6/9/19 9:25 PM Submitted 6/9/19 9:28 PM Status Completed Attempt Score 92 out of 100 points   Time Elapsed 2 minutes Results Displayed Submitted Answers, Correct Answers, Feedback • Question 1 10 out of 10 points What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services within the coming year? Selected Answer: c.  OIG Work Plan Correct Answer: c.  OIG Work Plan Response Feedback: Rationale: Twice a year, the OIG releases a Work Plan outlining its priorities for the fiscal year ahead. Within the Work Plan, potential problem areas with claims submissions are listed and will be targeted with special scrutiny. • Question 2 0 out of 10 points According to the example LCD from Novitas Solutions, measurement of vitamin D levels is indicated for patients with which condition? Selected Answer: d.  muscle weakness Correct Answer: b.  fibromyalgia Response Feedback: Rationale: According to the LCD, measurement of vitamin D levels is indicated for patients with fibromyalgia. • Question 3 10 out of 10 points Under HIPAA, what would be a policy requirement for “minimum necessary”? Selected Answer: a. Only individuals whose job requires it may have access to protected health information. Correct Answer: a. Only individuals whose job requires it may have access to protected health information. Response Feedback: Rationale: It is the responsibility of a covered entity to develop and implement policies, best suited to its particular circumstances to meet HIPAA requirements. As a policy requirement, only those individuals whose job requires it may have access to protected health information. • Question 4 0 out of 10 points Which act was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA) and affected privacy and security? Selected Answer: a.  HIPAA Correct Answer: b.  HITECH Response Feedback: Rationale: The Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted as a part of the American Recovery and Reinvestment Act of 2009 (ARRA) to promote the adoption and meaningful use of health information technology. Portions of HITECH strengthen HIPAA rules by addressing privacy and security concerns associated with the electronic transmission of health information. • Question 5 10 out of 10 points What form is provided to a patient to indicate a service may not be covered by Medicare and the patient may be responsible for the charges? Selected Answer: d.  ABN Correct Answer: d.  ABN Response Feedback: Rationale: An Advanced Beneficiary Notice (ABN) is used when a Medicare beneficiary requests or agrees to receive a procedure or service that Medicare may not cover. This form notifies the patient of potential out of pocket costs for the patient. • Question 6 0 out of 10 points What document assists provider offices with the development of Compliance Manuals? Selected Answer: c.  OIG Suggested Rules and Regulations Correct Answer: a.  OIG Compliance Plan Guidance Response Feedback: Rationale: The OIG has offered compliance program guidance to form the basis of a voluntary compliance program for physician offices. Although this was released in October 2000, it is still active compliance guidance today. • Question 7 10 out of 10 points Who would NOT be considered a covered entity under HIPAA? Selected Answer: d.  Patients Correct Answer: d.  Patients Response Feedback: Rationale: Covered entities in relation to HIPAA include Health Care Providers, Health Plans, and Health Care Clearinghouses. The patient is not considered a covered entity although it is the patient’s data that is protected. • Question 8 10 out of 10 points Select the TRUE statement regarding ABNs. Selected Answer: a.  ABNs may not be recognized by non-Medicare payers. Correct Answer: a.  ABNs may not be recognized by non-Medicare payers. Response Feedback: Rationale: ABNs may not be recognized by non-Medicare payers. Providers should review their contracts to determine which payers will accept an ABN for services not covered. • Question 9 10 out of 10 points When presenting a cost estimate on an ABN for a potentially noncovered service, the cost estimate should be within what range of the actual cost? Selected Answer: c.  $100 or 25 percent Correct Answer: c.  $100 or 25 percent Response Feedback: Rationale: CMS instructions stipulate, “Notifiers must make a good faith effort to insert a reasonable estimate…the estimate should be within $100 or 25 percent of the actual costs, whichever is greater.” • Question 10 10 out of 10 points Which statement describes a medically necessary service? Selected Answer: b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Correct Answer: b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Response Feedback: Rationale: Medical necessity is using the least radical services/procedure that allows for effective treatment of the patient’s complaint or condition. Thursday, September 21, 2017 7:47:13 PM MDT Review Test Submission: Chapter 1 Quiz   User Course 2017 Physician Coding for CPC Preparation (Q-S) Test Chapter 1 Quiz Started 6/9/17 9:09 PM Submitted 6/9/17 9:30 PM Status Completed Attempt Score 100 out of 100 points   Time Elapsed 21 minutes Results Displayed Submitted Answers, Correct Answers, Feedback • Question 1 10 out of 10 points Select the TRUE statement regarding ABNs. Selected Answer: a.  