Category Archives: Anatomy & Physiology

Practice Questions For CPC Exam 2017 -Part 1

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This is very first post of my next CPC Practice Questions 2017 series post. I will publish more questions in coming days. Do check these. Practice more and more these questions and find answers in the next post. Continue reading Practice Questions For CPC Exam 2017 -Part 1

Anatomy and Billing Questions


  1. What term could describe an inflammation of the plantar, causing foot or heel pain when walking or running?

a. Plantar fasciti



d.Tendon fascitis

2. Blephroplasty describes what type of a procedure?

  1. Surgical reduction of the upper/lower eyelids to remove excess fat, skin, and muscle
  2. Treatment for spider veins with injections of sclerosing solution
  3. Replacement of damaged skin with healthy tissue taken from a donor
  4. Destruction of tissue by burning or freezing
  1. Which autoimmune disorder will eventually destroy the thyroid gland?
  2. Hayem-Farber disease
  3. Alzheimer’s thyroiditis
  4. Lou Gehrig’s disease
  5. Hashimoto’s thyroiditis
  1. Which of the following statements best describes a rheumatologist?
  2. A specialist who provides medical care and drug treatments focused on mental and cognitive disorders.
  3. A specialist who provides treatment to women during pregnancy, childbirth, and their aftercare
  4. A specialist who provides the diagnosis and treatment of disease characterized by inflammation of the connective tissues.
  5. A specialist who provides the diagnosis and surgical treatment of bone disorders
  1. A patient suffered a burn that involved the epidermis, dermis, and subcutaneous layers with some muscle involvement. What degree of burn would describe this injury?
  2. First-degree, superficial with blisters
  3. Second-degree, partial thickness with muscle
  4. Third-degree, full thickness
  5. None of the above
  1. In which part of the body would you find the choroid?
  2. Brain
  3. Eyeball
  4. Muscles of the hand
  5. Spinal column
  1. Which combining form refers to the small intestine?
  2. enter/o
  3. gastr/o
  4. celi/o
  5. col/o
  1. An ERG is what type of a procedure?
  2. Electroretinography
  3. Electrorenalography
  4. Electroretinograph
  5. Electrorhidogram
  1. Which term refers to the anus, rectum, and the cecum?
  2. rectal
  3. anorectal
  4. esophageal
  5. ilium
  1. Which term does not refer to a level of consciousness?
  2. Syncope
  3. Stupor
  4. Coma
  5. Sciatica
  1. What type of condition describes a patient diagnosed with oligospermia?
  2. Knots is the varicose veins
  3. An inflammation of the prostate gland
  4. An abnormally low number of sperm in the semen
  5. Failure to ovulate
  1. What does the term cystopexy mean?
  2. Inflammation of the spinal cord and brain
  3. Surgical fixation of the urinary bladder
  4. Surgical suture of the knee joints
  5. Crushing procedure to remove cysts
  1. What is an episiotomy and why would a patient need to have this procedure?
  2. Surgical suturing of the rectum caused by extensive tissue damage following a bowel repair
  3. Surgical incision of the vulva to facilitate delivery of a baby
  4. Surgical puncture of the cervix to remove fluid
  5. Surgical creation of an opening into the small intestine to provide relief of excessive gastritis
  1. What direction describes raising the foot, pulling the toes toward the shin?
  2. Protraction
  3. Dorsiflection
  4. Plantar flexion
  5. Pronation
  1. Which artery opens to allow oxygen-rich blood to pass from the left ventricle into the aorta where the blood is delivered to the rest of the body?
  2. Renal
  3. Aortic
  4. Superior vena cava
