Cpt Medical Coding Questions And Answers Pdf

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In order to ensure that medical services of all kinds can be properly classified, the medical profession has developed a comprehensive codification system for the many diseases and conditions for which people seek treatment. This complex system, which has been evolving for well over a century, is currently known as the ICD In an attempt to be as precise as possible, the ICD contains codes for all common and uncommon diseases and medical conditions.

If you're interested in pursuing a job in medical administration, you will likely have to answer one or more questions about medical coding. Medical coding is a specialized skill that enables medical administrators to properly sort medical records and communicate with physicians, insurers and patients about the status of their medical bills. It is important to prepare for medical coding interview questions before attending an interview so that you can properly demonstrate your professional expertise and aptitude for medical coding tasks.

10 Medical Coding Interview Questions and Answers

Certification as a medical coder demonstrates one's knowledge and skill in the field of medical coding and can help one get a job as a medical coder and earn more in pay. The medical coder exam must be passed to earn certificaiton. The medical coding exam has multiple choice questions and five hours and forty minutes is given to complete the exam. Grade Answers as You Go. Edema is a symptom of both hypertension and CKD. ICDCM guidelines state there is a casual relationship assumed between CKD and hypertension unless the provider specifically states that the hypertension is not related to the CKD, giving this patient hypertensive chronic kidney disease instead of regular hypertension.

Incorrect answer. Please choose another answer. Although the patient's chart has a detailed history and moderate medical decision making, the provider only reached 11 bullet points, making this level a The provider performs an excision, not an incision, completely removing the cyst. The excision is intermediate because it involves subcutaneous extensions and the repair is included with the procedure. Pediatric vaccines with counseling are coded per component.

Each first component of a vaccine Measles and Diphtheria in this case are coded as one unit of Each additional component to the vaccine mumps, rubella, tetanus and acellular pertussis receive another for an additional component code. The provider must be queried for clarification. According to chapter guidelines, if a patient is seen for an HIV-related condition, which oral hairy leukoplakia is , then B20 is coded first, then the complications.

Only the provider's statement is needed that the patient has HIV, not a positive lab test. Cystitis is an infection of the bladder. The provider must specifically state that the infection or condition is not affecting the pregnancy for an incidental code. The patient is experiencing blood in her urine, which gives us the hematuria portion of the diagnosis. Anesthesia for all closed procedures on humerus and elbow.

The code is only used for patients under 1 year old or over 70 years old. The Omnibus Rule established HITECH and the AARA of and finalized the Breach Notification Rule, mandating that covered entities who have more than 10 individuals with outdated contact information involved in a data breach must be notified by posting a notice on their website or creating a local ad in the newspaper.

For breaches over individuals, major news outlets must be contacted and the Secretary of HHS immediately. Removing protected health information, encrypting email and creating confidentiality notices are a multi-layered security approach that is best-practice to prevent breaches of data.

The Inpatient Prospective Payment System drives value-based care by paying inpatient stays based on DRGs Diagnosis-Related Group s which are groups of diagnoses with similar weights in order to determine "how much" a patient's stay ought to cost. These drivers force hospitals to work to be most efficient in their use of resources to come in under what they will be paid in order to avoid losing money. A conversion factor, which is a national number that changes annually, is multiplied by the sum of RVUs that are multiplied by the GPCI to calculate payment for professional fee schedules.

The HAC-POA Hospital acquired condition, present on admission program was created by the Deficit Reduction Act of any of these conditions which are not present on admission and could have reasonably been prevented by following accepted standards of care will not be reimbursed.

Usually, adding the DRG weight would have increased the facility's reimbursement, but this forces hospitals to avoid hospital acquired conditions, rather than profit from them. RVUs multiplied by conversion factor gives you the amount payable for a provider's fee schedule.

CMS conditions of participation require that the patient's history and physical be completed and documented within the patient's record within 24 hours of admission, but not greater than 30 days prior to admission.

ROS is performed to make sure the provider did not miss any relevant complaints and can be pulled from the HPI if needed. Rubber stamps were prohibited by CMS in for provider authentication. An open-record review takes place when a qualitative analysis of the patient's record is done while the patient is in active treatment. The Joint Commission requires these reviews to ensure that documentation standards are met while the patient is still under care.

Only the first 3 digits of a patient's zip code is not PHI, as long as there are more than 20, people in the group that forms all zip codes. Otherwise the zip code must be changed to EMRs do not have this capacity. The OIG states that billing companies who submit fraudulent claims as well as the person who submitted them! Both undercoding and overcoding are examples of fraudulent claims, the claim submitted must accurately represent the services rendered. Procedures include a minor evaluation and management service.

If the patient comes in complaining of hypertension and an abscess is discovered, then it would be acceptable to report an evaluation and management service. Providers must not add documentation solely for the purpose of being reimbursed and it must be within a reasonable time frame. Prev Next Finish. Bookmark Page. Clinical Classification Systems. A year-old female, who is a new patient, presents with foul-smelling urine, frequency, flank pain and fever for 4 days. Patient denies nausea and headache.

Patient is not sexually active and is a non-smoker. The provider performs the following exam in addition to patient's height, weight and blood pressure check: General: Well-developed, well nourished, in no acute distress Ears: external ears normal, TM bilaterally intact Neck: Supple, no thyromegaly Extremities: No edema Cardiovascular: RRR, no bruits Lungs: Clear to auscultation The patient is prescribed ciprofloxacin and given a diagnosis of acute cystitis without hematuria.

A patient presents with a cyst at the base of his tailbone. It is swollen and painful for the patient to sit down. The provider drapes the patient in the usual fashion, administers lidocaine and uses a scalpel to excise the 2cm cyst and a subcutaneous extension, rinses it with sterile saline, performs an intermediate repair of the wound with a layered closure.