ABNs may not be recognized by non-Medicare payers. Correct Answer: a.  ABNs may not be recognized by non-Medicare payers. Response Feedback: Rationale: ABNs may not be recognized by non-Medicare payers. Providers should review their contracts to determine which payers will accept an ABN for services not covered. • Question 2 10 out of 10 points Under HIPAA, what would be a policy requirement for “minimum necessary”? Selected Answer: a.  Only individuals whose job requires it may have access to protected health information. Correct Answer: a.  Only individuals whose job requires it may have access to protected health information. Response Feedback: Rationale: It is the responsibility of a covered entity to develop and implement policies, best suited to its particular circumstances to meet HIPAA requirements. As a policy requirement, only those individuals whose job requires it may have access to protected health information. • Question 3 10 out of 10 points According to the example LCD from Novitas Solutions, measurement of vitamin D levels is indicated for patients with which condition? Selected Answer: b.  fibromyalgia Correct Answer: b.  fibromyalgia Response Feedback: Rationale: According to the LCD, measurement of vitamin D levels is indicated for patients with fibromyalgia. • Question 4 10 out of 10 points What document assists provider offices with the development of Compliance Manuals? Selected Answer: a.  OIG Compliance Plan Guidance Correct Answer: a.  OIG Compliance Plan Guidance Response Feedback: Rationale: The OIG has offered compliance program guidance to form the basis of a voluntary compliance program for physician offices. Although this was released in October 2000, it is still active compliance guidance today. • Question 5 10 out of 10 points Who would NOT be considered a covered entity under HIPAA? Selected Answer: d.  Patients Correct Answer: d.  Patients Response Feedback: Rationale: Covered entities in relation to HIPAA include Health Care Providers, Health Plans, and Health Care Clearinghouses. The patient is not considered a covered entity although it is the patient’s data that is protected. • Question 6 10 out of 10 points What form is provided to a patient to indicate a service may not be covered by Medicare and the patient may be responsible for the charges? Selected Answer: d.  ABN Correct Answer: d.  ABN Response Feedback: Rationale: An Advanced Beneficiary Notice (ABN) is used when a Medicare beneficiary requests or agrees to receive a procedure or service that Medicare may not cover. This form notifies the patient of potential out of pocket costs for the patient. • Question 7 10 out of 10 points Which act was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA) and affected privacy and security? Selected Answer: b.  HITECH Correct Answer: b.  HITECH Response Feedback: Rationale: The Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted as a part of the American Recovery and Reinvestment Act of 2009 (ARRA) to promote the adoption and meaningful use of health information technology. Portions of HITECH strengthen HIPAA rules by addressing privacy and security concerns associated with the electronic transmission of health information. • Question 8 10 out of 10 points When presenting a cost estimate on an ABN for a potentially noncovered service, the cost estimate should be within what range of the actual cost? Selected Answer: c.  $100 or 25 percent Correct Answer: c.  $100 or 25 percent Response Feedback: Rationale: CMS instructions stipulate, “Notifiers must make a good faith effort to insert a reasonable estimate…the estimate should be within $100 or 25 percent of the actual costs, whichever is greater.” • Question 9 10 out of 10 points Which statement describes a medically necessary service? Selected Answer: b.  Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Correct Answer: b.  Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Response Feedback: Rationale: Medical necessity is using the least radical services/procedure that allows for effective treatment of the patient’s complaint or condition. • Question 10 10 out of 10 points What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services within the coming year? Selected Answer: c.  OIG Work Plan Correct Answer: c.  OIG Work Plan Response Feedback: Rationale: Twice a year, the OIG releases a Work Plan outlining its priorities for the fiscal year ahead. Within the Work Plan, potential problem areas with claims submissions are listed and will be targeted with special scrutiny. Thursday, September 21, 2017 7:47:41 PM MDT Review Test Submission: 2017 Chapter 1 Practical Application   User Course 2017 Physician Coding for CPC Preparation (Q-S) Test 2017 Chapter 1 Practical Application Started 6/10/17 12:52 PM Submitted 6/10/17 12:58 PM Status Completed Attempt Score 90 out of 100 points   Time Elapsed 5 minutes Results Displayed Submitted Answers, Correct Answers, Feedback • Question 1 10 out of 10 points What type of profession, other than coding, might skilled coders enter? Selected Answer: c.  Consultants, educators, medical auditors Correct Answer: c.  Consultants, educators, medical auditors • Question 2 10 out of 10 points What is the difference between outpatient and inpatient coding? Selected Answer: d.  