Coding Compliance and Ethics Test
Questions
Course Introduction
Coding Compliance and Ethics examines the standards, laws, and regulations that govern accurate medical coding in healthcare settings. The course explores the critical importance of ethical decision-making and integrity in maintaining compliance with federal, state, and organizational requirements. Students will learn to identify common coding errors and fraud risks, understand the consequences of non-compliance, and apply strategies for adherence to coding guidelines. Emphasis is placed on practical applications through case studies, reinforcing the role of ethics and compliance in supporting quality patient care and organizational accountability.
Recommended Textbook
ICD 10 CM PCS Coding Theory and Practice 2016 Edition 1st Edition by Karla R. Lovaasen
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27 Chapters
1674 Verified Questions
1674 Flashcards
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Chapter 1: The Rationale for and History of Coding
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46 Verified Questions
46 Flashcards
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Sample Questions
Q1) A nomenclature is a system of ____ as used in preferred terminology.
A)diseases
B)procedures
C)conditions
D)names
Answer: D
Q2) In ICD-10-CM,the CM stands for ____.
A)Clinical Modification
B)Centers for Medicaid and Medicare
C)Core Measures
D)Chief Medical Officer
Answer: A
Q3) CPC-H stands for Certified Professional Coder-Health Care Based.
A)True
B)False
Answer: False
Q4) Without the __________ system,the comparison of data would be impossible. Answer: classification
Q5) HIPAA stands for __________ of 1996.
Answer: Health Insurance Portability and Accountability Act
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Chapter 2: The Health Record As the Foundation of Coding
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39 Verified Questions
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Sample Questions
Q1) Plan
A)Accredits and certifies healthcare organizations
B)The problem in the patient's own words
C)The approach the practitioner is taking to solve the patient's problem
D)The condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care
E)Codes reported on health insurance claim forms that should be supported by documentation in the medical record
F)Person qualified by education and legally authorized to practice medicine
G)Requested by the attending physician to gain an expert opinion on the treatment of a particular aspect of the patient's condition that is outside the expertise of the attending physician
H)People who treat patients
I)The physician identifies the history,physical examination,and diagnostic tests
J)Where the subjective and objective combine for conclusion
K)Words of the patient;the reason the patient has presented to a healthcare facility for treatment
Answer: C
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4
Chapter 3: ICD-10-Cm Format and Conventions
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39 Verified Questions
39 Flashcards
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Sample Questions
Q1) The word(s) "____" should be interpreted to mean either "and" or "or" when it appears in the title.
A)with
B)see
C)omit code
D)and
Answer: D
Q2) In ICD-10-CM,there is an additional index for the External Causes of Injury.
A)True
B)False
Answer: True
Q3) Which statement is NOT true of inclusion terms?
A)An "inclusion note" under a code indicates that the terms excluded from the code are to be coded elsewhere
B)The terms may be included under some codes
C)These terms are the conditions for which that code number is to be used
D)The inclusion terms are not necessarily exhaustive
Answer: A
Q4) Why is it important for the coder to understand coding conventions?
Answer: Ensures accurate assignment and sequencing of codes
5
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Chapter 4: Basic Steps of Coding
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Sample Questions
Q1) The __________,if available,is the first step in the process of record review for code selection.
Q2) The coder should rely solely on the discharge summary to capture all of the diagnoses and procedures that were treated and performed.
A)True
B)False
Q3) What is the main purpose of the Alphabetic Index in ICD-10-PCS?
Q4) The main term for procedures in ICD-10-CM is identified by the ____.
A)anatomic site
B)place of incision
C)procedure performed
D)none of the above are correct
Q5) Exceptions to the general rule that main terms usually identify disease conditions are Z codes.
A)True
B)False
Q6) What is the main term in "esophageal reflux"?
Q7) Once a code has been selected from the Alphabetic Index to Diseases,what is the next step?
Page 6
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Chapter 5: General Coding Guidelines for Diagnosis
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Sample Questions
Q1) If the principal diagnosis was abdominal pain due to acute appendicitis,the abdominal pain would be coded as a secondary diagnosis.
