Which of the following statements is true of the Affordable

Health care practitioners who submit fraudulent bills to increase reimbursement may
A. be listed in the Coding Directory of Fraudulent Billing published annually by the Department of Health and Human Services.
B. be reported to the Office of the Attorney General.
C. be blacklisted according to geographic location.
D. face financial penalties or, in some cases, imprisonment.
52. A patient comes to the ambulatory surgery center for a fusion of the cervical spine. Prior to the beginning of the surgery, the patient suffers an allergic reaction to the anesthesia shortly after it’s administered. Because of this reaction, the surgery is not performed. What code would be assigned as the first-listed diagnosis?
A. The anesthesia administration
B. The allergy code
C. The reason that the surgery was scheduled to be performed
D. The observation code
53. The root word ENTER/O means
A. secretion.
B. intestine.
C. stomach.
D. tooth.
54. When coding burns, coders should
A. assign separate codes for each burn site.
B. assign the code for chronic burns.
C. classify all burns as acute burns.
D. assign the code for third-degree burns.
55. Which of the following forms is used to bill outpatient charges?
A. CMS-1500 or UCF-1500.
B. AMA-14 or UCF-1250
C. HCFA-1400 or CMS-1540
D. HCFA-1350 or CMS-650
56. A significant, separately identifiable E/M service performed by the same physician in conjunction with another service performed on the same day would be reported using what modifier?
A. -TC
B. -47
C. -90
D. -25
57. Which of the following modifiers would be assigned for a moribund patient?
A. P5
B. P1
C. P4
D. P3
58. Taking certain steps to protect PHI from being accidentally released to individuals who don’t need to know the information is called the
A. minimum necessary standard.
B. information provision standard.
C. privacy management statute.
D. health information guardianship guideline.
59. Codes for plastic repair of the perineum are found in which code range?
A. 57000–57426
B. 57000–57010
C. 57150–57180
D. 56800–56810
60. A coder overhears a confidential statement made outside of the court, and then, when called to testify, repeats the statement as being truth. This is an example of
A. speculation.
B. hearsay.
C. a direct quote.
D. cross-examination.
61. A nurse sustains an accidental needle pinprick to the right third finger while administering an injection. If an employee has an occupational exposure, what must happen?
A. An in-service meeting should be held for all employees who may potentially be exposed to the same occupational hazard.
B. The employee should contact the proper authorities.
C. Hospital administrators must maintain the nurse’s medical record for the remainder of her employment plus an additional 30 years.
D. The guidelines for OSHA should be included in the employment file.
62. Another name for third-party contractors who have access to medical information is
A. healthcare vendors.
B. insurance administrators.
C. covered entities.
D. business associates.
63. A patient receives two venous pressure clamps for hemodialysis. What HCPCS Level II code is assigned?
A. A4751
B. A4918 × 2
C. A4751 × 2
D. A4918
64. The anatomical location of the calyx is the
A. arm.
B. kidney.
C. spine.
D. brain.
65. A patient comes to the clinic complaining of ongoing headaches. The headaches began one week prior and have persisted ever since. A lumbar spinal tap is performed to pinpoint the source of the patient’s headaches. What CPT and ICD-10-CM codes are assigned?
A. 62270, G74.3
B. 62270, G44.1
C. 62141, G46.8
D. 62272, G46.9
66. A coder assigns a HCPCS Level II code to a patient’s medical record. The code description reads as follows: Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape. Based on this description, which HCPCS Level II code was assigned?
A. B4278
B. B4125
C. B4072
D. B4034
67. To conform to the HIPAA Privacy Rule, which of the following safeguards must be maintained in health care facilities?
A. ICD-7 provisional safeguards
B. Immunization and injection safeguards
C. Reasonable administrative, technical, and physical safeguards
D. Hazardous waste protection safeguards
68. A patient receives a blood glucose monitor. What HCPCS Level II code would be assigned?
A. E0976
B. E0562
C. E4752
D. E0607
69. Alternative dispute resolution (ADR) allows
A. lawyer-to-lawyer mediation during trial recess.
B. mediating disputes with a judge in the presence of the bailiff.
C. resolving medical malpractice suits by submitting pretrial depositions.
D. litigants to resolve disputes prior to or after the start of litigation.
70. A 65-year-old patient is admitted to the hospital for 48 hours to receive treatment from her physician. This patient would be covered under
A. Medicare Part B.
B. Medicare Part A.
C. Medicare Part D.
D. Medicare Part C.
71. Another term for disease evolution is
A. remission.
B. pathogenesis.
C. morphology.
D. exacerbation.
72. In relation to HIPAA regulations regarding the manner in which information can be disclosed, which of the following statements is true?