  5. Inferior vena cava
  1. What syndrome is a condition caused by abnormal production of the hormone gastrin?
  2. Vogt-Koyanagi
  3. Silvestroni-Bianco
  4. Sudeck-Leriche
  5. Zollinger-Ellison
  1. How can air pass through the upper respiratory tract?
  2. Via the nose, nasal cavity, nasopharynx, oropharynx, laryngopharynx, and larynx into the lower respiratory system.
  3. Via the nose, larynx, and bronchus
  4. Via nose, larynx, bronchus, and trachea
  5. Via nose, larynx, bronchus, trachea, and pleura
  1. What is the uvula?
  2. A receptacle for urine before it is voided.
  3. A female organ used to contain and nourish the embryo and fetus from the time the fertilized egg is implanted to the time of birth of the fetus.
  4. A small soft structure hanging from the free edge of the soft palate in midline above the root of the tongue. It is composed of muscle, connective tissue, and mucous membrane.
  5. A canal, used for the discharge of urine, that extends from the bladder to the outside of the body.
  1. What bones make up the axial skeleton?
  2. Skull, rib cage, and spine
  3. Spine, collar bones, and arms
  4. Shoulder bones, pelvic bones, arms, and legs
  5. Coccyx, ulna, femur, and tibia
  1. What term refers to white blood cells?
  2. Erythrocytes
  3. Monocytes
  4. Lymphocytes
  5. Leukocytes
  1. Which statement(s) describe a passive natural acquired immunity process?
  2. Use of immunoglobulin harvested from a donor who developed resistance against specific antigens
  3. The passage of antibodies through the placenta or breast milk
  4. Immunization that uses a greatly weakened form of the antigen, thus enabling the body to develop antibodies in response to this intentional exposure
  5. Both A and C
  1. What does the olecranon process refer to?
  2. The elbow
  3. Excision of a tumor in the large intestine
  4. Plasma membranes
  5. Use of a surgical endoscope in the knee
  6. What is the difference between entropion and ectropion?
A. Entropion is the inward turning of the eyelid and ectropion is the outward turning of the eyelid.
B. Entropion is the incomplete closure of the eyes and ectropion is the drooping of the eyelids.
C. Entropion is the outward turning of the eyelid and ectropion is the inward turning of the eyelid.
D. Entropion is the drooping of the eyelid due to nerve disorder and ectropion is the drooping of the eyelid due to muscle disorder.
  1. What type of graft is used when pigskin is applied to a burn wound?
  2. Xenograft B. Allograft C. Autograft                       D. Pinch graft
  1. Ventral, umbilical, spigelian and incisional are types of:
  1. Surgical approaches B. Hernias
  2. Organs found in the digestive system D. Cardiac catheterizations
  1. Fracturing the acetabulum involves what area?
  1. Skull B. Shoulder C. Pelvis                               D. Leg
  1. When a patient is having a tenotomy performed on the abductor hallucis muscle, where is this muscle located?
  1. Foot B. Upper Arm C. Upper Leg                      D. Hand
  2. What is the term used for inflammation of the bone and bone marrow?
A. Chondromatosis
B. Osteochondritis
C. Costochondritis
D. Osteomyelitis
  1. The root word trich/o means:
A. Hair
B. Sebum
C. Eyelid
D. Trachea
  1. Complete this series: Frontal lobe, Parietal lobe, Temporal lobe, ____________.
A. Medulla lobe
B. Occipital lobe
C. Middle lobe
D. Inferior lobe
  1. A patient is having pyeloplasty performed to treat a uretero-pelvic junction obstruction. What is being performed?
A. Surgical repair of the bladder
B. Removal of the kidney
C. Cutting into the ureter
D. Surgical reconstruction of the renal pelvis
32. Which of the following is an example of electronic data?