A)True
B)False
Q2) A patient is admitted to the hospital with Crohn's disease,hypertension,and rheumatoid arthritis for bowel resection.In the OR before incision,the patient develops tachycardia,and the procedure is canceled.What is the principal diagnosis?
Q3) Conditions that are routinely associated with a disease or condition should not be coded as additional diagnoses unless instructed by the classification or unless they affect the patient's condition or treatment given
A)True
B)False
Q4) What is the diagnosis code(s) for acute and chronic cholecystitis?
Q5) What is the diagnosis code(s) for cognitive deficits due to previous cerebral infarction?
Q6) A patient who is a known diabetic is admitted for treatment of an ulcer of the left great toe.What is the principal diagnosis?
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Page 7
Chapter 6: General Coding Guidelines for Medical and Surgical Procedures
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173 Verified Questions
173 Flashcards
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Sample Questions
Q1) Procedure codes identified by the Medicare Code Editor as procedures covered under limited circumstances
A)Non-OR procedure affecting MS-DRG assignment
B)Limited coverage
C)Noncovered OR procedure
D)Valid OR procedure
E)Bilateral procedure
Q2) A closed reduction of a fracture is coded to the external approach.
A)True
B)False
Q3) Uses an instrument that examines any cavity of the body with a rigid or a flexible scope
A)Thoracoscopic approach
B)Arthroscopic approach
C)Laparoscopic approach
D)Endoscopic approach
Q4) An obstetric procedure is any procedure performed on a pregnant woman.
A)True
B)False
Q5) The vas deferens is in what body system?
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Chapter 7: General Coding Guidelines for Other Medicaland
Surgical-Related Procedures and Ancillary Procedures
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107 Verified Questions
107 Flashcards
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Sample Questions
Q1) Physical therapy treatment to increase ROM shoulder
Q2) What is the section value for other procedure?
Q3) Modality qualifier is the fifth character in the radiation oncology section.
A)True
B)False
Q4) The first character value for a physical rehabilitation or diagnostic audiology procedure is B.
A)True
B)False
Q5) Nonautologous bone marrow transplant via central venous catheter
Q6) Irrigation is defined as putting in or on a cleansing substance. A)True B)False
Q7) The first character value for substance abuse treatment is B. A)True B)False
Q8) Upper GI series,fluoroscopic imaging using barium
Q9) Mechanical respiratory ventilation less than 24 hours Page 9
Q11) Abortion induced with Laminaria
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Page 10
Chapter 8: Symptoms,
Signs, and
Abnormal
Clinical and Laboratory Findings Not Elsewhere Classified, and Z Codes
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Sample Questions
Q1) Positive Mantoux test: __________
Q2) Subjective evidence of a disease or of a patient's condition as perceived by the patient
A)A primary circumstance for using Z codes
B)Symptom
C)Screening exam
D)Is a main term in the Alphabetic Index
E)Sign
Q3) Objective evidence of a disease or of a patient's condition as perceived by the patient's examining physician
A)A primary circumstance for using Z codes
B)Symptom
C)Screening exam
D)Is a main term in the Alphabetic Index
E)Sign
Q4) Encounter for admission examination for prisoner: __________
Q5) Patient is admitted to the hospital with the "worst headache" he has ever had.Workup for aneurysm is performed.There is a strong family history of stroke.No cause for the headache is determined: __________
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Chapter 9: Certain Infectious and Parasitic Diseases
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Sample Questions
Q1) A homeless man presented to the ER with skin ulcers of the right calf of the leg that are infested with cutaneous maggots.
A)B87.1
B)B87.0
C)L97.219,B87.0,Z59.0
D)L97.219,B87.8
Q2) What virus is spread to individuals by a mosquito bite?
Q3) Patient has elevated liver function tests and was diagnosed with viral hepatitis C.
A)B19.20
B)B19.21
C)B19.9
D)B19.20,R79.89
Q4) What disease causes inflammation of the liver and can be caused by several different viruses?
Q5) Jock itch is coded to ____.
