American Academy of Professional Coder
Certified Professional Coder Test for CPC-P
1. Codes and Ethics of Coders
2. Medical Terminology and Anatomy Review (all systems)
3. ICD-9-CM (complete)
4. CPT coding, surgery guidelines, HCPCS, and modifiers
5. Introduction to Integumentary system including ICD-9 and CPT codes
6. Introduction to Musculoskeletal System including ICD-9 and CPT codes
7. Introduction to Respiratory, Hemic, Lymphatic, Mediastinum and Diaphragm including ICD-9 and CPT codes
8. Introduction to Cardiovascular system including ICD-9 and CPT codes
9. Introduction to Digestive system including ICD-9 and Cpt Codes
10. Introduction to Urinary System and Male Genital System including ICD-9 and CPT codes
11. Female Reproductive system including ICD-9 and CPT codes
12. Edocrine and Nervous System including ICD-9 and CPT codes
13. Eye and Ocular Adnexa, Auditory System including ICD-9 and CPT codes
14. Anesthesia including ICD-9 and Cpt
15. Radiology including ICD -9 and Cpt
16. Pathology and Laboratory including ICD-9 and CPT
17. Evaluation and Management including ICD-9 and CPT
18. Medicine including ICD-9 and CPT
2553895016 | Proper code assignment is determined by | content of the medical record and by the unique rules that governs each code set | 0 | |
2553895017 | What are 3 things that Coder must master | 1. anatomy 2. medical terminology 3. must be detail-oriented | 1 | |
2553895018 | Medical coders assign a code to what | 1. Each diagnosis 2. Service/procedure 3. Supply, using the classification system when applicable | 2 | |
2553895019 | The classification system determines ______ | the amount health care providers will be reimbursed if the patient is covered by Medicare, Medicaid, or other insurance programs using the system | 3 | |
2553895020 | A coder must evaluate the medical record for | 1. completeness and accuracy 2. communicate regularly with physicians and the health care professional to clarify DX or obtain additional PT info. | 4 | |
2553895021 | Techicians who speciallize in coding inpatient hospital services are referred as | 1. Health information coders 2. medical record coders 3. Coder/abstractors 4. Coding Specialist | 5 | |
2553895022 | What is EHR | Electronic health record | 6 | |
2553895023 | Skilled coders may become | consulatants, educators or medical auditors | 7 | |
2553895024 | What is the difference between Hospital and Physican Services | 1. Outpatient coding (physician services)- learning CPT, HCPCS, LEVEL II, ICD-9 CM codes Volume 1 and 2 2. Inpatient coding (Hospital services)- Learning CPT, ICD-9 CM codes Volumes 1,2,3 and MS-DRGS | 8 | |
2553895025 | What is the coder's role in a physician's office | Extremely important for the proper reimbursement of services and the livelihood of the physician | 9 | |
2553895026 | What is the most significant government insurer | Medicare | 10 | |
2553895027 | What is Medicare | Federal health insurance program- Administered by the Center for Medicare & Medicaid Services (CMS) | 11 | |
2553895028 | What is CMS and what does it provide | Center for Medicare & Medicaid Services (CMS) provides coverage for people over the age of 65, blind, or disabled individuals, people with end -stage renal disease | 12 | |
2553895029 | What are the parts of Medicare | Medicare A Medicare B Medicare C Medicare D | 13 | |
2553895030 | What is Medicare Part A? | Covers inpatient hospital care, as well as care provided in skilled nursing facilites, hospice care, and home health care | 14 | |
2553895031 | What is Medicare Part B? | Covers medically necessary doctors' services, outpatient care, other medical services (including some preventive service not covered under Medicare Part A) | 15 | |
2553895032 | Medicare Part B is considered what? | A optional benefit for which the patient must pay a premium and which generally requires a yearly copay | 16 | |
2553895033 | Where is Medicare Part B usually used | Physician offices (Outpatient Facility) | 17 | |
2553895034 | What is Medicare Part C | Combines the benefits of Medicare Part A, Part B, and sometimes Part D. | 18 | |
2553895035 | What is PPO | Preferred Provider Organizations | 19 | |
2553895036 | What is HMO | Health Maintenace Organizations | 20 | |
2553895037 | Which plan covers PPO and HMO | Medicare Part C | 21 | |
2553895038 | What is Medicare Part D | Prescription drug coverage program available to all Medicare beneficiaries. Private companies approved by Medicare provide the coverage. | 22 | |
