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CPC Practice Exam Questions & Answers 2024
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When a patient has a blood test for HIV that is inconclusive, what ICD-10-CM code is assigned a. Z b. R c. B d. Z11.4 - ✔b. R What does MRSA stand for a. Methicillin Resistant Staphylococcus Aureus b. Methicillin Resistant Streptococcus Aureus c. Moderate Resistance Susceptible Aureus d. Mild Resistance Steptococcus Aureus - ✔a. Methicillin Resistant Staphylococcus Aureus What does the forth character in diabetes mellitus diabetes codes indicate? a. The condition as controlled or uncontrolled b. Any complication associated with diabetes c. Type of diabetes (type 1, or Type 2, secondary) d. If the diabetes is primary or secondary diabetes - ✔b. Any complication associated with diabetes When do you code acute respiratory failure as a secondary diagnosis a. the patient has any other condition at the same time b. When it is determined to be the cause of the shortness of breath c. Acute respiratory failure is always listed first d. When it occurs after admission - ✔d. When it occurs after admission When the type of diabetes mellitus is not documented in the medical note, what is used as the default type a. Type 2 b. Type 1 c. Can be type 1 or 2 d. Scondary diabetes - ✔a. Type 2 When is it appropriate to use history of malignancy, from category Z a. once the malignancy is removed form that site but the patient is still receiving chemotherapy b. When the patient cancels treatment for that site c. It has been excised, no evidence of any existing primary malignancy, and there is not further treatment directed to the site d. when 5 years has passed after surgery -
✔c. It has been excised, no evidence of any existing primary malignancy, and there is not further treatment directed to the site If a patient uses insulin, what type of diabetic does it mean the patient is a. secondary diabetes b. type 2 c. type 1 d. the use of insulin does not specify the patient is a certain type of diabetic - ✔d. the use of insulin does not specify the patient is a certain type of diabetic Pneumonia due to adenovirus. What ICD-1-CM code is reported a. B34. b. J12. c. B97. d. B30.1 - ✔b. J12. a 50 year old patient has been diagnosed with elevated blood pressure. The patient does not have a history of hypertension. The correct ICD-10-CM code to report is a. R03. b. I c. I13. d. I15.0 - ✔b. I What type of fracture is considered traumatic a. pathologic fracture b. spontaneous fracture c. stress fracture d. compound fracture - ✔d. compound frature Can Z codes be listed as a primary code? a. No; Z codes are never listed as primary codes b. No; Z codes are always reported as secondary codes c. No; Z codes are reported for external injuries and where it happened which is always listed as secondary d. Yes; Z codes can be sequenced as primary and secondary codes - ✔d. Yes; Z codes can be sequenced as primary and secondary codes Where can you find the Table of Drugs and Chemicals a. Tabular List of the ICD-10-CM codebook b. Alphabetic Index of the ICD-10-CM codebook c. Index to Procedures of the b. Alphabetic Index of the ICD-10-CM codebook d. CPT codebook - ✔b. Alphabetic Index of the ICD-10-CM codebook In which circumstances would an external cause code be reported a. Delivery of a newborn b. Causes of injury or health condition
a. N18. b. N18.6, N18. c. N18.4, N18. d. N18.6 - ✔d. N18. What is the definition of a postpartum complication? a. any complication occurring within the six-week period prior to delivery b. b. Any complication occurring within the six-week period after delivery - ✔b. Any complication occurring within the six-week period after delivery What is NOT an example of active treatment for pathological fractures a. Surgical treatment b. Emergency department encounter c. Evaluation and treatment by a new physician d. Cast change - ✔d. Cast change According to ICD-10-CM Official Guidelines for Coding and Reporting, Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A) codes have sequencing priority over what codes a. Codes from all other chapters b. All codes including Z33.1 - ✔a. Codes from all other chapters Many coding professionals go on to find work as a. Accountants b. Consultants - ✔b. Consultants A medical record contains information on all but what areas a. Observations b. Medical or surgical interventions c. Treatment outcomes d. Financial records - ✔d. Financial records Technicians who specialize in coding are called a. coding specialists b. LPN's - ✔a. coding specialists What type of provider goes through approximately 26 1/2 months of education and is licensed to practice medicine with the oversight of a physician - ✔Physician Assistant (PA) The Medicare program is made up of several parts. Which part is most significant to coders working in physician offices and covers physician fees without the use of a private insurer? - ✔Part B The Medicare program is made up of several parts. Which part is affected by the Centers for Medicare and Medicaid -Hierarchical Condition Categories (CMS-HCC) -