A)B35.9
B)B35.8
C)B35.6
D)B35.4
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Chapter 10: Neoplasms
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Sample Questions
Q1) Patient has a malignancy in the right upper outer quadrant of the breast.There is another primary malignancy in the right lower outer quadrant.She will be scheduled for a mastectomy soon.
A)C50.421,C50.422
B)C50.411,C50.511
C)C50.811
D)C50.821,C79.81
Q2) Primary cancer of the cauda equina: __________
Q3) Preventive or ____________________ surgery is performed to remove tissue that has the potential to become cancerous.
Q4) When cancers are staged,stage ____________________ means that the cancer has spread into surrounding tissues but not beyond the location of origin.
Q5) ____ is the use of high-energy radiation to treat cancer.
A)Chemotherapy
B)Radiation
C)Brachytherapy
D)Palliative procedure
Q6) Glossopalatine fold carcinoma: __________
Q7) Cancer of the lymphatic system is called ____________________.
Page 13
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Chapter 11: Diseases of the Blood and Blood-Forming
Organs and Certain Disorders Involving the Immune
Mechanism
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Sample Questions
Q1) A patient is admitted with thrombocytopenia and coagulopathy due to alcoholic cirrhosis of liver and alcohol dependence.Patient receives platelet transfusion via peripheral vein,percutaneous approach,and vitamin K.Patient's blood count improves before Patient is discharged.__________
Q2) The percentage of blood volume made up of red blood cells
A)Apheresis
B)Blood
C)Autologous transfusion
D)5000 to 10,000/mm3
E)Hemoglobin (HGB)
F)Purpura
G)Idiopathic
H)Hematocrit (Hct)
I)Bone marrow biopsy
J)WBC
K)Secondary thrombocytopenia
Q3) ____________________ is an increased number of white cells in the blood.
Q4) What is the function of leukocytes (WBC)?
Q5) ____________________ is a breakdown in the clotting process of the blood. Page 14
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Page 15
Chapter 12: Endocrine, Nutritional, and Metabolic Diseases
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69 Verified Questions
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Sample Questions
Q1) A patient is admitted for care of a diabetic ulcer on the left midfoot.The patient also has chronic kidney disease,stage 3,resulting from diabetes.
A)E13.621,E13.22,N18.9
B)E10.621,E10.22,N18.3
C)E11.621,L97.429,E11.22,N18.3
D)E11.621,L97.429,E11.22,N18.9
Q2) When blood sugar becomes abnormally low,this is called ____.
A)hyperglycemia
B)hypoglycemia
C)hyperpituitarism
D)hypopituitarism
Q3) Type 1 diabetics must use ____________________ to replace what their bodies do not produce.
Q4) Gigantism occurs when there is hypersecretion of hGH before puberty and when there is a proportional overgrowth of all body tissues,especially the long bones.
A)True
B)False
Q5) DKA in patient with uncontrolled type 1 diabetes: __________
Q6) Vitamin D deficiency: __________
Page 16
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Chapter 13: Mental, Behavioral, and Neuro developmental Disorders
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Sample Questions
Q1) An impaired mental state in which the perception of reality has become distorted is called ____________________.
Q2) Panic agoraphobia: __________
Q3) Seizure due to alcohol withdrawal.Patient is dependent on alcohol and usually drinks every day.
A)R56.9,F10.230
B)F10.230,R56.9
C)F10.221,R56.9
D)F10.239,R56.1
Q4) Homicidal ideation: __________
Q5) What do ADD and ADHD stand for?
Q6) What drug could be given to treat depression?
A)Adderall
B)Zoloft
C)Valium
D)Dilantin
Q7) ICD-10-CM does not have a history code for history of drug or alcohol abuse.
A)True
B)False
Q8) Catatonic schizophrenia in remission: __________ Page 17
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Page 18
Chapter
Eye and Adnexa,and Diseases of the Ear and Mastoid
Process
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59 Verified Questions
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Sample Questions
Q1) Disorder of the optic nerve resulting in vision loss
A)Glaucoma
B)Hydrocephalus
C)Meningitis
D)Epilepsy
E)Parkinson's disease
F)Cataract
G)Cholesteatoma
H)Mastoiditis
I)Myasthenia gravis
J)Alzheimer's disease
Q2) A patient with intractable epilepsy presents for open implantation of a single array neurostimulator pulse generator with leads.The generator was placed in the chest via open approach and the leads were placed in the neck and attached to the vagus nerve via percutaneous approach.
