LLRI National Level Exam

A patient is admitted with acute-on-chronic systolic heart failure. Which ICD-10-CM code is the most appropriate principal diagnosis? I50.21 I50.23 50.31 I50.33

According to ICD-10-CM guidelines, which statement is TRUE about coding sepsis? Sepsis requires at least two codes: the underlying infection and R65.2 Severe sepsis (R65.2) may be assigned alone without an underlying organism code The underlying systemic infection is sequenced first, followed by R65.20 or R65.21 SIRS of non-infectious origin is coded with A41.9

A patient fractures the neck of the right femur in a fall from a ladder at work. The encounter is the initial visit. Which code set applies? S72.001A, W11.XXXA, Y93.89 S72.001A, W11.XXXA, Y99.0 S72.009A, W11.XXXA, Y93.89 S72.091A, W11.XXXA, Y99.0

Which of the following best describes the ICD-10-CM placeholder character 'X'? It fills a position when additional characters are required but no information is available It indicates the code is for an external cause It denotes an unspecified laterality It is used only in Chapter 19 injury codes

A patient presents with type 2 diabetes mellitus with diabetic chronic kidney disease, stage 3. The correct coding sequence is: N18.3, E11.65 E11.65, N18.3 E11.649, N18.3 E11.65 only

Which ICD-10-CM guideline governs 'coding for signs and symptoms' in outpatient settings? Code the confirmed diagnosis even if not established Code signs and symptoms unless a definitive diagnosis is established Always assign codes for both signs and their underlying cause Use 'probable' or 'suspected' diagnoses freely in outpatient coding

A patient with known CAD presents with unstable angina. The cath report confirms atherosclerosis of native coronary artery. The correct code is: I25.110 I25.111 I25.119 I20.0

Which is the correct ICD-10-CM code for a patient with essential hypertension and stage 4 chronic kidney disease? I10, N18.4 I12.9, N18.4 I12.1, N18.4 I13.10, N18.4

When can a code from category Z3A (Weeks of gestation) be used? On the maternal record during the antepartum period only On any record, including the newborn On the maternal record whenever an obstetric code from Chapter 15 is assigned Only for complications of pregnancy in the third trimester

A patient is seen for a pathological fracture due to metastatic carcinoma of bone from primary breast cancer. The correct sequencing is: C79.51, C50.919, M84.551A M84.551A, C79.51, C50.919 C50.919, C79.51, M84.551A M84.551A, C50.919

Which Z code is assigned when a patient with no symptoms is seen for a prophylactic mastectomy due to strong family history of breast cancer? Z40.01 Z12.31 Z80.3 Z15.01

A patient is admitted with acute respiratory failure. The underlying cause is community-acquired pneumonia. The correct principal diagnosis is: J18.9 (pneumonia) J96.00 (acute respiratory failure) Code both equally — either can be principal J96.00 and J18.9 in any order

What is the correct ICD-10-CM code for major depressive disorder, recurrent, severe, with psychotic features? F32.3 F33.2 F33.3 F32.9

The ICD-10-CM Tabular List instruction 'Code first' means: The mentioned code must always be sequenced as the principal diagnosis The mentioned condition must be coded first when both conditions are present The mentioned code is optional The code is always an additional diagnosis

A newborn male is born via C-section and is diagnosed with transient tachypnea of the newborn. Which code is assigned? P22.1 P22.0 P96.4 J80

A surgeon performs a laparoscopic cholecystectomy with intraoperative cholangiography. Which CPT code(s) are reported? 47562, 47563 47563 47562 and 74300 47600

Which CPT modifier indicates that two surgeons each performed distinct parts of a procedure? Modifier -54 Modifier -55 Modifier -62 Modifier -80

A patient undergoes excision of a malignant lesion from the trunk with excised diameter of 2.3 cm. The correct CPT code is: 11601 11602 11603 11604

Under the 2021+ E/M guidelines, the level of Medical Decision Making (MDM) is determined by which three elements? Number of diagnoses, amount of data reviewed, risk of complications Chief complaint, history, physical examination History, MDM, total time HPI, ROS, PFSH, and exam

The global surgical package for a major surgery includes all of the following EXCEPT: Preoperative evaluation on the day of surgery Complications requiring additional return trips to the OR Postoperative visits within the global period Evaluating the patient in the recovery room

Which modifier is appended when a procedure is performed bilaterally and the descriptor does not specify 'bilateral'? -50 -51 -52 -53

Which CPT code is reported for a diagnostic upper GI endoscopy (EGD) with biopsy? 43239 43235 43238 43240

What does the 'technical component' (modifier -TC) of a radiology service represent? The physician's interpretation and report The equipment, staff, and supplies used to produce the image Both equipment and professional interpretation The supervision and administration of contrast

A physician performs a diagnostic bronchoscopy and then inserts a bronchial stent during the same session. How should this be reported? 31622 and 31636 31636 only 31622 -51 and 31636 31622 and 31636 -59

Category III CPT codes represent which of the following? Emerging technologies and services Proprietary laboratory analyses Multianalyte assays Performance measurement codes

A new patient office visit with high complexity MDM taking 75 minutes total time. Which code applies? 99205 99215 99205 + 99417 99204

A surgeon excises a 2.0 cm benign lesion from the back and repairs with a layered closure. How are these services reported? 11402 and 12032 11402 only 11402 and 13100 12032 only

Which of the following is NOT one of the 'Three Key Components' for E/M coding under the old (pre-2021) guidelines? History Medical decision making Physical examination Time

A surgeon performs CABG using two arterial grafts and one venous graft. Which CPT codes are reported? 33534, 33533 33534, 33518 33534, 33535, 33517 33535, 33517

