CPC Sample Questions

Sample/Practice/Free CPC/CPC-H Exam Coding Questions

1. Jill is a 29-year-old patient of Dr. Marks. She is seen by Dr. Marks for a cough with wheezing and yellow-colored mucus of three days’ duration, as well as four days of external bleeding hemorrhoids and diarrhea. Dr. Marks gives Jill Amoxicillin for acute viral bronchitis, instructions for care of external hemorrhoids, and a diet plan to assist with the diarrhea. What diagnoses should Dr. Marks use for this encounter?

a. 466.0, 455.5, 787.91

b. 787.91, 466.11, 455.5

c. 466.11, 787.91, 455.2

d. 466.0, 455.8, 787.91

2. What HCPCS Level II code describes Ensure HN therapy with an enteral infusion pump with alarm?

a. B4150, B9002

b. B4152, B9000

c. B4150

d. None of the above

3. Which types of joints are considered synovial?

a. Suture joint, medial joint, and articulation joint

b. Ball-and-socket joint, hinge joint, and saddle joint

c. Pivot joint, talus joint, and cranial joint

d. Ball-and socket joint, nasal joint, and elevation joint

4. A physician applied a cast and also provided all of the subsequent fracture care. The same physician may report the application of the cast separately from the fracture care.

a. True

b. False

5. Immediately prior to inserting a permanent pacemaker and placing an electrode in the ventricle, the same physician surgically created a pocket to hold the pulse generator. How should the physician report the creation of the pocket?

a. Skin pocket is included

b. 33222

c. 33222, 33215-51

d. 33233

6. What modifier should be used for an incomplete colonoscopy when the patient was prepared for a full colonoscopy?

a. 78

b. 52

c. 24

d. None of the above

7. A physician inserts a single temporary transvenous pacing catheter into the right atrium and connects the electrode to an external pulse generator. How should the physician report these services?

a. 33214

b. 33206

c. 33210

d. 33211-52

8. A surgeon performs a diagnostic laparoscopy followed by a laparoscopic

nephrectomy (including partial ureterectomy). How should the physician report these services?

a. 50546

b. 49320, 50546-51

c. 49320

d. 50549

9. It is appropriate to separately report a visceral repair when a closure of an

ureterovisceral fistula is performed during the same surgical session.

a. True

b. False

10. A dermatologist excises a 3.5 cm benign lesion from a patient’s back. After the lesion is successfully removed, the dermatologist performs an intermediate 3.5 cm layered closure. How should you report these services?

a. 11404, 12031

b. 11404, 12032-51

c. 11404

d. 11404, 12032-57

11. How would a physician report a bilateral diagnostic nasal endoscopy followed by endoscopic debridement of the nasal cavity during the same operative session?

a. 31240, 31237

b. 31254

c. 31237-50

d. 31237

12. What is the name of a procedure that involves the passage of an endoscope down through the esophagus?

a. Septoplasty

b. Sinusotomy

c. Laryngoscopy

d. Esophagoscopy

13. A physician excises a lesion from the iris of the right eye. How should the physician report these services?

a. 66761-50

b. 66770-RT

c. 66635-52

d. 66600-RT

14. A patient presents to have corns removed from his foot. The physician performs paring to successfully remove four lesions. How should the physician report these services?

a. 11056

b. 11056, 12000

c. 11056 x 4

d. 11704

15. The subsection microbiology in the Pathology and Laboratory section of the CPT Manual includes codes for bacteriology, mycology, parasitology, and  virology.

a. True

b. False

16. A 13-year-old patient suffering from end-stage renal disease received a full month of services, including growth and development assessment, parent counseling, and monitoring of adequate nutrition. These services were completed in an outpatient facility. How would the physician report these services?

a. 90999

b. 97803, 90924

c. 90920

d. 90924

17. A patient is admitted to the hospital for insertion of 15 interstitial radiation ribbons. How would the facility report the radiology services?

a. 77778

b. 99222, 77763

c. 77777-TC

d. 77762 x 15

18. Mrs. Smith was seen by her family physician, Dr. Marks. Mrs. Smith complains she has had a sore throat, breathing problems, and a fever for five days. She is a diabetic patient and has been taking over-the-counter medications that have interfered with her insulin medication. Dr. Marks documented a detailed history, detailed examination, and moderately complex decision-making. Dr. Marks spent 35 minutes with the patient during the examination. How should the physician report this service?

a. 99215

b. 99204

c. 99205

d. 99214

19. Pediatric critical care patient transport codes include vascular access procedures, blood gases, and review of information data stored in computer.

a. True

b. False

20. An anesthesiologist administers anesthesia for a male patient prior to the surgeon performing a total hip replacement. The patient is 75 years old and suffers from mild hypertension. How should you code the anesthesia services?

a. 01214, 99100-59

b. 01214-47

c. 01214-P2, 99100

d. 01214-P3

Answers

1.      A

2.      A

3.      B

4.      B

5.      A

6.      B

7.      C

8.      A

9.      B

10. B

11. C

12. D

13. D

14. A

15. A

16. C

17. A

18. D

19. A

20. C

CCS Prep Resources

CCS Exam Preparation Resources:

1. Articles on commonly assigned DRGs and related guidance from the Coding

   Clinic on the conditions that group to those DRGs

http://www.primaris.org/professionals/products.asp?SETTING=Hospital&TOPIC=HPMP

 (Note: TMF updated a lot of these in 2007 for the MS-DRGs, but they are now

gone from the website—email cmbenjamin@bellsouth.net for these.