A)G40.919,0JH60BZ,00HE3MZ
B)G40.911,0JH60M6,00HE3MZ
C)G40.919,0JH60M8,00HE3MZ
D)G40.911,00HE0MZ,0MH60M6
Page 19
Q3) Meningitis due to Klebsiella: __________
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Page 20
Chapter 15: Diseases of the Circulatory System
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Sample Questions
Q1) Insertion of pacemakers most often requires five codes.
A)True
B)False
Q2) History of heart transplant
A)Z82.3
B)Z94.1
C)Z95.811
D)Z95.9
E)Z76.82
Q3) Heart assist device
A)Z82.3
B)Z94.1
C)Z95.811
D)Z95.9
E)Z76.82
Q4) Diuretics such as Lasix,Bumex,and Zaroxolyn;beta blockers
A)Angina
B)Atrial fibrillation
C)Congestive heart failure
D)Hypertension
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Chapter 16: Diseases of the Respiratory System
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Sample Questions
Q1) Patient was admitted with flu like symptoms.The final diagnosis on the discharge summary is possible novel influenza A.
A)J09.X2
B)J09.X3
C)J11.1
D)J11.89
Q2) Patient is admitted with acute on chronic respiratory failure due to emphysema.Patient is dependent on oxygen and has had numerous admissions for pneumonia.Patient is treated with continuous BIPAP for 48 hours and is a DNR/DNI.No infection is identified,and deterioration in respiratory status is thought to be a progression of his emphysema.Patient was made comfort care and was discharged to at-home hospice care the following day.Final Diagnoses: End-stage emphysema.Chronic respiratory failure with hypoxia.Procedure: BIPAP.
A)J96.00,J43.0,Z99.81,Z87.01,Z51.5,5A09557
B)J96.01,J43.9,Z99.81,Z87.01,Z66,5A09357
C)J96.21,J43.9,Z99.81,Z87.01,Z66,Z51.5,5A09457
D)J96.22,J43.9,Z99.81,Z87.01,5A09357
Q3) ____________________ is a chronic lung disease that can result from other infections or,most commonly,cigarette smoke.
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Page 22
Chapter 17: Diseases of the Digestive System
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Sample Questions
Q1) A patient is admitted for chemotherapy (via central venous catheter) for pancreatic cancer and develops ulcerative mucositis of the mouth due to gemcitabine.
A)K12.31,Z51.11,C25.9,3E04305
B)Z51.11,C25.9,T45.1X5A,3E03305
C)C25.9,Z51.11,K12.31,3E04305
D)Z51.11,C25.9,K12.31,T45.1X5A,3E04305
Q2) Done for the removal of the gallbladder,common bile duct,part of the duodenum,and the head of the pancreas
A)Nissen fundoplication
B)Herniorrhaphy
C)Appendectomy
D)Colostomy
E)Lysis of adhesions
F)PEG (percutaneous endoscopic gastrostomy)
G)TIPS (transjugular intrahepatic portosystemic shunt) procedure
H)Whipple procedure
Q3) What is the term for degeneration of the liver tissue that causes blockage of the blood through the liver and inhibits its function?
Q4) What happens to food once it arrives in the stomach?
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Chapter 18: Diseases of the Skin and Subcutaneous Tissue
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Sample Questions
Q1) Nail horn,left thumb: __________
Q2) The functions of the integumentary system include all of the following EXCEPT ____.
A)protection
B)temperature regulation
C)sensory reception
D)vitamin A synthesis
Q3) In ICD-10-CM,decubitus ulcers use a combination code for location and stage.