Inpatient coders use ICD-10-CM and ICD-10-PCS. Correct Answer: d.  Inpatient coders use ICD-10-CM and ICD-10-PCS. • Question 3 10 out of 10 points What is a mid-level provider? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - A couple has been trying to conceive for nine months without success. Preliminary studies show the woman ovulates and the husband’s sperm count is good. A sperm sample is submitted for both a post coital Huhner test and a hamster penetration test. Report the codes. Selected Answer: c.  89300, 89329 Correct Answer: c.  89300, 89329 Response Feedback: Rationale:  The post coital test is described by code 89300 Semen analysis; presence and/or motility of sperm including Huhner test (post coital) and is listed in the CPT® Index under Huhner Test/Semen Analysis. It is not specified as a complete. The second test ordered and performed on the sperm sample is a hamster penetration test specified by code 89329 Sperm evaluation; hamster penetration test. This can be found in the CPT® Index under Hamster Penetration Test/Sperm Evaluation. • Question 24 4 out of 4 points A virus is identified by observing growth patterns on cultured media.  What is this type of identification is called? Selected Answer: a.  Presumptive Correct Answer: a.  Presumptive Response Feedback: Rationale:  Presumptive identification identifies microorganisms like viruses by observing growth patterns and other characteristics. • Question 25 4 out of 4 points Esther Glass has a primary cancer located in the intra-hepatic biliary tract and had a cholecystectomy and biopsy of the duodenum done. Two separate specimens (gall bladder, biopsy of duodenum) were sent to the pathologist working at a hospital laboratory. The technician prepared the slides and the pathologist (self-employed) read them. Select the best code or codes for the pathologist’s services. Selected Answer: c.  88304-26, 88305-26 Correct Answer: c.  88304-26, 88305-26 Response Feedback: Rationale:  Two different specimens from two different locations were sent to pathology. The first specimen is the gall bladder as evidenced by the documentation for cholecystectomy. Code 88304 is a level III specimen. Code 88305 corresponds to a level IV biopsy of the duodenum. In the CPT® Index, see Pathology and Laboratory/Surgical Pathology/Gross and Micro Exam. Modifier 26 is added to each code because the pathologist was not an employee of the hospital lab and provided the professional component only. Friday, September 22, 2017 10:48:25 PM MDT Review Test Submission: Chapter 19 Quiz   User Course 2017 Physician Coding for CPC Preparation (Q-S) Test Chapter 19 Quiz Started 9/9/17 12:59 PM Submitted 9/9/17 2:49 PM Status Completed Attempt Score 50 out of 100 points   Time Elapsed 1 hour, 49 minutes Results Displayed Submitted Answers, Correct Answers, Feedback • Question 1 0 out of 10 points John, a 16-year-old male, is admitted by the emergency department physician for observation after an ATV accident. The patient is discharge from observation by another provider the next day. What category or subcategory of evaluation and management codes would be selected for the emergency department physician? Selected Answer: b.  Emergency department services Correct Answer: d.  Initial observation care Response Feedback: Rationale: The patient presented to the Emergency Department and was admitted to observation by the ED physician. The guidelines for Initial Observation Care state that all services provided by the admitting physician for the same date of service are included in the initial hospital care, and in this instance the emergency department services would not be coded. If the patient was discharged on the same date of service, a code from Observation or Inpatient Care Services (Including Admission and Discharge Services) would be selected. • Question 2 0 out of 10 points During a soccer game, Ashley, a 26-year-old female, heard a popping sound in her knee. Her knee has been unstable since the incident and she decided to consult an orthopedist. She visits Dr. Howard, an orthopedist she has not seen before, to evaluate her knee pain. Dr. Howard's diagnosis is a torn ACL. From what category or subcategory of evaluation and management code would be selected for the visit to Dr. Howard? Selected Answer: c.  Outpatient consultation Correct Answer: a.  Office visit, new patient Response Feedback: Rationale: Consultations performed at the request of a patient are coded using office visit codes. Because the patient has not seen Dr. Howard before, this would be considered a new patient visit. • Question 3 0 out of 10 points HISTORY OF PRESENT ILLNESS
A 73-year-old man who is a veterinarian is seen here for the first time today. He has a history of squamous cell carcinoma on the left arm and a basal cell carcinoma on the right forehead near the temple, both in January 20XX. He says he has had a lesion on his forehead for approximately one year. He is concerned about what it is and thinks it may be another skin cancer. He is also concerned about another lesion that has been present for a while, just lateral to his right eye. He would also like a full skin check today. He uses a hat for sun protection. He has lived in California and has had significant sun exposure in the past.

