COC 2020 Final Exam Study Questions - Set 8 (Complete Solutions, Answered)

COC 2020 Final Exam Study Questions - Set 8 (Complete Solutions, Answered) Somatic nerve Part of the peripheral nervous system Special payments under OPPS may be made for new technology items under what circumstance? P ...

COC 2020 Final Exam Study Questions - Set 8 (Complete Solutions, Answered) Somatic nerve Part of the peripheral nervous system Special payments under OPPS may be made for new technology items under what circumstance? Pass-through payments for certain drugs, biological agents, brachytherapy devices, and other medical devices for a period of at least two years but no more than three years. Rationale: Special drugs, such as chemotherapy drugs and devices or supplies that are considered "new technology" items will need to be assigned new "pass-through" codes to receive additional reimbursement. The HCPCS Level II C codes are used under the OPPS to identify pass-through drugs and biologicals. The additional payment for a given item is established for at least two, but not more than three years. Squamous cell carcinoma and basal cell carcinoma are cancers of cell tissue of the skin, lining of the blood vessels, respiratory, intestinal, urinary tracts, and other body systems. These carcinomas are found in what type of tissue? Epithelial tissue Status indicator G indicates services are: Paid under OPPS;separate APC payment Status indicator G is: Paid under OPPS; separate APC payment Status indicator H is: Separate cost-based pass-through payment; not subject to copayment Status indicator V is used to indicate: Clinic or emergency department visits Stopping, or attempting to stop, post-procedural bleeding is coded to the root operation of: Control Strangulation Constriction of a body part to cut off blood or oxygen Subcarinal means beneath the carina. Where is the carina located? At the bifurcation of the trachea into two bronchi Supplementary words enclosed in parentheses in the ICD-10-CM code book have what effect on the coding? Refer to ICD-10-CM guideline I.A.7. They do not affect code assignment. Sweat is collected from a patient suspected of having cystic fibrosis. The specimen is taken by iontophoresis. What CPI® code is reported? 89230 Syrinx A synonym for syringomyelia, a cyst within the spinal cord Teaching facilities are: Answer: Affiliated with a medical school Rationale: Teaching hospitals are affiliated with medical schools to train physicians. Tendon sheath: a layer of synovial membrane around a tendon. It permits the tendon to stretch and not adhere to the surrounding fascia. It has two layers: synovial sheath. fibrous tendon sheath. The must include: albumin (82040), bilirubin (total) (82247), bilirubin (direct) (82248), phosphatase (alkaline) (84075), protein (total) (84155), transferase alanine amino (ALT) (SGPT) (84460), transferase aspartate amino (AST (SGOT) (84450). Hepatic Function Panel (80076) The abbreviation RML stands for: Right middle lobe. The abbreviation RTP indicates: The claim must be returned to the provider for correction The acronym ACEP means: American College of Emergency Physicians The admitting office is responsible for: Answer: Obtaining demographic information, insurance information, recording the type of service the patient requires, establishing an account, and obtaining consent for treatment Rationale: Insurance information, demographics, and the type of services the patient requires are recorded. The patient's insurance card is generally copied for verification purposes. An account is established through a computerized system that transfers patient information for hospital-wide availability during patient care. The admitting office is also responsible for obtaining consent for treatment or surgical services from the patient as well as other pertinent information required for patient management. The background relating to OPPS and APCs can be located in which publication? Federal Register The beneficiary's principal Dx and up to how many secondary Dx that may include comborbidites or complications deterine the DRG assignment? Twenty-four The brain and spinal cord are part of which system? Central Nervous System The bronchi are found in what body cavity? Thoracic cavity The cardiologist performs a percutaneous stent placement through a right common femoral access into the left iliac vessel. Report the CPT ® code(s). 37221 The Chargemaster includes: Revenue codes Rationale: The chargemaster is a master inventory list of everything that can be reported or performed in the hospital. Also listed are Uniform Billing (UB) revenue codes, charge descriptions, and other services. These services are identified by the department performing the service. The CPT®/HCPCS Level II code is already built into the system; it is not entered manually. The complete ICD-10-PCS is presented in what three parts? the tables, the index, and the list of codes The corpus luteum secretes progesterone. What is an effect of this secretion? Thickens the endometrium for implantation and is necessary to sustain pregnancy The correct diagnosis code(s) for a patient admitted to observation with severe sepsis and septic shock following an induced abortion is: O04.87, R65.21 The department responsible for coding procedures and services in the hospital facility is: Answer: HIM department Rationale: The Health Information Department includes sections for coding, chart construction or organization, transcriptions (some hospitals and facilities contract with transcription companies), release of information, birth and death certification, scanning or filing to input information into charts, and other sections required to maintain a consistent flow of patient information throughout the hospital or facility. The department that is not open 24 hours a day but provides emergent care is called: Answer: Emergency department type B Rationale: A T ype B emergency department is a facility meeting specific licensing requirements for emergent or urgent care patients not open 24 hours per day. The diagnosis caudal cervical inflammatory spondylopathy is assigned ICD-10-CM code M46.82 and is an example of what ICD-10-CM coding convention? NEC The dome-shaped muscle under the lungs flattening during inspiration is the: Diaphragm The ENT performs a diagnostic nasal endoscopy bilaterally, followed by right partial ethmoidectomy and removal of tissue from the maxillary sinus bilaterally. The diagnosis is chronic sinusitis of the ethmoid and maxillary sinuses. 31254-RT, 31267-50, J32.8 The first character in the code determines the broad _____________________ category, or _________________, where the code is found. procedure, section The following applies to C-APCs: Comprehensive APCs include the cost of blood and blood products The following are true for the SCHIP Balanced Budget Act EXCEPT: The SCHIP Balanced Budget Act is part of HIPAA. Rationale: A transitional pass-through payment for innovative and generally expensive medical devices, drugs, and biologicals is included in the OPPS, as required by the Medicare, Medicaid, and SCHIP (State Children's Health Insurance Program) Balanced Budget Refinement Act of 1999 (BBRA), also known as the Balanced Budget Refinement Act (BBRA). HIPAA is not part of BBRA. The following is TRUE about the chargemaster: It must be updated when coding changes occur. Rationale: A department review should be performed at least annually to ensure accurate coding. It is also recommended to review when coding changes or payment policy changes occur. A comprehensive overview is recommended at least every three years. The following is true concerning outlier payments: The cost-to-charge ratio is based on the hospital’s total revenue minus expenses. The following items must be included in the: HAAb, IgM antibody (86709), HBcAb, IgM antibody (86705), HBsAg (87340) and hepatitis C antibody (86803). This panel of tests is used for differential diagnosis in a patient with symptoms of liver disease or injury. When the time of exposure or the stage of the disease is not known, a patient with continued symptoms ofliver disease despite a completely negative hepatitis panel may need a repeat panel approxi mately two weeks to two months later to exclude the possibility of hepatitis. When a diagnosis is established, specific tests can be used to monitor the course of the disease. Acute hepatitis panel (80074)