A. A digital X-ray
B. An explanation of benefits
C. An advance beneficiary notice
D. A written prescription

33. Which of the following health plans does not fall under HIPAA?

A. Medicaid
B. Medicare
C. Workers’ compensation
D. Private plans

34. Guidelines from which of the following code sets are included as part of the code set requirements under HIPAA?

D. ADA Dental Codes

35. Which of the following is an example of a case in which a diabetes-related problem exists and the code for diabetes is never sequenced first?

A. If the patient has an underdose of insulin due to an insulin pump malfunction
B. If the patient is being treated for secondary diabetes
C. If the patient is being treated for Type II diabetes
D. If the patient has hyperglycemia that is not responding to medication

36. Glomerulonephritis is an inflammation affecting which system?

A. Digestive
B. Nervous
C. Urinary
D. Cardiovascular

37. When a patient has fractured the proximal end of his humerus, where is the fracture located?

A. Upper end of the arm
B. Lower end of the leg
C. Upper end of the leg
D. Lower end of the arm

38. What is another term for when a physician performs a reduction on a displaced fracture?

A. Casting
B. Manipulation
C. Skeletal traction
D. External fixation

39. What does oligiospermia mean?

A. Presence of blood in the semen
B. Deficiency of sperm in semen
C. Having sperm in urine
D. Formation of spermatozoa

40. Thoracentesis is removing fluid or air from the:

A. Lung
B. Chest cavity
C. Thoracic vertebrae
D. Heart

41. An angiogram is a study to look inside:

A. Female Reproductive System
B. Urinary System
C. Blood Vessels
D. Breasts

42. When a person has labyrinthitis what has the inflammation?

A. Inner ear
B. Brain
C. Conjunctiva
D. Spine

43. Which place of service code should be reported on the physician’s claim for a surgical procedure performed in an ASC?

A. 21
B. 22
C. 24
44. What is orchitis?

A. Inner ear imbalance                                                                  B. Lacrimal infection

C. Inflammation of testis                                                              D. Inflammation of an ilioinguinal hernia

45. The wound was debrided. What was done to the wound?

A. It was closed with layered sutures and dressed
B. It was medicated and left open to heal
C. It was cleansed of foreign materials or dead tissue
D. It was examined radiographically for defects

46. Which of the following patients might be documented as having meconium staining?

A. Woman with renal failure                                                       B. Teenage boy with sickle cell anemia

C. Newborn with pneumonia                                                     D. Man with alcoholic cirrhosis of liver

47. Which of the following anatomical sites have septums?

A. Nose, heart                                                                                   B. Kidney, lung

C. Sternum, coccyx                                                                          D. Orbit, ovary

48. Lordosis is a disorder of which anatomical site?

A. Spine                                                                                               B. Integument

C. Male genitalia                                                                               D. Nasal sinus

49. Which of the following place of service codes is reported for fracture care performed by an orthopedic physician in the emergency department?

A. 11                                                                                                      B. 20

C. 22                                                                                                      D. 23

50. Which of the following is an example of fraud?

A. Reporting the code for ultrasound guidance when used to perform a liver biopsy.
B. Reporting a biopsy and excision performed on the same skin lesion during the same encounter.
C. Failing to append modifier 26 on an X-ray that is performed in the physician’s office.
D. Failure to append modifier 57 on the EM service performed the day prior to a minor procedure.
51.. What occurs in angiography?

A. The veins or arteries are viewed by X-ray        B. The patient is checked for angina

C. The heart is viewed using ultrasonography     D. The electrical current of the heart is mapped

52. Meatus describes:

A. Septum                                                                                           B. Muscle

C. Passageway                                                                                  D. Nutrient

53. Which of the following is not like the other three?

A. Radius                                                                                             B. Femur

C. Tibia                                                                                                  D. Calcaneus

54. What is the function of the esophagus?

A. To carry air from the pharynx into the lungs
B. To carry nutrients from the pharynx into the larynx
C. To carry air from the nose into the larynx
D. To carry nutrients from the pharynx into the stomach
55. for a patient who has had a primary malignancy of the thyroid cartilage that was completely excised a year ago, which of the following statements is TRUE?

A. When no further treatment is provided and there is no evidence of any existing primary malignancy, code V10.87.
B. When further treatment is provided and there is evidence of an existing metastasis, code first V10.87 and then 161.3.
C. Any mention of extension, invasion, or metastasis to another site is coded as a 239.1.
D. When further treatment is provided and there is evidence of an existing metastasis, code first 197.3

56. In order to use the critical care codes, which of the following statements is TRUE?

A. Critical care services can be provided in an internist’s office
B. Critical care services provided for more than 15 minutes but less than 30 minutes should be billed with 99291 and modifier 52.
C. Time spent reviewing laboratory test results or discussing the critically ill patient’s care with other medical staff in the unit or at the nursing station on the floor cannot be included in the determination of critical care time.
D. Critical care services can only be billed if the patient is in a licensed emergency room or intensive care type unit (i.e., cardiac, surgical, respiratory).