A. Protected health information must be disclosed only when the patient is unable to testify in a court proceeding.
B. Protected health information may never be disclosed.
C. Protected health information may be disclosed in a judicial or administrative proceeding if the request is made through an order from a court or administrative tribunal.
D. Protected health information may be disclosed only within a deposition.
73. The gatekeeper concept refers to the operation of
A. ambulatory payment surgery centers.
B. prospective payment organizations.
C. retrospective payment organizations.
D. health maintenance organizations.
74. Which of the following procedures would be performed to treat prostate cancer?
A. Transurethral resection of the prostate (TURP)
B. Meniscectomy
C. Vasoconstriction
D. Arthroscopy
75. What diagnosis code would be assigned for a patient diagnosed with Type 2 diabetes mellitus with diabetic nephropathy?
A. E11.21
B. E11.01
C. E11.22
D. E11.9
76. Another name for Medicare Advantage is
A. Medicare Part A.
B. Medicare Part C.
C. Medicare Part B.
D. Medicare Part D.
77. The codes for pacemakers and implantable defibrillators would be found in what section of CPT?
A. 33200–33205
B. 33437–33537
C. 33202–33273
D. 33533–33799
78. A patient comes to the emergency room complaining of abdominal pain. She was previously diagnosed with type I diabetes. She also complains of watery eyes, congestion, pressure in the sinuses, and difficulty breathing. Her final diagnoses are right lower quadrant abdominal pain, type I diabetes, acute sinusitis, and asthma. What CPT and ICD-10-CM codes are assigned?
A. 99222, R18.91, E16.9, J01.91, J45.919
B. 99221, R17.41, E17.9, J01.90, J45.909
C. 99223, R14.31, E15.9, J01.90, J45.929
D. 99221, R10.31, E10.9, J01.90, J45.909
79. What is considered to be protected health information (PHI)?
A. Any health information that can identify the individual to whom it refers
B. Records pertaining to ancestry
C. Statistical data compiled for research purposes only
D. Census data
80. In what CPT code range is Surgical Pathology found?
A. 88515–88598
B. 88300–88309
C. 88400–80499
D. 88000–80299
81. The federal law that requires a patient’s written consent prior to disclosure of certain medical information by government agencies is called the
A. Health Care Amendment of 1976.
B. Privacy Act of 1974.
C. Health Information Law of 2002.
D. Medical Consent Act of 1965.
82. Data stored in a health care facility must
A. be organized in accordance with state standards for electronic data interchange.
B. adhere to OIG policies and procedures.
C. conform to the physician’s expectations for data storage.
D. comply with HIPAA rules and must be maintained securely.
83. Under HIPAA, health care facilities must
A. maintain a clean, safe working environment.
B. choose a privacy officer in accordance with HIPAA policies and procedures.
C. keep records of patients who refill prescriptions more than once within a three-month timeframe.
D. follow up with patients who repeatedly miss scheduled appointments for mandatory services.
84. What CPT code would be assigned for a colpocentesis?
A. 57135
B. 57859
C. 57600
D. 57020
85. A patient is prescribed a medication that narrows the blood vessels and raises her blood pressure. The medication is most likely a
A. tranquilizer.
B. vasoconstrictor.
C. cardiotonic.
D. cardiogenic.
86. If patients choose to obtain copies of their medical records, under the terms of HIPAA, providers can
A. complete employee paperwork.
B. charge a reasonable fee for providing copies of those records.
C. reschedule office visits to allow time to update medical records.
D. also fulfill requests for prescription data.
87. According to the CMS National Physician Fee Schedule, what is the conversion factor for basic life support mileage?
A. $34.5741
B. $32.4726
C. $28.8457
D. $36.0666
88. According to HIPAA, a patient’s information may be released for
A. determining premiums based on a patient’s past medical history.
B. paternity testing.
C. research.
D. transferring electronic medical records to remote locations.
89. A patient comes to the clinic complaining of fever, diarrhea, nausea, and vomiting. The patient is diagnosed with salmonella meningitis. What ICD-10-CM code would be assigned?
A. A07.21
B. A02.21
C. A05.26
D. A23.24
90. Which of the following anatomical locations would contain the diaphysis?
A. Metatarsal
B. Tibia
C. Septum
D. Diaphragm
91. A patient comes to the clinic complaining of nausea, vomiting, fever, dizziness, and intermittent confusion. The physician conducts a detailed history and examination and reviews the patient’s lab results. The patient is diagnosed with pyelonephritis and is scheduled for an ultrasound to review the state of the kidneys and other organs. What CPT and ICD-10-CM codes are assigned?
A. 76775-TC, N15
B. 71010-26, B12
C. 76775-26, N10
D. 73256-TC, M11
92. A female patient is diagnosed with breast cancer of the lower-inner quadrant of the right breast. The patient undergoes a modified radical mastectomy of the right breast in an attempt to circumvent the spread of the cancer to any secondary anatomical sites. The procedure was performed in three stages. In addition to the radical mastectomy, the physician also performed a right breast biopsy to treat the breast tumor in the lower-inner quadrant. What ICD-10-CM and CPT codes are assigned?