2. Browse through CMS's webpage and related links discussing the acute care

   prospective payment system and the outpatient prospective payment system

http://www.cms.hhs.gov/AcuteInpatientPPS/

http://www.cms.hhs.gov/HospitalOutpatientPPS/

3. Patient Status Codes/discharge disposition:

http://www.trailblazerhealth.com/Publications/Job%20Aid/ub-92a_discharge.pdf

4. Excellent site with articles with quizzes and cases on various coding issues related

   to the CCS/CCS-P; The main prep article that is recommended to read first

   provides a recommended list of resources for further research

http://health-information.advanceweb.com/HIMStuff/CCSPrep.aspx

5. Info on the Coding Clinic query process.

http://www.ahacentraloffice.org/ahacentraloffice/html/icd9cm.html

6. Direct link to a DRG calculator! Enter in the codes from all your inpatient cases

   in and watch the magic of DRGs!

http://www.irpsys.com/cgi-bin/webplus.exe?Script=/irpsys/drgcalc.wml

   7. OIG workplan: Knowledge about compliance issues is not complete without an

   udnerstanding of the OIG and its workplan other related issues. The AHIMA text

   Effective Management of Coding Services also has a great chapter on Compliance

   issues in coding. Prepare now for Domain 9 of the 2007 CCS multiple choice

competencies by familiarizing yourself with compliance issues.

http://oig.hhs.gov/publications/workplan.html

8. HIPAA resource: Familiarize yourself with real-life privacy and confidentiality

    issues in preparation for the new 2007 CCS multiple choice competencies--Domain 8

http://www.hipaadvisory.com/

9. Check out AHIMA's recent presentation on ED coding also as you will need to

    make sure that you are abreast of the ICD-9 coding changes related to ED coding.

             http://campus.ahima.org/audio/2007/RB100207.pdf

10. APCs/OPPS: The main thing you need to know is what the items that are required to   
       group/calculate an APC and what items would affect or change them significantly.

http://www.acep.org/practres.aspx?id=30464

 11. OPPS/APC terminology: Terminology peculiar to APCs--for example instead of a

       case mix index (like for DRGs), there is a corresponding term "service mix index"     
       for APCs.

http://www.ahd.com/definitions/op_apc.html

Practice Cases/Questions

Sample/Practice/Free Cases/Questions:

 1. JustCoding quizzes: Test and develop your knowledge of basic coding principles

  (For CCS and CCS-P) Keep in mind that there may be mistakes in these

http://justcoding.com/quizlet_archive/

2. Ingenix's Code This scenarios. Sign up for free access to scores of coding cases with answers; a new case is added twice a month; there is an archive of all   previous cases.

http://www.shopingenix.com/modules/nonprod/default.asp?id=2534

 3. Advance’s Q&A archive: Go through each one of these and try to answer the  question yourself before reading the responses.

http://health-information.advanceweb.com/common/contenttools/archives.aspx?int=3&CTIID=1469

4. Michelle Green’s archive: To access the other cases besides the first one, for

   which the link is already listed, go to the web address bar at the top of your

   browser page and change the number of the case. For example, to access the

   4th ASU case, you would use the following weblink:

http://web.alfredstate.edu/him/records/asucases/asucase004.pdf

http://web.alfredstate.edu/him/records/records.htm

General Coding References

General Medical Coding References on the Web:

Online Pathophysiology references

Knowing pathology and disease processes and treatments is crucial for coding and Part I

of the CCS exam; this site is Merk Manual online and it specifies pathophysiology,

symptoms/signs, treatment and more for a myriad of conditions.

http://www.merck.com/mrkshared/mmanual/tables/296tb2.jsp

Anatomy: (there are plenty of sites including Gray’s Anatomy)

http://www.bartleby.com/107/

http://mywebpages.comcast.net/wnor/homepage.htm

http://www.netterimages.com

Pharmacology References:

www.pdr.net

www.rxlist.com

http://www.nlm.nih.gov/medlineplus/druginformation.html

Abbreviation/Acronym website:

http://www.acronymfinder.com

Online Medical Dictionary websites:

http://www.medlineplus.com

(this site is rich with great sources: encyclopedia, medical dictionary, etc.)

and there is an online Dorland’s

 http://www.dorlands.com/wsearch.jsp

General Surgery/Procedure references:

http://www.mercksource.com/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcnszSzcontentzSzadamzSzencyzSzarticlezSzsurgidxazPzhtm

http://www.yoursurgery.com

http://www.vesalius.com

http://www.or-live.com/upcomingBroadcasts.cfm

http://www.nlm.nih.gov/medlineplus/surgeryvideos.html

Medical Terminology: Knowing medical terminology is very crucial to medical coding;

one can figure out the meaning of a complex procedural term just by breaking down the

term into the prefix, suffix, etc and applying the meaning of each; check the full list of

prefix's & suffix's.

http://www.mtworld.com/tools_resources/root_words.php?letter=all

Job Details

Inpatint Coding Job Details:

JOB DEFINITION: Under limited supervision, reviews medical records and performs coding on all diagnoses, procedures, (both medical and surgical), and assigns the correct diagnostic related grouping (DRG). Uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient’s treatment. Maintains the confidentiality of patient records and procedures.

