Free Medical Coding (CMCS) MCQ Questions and Answers

Question 1

A patient is diagnosed with stage III CKD, hypertension, and edema. In this graphic, the appropriate ICD-10 CM codes are:

Accepted Answer

N18.3, I12.9

Answer

For a patient diagnosed with Stage III CKD and hypertension, the correct ICD-10-CM codes are N18.3 for Chronic kidney disease, stage 3, and I12.9 for Hypertensive chronic kidney disease with stage 1-4 chronic kidney disease, or unspecified. When hypertension and CKD are linked, the combination code I12.9 is used, which implicitly includes the hypertension. Edema (R60.9) would be coded if it's a separate symptom, but the question implies the primary diagnoses.

Question 2

A 7-year-old comes in for a round of shots. The patient is given DTaP, MMR, and vaccination advice. For this procedure, the appropriate CPT code is:

Accepted Answer

90460x2, 90461x4

Answer

CPT codes 90460 and 90461 are used for immunization administration with counseling for patients 18 years and younger. Code 90460 is for the first component of each vaccine, and 90461 is for each additional component. DTaP is a 3-component vaccine (Diphtheria, Tetanus, acellular Pertussis), and MMR is also a 3-component vaccine (Measles, Mumps, Rubella). Therefore, for DTaP, you would code one 90460 and two 90461s. For MMR, you would also code one 90460 and two 90461s, resulting in a total of two 90460s and four 90461s.

Question 3

Bases for facility payments include:

Accepted Answer

IPPS using DRGs

Answer

The Inpatient Prospective Payment System (IPPS) using Diagnosis-Related Groups (DRGs) is the primary method for reimbursing hospitals for inpatient services provided to Medicare beneficiaries. Under this system, hospitals receive a fixed payment amount for each patient discharge, based on the patient's DRG, regardless of the actual costs incurred. This incentivizes hospitals to manage costs efficiently and promotes standardized care.

Question 4

Examples include pulmonary embolisms, DVTs, pressure ulcers, falls, head injuries, catheter-associated uTIs, and urinary tract infections.

Accepted Answer

Hospital-acquired conditions that will not be reimbursed

Answer

The conditions listed, such as pulmonary embolisms, DVTs, pressure ulcers, and catheter-associated UTIs, are examples of Hospital-Acquired Conditions (HACs) or 'Never Events.' Under Medicare's payment policies, hospitals generally will not receive additional reimbursement for treating these conditions if they were acquired during the patient's hospital stay. This policy aims to incentivize hospitals to improve patient safety and prevent these preventable complications.

Question 5

What part of the following does not make up personal health information?

Accepted Answer

All of the above are PHI elements

Answer

Protected Health Information (PHI) under HIPAA includes any individually identifiable health information, as well as demographic data that can be used to identify an individual. This encompasses a wide range of identifiers, including license plate numbers, zip codes, and URLs, in addition to more obvious health-related data. Any piece of information that could potentially link to a specific person's health record is considered PHI.

Certified Medical Coding Specialist Practice Test

Certified Medical Coding Specialist Practice Test

Free Medical Coding (CMCS) MCQ Questions and Answers