A)True
B)False
Q4) Open sores in the skin
A)Decubitus ulcer
B)Skin ulcers
C)Cellulitis
D)Stasis ulcer
E)Stasis dermatitis
F)Intertriginous dermatitis
G)Gangrene
H)Hives
I)Dermatitis
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Chapter 19: Diseases of the Musculoskeletal System and Connective Tissue
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Sample Questions
Q1) ____ is/are the front of the body or organ.
A)Anterior
B)Dorsal
C)Proximal
D)Ventral
E)Anterior and ventral
Q2) Degenerative polyarticular arthritis: __________
Q3) Patient with a family history of rheumatoid arthritis is being screened for rheumatoid arthritis.
A)Z13.820,Z82.69
B)Z13.89,Z82.62
C)Z13.828,Z82.61
D)Z13.828
Q4) Ball joints are small stabilizing joints located between and behind adjacent vertebrae.
A)True
B)False
Q5) Myelopathy is compression of the ____________________.
Q6) Right plantar fasciitis (right): __________
Q7) Ankylosis of right shoulder: __________ Page 25
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Chapter 20: Diseases of the Genitourinary System
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Sample Questions
Q1) Overflow incontinence is the constant dribbling of urine.Treatments for overflow incontinence include all of the following EXCEPT ____.
A)Kegel exercises
B)diet
C)immediate surgery
D)bladder training
Q2) A patient is admitted to the hospital with fever and chills,flank pain,and burning on urination with increased frequency.CT scan shows stranding around the right kidney consistent with pyelonephritis.Urine culture is positive for Proteus mirabilis.The patient has a long history of obstructive uropathy due to BPH.Final Diagnosis: Fever due to acute pyelonephritis due to P.mirabilis.Obstructive uropathy due to benign prostatic hypertrophy.
A)N11.0,B96.4,N40.1,N13.8
B)N10,B96.5,N40.0,N13.9
C)N10,B96.4,N40.1,N13.8
D)N11.9,B96.89,N40.0,N13.1
Q3) Carbuncle scrotum: __________
Q4) Leukoplakia of vulva: __________
Q5) Mittelschmerz: __________
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Chapter 21: Pregnancy, Childbirth, and the Puerperium
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Sample Questions
Q1) The patient is admitted to the hospital in preterm labor.She is 27 weeks pregnant.Terbutaline is administered,and the patient remains on bed rest.In the third week of bed rest,her water breaks,and she is taken to the delivery room.She vaginally delivers a baby girl.
A)O60.12x1,Z38.00,Z3A.27,10E0XZZ.
B)O60.13x0,Z37.0,Z3A.27,10E0XZZ
C)O60.12x1,Z38.00,Z3A.27,10E0XZZ
D)O60.130,Z37.0,Z3A.27,10E0XZZ
Q2) ICD-10-CM does NOT have separate categories for high-risk pregnant individuals.
A)True
B)False
Q3) What drug could be given to induce labor?
A)Stadol
B)Epidural
C)Pitocin
D)Terbutaline
Q4) When a vaginal delivery occurs,the principal diagnosis should correspond to the main circumstance or complication of the delivery.
A)True
B)False
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Chapter 22: Certain Conditions Originating in the Perinatal
Period and Congenital Malformations, deformations, and
Chromosomal Abnormalities
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Sample Questions
Q1) Which of the following is NOT a congenital condition?
A)Marfan syndrome
B)Down syndrome
C)Bronchopulmonary dysplasia
D)Klinefelter's syndrome
Q2) Cleft lip occurs in approximately 1 in every 2000 babies.
A)True
B)False
Q3) What is meconium?
Q4) Vaginal delivery of infant with a birth weight of 4600 grams at 42 weeks;physician documents large for dates: __________
Q5) A code from category A41,septicemia,should not be used on a(n) ____ record.
A)newborn
B)child
C)teenager
D)adult
A)True Page 29
Q6) Prematurity is based on recorded birth weight and gestational age and documentation of prematurity.
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Page 30
Chapter 23: Injuries and Certain Other Consequences of
External Cases and External Causes of Morbidity
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Sample Questions
Q1) Which of the following is NOT a common site for a laceration?