57. Which of the following statements regarding advanced beneficiary notices (ABN) is TRUE?

A. ABN must specify only the CPT® code that Medicare is expected to deny.
B. Generic ABN which states that a Medicare denial of payment is possible or the internist is unaware whether Medicare will deny payment or not is acceptable.
C. An ABN must be completed before delivery of items or services are provided.
D. An ABN must be obtained from a patient even in a medical emergency when the services to be provided are not covered.

58. Which of the following services are covered by Medicare Part B?

A. Inpatient chemotherapy
B. Minor surgery performed in a physician’s office
C. Routine dental care
D. Assisted living facility

59. What is the approach in PTCA?

A. The pancreatic and common bile ducts are accessed via the stomach and duodenum.
B. A catheter is threaded through an extremity vein and into the heart.
C. A bronchoscope is threaded down the throat and into the alveoli of the lung.
D. Through a wide, open incision, the ankle fracture is reduced and internal fixation placed.

60. A patient with a contralateral fracture has what?

A. A second fracture on the same side                   B. Multiple and complete bone fractures

C. A fracture of only the surface of the bone       D. A fracture on the opposite side

61. What is ascites?

A. Fluid in the abdomen                                                                B. Enlarged liver and spleen

C. Abdominal malignancy                                             D. Abdominal tenderness

62. Which of the following is a disorder of the facial nerve?

A. Exotropia                                                                       B. Tarsal tunnel syndrome

C. Brachial plexis lesions                                                D. Bell’s palsy

63. Which of the following describes functions of the lymphatic system?

A. Remove excess fluid from tissue and transports and protect the body against disease
B. Maintain blood pressure and circulate hormones throughout the body
C. Return carbon dioxide to the lungs and protect the body against disease
D. Circulate hormones throughout body and return carbon dioxide to the lungs

64. Islets of Langerhans are found in which organ?

A. Kidney                                                                             B. Parathyroid gland

C. Pancreas                                                                         D. Liver

65. Which of the following conditions would most likely be attributed to hyperlipidemia?

A. Atherosclerosis                                                           B. Multiple myeloma

C. Kwashiorkor                                                                  D. Pernicious anemia

66. Which of the following statements regarding the ICD-9-CM coding conventions is TRUE?

A. If the same condition is described as both acute and chronic and separate subentries exist in the Alphabetic Index at the same indentation level, code only the acute condition.
B. Only assign a combination code when the Alphabetic Index explanation directs the coder to use it.
C. An ICD-9-CM code is still valid even if it has not been coded to the full number of digits required for that code.
D. Signs and symptoms that are integral to the disease process should not be assigned as additional codes, unless otherwise instructed.

67. Which modifier should be append to a CPT®, for which the provider had a patient sign an ABN form because there is a possibility the service may be denied because the patient’s diagnosis might not meet medical necessity for the covered service?

A. GJ                                                                                                                      B. GA

C. GB                                                                                                                     D. GY

68. What is the patient’s right when it involves making changes in the personal medical record?

A. Patient must work through an attorney to revise any portion of the personal medical information.
B. They should be able to obtain copies of the medical record and request corrections of errors and mistakes.
C. It is a violation of federal health care law to revise a patient medical record.
D. Revision of the patient medical record depends solely on the facility’s compliance program policy.


  1. “a” You can find this answer by studying or knowing medical terminology.
  1. “a” You can find this answer in the index of the CPT Professional Edition. Once you locate the term, cross reference the code(s) to determine the type of procedure.
  1. “d” You can find this answer in the ICD-9-CM index under Thyroiditis, Hashimoto’s and cross reference it to determine the type of disease.

4.“c” This question is an example of an answer that you could not find in the source materials allowed for the CPC exam. This type of question is based on general knowledge of medical specialties.