The correct CPT code assignment for this procedure is:. A 7-year-old child presents for a series of vaccines. ICD codes are used:. All of the above. For urosepsis, a coder must:. Use the code for severe sepsis. Use the code for sepsis with organ dysfunction. Query the provider. Code first localized sepsis. A patient comes into the office with white fuzzy patches on their tongue and is diagnosed with oral hairy leukoplakia.

The provider runs a test for HIV and notates that the patient has HIV in the chart, but does not have a positive lab test yet.

The patient is a smoker. What is the correct sequencing of these ICD codes? B20, K A year-old patient is 27 weeks and 6 days pregnant.

The patient is experiencing dysuria and blood in her urine. She is diagnosed with acute cystitis. What is the correct coding of this patient's chart? A patient comes in after her pressure cooker has exploded and covered her face with boiling soup. She was luckily wearing a sweater which protected her arms. She has partial-thickness burns covering her entire face.

What is the correct CPT code to be assigned as the hospital removes chicken, celery and burnt tissue from her face and places dressings on it? A 2-year-old child had their humerus fractured by a falling dresser and requires anesthesia to repair the break because they will not hold still for a reduction.

The procedure billed is What anesthesia service is reported? Confidentiality and Privacy. Security Rule, less than individuals but more than 5, post a notice in the newspaper for days.

Omnibus Rule, less than individuals but more than 10, post a notice on their website for 90 days. Security Rule, or more individuals, post a notice on their website and create a radio ad for 60 days.

Privacy Rule, 5 or more individuals, post a notice on their website, in the lobby and send postcards with information at least 3 times over 90 days. Sally calls the coding department to contest the duplicate procedures that her adult sister received while admitted to an inpatient mental health facility. Sally has her sister's date of birth, her name but not her ID number. She says her sister is too depressed to advocate for herself and Sally just wants the charges reviewed.

What do you do? Tell Sally you'll review her sister's chart while she was hospitalized and process a corrected claim if needed. Tell Sally you're sorry, but her sister must call when she gets out of the hospital, HIPAA does not allow you to speak to Sally without her sister's written consent.

Tell Sally her sister's patient ID number so she can better advocate for her sister in other departments. Tell Sally that according to HIPAA she must obtain her sister's written consent in order to discuss any protected health information with her and give her the fax number where she can send the written release.

You need a second opinion on coding a chart from your Coding Manager, who does not have access to the patient's records. You decide to e-mail a screenshot of the chart to the Coding Manager. What steps must you take to ensure that the patient's data is protected in your email? Create a confidentiality notice in your email, asking an unintended recipient to delete the information.

Follow all company guidelines to encrypt your email. Remove patient's name, date of birth, insurance ID , SSN, address and patient number before emailing.

Reimbursement Methodologies.

Model Question and Answers for Medical Coding CPC Exam 2019

Melody S. Students ask me often if it is necessary to take Medical Terminology, Anatomy, or Medical Billing and Coding if they either have been in the field or have taken the classes in the past. If you fail this area of the test, you fail the entire test. These tests will give you an idea of your own knowledge base and if you need additional classes or refresher courses, and do not reflect admission to Career Coders classes. Contact Melody Irvine by email at MelodyIrvine careercoders. Make sure you print out your results and have them ready.

A certified medical coder will have a greater level of expertise than a non-certified coder and will be a greater asset to your practice. Certification courses also train prospective coders in specific types of medical coding, such as inpatient versus outpatient coding. If the position you're hiring for requires a particular skill set, this question will help you to quickly decide if the applicant has the qualifications you need. What to look for in an answer:. Whenever I can, I take qualification courses to increase the breadth of my knowledge. You will want to check if the applicant is familiar with the particular codes for the medical services used at your practice.

Certification as a medical coder demonstrates one's knowledge and skill in the field of medical coding and can help one get a job as a medical coder and earn more in pay. The medical coder exam must be passed to earn certificaiton. The medical coding exam has multiple choice questions and five hours and forty minutes is given to complete the exam. Grade Answers as You Go. Edema is a symptom of both hypertension and CKD. ICDCM guidelines state there is a casual relationship assumed between CKD and hypertension unless the provider specifically states that the hypertension is not related to the CKD, giving this patient hypertensive chronic kidney disease instead of regular hypertension.


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Medical Coding Interview Questions & Answers

These free questions are available for you to familiarize yourself with the type of questions you will encounter on our CPC certification exam. Questions will be updated regularly. Sign up to receive a notification when new CPC sample questions are posted. The physician performs a detailed history.

The types of questions covered are general, conceptual, technical, behavioral, situational, and experience based. You can also find interesting examples and sample answers with each question. Who are these Medical Coding Interview Questions useful for? These interview questions will be very useful for all candidates appearing for the role of Medical Coder, Clinical Coder, Clinical Coding Officer, Diagnostic Coder, Nosologist or Medical records technician Both entry level freshers and experienced candidates will be benefited by these questions and answers. What is Medical Coding?

Medical Coder Practice Test

The patient is seen for acute gastroenteritis, nausea with vomiting, and abdominal pain. Which diagnosis or diagnoses should be reported?

Medical Coder Practice Test

CPC exam is questions long. This exam tests your knowledge of physician coding and guidelines. The exam is questions. You are allowed 5 hours and 40 minutes to complete the exam. It is an open book exam. That means you can get 45 questions wrong and still get your certification.

Do you have a certificate in Medical coding? Are you a person with an experience in health care industry? Want to become a specialist in medical coding then log on to wisdomjobs online site and reward your career. Medical coding is transformation of health care diagnosis, procedures, medical services and equipment into universal medical alphanumeric codes.

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