ESSENTIAL FUNCTIONS: The following duties ARE NOT intended to serve as a comprehensive list of all duties performed by all employees in this classification. Shown are duties intended to provide a representative summary of the major duties and responsibilities. Incumbent(s) may not be required to perform all duties listed and may be required to perform additional, position-specific duties.

REPRESENTATIVE DUTIES: Responsible for abstracting, coding, and sequencing the classification of medical and surgical procedures, diagnosis, and treatment modalities on Inpatient and Day Surgery records. Selects the most accurate and descriptive codes from the listings of International Classification of Diseases, Ninth Revision, Clinical Modification, (ICD-9-CM American Medical Association Current Procedural Terminology (CPT-4) Coding system, and Healthcare Common Procedure Coding System (HCPCS). Assigns DRG’s and performs coding compliance reviews. Abstracts and codes pertinent medical data into multiple software programs. Follows official coding guidelines to review and analyze health records. Maintains compliance with both external regulatory and accreditation requirements, and with State and Federal regulations. Extracts pertinent data from the patient’s health record, and determines appropriate coding for reports and billing documents. Identifies codes for reporting medical services, procedures performed by physicians, and enters codes into computer system. Provides feedback and education to physician and professional staff regarding changes in coding methodology and enhanced documentation procedures for optimizing reimbursement. Utilizes the coding query process to providers to request missing information. Corrects records with inconsistent information and/or containing discrepancies. Provides training and mentoring to new employees as needed. Performs routine audits independently and participates in performance improvement. Participates in coding compliance plans, research and analysis, benchmarking, financial and strategic planning, and other customer requested project. Reviews and discusses informational requirements with individuals to determine the most expeditious method for data acquisition and availability of data. Retrieves and compiles data for reports as directed. Maintains the confidentiality of patient records and procedures. Performs other duties as assigned or required.

Knowledge and Skills

   KNOWLEDGE and SKILLS:

·        Knowledge of coding software.

·        Knowledge of medical terminology, abbreviations, anatomy and physiology; major disease processes and pharmacology.

·        Knowledge of classification systems, ICD-9-CM nomenclature, CPT-4 and HCPCS nomenclature, coding rules, guidelines and proper sequencing.

·        Knowledge of coding conventions and rules established by the American Medical Association (AMA), the American Hospital Association (AHA) and the Center for Medicare and Medicaid (CMS), for assignment of diagnostic and surgical procedural codes.

·        Knowledge of JCAHO, Privacy Act of 1974, and HIPAA standards affecting medical records and the impact on reimbursement and accreditation.

·        Knowledge of ethical coding principles and revenue cycle activities.

·        Knowledge of the principles and practices of medical file and record management.

·        Skill in reading medical records, and finding and resolving documentation discrepancies.

·        Skill in operating computerized medical coding and information processing systems.

·        Skill in operating a personal computer and utilizing a variety of software applications.

·        Skill in understanding medical/surgical coding procedures and protocols.

·        Skill in linking diagnosis to services and applying appropriate codes to diagnosis, procedures and supplies.

·        Skill in using analytical and research modalities skills to define and solve problems.

·        Skill in interpreting and applying ethical coding standards, federal and state laws and regulations; rules; policies and procedures; and professional practice standards for health care organization coding compliance program activities.

·        Skill in effective verbal and written communication with peers, physicians and other hospital staff.

·        Skill in writing reports and other materials.

·        Skill in oral communication and presenting information to providers.

Qualification

Medical Coding Job Qualification

MINIMUM QUALIFICATIONS: An Associate’s Degree in Health Information Management, AND two (2) years of medical/surgical coding experience; OR an equivalent combination of education and experience. Certified Coding Specialist (CCS) required. If no CCS applicant, will consider a Certified Coding Specialist-Physician (CCS-P), Certified Professional Coder-Hospital (CPC-H) and/or a Certified Professional Coder (CPC) with the understanding they will sit for the CCS exam within 1st year of employment.

ADDITIONAL REQUIREMENTS: May be required to work outside the traditional work schedule. According to the needs of the organization, some incumbents in this job class may be required to obtain specific technical certifications. Incumbent must pursue the CCS certification if not credentialed at the time of hire.

MINIMUM PHYSICAL REQUIREMENTS: The following demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. This position requires persistent repetitive movements of the hands, wrists and fingers and the ability to sit for long periods of time. ANMC is not a latex free environment. High stress, constant change due to 3rd party and CMS reimbursement rules and regulations. Therefore, some latex exposure can be expected. May occasionally be exposed to infectious diseases. The majority of work is performed with a wide variety of people with differing functions, personalities and

abilities.

AGE REQUIREMENTS: None.

This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.