  1. “c” The degree of a burn is determined by the layers of skin involved. A third degree burn, also known as a full thickness burn, involves damage to all three layers of skin and possibly the muscle. You could find this by looking up burn in the ICD-9-CM book and cross referencing to that section for further definition.

6.“b” You can find this answer in the CPT Professional Edition in the illustrations of anatomical and procedural review at the front of the book. You could also find this answer by looking in the in the CPT index under Choroid and then cross referencing the procedures.

  1. “a” This question is best answered by studying or knowing medical terminology. However you could also discover the correct answer by using the CPT Professional Edition index and looking up procedures that beginwith enter/o.

8.“a” You can find the answer in the index of the CPT Professional Edition by looking up ERG.

  1. “b” This answer comes from studying medical terminology. You can break down the term anorectal (an/o – anus, rect – rectum, and –al pertaining to).
  1. “d” Sciatica is an inflammation of the sciatic nerve that results in pain, burning, and tingling along the course of the nerve through the thigh and leg. You could find the answer by looking up each term in the ICD-9-CM index, if necessary.
  1. “c” You can find this answer by looking up the term in the ICD-9-CM index of diseases and then cross referencing the code.
  1. “b” You can find the answer by breaking down the medical term cystopexy (cyst/o – urinary bladder, pexy – surgical fixation). The CPT Professional Edition lists a few surgical procedure suffixes in the front of the book, which are helpful for learning medical terminology.
  1. “b” You can find this answer in the index of the CPT Professional Edition under the procedure Episiotomy, then cross referencing the code. You could also reference the list in the front of the book that describes surgical procedures (suffix otomy– cutting into or incision).
  2. “a” This is an example of an answer that you may not be able to find in the resource material available for the CPC exam. Studying and knowing anatomy and medical terminology is the best way to answer this question. The lower respiratory tract consists of the trachea, bronchi, bronchioles, alveoli, and capillaries of the lungs.
  1. “c” You can find this answer by looking up uvula in the CPT Professional Edition and cross referencing the codes listed. This will provide information about where the uvula is located in the body.
  1. “a” This is an example of an answer that you may not able to find using the resource material available for the CPC exam. Studying and learning anatomy and medical terminology is the best way to answer this question.
  1. “d” This is an example of an answer that you may not be able to find in the resource material available for the CPC exam. Studying and knowing anatomy and medical terminology is the best way to answer this question. Break down the word (leuk/o – white and cytes – cell).
  1. “b” This is an example of an answer that you may not be able to find in the resource material available for the CPC exam. Studying and knowing anatomy and medical terminology is the best way to answer this question. Read the answers carefully. Both the use of vaccination and immunoglobulins harvested are “artificial” not “natural” means of immunity.
  1. “a” You can find this answer in the CPT Professional Edition in the index under Olecranon Process. If you cross reference the codes, you will discover the answer is the elbow.
  1. “b” This is an example of an answer that you may not be able to find in the resource material available for the CPC exam. Studying or knowing anatomy and medical terminology is the best way to answer this type of question.
  1. “b” The aorta is an artery not a vein. There are four types of valves that regulate blood flow through the heart.
  2. The tricuspid valve regulates blood flow between the right atrium and right ventricle.
  3. The pulmonary valve controls blood flow from the right ventricle into the pulmonary arteries, which carry oxygen-poor blood to the lungs to pick up oxygen.
  4. The mitral valve lets oxygen-rich blood from the lungs pass from the left atrium into the left ventricle.
  5. The aortic valve opens to allow oxygen-rich blood to pass from the left ventricle into the aorta, the largest artery, where this blood is delivered to the rest of the body.
  1. “d” You can find this answer in the ICD-9-CM index under Syndrome, Zollinger-Ellison. Once you locate the code, cross reference to review the definition provided

23 A The definitions of ectropion and entropion can be found in the ICD-9-CM tabular index. The alphabetic index refers you to code 374.00 for Entropion and 374.10 for Ectropion.

