April 2018

Question 1 C
Bob was referred to an OT status post left index finger arthroplasty. The patient’s
goal is to decrease pain and return to pre-morbid functional status with use of
hand. The OT should look to which G codes for reporting therapy sessions?
A. Changing and maintaining body positions G code set
B. Other PT/OT subsequent G code set
C. Carrying, moving, and handling objects G code set
D. Mobility G code set

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Question 2 D
Tina was referred to a PT for low back pain that radiates to her left, lower
extremity. Pain increases when she ascends/descends stairs, goes from sitting to
standing or vice versa, and when she lies down. The patient’s goal is to reduce
her pain and be more comfortable. The PT should look to which G codes for
reporting therapy sessions?
A. Other PT/OT primary G code set
B. Self-care G code set
C. Mobility G code set
D. Changing and maintaining body positions G code set

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Question 3 D
A physician orders 90 minutes of HBOT. The documentation for the HBOT
treatment indicates the patient was in the chamber at 100 percent oxygen for 90
minutes. Additional time of 10 minutes for descent, a 10-minute air break, and 10
minutes for ascent was also documented. How many units of G0277 are billed by
the hospital?
A. 3 units
B. 5 units
C. 2 units
D. 4 units

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Question 4 D
Put a policy in place that requires a scribe to sign and date all medical records
entries:
A. When the practice is under the jurisdiction of a MAC that requires it
B. Never, since a signature is not required by a scribe
C. When the scribe is certified by a national organization
D. When the practice/organization may be surveyed by The Joint Commission

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Question 5 A
Can an NPP work as a scribe?
A. Only if they indicate in the documentation that they are working as a scribe,
and not as a clinician.
B. Never. It’s too expensive to use NPPs as scribes.
C. Yes, because they are able to interject observations and impressions the
provider might leave out, resulting in better documentation.
D. Only if they have the appropriate scribe certification.

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Question 6 D
Mr. Valdez arrives in the emergency department with complaints of shortness of
breath and wheezing. After study, he is found to have an exacerbation of COPD.
He has a history of emphysema. ICD-10-CM code(s) are:
A. R06.02, R06.2
B. J44.1
C. J44.1, J43.9
D. J43.9

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Question 7 A
Ms. Gardose is a 75-year-old woman who presented to emergency department
with sharp pain during inhalation. The physician diagnosed her with pneumonia
and flare up of COPD. Diagnosis code(s) to report this patient’s condition are:
A. J44.0, J18.9
B. J44.0, J18.9, J44.1
C. J44.1, J18.9
D. J18.9
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Question 8 D
What documentation indicates a “rupture” when coding for an endovascular
repair?
A. Pseudoaneurysm
B. Chronic rupture
C. Dissection
D. Acute hemorrhage

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Question 9
Code +34709 for placement of an extension may be assigned for which
scenario?
A. An extension is placed in the common iliac artery.
B. A docking limb is placed in the common iliac artery.
C. An extension is placed in the external iliac artery.
D. A docking limb is placed in the external iliac artery.

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Question 10 D
Which diagnostic test or procedure can be used to diagnose a patient with CVS?
A. Abdominal X-ray
B. Abdominal ultrasound
C. Upper GI endoscopy
D. None of the above

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Question 11 C
What is the ICD-10-CM code for a diagnosis of “cyclic vomiting syndrome?”
A. R11.2
B. R11.12
C. G43.A0
D. G43.A1
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Question 12 A
Payer policies follow the indications for the drugs and what has been approved
by the:
A. FDA
B. CMS
C. OSHA
D. None of the above.

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Question 13 B
A peer-to-peer prior authorization entails:
A. A discussion between the ordering provider and nurse practitioner
B. A discussion between the ordering provider and payer’s medical director or
pharmacist
C. A discussion between two providers in the same office
D. A discussion between a pharmacist and pharmacy technician

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Question 14 D
Guard against insurance and patient check payment theft by:
A. Using insurance company direct deposit options
B. Using bank check scanners in your office for depositing checks
C. Using a bank lock box to avoid checks coming to the office
D. All of the above

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Question 15 A
What type of insurance plans do not include out-of-network benefits?
A. HMO/EPO
B. PPO
C. POS
D. Traditional
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Question 16 D
You may want to consider being an out-of-network provider if all of your referrals
come from the following marketing sources:
A. Word of mouth
B. Other colleagues
C. Independent marketing
D. All of the above

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Question 17 C
A patient presents to the urgent care after accidently cutting two fingers with a
bagel knife. The laceration on the index finger is 1 cm and the laceration on the
middle finger is 2 cm. Simple repairs are performed on each laceration with 5-0
nylon. How should you code these repairs?
A. 12001 x 2
B. 12001
C. 12002
D. 12042

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Question 18 B
A patient presents with an abscess on his back that requires drainage. The
procedure note indicates: I&D of abscess - complicated. Area injected with 1%
lidocaine, anesthesia achieved. Area incised with #11 blade, frank pus expressed
approx. 5 mL. Abscess probed to break loculations and wound irrigated and then
packed with nugauze. Sterile dressing applied. How should you code?
A. 10040
B. 10061
C. 10060
D. 10180

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Question 19 A
The patient is a 49-year-old woman who presents to the ER with an acute onset
of pain in her right wrist after falling while being chased by a dog. She fell onto an
outstretched hand and struck it sharply against her front doorstep. X-rays of her
right hand and wrist confirm she sustained a Colles distal radius fracture. The
orthopedist on call places her in a short-arm cast and the visit is documented to
Level 3.
A. 25600-RT, 99283-57
B. 25600-RT, 29075-59-RT, 99283-57
C. 25605-RT, 29075-51-RT, 99283-25
D. 25605-RT, 99283

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Question 20
A 68-year-old, Medicare patient was woodworking in his basement workshop in
his single-family home, preparing a new finish to a coffee table. He lost his grip
on a powered sander and suffered a crushing injury into the capitate and hamate
bones of his right wrist as well as a Gustilo-Anderson Type I open fracture of the
hamate body. In the hospital, an orthopedic surgeon performed a flexor tendon
decompression fasciotomy with extensive debridement of muscle, nerve tissue
and bone as well as a 2-bone carpectomy. An ORIF of the fracture was also
done. The surgery took place in the hospital the day after admission at Level 2
subsequent hospital care. This procedure was actually done in consult, but
Medicare does not pay for consultation CPT® codes. The patient is placed in an
extension control cock-up wrist splint. Code the encounter.
A. 25023-RT, 25628-51-RT, 25210-51-RT
B. 25023-RT, 25628-51-RT, 25210-51-RT x 2
C. 25023-RT, 11012-51, 25645-51-RT, 25210-51-RT x 2
D. 25023-RT, 25645-51-RT, 25210-51-RT x 2, 99232-57