REVIEW OF SYSTEMS: Otherwise well, no other skin complaints.

PAST MEDICAL HISTORY
Coronary artery disease status post bypass surgery, history of squamous and
basal cell carcinomas as noted above, hay fever, and hyperlipidemia. He
has had lipomas removed.

MEDICATIONS: Tylenol, tramadol, thyroxin, fish oil, flax seed oil, simvastatin, Zyrtec®, 5% saline in eyes.

ALLERGIES: No known drug allergies.

FAMILY HISTORY: No family history of skin cancer or other skin problems.

SOCIAL HISTORY: Patient is a veterinarian. He recently moved to the Rochester area from Pennsylvania. He is married.

What is the level of history? Selected Answer: a.  Problem focused Correct Answer: b.  Expanded problem focused Response Feedback: Rationale: History HPI
Location Severity Timing Modifying Factors
Quality Duration Context Assoc Signs & Symptoms Brief
(1-3) Brief
(1-3) Extended (4 or more) Extended
(4 or more) ROS
Const GI Integ Hem/lymph
Eyes GU Neuro All/Immuno
Card/Vasc Musculo Psych All other negative
Resp ENT, mouth Endo None Pertinent to problem
(1 system) Extended (2-9 systems) Complete PFSH
Past history (current meds, past illnesses, operations, injuries,
treatments)
Family history (a review of medical events in the patient’s family)
Social history (an age appropriate review of past and current activities) None None Pertinent (1 history area) Complete (2 (est) or
3 (new) history areas)   Problem Focused Expanded Problem Focused Detailed Comprehensive           CC: Skin lesions
HPI:       Location – Forehead and lateral to right eye
      Duration – About a year
ROS:       Integumentary – No other skin complaints
      Stated, “Otherwise well”, this is not an indication that all other systems were reviewed.
PFSH:      Past, Family, and Social all reviewed as it relates to skin. • Question 4 10 out of 10 points The patient presents to the clinic today for a follow-up of his hospitalization for pneumonia. He was placed back on Singulair® and has been improving with his breathing since then. He has no complaints today. What is the level of history? Selected Answer: a.  Problem focused Correct Answer: a.  Problem focused Response Feedback: Rationale: History HPI
Location Severity Timing Modifying Factors
Quality Duration Context Assoc Signs & Symptoms Brief
(1-3) Brief
(1-3) Extended (4 or more) Extended
(4 or more) ROS
Const GI Integ Hem/lymph
Eyes GU Neuro All/Immuno
Card/Vasc Musculo Psych All other negative
Resp ENT, mouth Endo None Pertinent to problem (1 system) Extended (2-9 systems) Complete                     PFSH
Past history (current meds, past illnesses, operations, injuries,
treatments)
Family history (a review of medical events in the patient's family)
Social history (an age appropriate review of past and current activities) None None Pertinent (1 history area) Complete (2 (est) or
3 (new) history areas)   Problem Focused Expanded Problem Focused Detailed Comprehensive           CC: Follow-up of hospitalization for pneumonia.
HPI: Modifying Factor: He was placed back on Singulair® and has been improving with his breathing since then.
ROS: None
PFSH: None • Question 5 0 out of 10 points Physical Exam:
GENERAL APPEARANCE: Healthy appearing individual in no distress
ABDOMEN: Soft, non-tender, without masses. No CVA tenderness
FEMALE EXAM:
VULVA/LABIA MAJORA: No erythema, ulcerations, swelling, or lesions seen.
BARTHOLIN GLANDS: No cysts, abscesses, induration, discharge, masses, or inflammation noted.
SKENE’S: No cysts, abscesses, induration, discharge, masses, or inflammation noted.
CLITORIS/LABIA MINORA: Clitoris normal. No atrophy, adhesions, erythema, or vesicles noted. Labia unremarkable.
URETHRAL MEATUS: Meatus appears normal in size and location. No masses, lesions or prolapse.
URETHRA: No masses, tenderness or scarring.
BLADDER: Without fullness, masses or tenderness.
VAGINA: Mucosa clear without lesions, Pelvic support normal. No discharge.
CERVIX: The cervix is clear, firm and closed. No visible lesions. No abnormal discharge.
UTERUS: Uterus non-tender and of normal size, shape and consistency. Position and mobility are normal.
ADNEXA/PARAMETRIA: No masses or tenderness noted.