  1. A CPT® defines xenograft: Application of non-human skin graft or biologic wound dressing (example, porcine tissue or pigskin) to a part of the recipient’s body following debridement of the burn wound or area of traumatic injury, soft tissue infection and/or tissue necrosis, or surgery. The index of your CPT® manual has Xenograft referring you to codes 15400-15401. That is where you will find the definition of a xenograft.
  1. B These are types of hernias. CPT® codes 49491-49659 are categorized by the type of hernias to be repaired.
  1. C The acetabulum is the cup-shaped socket of the hip joint which is part of the pelvis. You can locate this answer in the ICD-9-CM manual. In the alphabetic index look up Fracture/ acetabulum and you are referred to code 808.0. In the tabular index this code falls under the category code 808, Fracture of pelvis.
  1. A The abductor hallucis is a muscle of the foot that abducts the big toe. In the CPT® index under Tenotomy there are many anatomical areas to choose from, but you will find this muscle located in the description of code 28240. All the codes in that section deal with the foot.
  2. D Osteomyelitis is an inflammation of bone and bone marrow caused by a bacterial infection which can lead to a reduction of blood supply to the bone. In the ICD-9-CM alphabetical index, osteomyelitis guides you to code 730.2. In the tabular index, category code 730 is Osteomyelitis, periostitis, and other infections involving bone.
  1. A Trich/o means hair. In the ICD-9-CM alphabetical index look for a diagnosis that starts with Trich. The first diagnosis that starts with that root word is, Trichiasis referring you to code 704.2. In the tabular section for category 704 is Diseases of hair and hair follicles.
  2. B The series of terms are lobes found in the brain. You can find an illustration of the brain showing the different lobes in your CPT® manual in the beginning of the Nervous System section.
  1. D Pyeloplasty is the surgical reconstruction or revision of the pelvis of the kidney (renal) to correct an obstruction. The CPT® manual index refers you to codes 50400-40504, and 50544 for Pyeloplasty. The code is found under the Repair heading in the Tabular and the code description states “plastic operation on renal pelvis” to help you know what is being performed.
  2. A While B, C, or D might be done electronically, by definition they aren’t required to be done electronically. A digital X-ray is an X-ray with an image that is stored electronically rather than on film, and so A is the correct answer.
  1. C Workers’ compensation is excluded from the definition of a health plan under the Health Insurance Portability and Accountability Act (HIPAA). Therefore, Workers Comp plans are not required to meet HIPAA standards for privacy, security or code sets.

34.B ICD-9-CM guidelines are the only guidelines specifically mentioned in HIPAA. While HIPAA requires the use of the other code sets listed, there is no specific mention of the other guidelines in the law. This information is found in the guidelines at the front of your ICD-9-CM code book: These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-9-CM itself. These guidelines are based on the coding and sequencing instructions in Volumes I, II and III of ICD-9-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-9-CM diagnosis and procedure codes is required under the Health Insurance Portability and Accountability Act (HIPAA).

35.A The guidelines read: An underdose of insulin due to an insulin pump failure should be assigned 996.57, Mechanical complication due to insulin pump, as the principal or first listed code, followed by the appropriate diabetes mellitus code based on documentation.

