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Name: Class: Date:
4. Which is the most likely reason a student would be terminated from the internship site, fails internship course, or
suspended and/or expelled from the academic program?
a. arriving late due to weather conditions
b. breaching patient confidentiality
c. contacting the site about an absence
d. dressing in a business casual style
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 2:43 PM
5. Coders also have the opportunity to work at home for employers who partner with an Internet-based organization called
a(n) __________, which is a third-party entity that manages and distributes software-based services and solutions to
customers using the Internet.
a. application service provider (ASP)
b. knowledge process outsourcing (KPO)
c. third-party logistics (TPL)
d. wide area network (WAN)
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 2:44 PM
6. Which professional is employed by third-party payers to review health-related claims to determine whether the costs
are reasonable and medically necessary based on the patient’s diagnosis?
a. health information technician
b. insurance specialist
c. liability underwriter
d. medical assistant
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
7. Students who join a professional association for a reduced membership fee often receive most of the same benefits as
active members. Which is an example of a benefit of joining a professional association?
a. guaranteed receipt of academic scholarship and grants
b. opportunity to network with members of the association
c. placement by the association at an internship facility
d. waiver provided for certification examination fees
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 2:47 PM
8. Which represents an online professional network about a variety of topics and issues?
a. application service provider
b. listserv
c. place-bound conference
d. wide area network
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 2:47 PM
9. Which organizes a medical nomenclature according to similar conditions, diseases, procedures, and services, and
contains codes for each?
a. classification system
b. data dictionary
c. hybrid record
d. medical nomenclature
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
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Name: Class: Date:
10. Which is a vocabulary of clinical and medical terms used by health care providers to document patient care?
a. classification system
b. data dictionary
c. hybrid record
d. medical nomenclature
ANSWER: d
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 2:48 PM
11. Which includes numeric and alphanumeric characters that are reported to health plans for health care reimbursement,
to external agencies for data collection, and internally for education and research?
a. codes
b. dictionary
c. nomenclature
d. placeholders
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 2:48 PM
12. Coding is the assignment of codes to diagnoses, services, and procedures based on __________.
a. federal government regulations
b. health information management
c. patient record documentation
d. third-party payer requirements
ANSWER: c
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 2:49 PM
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: c
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 2:49 PM
15. Which is published by the AMA and used to classify procedures and services in an outpatient setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:11 PM
16. Which is managed by CMS and used to classify medical equipment, injectable drugs, transportation services, and
other services in an outpatient setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
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Name: Class: Date:
d. ICD-10-PCS
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:11 PM
17. The Centers for Medicare & Medicaid Services (CMS) is a(n) __________ in the federal Department of Health and
Human Services (DHHS).
a. administrative agency
b. compliance section
c. private organization
d. third-party payer
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:11 PM
19. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is federal legislation that amended the
Internal Revenue Code of 1986 to __________.
a. create privacy and security standards for health information
b. eliminate standards for electronic health information transactions
c. limit access to long-term care services and coverage
d. produce waste, fraud, and abuse in health insurance and health care delivery
ANSWER: a
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Name: Class: Date:
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:12 PM
20. The process of standardizing data by assigning alphanumeric values to text or other information is called __________.
a. encoding
b. mapping
c. potentiating
d. sequencing
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:13 PM
21. The HIPAA small code set collects information concerning _____.
a. actions taken to prevent, diagnose, treat, and manage diseases and injuries
b. causes of injury, disease, impairment, or other health-related problems
c. diseases, injuries, impairments, and other health-related problems
d. race, ethnicity, type of facility, and type of unit
ANSWER: d
POINTS: 1
DIFFICULTY: Difficult
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:13 PM
22. The HIPAA large code set collects information concerning _____.
a. actions taken to prevent, diagnose, treat, and manage diseases and injuries
b. privacy and security standards for health information
c. race, ethnicity, type of facility, and type of unit
d. waste, fraud, and abuse in health insurance and health care delivery
ANSWER: a
POINTS: 1
DIFFICULTY: Difficult
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
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Name: Class: Date:
23. HIPAA requires health plans that do not accept standard code sets to modify their systems to accept all valid codes or
to contract with a(n) _____.
a. electronic data interchange
b. health care clearinghouse
c. insurance company
d. third-party administrator
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:14 PM
24. Which is an insurance company that establishes a contract to reimburse health care facilities and patients for
procedures and services provided?
a. clearinghouse
b. health plan
c. provider
d. third-party administrator
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:14 PM
26. Which is an example of another health care professional who performs procedures or provides services to patients?
a. clearinghouse staff
b. health information technician
c. medical assistant
d. nurse practitioner
ANSWER: d
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:15 PM
28. Adopting HIPAA’s standard code sets has improved data quality and simplified claims submission for health care
providers who routinely deal with multiple __________.
a. clearinghouses
b. health plans
c. markets
d. physicians
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:16 PM
29. A third-party administrator (TPA) is an entity that __________ and may contract with a health care clearinghouse to
standardize data for claims processing.
