Final CCS Prep! Segment Provides Mock Test
Patricia Maccariella, RRA, CCS
As the deadline approaches for exam day, you should be in the final stages of your studies in preparation for taking the certified coding specialist (CCS) or CCS-P (physician-based) exam. We hope that the CCS Prep! series has helped in your preparation for taking the tests.
Now would be a good time to review all of the past CCS Prep! columns, and revisit those areas you had difficulty with. Remember, the CCS Prep! articles can be accessed online at www.advanceweb.com.
In addition, review the certification guide you received with your application to take the tests. This includes valuable information on test content and procedure. Remember, you can write notes in your code books, but you cannot bring in loose notes or any other reference materials. Be sure your coding notations are written or affixed in your code books.
There is also a "Professional Review Guide for the CCS and CCS-P Examinations," published by PRG Publishing (888-383-PRG1).
For this final segment of CCS Prep! we will provide you with a short mock examination. The questions will cover content of both the CCS and CCS-P examinations. Most of the questions could occur on both tests. Those questions pertinent to only the CCS-P exam are marked with an asterisk (*). The questions are formatted as to how they would most likely appear on the exams. Remember, part I of both tests consists of 60 multiple-choice questions. Part II of both tests requires you to code 21 medical records.
Here they are!
1. The three key elements of evaluation and management code assignment are:
a) Time, History, Examination
b) History, Examination, Medical Decision Making
c) Time, History, Medical Decision Making
2. The HCFA 1500 form is used primarily for:
a) Inpatient hospital billing
b) Physician billing and outpatient surgery hospital billing
c) Physician billing
3.* In assigning evaluation and management codes, only two of the three key elements can be documented in the following situations:
a) Subsequent hospital care, follow-up inpatient consultations, established patient
b) Confirmatory consultations, follow-up consultations, subsequent hospital care
c) Hospital observation services, subsequent hospital care, follow-up consultations
4. Diagnoses documented as "probable," "suspected," "questionable" or "rule out":
a) Can never be coded
b) Can be coded for inpatient cases and outpatient and physician cases
c) Can be coded for inpatient cases but not in outpatient and physician office cases
5. In which code series would you expect to find DME?
a) Level I
b) Level II
c) Level III
6. Describes where services are performed or from which department items are issued:
a) Revenue codes
b) Fee codes
c) Level codes
7. The tool used by the provider community to determine the appropriate billing of CPT and HCPCS codes. It addresses the inappropriate unbundling of comprehensive procedure codes into its component parts:
a) Medicare Code Editor
b) Correct Coding Initiative Manual
c) Medicare Carriers Manual
8. What do the three categories of "significant procedures and therapies," "medical visits" and "ancillary test and procedures" pertain to?
9. The federal action that makes health care fraud a federal crime is:
a) Operation Restore Trust 1995
b) Health Insurance Portability and Accountability Act 1996 (HIPAA)
c) Stark Laws I and II 1989 &1997
10.* HCPCS Level II National Modifier QM is an abbreviation for:
a) Ambulance service provided under arrangement by provider of service
b) Quality monitoring has been performed
c) Monitored anesthesia care service
11.*When physicians employ auxiliary (i.e., physician assistants, nurse practitioners) personnel to assist in rendering services to their patients and include the charges for their services in their own bill, the services of such personnel are considered:
a) "non-physician practitioner" services
b) "direct supervision non-practitioner" services
c) "Incident to" services
12. The patient is admitted to the emergency room with chest pain. The emergency room physician monitors the patient and documents "rule out gastritis" on the record. He consults a cardiologist who admits the patient to an inpatient bed for evaluation. The cardiologist diagnoses unstable angina, and discharges the patient to be followed up in two weeks. What is the principal diagnosis code?
a) 786.50 Chest pain, unspecified
b) 535.50 Gastritis, unspecified
c) 411.1 Intermediate coronary syndrome
13. A newborn infant is delivered by cesarean section at Hospital A. The infant is transferred to the neonatology unit of Hospital B with transient tachypnea, bradycardia and jaundice. The infant is premature at 36 weeks with a birth weight of 1650 grams. The infant was put on oxygen and EKG heart monitor. Incidentally, it was discovered that the infant has Tetralogy of Fallot, which will be followed up after discharge by a cardiologist. Slight head molding was found which resolved on its own by discharge. What is the principal diagnosis for the record at Hospital B?
a) V30.01 Single Newborn delivered in hospital by Cesarean Section
b) 770.8 Transient Tachypnea of Newborn
c) 786.09 Tachypnea
14. In the above example, head molding:
a) Would be coded to 767.3 Other injuries to skeleton
b) Would not be coded
15. A laminectomy patient experiences postoperative p.v.t. which resolved with the administration of IV Lidocaine. The diagnosis of postoperative p.v.t.:
a) Should not be coded
b) Should be coded to 427.1 paroxsymal ventricular tachycardia
c) Should be coded to 997.1 postoperative cardiac complication, 427.1 paroxsymal ventricular tachycardia
16. On the HCFA-1500 billing form, there is room for reporting of:
a) 10 final diagnoses codes
b) 6 final diagnoses codes
c) 4 final diagnoses codes
17. The UB-92 billing form allows for reporting of:
a) 9 final diagnoses codes and 6 procedures
b) 10 final diagnoses and 5 procedures
c) 10 final diagnoses and 3 procedures
18. An outpatient surgery patient receives a 200 square centimeter STSG harvested from his thigh and then meshed 2:1 and placed on a four hundred square centimeter abdominal defect. The correct CPT code assignment is:
a) 15000 (excisional prep or creation of recipient site), 15100 (split graft trunk, 100 sq. cm or less) 15101 (each additional 100 sq. cm)
b) 15100 (split graft trunk, 100 sq. cm. or less), 15101 (each additional 100 sq. cm), 15101, 15101.
c) 11406 (excision benign lesion over 4 cm, trunk) 15100, 15101, 15101, 15101.
19.* A premature newborn is admitted to the hospital NICU. The baby remains unstable and critical on days two and three. On the fourth day, the baby is stable, but still critical. What are the correct E/M codes to use for this case?
99295--initial neonatal intensive care, per day, for the E/M of critically ill neonate or infant
99296--subsequent neonatal in-tensive care, per day, for the E/M of critically ill and unstable neonate or infant
99297--subsequent neonatal in-tensive care, per day, for the E/M of critically ill though stable neonate or infant
a) 99296, 99296, 99296
b) 99295, 99296, 99297
c) 99295, 99296, 99296, 99297
20. The abbreviation C.C.S. is short for:
a) Can Code Superbly
b) Certified Coding Specialist
c) Could Code Sleeping
d) All of the above
Good luck to all of you on Saturday, Sept. 12, 1998!
Patricia Maccariella is manager of coding services at United Audit Systems Inc. (UASI), a national consulting company offering multifaceted HIM and business office management services, headquartered in Cincinnati.