  1. C Glomerulnephritis is a form of nephritis marked by inflammation of the glomeruli of the kidney. The ICD-9-CM alphabetical index refers you to code 583.9 for Glomerulonephritis. In the tabular index this code is found in the chapter for DISEASES OF THE GENITOURINARY SYSTEM.
  1. A The humerus is the bone extending from the shoulder to the elbow. The humerus is a relatively thick bone with a large, round, smooth head that is joined at its upper end (proximally) with the shoulder blade (scapula) to form the shoulder joint and is joined at its lower end (distally) with the elbow. In the ICD-9-CM index Fracture, humerus, proximal end refers you to see Fracture/humerus/ upper end.
  1. B The subsection guidelines in the CPT® manual in the Musculoskeletal System section defines Manipulation: is used throughout the musculoskeletal fracture and dislocation subsections to specifically mean the attempted reduction or restoration of a fracture or joint dislocation to its normal anatomic alignment by the application of manually applied force.
  1. B This is when a man produces very little sperm count. The ICD-9-CM alphabetical index refers you to code 606.1 for Oligiospermia. In the tabular section oligiospermia is a type male infertility and most ICD-9-CM manuals have a definition under this diagnosis that states: Insufficient number of sperm in semen. Oligio means few and spermia (sperma) means sperm.
  1. B Thoracentesis is indexed in the CPT® manual guiding you to codes 32421-32422. The code description has pleural cavity. Pleura is a thin serous membrane that envelops each lung and folds back to make a lining for the chest cavity. Thorac/o means chest or chest wall.
  1. C An angiogram is an X-ray photograph or an imaging technique that uses contrast/dye to look inside blood vessels. The CPT® index under Angiography refers to codes in the Radiology section in which many arteries are listed in alphabetical order.
  1. A Labyrinthitis is an inflammation of the inner ear which can cause vertigo and vomiting. In the alphabetical index, look for Labyrinthitis and you will see next to the term inner ear in parenthesis.
  2. C Place of service codes are reported on the CMS-1500 to identify the location where a service was provided. In the front of the CPT® is a list of all place of service codes. A service provided in an ASC is reported with POS code 24.
  3. C. Orchitis is marked by painful swelling of the testis. It may occur without cause, or be the result of infection. The Greek root orchis means testicle, and –itis is a suffix indicating inflammation or infection.
  4. C. Debridement is the removal of foreign materials and dead tissue from a wound so that clean, vital tissue is all that remains. Debridement can be surgical, with dissection of nonvital tissue, or it can be a manual process.
  5. C. Meconium is fetal stool, composed of materials ingested in utero. It is odorless and tarlike. Meconium is usually expelled in a neonate’s first bowel movements, but during stress before or during birth, may be expelled into the amniotic fluid. It can be inhaled into the fetal lung and cause pneumonia at birth. Meconium staining refers to discoloration of the amniotic fluid, or of the neonate (for example, meconium staining of fingernails).
  1. A.Both the heart and the nose have a septum, defined as a wall dividing two chambers. The nasal septum separates the two nostrils. A septum also divides the right and left atriums and right and left ventricles of the heart.
  1. A. Lordosis is a spinal deformity in which the anterior curvature of the lumbar spine is excessive. It is also called a “sway back.” Lordosis may be caused by tight lower back muscles, obesity, or pregnancy. It can lead to lower back pain. The answer to this question is easily found by looking in the ICD-9-CM Index.
  2. D. Place of service codes are reported on the claim form to identify the site of the service provided. In this case, the services are rendered in the emergency department which is reported with POS 23. The place of service codes can be found on in the CPT® manual.
  1. B. Answer b is the only example of unbundling of CPT® which would result is a fraudulent claim. According to NCCI (National Correct Coding Initiative) and CPT® coding guidelines, a biopsy performed on the same lesion as an excision during the same encounter is an incidental service and is not reported separately. If ultrasound guidance is performed for a liver biopsy, it is billable. X-rays performed in a physician’s office does not require modifier 26. Since the physician owns the equipment and performs the interpretation, he bills the global service. Modifier 57 is appended to the EM service the day prior or day of a major surgery, not a minor surgery.
  2. Angi- is a Greek combine form for “a vessel” and the suffix graphy refers to writing or a graph. In angiography, an imaging technique is used to allow the visualization of the inside of blood vessels. An opaque contrast agent is usually injected and X-ray performed so the veins and arteries can be reviewed.
  1. Meatus is a Latin word meaning passage, and describes any of numerous passages within the body that have external openings: acoustic meatus (ear canal); urinary meatus (urethra); and middle, inferior, or superior nasal meatus (nasal openings into the sinus).