a. combats waste, fraud, and abuse in health insurance and health care delivery
b. improves portability and continuity of health insurance coverage in group/individual markets
c. processes health care claims and performs related business functions for a health plan
d. simplifies the administration of health insurance by creating unique identifiers
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:17 PM
30. The medical coding process requires the __________ of patient record documentation to identify diagnoses,
procedures, and services for the purpose of assigning ICD-10-CM, ICD-10-PCS, HCPCS level II, and/or CPT codes.
a. correction
b. entry
c. omission
d. review
ANSWER: d
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:17 PM
31. Professional associations establish a code of ethics to help members understand how to differentiate between “right”
and “wrong” and apply that understanding to __________.
a. credentialing
b. decision making
c. documentation
d. focused review
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:18 PM
32. Concurrent coding is the review of records and/or use of encounter forms and chargemasters to assign codes
__________.
a. after the patient has been discharged from care
33. Which is used to record data about office procedures and services provided to patients?
a. chargemaster
b. encounter form
c. insurance claim
d. uniform bill
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:19 PM
34. Which contains a computer-generated list of procedures, services, and supplies and corresponding revenue codes
along with charges for each?
a. chargemaster
b. encounter form
c. insurance claim
d. uniform bill
ANSWER: a
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:19 PM
35. Coders are prohibited from performing assumption coding, which is the assignment of codes based on assuming, from
a review of clinical evidence in the patient’s record, that the patient has certain diagnoses or received certain
procedures/services even though the __________.
a. responsible physician was contacted to confirm diagnoses, procedures, and services
b. physician query process was not implemented by the health care facility or physician
c. provider did not specifically document those diagnoses or procedures and services
d. risk for health care fraud and abuse is assumed by the health care facility or physician
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:20 PM
36. When coders have questions about documented diagnoses or procedures/services, they use a physician query process
to contact the responsible physician to __________.
a. confirm diagnoses, procedures, and services already documented in the record
b. eliminate the risk for fraud and abuse even though assumed by the facility or physician
c. request clarification about documentation and the code(s) to be assigned
d. document diagnoses, procedures, or services that will increase reimbursement
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:20 PM
37. Integrating the __________ physician query process with the electronic health record allows physicians to more easily
receive and reply to queries, which results in better and timely responses from physicians.
a. automated
b. complete
c. legible
d. precise
ANSWER: a
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:21 PM
38. A physician lists “viral pneumonia” as the final diagnosis. However, the coder notes that laboratory results state
“gram-negative bacteria.” There is also documentation of chest pain, fever, and dyspnea due to pneumonia. What should
the coder do?
a. Assign a code to the final diagnosis of viral pneumonia
b. Code bacterial pneumonia, chest pain, fever, and dyspnea
39. The purpose of a clinical documentation improvement (CDI) program is to help health care facilities comply with
government programs and other initiatives with the goal of improving health care quality. Thus, a CDI specialist initiates
concurrent and retrospective reviews of inpatient records to identify __________ provider documentation.
a. abusive and fraudulent
b. conflicting, incomplete, or nonspecific
c. illegible physician queries and
d. redacted health insurance claims and
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:22 PM
40. A coding compliance program ensures that the assignment of codes to diagnoses, procedures, and services follows
established coding guidelines, and health care organizations write policies and procedures to assist in implementing the
coding compliance stages of __________.
a. detection, correction, prevention, verification, and comparison
b. portability, continuity, and combating waste, fraud, and abuse
c. legibility, completeness, clarify, consistency, and precision
d. unbundling, upcoding, overcoding, jamming, and downcoding
ANSWER: a
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:22 PM
41. An effective coding compliance program monitors coding processes for __________.
a. completeness, reliability, validity, and timeliness
b. diagnostic/management, therapeutic, and education plans
42. Computer-assisted coding uses software to automatically generate __________ by “reading” transcribed clinical
documentation provided by health care practitioners.
a. data entry
b. insurance claims
c. medical codes
d. validation/audit reviews
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:29 PM
43. A patient record is the business record for a patient encounter that documents __________.
a. encounter forms data sent to third-party payers
b. inaccurate information that cannot be altered
c. health care services provided to a patient
d. insurance claims submitted to health care plans
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:30 PM
44. Demographic data is patient identification information that is collected according to facility policy and includes
information such as the __________.
a. insurance claim submitted
b. medical codes reported
c. patient’s date of birth
d. quality of patient care
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Name: Class: Date:
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:30 PM
48. A teaching hospital is engaged in an approved graduate medical education __________ program in medicine,
osteopathy, dentistry, or podiatry.
a. health care
b. medicolegal
c. residency
d. third-party
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:32 PM
49. Residents are supervised by a(n) __________ physician during patient care.
a. admitting
b. attending
c. responsible
d. teaching
ANSWER: d
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
DATE CREATED: 7/24/2018 11:44 AM
DATE MODIFIED: 10/24/2018 3:32 PM
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