A. 15852-58, Z48.01
B. 19307-58-RT, 19101-59-RT, C50.311
C. 19307-RT, 19101-RT, C50.211
D. 11602, 15240, C50.312
93. The concept of confidentiality can be substantiated based on the right of
A. easement.
B. constitutionality.
C. totality.
D. privacy.
94. The abbreviation INH indicates what route of drug administration?
A. Inhaled and intrathecal administration
B. Intrathecal injection
C. Inhalant solution
D. Inhaled and intravenous administration
95. A patient is seen in the physician’s office after the results of an earlier mammogram demonstrated microcalcification in the right breast as well as a breast lesion. The lesion is excised using needle localization. The patient’s final diagnosis is fibrosclerosis of the right breast. What CPT and ICD-10-CM codes are assigned?
A. 19123-RT, H16.11
B. 19126-LT, M25.1
C. 19125-RT, N60.31
D. 19120-RT, L10.11
96. What is the code description for 65101-LT?
A. Removal of ocular implant performed laterally
B. Biopsy of cornea performed on the lower third of the cornea
C. Enucleation of eye, without implant, performed on the left side of the body
D. Fine needle aspiration of orbital contents on the left third of the orbit
97. The foramen ovale is found in which anatomical location?
A. Fibula
B. Heart
C. Liver
D. Pancreas
98. During a routine examination, a patient indicates that she is taking an antihypertensive medication that causes her kidneys to excrete more urine. These antihypertensive medications are called
A. calcium-channel blockers.
B. anticoagulants.
C. diuretics.
D. beta blockers.
99. Code range 99231–99233 pertains to
A. initial hospital care.
B. hospital discharge services.
C. consultation services.
D. subsequent hospital care.
100. A 7-year-old patient is seen in follow-up after an earlier diagnosis of excessive daytime sleepiness. The physician obtains a sleep study and then reviews and interprets the results. What CPT and ICD-10-CM codes are assigned?
A. 95810-26, R40.0
B. 95811-TC, J14.0
C. 95815-TC, G45.0
D. 95812-26, H40.0
101. If a physician provides preoperative management only to a patient prior to surgery, which modifier would be added to the surgery code?
A. -56
B. -44
C. -32
D. -91
102. The HIPAA Privacy Rule indicates that
A. restrictions on information disclosure exist only for patients with life-threatening illnesses.
B. the level of information disclosure permitted is based on the nature of the procedure.
C. practitioners should disclose only the minimum amount of health information necessary for the purpose of the disclosure.
D. physicians may release medical information at their own discretion.
103. The atrioventricular (tricuspid) valve is located in the
A. fibula.
B. lung.
C. heart.
D. brain.
104. A physician is analyzing specific organs in a particular region of the patient’s body. In her notes, she refers to the transverse or cross-sectional plane, which divides the body
A. horizontally.
B. vertically.
C. inferiorly.
D. bilaterally.
105. A health care practitioner who knowingly submits false statements to obtain federal health care reimbursement is guilty of
A. Medicare fraud.
B. DHS claim misrepresentation.
C. Health Insurance Privacy and Portability misuse.
D. Medicaid omission.
106. According to the guidelines for medical records outlined in the Health Insurance Portability and Accountability Act (HIPAA), patients
A. have the right to have errors reviewed by a hospital administrator.
B. do not have the right to have errors corrected, as the data has been previously verified by the physician.
C. have the right to have errors in their medical records corrected.
D. have the right to correct errors in identification data only.
107. The Health Insurance Portability and Accountability Act (HIPAA) standards were developed to
A. ensure that coders could easily access each medical record.
B. determine the structure of insurance carrier payments for health care practitioners.
C. protect patient confidentiality when health information is transferred electronically.
D. define XLTM standards for health records management.
108. A coder would assign modifier -53 to report
A. procedures cancelled due to the patient’s condition.
B. anesthesia administration.
C. dental procedures.
D. repeat procedures.
109. A patient is diagnosed with breast cancer and undergoes a partial mastectomy. What CPT code would be assigned?
A. 19305
B. 19301
C. 19304
D. 19307
110. Which of the following anesthesia modifiers indicates a normal, healthy patient?
A. P1
B. P4
C. P3
D. P2
111. A coder searching for codes pertaining to tissue expanders would find them in what section of CPT?
A. 16200–16799
B. 12000–12300
C. 11960–11971
D. 15000–15999
112. A patient comes to the emergency room complaining of abdominal pain, nausea, and intractable vomiting. Unable to pinpoint the source of the patient’s complaints, the physician decides to admit the patient to the hospital. After conducting a complete history and examination, the patient’s final diagnosis is determined to be chronic duodenal ulcer. The patient remains hospitalized for three days. The physician sees the patient on the day of discharge. What ICD-10 and CPT codes are assigned?