A)Above the eyebrows
B)Scalp
C)Stomach
D)Knees
E)Face
Q2) A patient is admitted with a laceration of the forehead due to a collision with another player during a professional soccer game.On further examination,it feels as though there may be a foreign body,so the patient is taken to the OR for exploration,where the area is incised and a foreign body is removed.The laceration is sutured.The pathology report determines the foreign body to be a tooth.
Q3) When air or gas bubbles get into the bloodstream,this is called a(n)
Q4) What are external cause codes? ____________________
Q5) An open fracture occurs when the bone is broken but the skin remains intact.
A)True
B)False
Q6) What does TBI stand for?
Page 31
Q7) C5 spinal cord injury with complete lesion,initial encounter: __________
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Chapter 24: Burns, adverse Effects, and Poisonings
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Sample Questions
Q1) Allergy other than to medicinal agents-milk products
A)Z69.020
B)Z88.8
C)Z91.030
D)Z88.7
E)Z91.010
F)Z91.89
G)Z91.011
H)Z91.410
Q2) Active treatment of non-healing second-degree burn to right forearm due to hot iron while ironing (accidental): __________
Q3) In a toxic poisoning,the toxic poisoning code (T36-T50) should be sequenced first,followed by the external cause code(s).
A)True
B)False
Q4) What are the four major types of abuse?
Q5) Spontaneous hematoma in right thigh muscle due to anticoagulant;patient is taking Coumadin for mechanical mitral valve replacement: __________
Q6) Sunburned chest: __________
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Chapter 25: Complications of Surgical and Medical Care
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Sample Questions
Q1) Code only complications that occur within 2 weeks of a transplant surgery.
A)True
B)False
Q2) Patient has subclavian vein thrombosis due to PICC: __________
Q3) The patient had a cerebrovascular accident embolic in nature and was documented by the surgeon as being due to the surgical procedure.The patient initially had been admitted for treatment of coronary artery arteriosclerosis with CABG.The patient is taken to the OR for an open three-vessel aorta to coronary artery using greater saphenous vein.The left greater saphenous vein was harvested via percutaneous approach.Cardiopulmonary bypass is performed during the surgery.
A)I97.820,I25.10,I63.40,Y84.2,021109W,06BS0ZZ
B)I25.10,I97.820,Y83.9,02110AW,06BS3ZZ
C)I25.10,I97.820,I63.40,Y83.2,021209W,06BQ3ZZ,5A1221Z
D)I63.40,I25.10,I97.820,Y83.8,021209W,06BQ3ZZ,5A1221Z
Q4) When looking for a complication code in the Index,the coder should first look under the ____________________.
Q5) There is a time limit for complications to occur. A)True B)False
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Chapter 26: Reimbursement Methodologies
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43 Flashcards
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Sample Questions
Q1) The ____________________ is the condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care.
Q2) Quality improvement organizations (QIO) work with consumers,____________________,and ____________________ to make sure that patients are getting the "right care at the right time."
Q3) A preexisting condition that is present on admission and may lead to increased resource use is a ____.
A)comorbidity
B)complication
C)provisional diagnosis
D)morbidity
Q4) Which of the following is a factor in determining how sick the patient is and is an interrelated part of case-mix?
A)Severity of illness
B)Prognosis
C)Need for intervention
D)All of the above
E)None of the above
Q5) RAC stands for __________.
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Chapter 27: Out patient Coding
Available Study Resources on Quizplus for this Chatper
42 Verified Questions
42 Flashcards
Source URL: https://quizplus.com/quiz/42626
Sample Questions
Q1) The outpatient term equated to principal diagnosis is "first-listed diagnosis" or "primary diagnosis."
A)True
B)False
Q2) What are ancillary service visits?
Q3) The Uniform Discharge Data Set definition of principal diagnosis applies to inpatients in ____.
A)short-term care
B)long-term care
C)psychiatric hospitals
D)all of the above situations
E)none of the above situations
Q4) Patient with acute appendicitis had laparoscopic appendectomy: __________
Q5) Encounter for well-baby check of an infant 7 days old
A)Z33.1
B)O09.01
C)Z30.431
D)Z00.129
E)Z04.41
F)Z01.811
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