✔Part C What does CMS-HCC stand for a. Centers for Medicare and Medicaid Services - Hierarchial Condition Category b. Centers for Medicare and Medicaid Services - Hospital Correct Coding Initiative - ✔a. Centers for Medicare and Medicaid Services - Hierarchial Condition Category When coding an operative report, what action would NOT be recommended a. Starting with the procedure listed b. Reading the body of the report c. Coding form the header without reading the body of the report. d. Highlighting unfamiliar words - ✔c. Coding form the header without reading the body of the report. Outpatient coders focus on learning which coding manuals - ✔CPT, HCPCS Level II, ICD-10-CM If an NCD doesn't exist for a particular service/procedure performed ona Medicare patient, who determines coverage - ✔MAC (Medicare Administrative Contractor) The ___ describes whether specific medical items, services, treatment procedures, or technologies are considered medically necessary under Medicare. a. NCD b. Medicare Physician Fee Schedule c. MS-DRG d. Internet Only Manual - ✔NCD (National Coverage Determinations Manual) NCD serve what purpose a. to provide payment options to physicians b. To spell out CMS policies on when Medicare will pay for items or services. - ✔b. To spell out CMS policies on when Medicare will pay for items or services. MAC stands for - ✔Medicare Administrative Contractor Local Coverage Determinations (LCD) are administered by - ✔Each regional MAC LCD only have jurisdiction in their ____ area - ✔regional ABN stands for - ✔Advance Beneficiary Notice When are providers responsible for obtaining an ABN for a service not considered medically necessary a. Prior to providing a service or item to a beneficiary b. After providing a service or item to a beneficiary - ✔a. Prior to providing a service or item to a beneficiary A covered entity does NOT include a. Healthcare provider b. Patient
What will the scope of a compliance program depend on a.The insurance carrier the physician is contracted with b. Size and resources of the physician's practice - ✔b. Size and resources of the physician's practice Evaluation and Management services are often provided in a standard format such as SOAP. What does the acronym SOAP stand for - ✔Subjective Objective Assessment Plan According to the OIG, internal monitoring and auditing should be performed by what means a. Periodic audits b. a baseline audit - ✔a. Periodic audits Voluntary compliance programs also provide benefits by not only helping to prevent erroneous or ___, but also by showing that the physician practice is making additional good faith efforts to submit claims appropriately a. Mistaken principals b. Fraudulent claims - ✔b. Fraudulent claims How many components should be included in an effective compliance plan - ✔ 7 According to AAPC's Code of Ethics, a member shall use only ___ and ___ means in all professional dealings - ✔Legal Ethical Medicare Part D is what type of Insurance - ✔Prescription drug coverage available to all Medicare Beneficiaries What type of health insurance provides coverage for low-income families - ✔Medicaid What is PHI - ✔Protected Health Insurance What form is used to send a provider's charge to the insurance carrier - ✔CMS- Which option below is NOT a covered entity under HIPAA a. Medicare b. Medicaid c. BCBS d. Workers Compensation - ✔d. Workers Compensation WHich of the following is a BENEFIT of electronic transactions a. Payment of claims b. Timely submission of claims - ✔b. Timely submission of claims
What is the value of a remittance advice a. It catalogs the patient's coverage benefits b. It tells you what you will be paid and why any changes to charges were made - ✔b. It tells you what you will be paid and why any changes to charges were made The OIG recommends that the physician's practice enforcement and disciplinary mechanisms be a. Frequent b. Consistent - ✔b. Consistent Each October the OIG releases a ___ outlining its priorities for the fiscal year ahead
b. venous system c. arterial system d. lymphatic system - ✔. endocrine system