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COC 2020 Final Exam Study Questions - Set 5 (Complete Solutions, Answered)

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COC 2020 Final Exam Study Questions - Set 5 (Complete Solutions, Answered) After suffering a fracture of the ankle three months ago, a 69 year-old patient presented with what was found to be a malun... ion fracture. She was treated with additional surgery and discharged. Which injury diagnosis code(s) is/are assigned? S82.899P All codes in ICD-10-PCS have how many characters? 7 All entries in the medical record must be: Signed and dated by the author with a method to establish the author's identity. All payers employ the same rules concerning coding and reimbursement. B. False Rationale: PPOs, HM Os, Medicaid, TRICARE/CHAMPUS, Workers Compensation, and many private insurers employ their own rules regarding coding and reimbursement. Additional restrictions may apply when participating in a network. All the following are examples of outpatient facilities except: Answer: OPPS Rationale: OPPS stands for Outpatient Prospective Payment System. This is a payment system and not a type of facility such as CORF, CAH, ASC are. Ambulatory surgical centers include: Answer: An independent ASC Rationale: Independent ASCs offer ambulatory surgical services or same-day surgeries to patients who only require services with immediate postoperative care. When the ASC is owned by the hospital, it is generally considered to be an extension of the physical hospital and the same as any other outpatient department. In general, an independent ASC must be financially independent from the hospital, not be included on the hospital's cost reports. Amputation: the surgical removal of all or part of a limb or extremity such as an arm, leg, foot, hand, toe, or finger. An 18 day-old infant develops bradycardia. What ICD-10-CM code is reported? P29.12 An 18 month-old male with bilateral chronic serous otitis media and hypertrophy of the adenoids presents to the hospital surgery department and undergoes an initial adenoidectomy and insertion of ventilation tubes in both ears under general anesthesia. What is the correct code selection for the procedure and diagnoses? 42830, 69436-50, H65.23, J35.2 An 18 year-old male with complaints of right knee pain, swelling and a pop-like feeling after falling on the sidewalk is seen in the emergency department. It is decided that the patient needs to have an arthrogram of the knee. The patient goes to the outpatient radiology department. Once back in the X-ray room, the patient was placed in supine position with his right knee flexed over a pillow. After the knee was prepped and draped, topical anesthesia was applied. A 20-gauge needle was then inserted into the femoropatellar space of the knee. Air and single contrast media were injected and the patient was instructed to move his knee in order to provide even coating. Multiple arthrographic views were taken. Closed dislocation of the knee was the diagnosis. What are the correct procedure and diagnosis codes for this service? 27369-RT, 73580-RT, S83.104A An 18 year-old with a dislocated patella is in the hospital outpatient orthopedic center for reconstruction. After being prepped and draped, the orthopedist makes an incision on the anteromedial aspect of the left knee, starting above the patella and ending just below the tibial tuberosity. Once the patellar tendon is resected, it is pulled medially and distally on the tibia for reattachment. The vastus medialis muscle is then inserted by transforming it laterally and distally, suturing it into place. Alignment of the patella is achieved, then the patellar tendon is anchored into the tibia with staples. The incision is closed with Steri-strips. The patient had no complications and was released after recovery. What are the correct procedure and diagnosis codes for this scenario? 27422, S83.005A An 18-month-old with chronic serous otitis media and hypertrophy of the adenoids presents to the outpatient surgery department and undergoes an initial adenoidectomy and insertion of bilateral ventilation tubes. General anesthesia was required. What CPT® and ICD-10-CM codes are reported by the facility for the surgery? 42830, 69436-50, J35.2, H65.23 An 8 year-old boy was helping his father install a new window at their house. The window fell, causing some of the glass to cut the boy's left hand, left forearm, and his left thigh. The laceration on the hand was 2 cm, the forearm laceration was 3.3 cm, and the thigh laceration was 1.9 cm. The lacerations were all closed using simple repair. What are the correct procedure and diagnosis codes for this encounter? 12002; S61.412A, S51.812A, S71.112A, W25.XXXA, Y93.H9, Y92.009 An 80-year-old female with a dual chamber pacemaker, used to treat bradycardia caused by Wenckebach type atrioventricular block (type I, second degree block), is admitted for change of the battery in her pacemaker. An electronic analysis at the cardiologist's office indicated that the battery is malfunctioning and needs to be replaced. The battery has been in place for several years and has functioned without problems until recently. The procedure is performed on an outpatient basis at the hospital. 