Based on the 1995 documentation guidelines, what is the level of exam? Selected Answer: d.  Detailed Correct Answer: c.  Comprehensive Response Feedback: Rationale: Organ Systems: The documentation supports a comprehensive/complete single system (Female Genitourinary) exam. The level of exam is Comprehensive. • Question 6 10 out of 10 points Physical Exam: 
General/Constitutional: No apparent distress. Well nourished and well developed.
Ears: TM’s gray. Landmarks normal. Positive light reflex.
Nose/Throat: Nose and throat clear; palate intact; no lesions.
Lymphatic: No palpable cervical, supraclavicular, or axillary adenopathy.
Respiratory: Normal to inspection. Lungs clear to auscultation.
Cardiovascular: RRR without murmurs.
Abdomen: Non-distended, non-tender. Soft, no organomegaly, no masses.
Integumentary: No unusual rashes or lesions.
Musculoskeletal: Good strength; no deformities. Full ROM all extremities.
Extremities: Extremities appear normal.

What is the level of exam? Selected Answer: d.  Comprehensive Correct Answer: d.  Comprehensive Response Feedback: Rationale: Organ Systems: Constitutional, ENMT, Lymphatic, Respiratory, Cardiovascular, Gastrointestinal, Skin, Musculoskeletal. There are 8 organ systems examined. The level of exam is Comprehensive. • Question 7 10 out of 10 points Subsequent Hospital Visit
LABS: BUN 56, creatinine 2.1, K 5.2, HGB 12.

IMPRESSION:
1. Severe exacerbation of CHF
2. Poorly controlled HTN
3. Worsening ARF due to cardio-renal syndrome

PLAN:
1. Increase BUMEX to 2 mg IV Q6.
2. Give 500 mg IV DIURIL times one.
3. Re-check usual labs in a.m.
Total time: 20minutes.

What is the level of medical decision making? Selected Answer: d.  High Correct Answer: d.  High Response Feedback: Rationale: Three problems worsening (six points); labs reviewed (one point); chronic illnesses posing a threat to life (exacerbation of congestive heart failure, poorly controlled hypertension, worsening acute renal failure due to cardio-renal syndrome). The medical decision making is High. • Question 8 0 out of 10 points IMPRESSION: Right recurrent gynecomastia.

PLAN: The patient had a right breast ultrasound on November 17, which showed a hypoechoic area measuring 1.7 x 0.7 x 1.2 cm in the 11 o’clock position of the right breast. There was no Doppler flow, and the transmission suggested that this was a cystic lesion. Follow-up in a month was suggested at that time. Because of this ultrasound and because this is symptomatic, I have recommended a simple mastectomy under general anesthesia. The patient is in agreement. I filled out the prison forms requesting permission, and I described the operation to the patient. 

What is the level of medical decision making? Selected Answer: c.  Moderate Correct Answer: b.  Low Response Feedback: Rationale: Established problem worsening (two points); ultrasound reviewed (one point), risk is moderate (simple mastectomy). The medical decision making is Low. • Question 9 10 out of 10 points A patient is admitted to the hospital for a lung transplant. The admitting physician performs a comprehensive history, a comprehensive exam, and a high level of medical decision making. What CPT® code is the appropriate E/M code for this visit? Selected Answer: c.  99223 Correct Answer: c.  99223 Response Feedback: Rationale: Initial hospital care codes require all three key components be met to determine a level of visit. In this case, the comprehensive history and exam, and the high level of medical decision making support a 99223. • Question 10 10 out of 10 points An established patient is seen in clinic for allergic rhinitis. A problem focused history, expanded problem focused exam, and a low level of medical decision making are performed. What E/M code is reported for this visit? Selected Answer: b.  99213 Correct Answer: b.  99213 Response Feedback: Rationale: Established patient codes require two of three key components be met to determine a level of visit. In this case, the expanded problem focused exam and low level of medical decision making support a level 3 established patient office visit 99213. Friday, September 22, 2017 10:48:52 PM MDT Review Test Submission: Chapter 19 Quiz   User Course 2017 Physician Coding for CPC Preparation (Q-S) Test Chapter 19 Quiz Started 9/9/17 3:11 PM Submitted 9/9/17 3:44 PM Status Completed Attempt Score 80 out of 100 points   Time Elapsed 33 minutes Results Displayed Submitted Answers, Correct Answers, Feedback • Question 1 10 out of 10 points A mother takes her 2-year-old back to Dr. Denton for an annual well child exam. The patient has a comprehensive check-up and vaccinations are brought up to date. Which category or subcategory of evaluation and management codes would be selected for the well child exam? Selected Answer: b.  Preventive medicine, established patient Correct Answer: b.  Preventive medicine, established patient Response Feedback: Rationale: The mother "takes her 2-year-old back to Dr. Denton" indicates this is an established patient. This is a well child exam with no complaints and a code from preventive medicine, established patient, would be selected. The preventive medicine, individual counseling codes are used for risk reduction such as diet and exercise, substance abuse, family problems, etc. [Show More]

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