Download 2016 Annual Self-Review

2016 Annual Self-Review
CERTIFIED CODING SPECIALIST–PHYSICIAN BASED
Gill Sans
ahima.org
2016 Certified Coding Specialist (CCS-P) Self Review
1. This 12-year-old male patient had a nondisplaced comminuted fracture of the left fibula and had treatment
in the ED and then with an orthopod. He followed-up
with the orthopod for a recheck at three weeks for cast
change. Then the family moved out of state and he
now presents at a new orthopod after moving. X-rays
were ordered which revealed almost complete healing
of the fracture; scheduled for another appointment in
two weeks to remove the cast. How is this visit coded?
a. S82.45
b. S82.455D
c. S82.455S
d. Z47.89
2. A 79-year-old male patient was admitted to the hospital for aspiration pneumonia. The patient also has a
history of an acute cerebral infarction that resulted in
left-sided weakness of his dominant side. What is the
code assignment for the residual left-sided weakness?
a. I69.352
b. I69.398, R53.1
c. I69.30, R53.1
d. I63.9, R53.1
3. A TMVR was performed with a percutaneous approach
for mitral valve repair with a transeptal puncture. An
additional device was required to decrease the mitral
regurgitation. How is this coded?
a. 0345T
b. 33418, 33419
c. 33418
d. 33419
4. How is hallux limitus correction (without osteotomy)
coded?
a. 28288
b. 28289
c. 28290
d. 28292
5. What code is assigned for saccadic eye movement testing with recording?
a. 92265
b. 92499
c. 92225
d. 92700
6. A right-sided radiocephalic AV fistula was created, after
a right upper extremity ultrasound was performed.
How is this coded?
a. 36821
b. 36821, 76998
c. 76998
d. 36821, 76998-59
7. Synovectomies of the extensor pollicis longus and
extensor digitorum of the wrist were performed. How
is this coded?
a. 25118
b. 25110
c. 25118, 25118-59
d. 25118--22
8. This 55-year-old male has a contracture with limited
range of motion in the right second finger. A tenolysis
and capsulotomy was done on the flexor tendon at the
IP joint. How is this coded? (Do not assign modifiers
in this exercise)
a. 26440
b. 26525
c. 26445
d. 26440, 26525
9. A colonoscopy was performed and a small rectal polyp
was removed with bipolar cautery. How is this coded?
a. 45384
b. 45385
c. 45380
d. 45999
10. An 82-year-old male has a leadless pacemaker system
which needs to be replaced. The device is removed and
the new pacemaker is inserted. How is this coded?
a. 0388T
b. 0387T
c. 0388T, 0387T
d. 33999
11. How is an endoscopic medial maxillectomy coded?
a. 30520
b. 31225
c. 21049
d. 31299
All questions were referenced with sources dated March 2016 or earlier
2016 Certified Coding Specialist (CCS-P) Self Review
12. This is described as a paraneoplastic syndrome, also referred to as acral psoriasiform dermatosis and acrokeratosis paraneoplastica. It affects the skin and is usually
associated with a malignant neoplasm.
a. Bazex syndrome
b. Skin necrosis
c. Eczema-thrombocytopenia syndrome
d. Conn’s syndrome
13. A type 1 diabetic patient was admitted to the hospital
because of lethargy. Blood sugar readings were low.
The diagnosis was documented as acute encephalopathy secondary to hypoglycemia. How is this coded?
a. E10.641
b. E10.641, G93.40
c. E10.641, E10.69, G93.49
d. E10.649, G93.41
14. Which of the following statements is false regarding
intrauterine pressure monitoring during labor?
a. It refers to a monitoring electrode
b. It refers to a pressure gauge
c. It provides exact measurements of contractions
d. It is inserted into the uterus to evaluate contractions
15. Which of the following syndromes is described as
an abnormality in the electrical activity of the heart
muscle with disruption of the heart’s normal rhythm,
because the heart takes less time than usual to recharge between beats?
a. Bernheim’s
b. Beau’s
c. Short QT
d. Sick sinus
16. According to the 2016 HHS OIG Work Plan, the OIG
introduced which of the following for review in 2016?
a. Physician home visits
b. Non-covered services for anesthesia
c. Services, supplies, and DME referred/ordered by
physicians
d. All of the above
17. Which E/M service is introduced in the 2016 HHS OIG
Work Plan?
a. Consultations
b. Prolonged services
c. Home health
d. Domiciliary
18. When coding in the Biliary Tract of CPT, what is defined
as a percutaneously placed device that is positioned
within the biliary tree and is completely internal, with
no portion extending outside the patient?
a. External biliary drainage catheter
b. Internal-external biliary drainage catheter
c. Stent
d. All of the above
19. The patient presents with left flank pain and fever.
Diagnosis documented: acute pyelonephritis due to
E.coli that is resistant to Cipro.
a. N10, B96.20, Z16.23
b. N10, A49.8 c. N10, B96.20
d. N10, B96.20, Z16.11
20. A patient was treated in the ED and has the following
diagnosis: septic shock with acute MRSA sepsis. How
is this coded?
a. R65.21, A41.02
b. A41.02, R65.21, A49.02
c. A41.02
d. A41.02, R65.21
21. This 54-year-old patient has bladder cancer. At the
time of diagnosis there were significant metastases,
and the patient declined surgical intervention. He
has mets to the bones, left lung, brain, and liver. He is
being treated for the severe metastases in the femurs;
he also has neoplasm related pain in the legs. What
code(s) are assigned?
a. C79.51, C67.9, C78.7, C79.31, C78.02
b. C79.51, C67.9, C78.7, C79.31, C78.02, G89.3
c. C79.51, C67.9, C78.7, C79.31, C78.02, G89.3, R52
d. C79.51, C67.9, C78.7, C79.31, C78.02, R52
All questions were referenced with sources dated March 2016 or earlier
2016 Certified Coding Specialist (CCS-P) Self Review
22. This female patient is receiving blood transfusions for
severe anemia due to carcinoma in the lower-outer
quadrant of the left breast. What code(s) are assigned?
a. D63.0, C50.512
b. C50.512, D64.9
c. C50.512, D63.0
d. D64.9, C50.511
23. The patient was seen for increasing shortness of
breath. He has increased exacerbation of his diastolic
heart failure. He was not able to afford his Lasix this
month, and has not taken any for 10 days. Diagnosis:
acute on chronic diastolic heart failure.
a. I50.33
b. I50.33, T50.1X6A
c. I50.31
d. I50.33, T50.1X6A, Z91.120
24. An 85-year-old patient has crescendo angina with
ASHD. He has no history of CABG. He did have a
stroke 2 years ago with residuals of right-side hemiparesis. How is this coded?
a. I25.110, I69.351
b. I25.10, I20.0, I69.351
c. I25.118, I69.351
d. I25.119, I69.359
25. The documentation is: nosocomial pneumonia with
hemoptysis and acute respiratory failure. How is this
coded?
a. J15.9, J96.00, Y95
b. J18.8, J96.00, R04.2
c. J18.9, J96.00, R04.2, Y95
d. J18.9, J96.00, Y95
All questions were referenced with sources dated March 2016 or earlier
MX1928.16CCS-P