33228, T82.518A, 144.1 An 85-year-old man is seen in the hospital ED after he tripped on a rug while walking in his home. He tried to break his fall and fractured both his wrists. Two view X-rays were taken of both wrists (73100) and short arm plaster casts (29075) were applied. The ED facility resources used were a level 3. An appointment was made for follow-up in the orthopedic clinic. Report the facility services and diagnoses. 99283-25, 73100-50, 29075-50, Q4009 x 2, S62.101A, S62.102A, W18.09XA, Y92.099 An 88 year-old widow with uterine prolapse and multiple comorbid conditions has been unsuccessful in the use of a pessary for treatment and elects to receive colpocleisis (LeFort type) to prevent further prolapse and avoid more significant surgery like hysterectomy. The treatment is successful. What are the CPT ® and ICD-10-CM codes reported for this procedure? 57120, N81.4 An ABN rendered in a timely manner is important for the facility to receive payment when Medicare does not cover the service, because the diagnosis does not support medical necessity. The facility may: Have the patient sign the ABN after administration of anesthesia. An ABN was presented to a 68-year-old Medicare patient for services that might not be covered. The services facing denial were specified on the ABN. The ABN did not specify the reason Medicare might likely deny the claim. The patient signed the ABN and the claim was denied. The patient received a bill from the facility and insists she did not understand the ABN or what she was signing. Is the patient responsible for payment? The ABN did not specify the reason Medicare might deny the claim, so the patient is not responsible for payment. An active treatment plan for therapy services must identify: Answer: The diagnosis, the goals of the treatment, the date the plan was established, and the type of modality or procedure used. Rationale: An active therapy treatment plan must identify the diagnosis, the anticipated goals of the treatment, the date the plan was established, and the type of modality or procedure used. An allergist in a hospital outpatient clinic prescribed rapid desensitization for a patient with penicillin hypersensitivity. A three-hour session was required to achieve the physician's desired outcome for the patient. What CPT® and ICD-10-CM codes are reported by the facility? 95180 x 3, T78.40XA An ecptopic pregnancy is a complication in which the fertilized ovum is implanted in any tissue other than the? Uterine wall An elderly established Medicare patient is seen in the hospital clinic for an accidental overdose of valium and is vomiting and has slurred speech. He is admitted by his physician to observation for 8 hours and then discharged the next day. The clinic facility use is level 3. Report the facility charges and diagnoses. G0463-25, G0379, G0378 x 8, T42.4X1A, R11.10, R47.81 An ENT specialist performed surgery at an ASC on a 5 year-old who stuck a foam hair roller up her nose. It was decided to remove the roller by lateral rhinotomy because of the position and depth of the foam roller in the nose. What CPT ® and ICD-10-CM codes are reported? 30320, T17.1XXA An established Medicare female patient with a history of breast cancer with metastasis to the right lung is seen in the hospital clinic (level 4) by her oncologist for discussion of treatment options including radiation therapy for the lung cancer. Report the facility services and diagnoses. G0463, C78.01, Z85.3 An established patient comes in complaining of nausea and vomiting and states she has not gotten her menstrual period. A complete CBC and automated differential WBC were ordered. Also, Hepatitis B surface antigen, HIV testing, Rubella, RPR, Antibody Screen, Blood Typing for Rh and ABO along with a urine pregnancy test. Report the CPT ® code(s) for the laboratory service(s). 80081, 81025 An established patient is in the outpatient clinic to evaluate three (3) plantar warts on the right foot that are bothering the patient and a small lesion on the left arm that looks suspicious. After examining the patient, the internist uses cryosurgery to destroy the three (3) warts and takes a punch biopsy of the left arm lesion. The pathology report of the biopsy demonstrates a blue nevus without any atypical features. What are the procedure and diagnosis codes? 17110, 11104-59, B07.0, D23.62 An excision of chalazion left upper eyelid and a biopsy of left lower eyelid are performed during the same operative session. Select the appropriate procedure codes. 67800-E1, 67810-E2 An exploratory laparoscopy was performed for right lower abdominal pain. Endometriosis of the pelvic viscera was found and lesions were removed with fulguration (58662). A right ovarian cystectomy was also performed (58661). What is the expected payment (Medicare and Pt responsibility) $4,833.17 An injection procedure for nephrostogram through existing access was performed in the outpatient radiology department. After the procedure was completed, the physician diagnosed the patient with vesicoureteral reflux with bilateral reflux nephropathy. What CPT® and ICD-10-CM codes are reported on a UB-04 form? 50431, N13.722, Z93.6 [Show More]

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