A physician discusses a new diagnosis of Alzheimer's disease with a patient's family member for 25 minutes. The patient is not present. Which code applies? 99213 99497 99358 99366

Which HCPCS Level II code is reported for a standard power wheelchair (non-complex rehab)? K0001 K0800 K0856 E1161

A patient requires home oxygen therapy via a stationary concentrator at 2 L/min. The appropriate HCPCS code is: E1390 E0431 E0433 E0439

HCPCS code J0696 (injection, ceftriaxone sodium) belongs to which code category? A code (transportation) J code (drugs) Q code (temporary) S code (private payer)

For DME billing, which HCPCS modifier indicates a new purchase of equipment? -RR (rental) -NU (new purchase) -UE (used equipment) -GY (excluded)

A patient receives an infusion of rituximab in an outpatient hospital. Which code type represents the drug itself? CPT add-on code HCPCS J code HCPCS Q code Revenue code only

HCPCS code A0427 for ambulance transport represents which level of service? BLS emergency transport ALS emergency transport, Level 1 ALS emergency transport, Level 2 Specialty care transport

Which HCPCS Level II code range covers temporary codes for drugs and biologicals pending FDA approval? A codes C codes Q codes S codes

A patient is fitted for a custom-fabricated thoraco-lumbo-sacral orthosis (TLSO). Which HCPCS code is most appropriate? L0450 L1000 L0480 L0455

The suffix '-ectasis' means: Surgical removal Dilation or expansion Inflammation Suture

Which anatomical term describes the back surface of the body? Anterior Posterior Superior Medial

The combining form 'hepat/o' refers to which organ? Kidney Spleen Liver Pancreas

Which of the following medical terms means 'pertaining to between the ribs'? Intracostal Intercostal Infracostal Epicostal

A patient's chart documents 'dysuria.' This term means: Excessive urination Painful or difficult urination Absence of urination Blood in urine

The term 'myocardial infarction' literally means: Inflammation of the heart lining Death of heart muscle tissue Enlargement of the heart Abnormal heart rhythm

In anatomical position, the term 'lateral' refers to: Toward the midline of the body Away from the midline Toward the back Below another structure

Which abbreviation stands for 'nothing by mouth' in medical documentation? PRN NPO QID STAT

The National Correct Coding Initiative (CCI/NCCI) edits are published by which organization? AMA AHIMA CMS AAPC

A claim submitted with a diagnosis not supported by the medical record is an example of: Upcoding Unbundling Lack of medical necessity Fraudulent billing

Under HIPAA, what is the standard code set mandated for professional claims submitted to payers? ICD-10-CM, CPT, HCPCS ICD-11, CPT, HCPCS ICD-10-CM only ICD-10-CM and ICD-10-PCS

The UHDDS definition of 'principal diagnosis' is: The condition with the highest DRG weight The condition chiefly responsible for causing the admission after study The admitting diagnosis listed by the physician The admitting diagnosis listed by the physician

Which of the following best describes 'unbundling' in medical coding? Billing multiple codes separately for a service covered by one comprehensive code Billing a higher-level service than documented Failing to code all appropriate diagnoses Incorrectly sequencing diagnosis codes

Medicare inpatient hospital stays are reimbursed under which payment system? Resource-Based Relative Value System (RBRVS) Inpatient Prospective Payment System (IPPS) using MS-DRGs Ambulatory Payment Classification (APC) Fee for Service per diem

Which of the following is NOT a core element of an OIG-recommended compliance program? Written policies and procedures Designated compliance officer Mandatory malpractice insurance for all staff Regular auditing and monitoring

Which federal law prohibits giving or receiving anything of value to induce referrals of services covered by federal healthcare programs? False Claims Act Stark Law Anti-Kickback Statute HIPAA Privacy Rule

Modifier -25 is appended to which type of code and under what circumstance? Surgery code; separate procedure on same day E/M code; significant separately identifiable E/M on same day as a procedure Anesthesia code; unusual circumstances Diagnostic code; additional diagnoses

Which modifier is used when a procedure is discontinued after patient preparation but before the service was started (outpatient, before anesthesia)? -52 -53 -73 -74

Modifier -59 is used to indicate: A bilateral procedure A distinct procedural service A reduced service A staged procedure

A surgeon performs a procedure and provides only the postoperative care. The appropriate modifier is: -54 -55 -56 -58

Which modifier indicates that a service was performed in part by a resident under a teaching physician's supervision? -GC -GE -GF -GJ

When a physician performs the same procedure on 3 separate fingers during the same session, which modifier is most appropriate? -50 -51 -59 -76

Which ICD-10-PCS root operation is defined as 'cutting out or off, without replacement, all of a body part'? Excision Resection Destruction Extraction

In ICD-10-PCS, the 4th character represents which axis of classification? Root operation Body system Body part Approach

A patient undergoes an open appendectomy. The correct ICD-10-PCS approach value is: 0 - Open 4 - Percutaneous endoscopic 3 - Percutaneous F - Via natural opening endoscopic

Under MS-DRG assignment, what is the function of a Major Complication or Comorbidity (MCC)? It always increases reimbursement It can affect DRG assignment by moving a patient to a higher-weighted DRG It replaces the principal diagnosis for DRG purposes It has no impact if the patient is not Medicare

Which ICD-10-PCS root operation is used for the insertion of a cardiac pacemaker device? Replacement Supplement Insertion Change

The 'present on admission' (POA) indicator is required for which type of claim? CMS-1500 professional claims UB-04 inpatient acute care claims HCFA outpatient claims Part D prescription claims

LLRI National Level Exam

Medical Coding Exam

Exam Instruction

NATIONAL MEDICAL CODING EXAMINATION

LLRI National Level Exam

Medical Coding Exam

Exam Instruction

NATIONAL MEDICAL CODING EXAMINATION

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