Coding Test Ch 1-4 (Med 140)

The Medicare program was established in?
1965
Medicare Part A pays for?
hospital/facility care
Medicare Part B pays for?
physician services and durable medical care
Who handles the day-to-day operation of the Medicare program for CMS?
MACs
Medicare pays for what percentage of covered charges?
80%
The incentive to Medicare participating providers is?
*All of the above*, 1)Direct payment on all claims 2) Faster processing 3) A 5% higher fee schedule
Part B services are billed using?
ICD-10-CM, CPT, HCPCS
Who is the largest third-party payer in the nation?
The government
A major change took place in Medicare in __________ with the enactment of the Omnibus Budget Reconciliation Act.
1989
The physician fee schedule is updated each April 15 and is composed of?
*All of the Above*
1) The relative value units for each service
2)A geographic adjustment factor to adjust for regional variations in the cost of operating a health care facility
3)A national conversion factor
If the surgeon performs more than one procedure on the same patient on the same day, and discounts were made on all subsequent procedures, Medicare would pay what percentages for the first, second, third, fourth, and fifth procedures?
100%, 50%, 50%, 50%, 50%
Medicare sets payment level for assistant surgeons at a percentage of the fee schedule amount for the ______ surgical fees?
gobal
What edition of the Federal Register would hospital facilities be especially interested in?
October
What edition of the Federal Register would outpatient facilities be especially interested in?
November and December
What are the three items that the Medicare beneficiaries are responsible for paying before Medicare will begin to pay for services?
Deductibles, Premiums, and Coinsurance
CMS handles the daily operation of the medicare program through the use of _________ formerly Fiscal Intermediaries?
Medicare Administrative Contractors
Medicare funds are collected by?
Social Security Administration
Which of the following is Not a stated goal of the Physician Payment Reform?
Limit provider liabilities
If a QIO provider renders a covered service that costs $100 and bills Medicare for the service and Medicare allowed $58, the provider would bill this amount to the patient?
$0
The Medicare Prescription Drug, Improvement, and Moderation Act of 2003 established these new benefits available under the Medicare program?
Part D
This program is also known as Medicare Advantage?
Part C
________ are activities involving the transfer of health care information and ________ means the movement of electronic data between two entities and the technology that supports the transfer.
Transactions, Transmission
This maps ICD-9 codes to ICD-10-CM codes?
GEMs
Which of the following is true about ICD-10-CM?
There are combination diagnosis/symptom codes.
The following are characteristics of the ICD-10-CM index?
*All of the above*
-Main terms in bold type
-Subterms are indented under the main term
-Only the first four characters of some codes are given
Which organizaton has been responsible for the development of ICD-10-CM?
NCHS
The maximum number of characters in an ICD-10-CM code is?
7
A combination code is a single code used to classify?
*All of the above*
-Two diagnoses
-A diagnosis with an associated secondary process (manifestation)
-A diagnosis with an associated complication
The following statements is true regarding late effects?
*All of the above*
-There is no time limit for the development of a residual
-A patient may devepole more than one residual
-A residual may occur months after an injury
The correct reporting for acute cholecystitis with cholelithiasis with obstruction?
K80.01
The correct reporting for stage IV chronic kidney disease associated with diabetes mellitus, type two?
E11.22, N18.4
The correct reporting for Staphyloccus pneumonia?
J15.20
The correct reporting for COPD with chronic bronchitis and emphysema?
J44.9
The correct reporting for hypertensive left heart failure?
I11.0, I50.1
The correct reporting for a pathological fracture of the left femur, due to neoplastic bone disease initial encounter?
M84.552A, D49.2
The correct reporting for chronic tonsillitis and hypertrophy of the tonsils?
J35.01
CMS
Centers for Medicare and Medicaid Services
QIO
Quality Improvement Organizations
RBRVS
Resource Based Relative Value Scale
OBRA
Omnibus Budget Reconciliation Act
MAAC
Maximum Actual Allowable Charge
RVU
Relative Value Unit
OIG
Office of the Inspector General
DHHS
Department of Health and Human Services
Corneal ulcer with hypopyon of left eye
ICD-10-CM Code?
H16.032
Screening for respiratory tuberculosis
ICD-10-CM Code?
Z11.1
Long term (current) use of systemic steroids
ICD-10-CM Code?
Z79.52
Long term (current) use of aspirin
ICD-10-CM Code?
Z79.82
Preoperative examination for a patient who will revieve a renal transplant due to ESRD, currently on dialysis
ICD-10-CM Codes?
Z01.818, N18.6, Z99.2
A multigravida 48 year old patiet presents for routine prenatal visit, first trimester. No complications are noted
ICD-10-CM Code?
O09.521
Encounter for blood type testing prior to surgery
ICD-10-CM Code?
Z01.83
Exposure to German measles
ICD-10-CM Code?
Z20.4
Patient admitted to observation following a highway accident in which he was the driver of the car that was struck by another car. No injuries indicated during this initial encounter
ICD-10-CM Code?
Z04.1, V43.52xA
Screening coloscopy for colon cancer
ICD-10-CM Code?
Z12.11
Established patient presents with chest pain. He has a history of previous myocardial infarction and coronary artery bypass surgery?
(ID first listed diagnosis)
Chest Pain
Initial office visit for patient with nausea and vomiting. Physician documented the nausea and vomiting were due to acute appendicitus
(ID first listed diagnosis)
Acute Appendicitis
Established patient seen for redness and sensitivity to light in her right eye. The documentation states the diagnosis is iritis.
(ID first listed diagnosis)
Iritis
An established patient is seen for management of diabetes and hypothyroidism and the physician spends equal time on each diagnosis
(ID first listed diagnosis)
Diabetes, hypothyroidism
An established patient is seen for migrains and seizures, to rule out the possiblility of a brain tumor.
Migraines, seizures
Acute and Chronic systolic (congestive) heart failure
ICD-10-CM Code?
I50.23
Acute and Chronic respiratory failure
ICD-10-CM Code?
J96.20
Primary Hypertension
ICD-10-CM Code?
I10
Hypertensive heart disease NOS
ICD-10-CM Code?
I11.9
Pseudocyst of the pancreas
ICD-10-CM Code?
K86.3
Acute and chronic prostatitis due to Escherichia Coli bacterial infection
ICD-10-CM Code?
N41.0, N41.1, B96.2
Subsequent encounter for malunion of displaced fracture of shaft of the first metacarpal bone, right hand
ICD-10-CM Code?
S62.241P
Right and left inguinal hernia
ICD-10-CM Code?
K40.20
Aphasia and cognitive defects, as a result of nontraumatic intracranial hemorrhage
ICD-10-CM Code?
I69.220, I69.21
Sunsequent encounter for a joint injection for a patient with acute pain due to a sprained right acromioclavicular joint
ICD-10-CM Code?
G89.11, S43.51xD
Chronic ostemyelitis with draining sinuses of right first tow due to Staphylococcus aureus
ICD-10-CM Code?
M89.471, B95.61
Osteoarthritis of both knees with pain and swelling
ICD-10-CM Code?
M17.0
Bilateral carotid Stenosis
ICD-10-CM Code?
I65.23
Rubella meningoencephalitis
ICD-10-CM Code?
B06.01
Arteriosclerosis of native arteries of the left leg with gangrene
ICD-10-CM Code?
I70.262