A. 99223, I48.91
B. 99238, K26.7
C. 99234, N17.9
D. 99291, D63.1
113. What is the code for excision of Meckel’s diverticulum?
A. 44820
B. 44700
C. 44800
D. 44850
114. The Health Insurance Portability and Accountability Act (HIPAA) was created for the purpose of
A. modifying legal and ethical issues surrounding medical records retention.
B. stabilizing administrative costs and productivity.
C. decreasing employee turnover and reducing the volume of new hire paperwork.
D. streamlining claims processing and reducing paperwork through electronic transmission.
115. The voluntary program that’s financed through a combination of payments from general federal revenues and premiums paid by beneficiaries who elect to participate is called
A. CHAMPVA.
B. Medicare Part B.
C. Medicaid.
D. TRICARE.
116. The I-10 helps coders classify patient
A. management information.
B. morbidity and mortality.
C. evaluation files.
D. reimbursement data.
117. A patient recently became eligible for health insurance through her employer. Her health insurance is considered to be an 80-20 policy. Under the terms of an 80-20 policy, the insurer pays 80 percent and the insured pays 20 percent of expenses. This 80-20 policy is an example of
A. coinsurance.
B. capitation.
C. prospective payment.
D. case management.
118. Performing a daily check for viruses and malware is one of the
A. requirements of the Help Desk.
B. routine aspects of software maintenance.
C. sensible guidelines for Internet use in health care facilities.
D. functions of HIM encoders.
119. Bones inside the nose are called
A. septal mucosa.
B. maxillae.
C. turbinates.
D. ethmoids.
120. A group of doctors who belong to the same network and provide discounted services to enrollees is called a/an
A. Managed Care Organization (MCO).
B. Individual Practice Association (IPA).
C. Health Maintenance Organization (HMO).
D. Preferred Provider Organization (PPO).
121. A female patient is seen for her annual gynecological examination. During the examination, the physician performs a test to detect cervical cancer. This test is called a/an
A. Pap smear.
B. carcinoembryonic antigen test.
C. mycobacterial culture.
D. immunoassay test.
122. Businesses that provide support services, like administration, to individual physicians are called
A. integrated provider organizations.
B. medical foundations.
C. management services organizations.
D. physician-hospital organizations
123. What is the full code description for 33536?
A. Repair of double outlet right ventricle with intraventricular tunnel repair
B. Repair of postinfarction ventricular septal defect, with or without myocardial resection
C. Closure of atrioventricular valve (mitral or tricuspid) by suture or patch
D. Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts
124. The CPT code for thrombolysis is
A. 93000.
B. 92920.
C. 93797.
D. 92975.
125. Which of the following statements is true of the Affordable Care Act?
A. It offers parents supplementary coverage for dependents with chronic illness.
B. It makes it mandatory for patients to carry health insurance.
C. It includes a provision for military service members who served in Afghanistan.
D. It requires health care facilities to maintain health records for at least 10 years.
126. A qualifying circumstance indicates a
A. situation that makes anesthesia administration more difficult.
B. condition that reduces the average recovery time for a particular type of surgery.
C. situation that may extend a patient’s length of stay in the hospital setting.
D. condition that impacts the outcome of surgery.
127. The portion of health insurance that an insured pays before he or she is entitled to receive benefits from an insurance plan is called the
A. capitation.
B. OPPS reimbursement.
C. coinsurance.
D. deductible.
128. A good compliance program in the health care setting includes
A. regular audit consultations with trustees of the AAPC.
B. HHS surveillance.
C. meetings with compliance officers.
D. regular tracking and monitoring of coding activities.
129. A 55-year-old patient was injured while working as a carpenter on a construction site. While framing the roof of a two-story house, he fell and hit his head. He was diagnosed with a concussion to the left side of his head, and underwent a right frontal parietal craniotomy with removal of a subdural hematoma. During the patient’s period of recovery, he was given a medication that resulted in a rash on his abdomen. The physician conducted an expanded problem focused history and exam, with straightforward medical decision making. What CPT code(s) should be assigned?
A. 99253
B. 99252
C. 99292, 99291
D. 99251
130. During a routine examination, a male patient is diagnosed with an elevated PSA. The physician performs a biopsy of the prostate with a rectal ultrasound to pinpoint the source of the problem. Which CPT and ICD-10-CM codes would be assigned?
A. 55720, 74000-26, R97.3
B. 55700, 76872-26, R97.2
C. 55734, 73200-26, R97.2
D. 55725, 76000-26, R93.6