  1. The first three bones listed are all long bones. The calcaneus is a triangular shaped bone in the foot – not a long bone. A long bone has a shaft and two heads, and they provide structure, mobility and strength to the body. Long bones contain yellow bone marrow and red bone marrow, whereas the calcaneus has a hard outer shell and a spongy bone center.
  1. The esophagus lies between the trachea and the spine. The trachea carries air into the lungs and the esophagus carries nutrients into the stomach. The esophagus of an adult is about 25 cm long, and is lined with muscles that contract to push food into the stomach. Glands along the lining of the esophagus produce mucus to facilitate the movement of food along its pathway.
  2. A. According to ICD-9-CM Official Coding Guidelines, when the patient has completed treatment for cancer and there is not an existing malignancy, select a personal history of malignancy by site. From the index, look up history/malignant neoplasm (of)/thyroid.
  3. A. Critical care services can be provided at any site. If the patient is critically ill, the services provided can be coded with critical care regardless of where the services take place. A minimum of 30 minutes of critical care must be performed in order to report 99291. If less than 30 minutes, select the appropriate E/M code based on the three key components. Time spent reviewing results and discussing the critically ill patient with medical staff is included in the critical care time.
  1. C. An ABN must include the service that may be denied, an estimated cost of the patient’s responsibility if Medicare denies the service and the response for the potential denial. Generic ABNs are not allowed. Signing of the ABN cannot be obtained during a medical emergency. The patient must be stable. The ABN must be signed prior to providing the service.
  1. B. Services performed by physicians are covered by Medicare Part B. Inpatient services are covered by Part A. Medicare does not cover routine dental care.
  2. B.Percutaneous transluminal coronary angioplasty mechanically widens narrowed blood vessels in the heart. The approach is transluminal, meaning a catheter is threaded through the skin and into a blood vessel, then carried into the heart artery where it will make the repair. Narrowed vessels in the heart can deprive cardiac tissue of the blood supply it needs to do its work effectively.
  3. D. Contra is derived from a Latin root meaning against, and lateral, from a Latin form meaning side. Contralateral means occurring on the opposite side. The opposite of contralateral is ipsilateral, meaning occurring on the same side.
  1. A. In ascites, fluid collects in the peritoneal cavity of the abdomen. Ascites is typically caused by cirrhosis, malignancy, or heart failure. It is usually managed medically but may be treated with paracentesis. Ascites is indexed in ICD-9-CM, and this answer could have been found by reviewing the tabular entry, which notes, “Fluid in peritoneal cavity.”
  1. D. Exotropia is an outward deviation of the eye. The muscles of the eye are controlled by the fourth cranial nerve. The facial nerve is the seventh cranial nerve. This distinction can be found in illustrations and written information within your ICD-9 and CPT® code books. Tarsal tunnel syndrome is nerve impingement in the foot, and brachial plexis lesions refer to a complex of nerves found between the neck and armpit. Bell’s palsy, is a common disorder of the facial nerve, and causes an inability to control facial muscles of expression. It may be caused by a brain tumor, stroke, or Lyme disease, but can be idiopathic and transient.
  2. A. The lymphatic system has three main functions: To collect interstitial fluid to help maintain the fluid balance in the body; to produce lymphocytes for fighting disease; and to absorb fats from the intestine and transport them to the blood. The lymphatic system is composed of the lymph nodes, spleen, thymus, bone marrow, lymph nodes, and ducts.
  1. C. The islets of Langerhans produce hormones, most notably insulin, within the pancreas. Insulin causes cells to take up glucose from the blood. If the production of insulin stops or becomes inefficient, the patient will develop diabetes.
  1. A. Hyperlipidemia occurs when too many fats are circulating in the blood and can lead to the buildup of fatty plaque in the blood vessels. This fatty plaque is also known as atherosclerosis.
  2. D. According to the ICD-9-CM Official Coding Guidelines, do not report signs and symptoms that are integral to a definitive diagnosis. When the same condition is diagnosed as acute and chronic and there is a separate code for both, report both codes. An ICD-9-CM code is not valid unless it is coded to the highest level of specificity. Combination code instructions are also in the tabular section. Do not rely solely on the alphabetic index to select the correct code.
  1. B. An ABN is a waiver of liability. When a patient has been informed a service that is otherwise covered by Medicare but might not be covered in a particular instance an ABN is signed by the patient prior to receiving the service. To inform Medicare the ABN has been signed, append modifier GA. If an ABN is signed, the claim is the patient’s responsibility if the claim is denied.
  1. B. Under HIPAA regulations, patients have the right to receive a copy of their medical record and request that errors are corrected.