2553895039 | What is Medicaid | A health insurance assistance program for some low income people (especially children and pregnant women) sponsored by federal and state governments | 23 | |
2553895040 | Medicaid is administered on___________ | a state-by-state basis and coverage varies- although each of the state programs adheres to certain federal guidelines | 24 | |
2553895041 | When is a physican considered a "participating physician" | When contracted with a insurance carrier whether that be a private insurance company or a governmental. | 25 | |
2553895042 | Participating Providers (Par Providers) are required to accept__________________ | the allowed payment amount determined by the insurance carrier as the fee for payment and follow all other guidelines stipulated by the contract | 26 | |
2553895043 | Non-participating Providers (non par) are? | 1. providers not contracted with the insurance carriers 2. not required to make the adjustment | 27 | |
2553895044 | What is a medical record | Documentation or the recording of pertinent facts and observation about an individual's health history, including past and present illness, tests, treatments and outcomes | 28 | |
2553895045 | Medical record chronologically | documents patient care to assist in continuity of care between providers, facilitate claims review and payment | 29 | |
2553895046 | Can a Medical record serve as legal document | YES | 30 | |
2553895047 | All services provided to a patient are_______ | supported and documented in the medical record | 31 | |
2553895048 | What are coders required to do with the medical records? | Read and understand the documentation in the medical record in order to accurately code the services rendered. | 32 | |
2553895049 | What are some different types of services documented in a medical record? | Evaluation and management Operative reports X-Rays | 33 | |
2553895050 | Evaluation and Management services are provided in what standard format | SOAP | 34 | |
2553895051 | What is SOAP documentation? | S- Subjective O-Objective A- Asssessment P-Plan | 35 | |
2553895052 | What is the definition of O in SOAP? | objective-The provider assesses and documents the patient's illness using observation, palpation, auscultation and percussion. Test and other services performed may be documented here as well | 36 | |
2553895053 | What is the definition of A in SOAP? | Assessment-Evaluation and conclusion made by the provider. This is usually where the diagnosis(es) for the services are found | 37 | |
2553895054 | What is the definition of P in SOAP? | Plan-Course of Action. Here, the provider will list eh next steps for the patient, whether it is ordering additional test, or taking over the counter medication | 38 | |
2553895055 | What is a operative report | a document the detail of a procedure performed on a patient | 39 | |
2553895056 | What is medical necessity related to? | whether a procedure or service is considered appropriate in a given circumstance | 40 | |
2553895057 | Generally what is a medically-necessary service? | the least radical service/procedure that allows for effective treatment of the patient's complaint or condition | 41 | |
2553895058 | What is the difference between Covered and Non-covered items | 1. Covered items-services and procedures are covered only when linked to designated, approved diagnosis 2. Non-covered items are deemed "not reasonable or necessary | 42 | |
2553895059 | Medicare and many insurance plan may deny payment for a service that is | not reasonable or necessary according to the Medicare reimbursement rules. | 43 | |
2553895060 | What is HIPAA | Health Insurance Portability and Accountability Act of 1996 | 44 | |
2553895061 | What does the acronym HCPCS stand for | Healthcare Common Procedure Coding System | 45 | |
2553895062 | What does the acronym CPT stand for? | Current Procedural Terminology | 46 | |
2553895063 | When will ICD-10-CM be effective? | October 1, 2013 | 47 | |
2553895064 | What does the acronym NPI stand for and who uses it? | 1. National Provider Indentifier 2. indentifier for providers required on the transactions | 48 | |
2553895065 | What is the acronym PHI stand for? | Protected health information | 49 | |
2553895066 | What is the HIPAA minimum necessary requirement? | The minimum necessary protected health information should be provided to satisfy a particular purpose. if the information is not required to satisfy a particular purpose, it must be withheld. | 50 | |
2553895067 | Identify the following prefix of location : Mes/o | middle | 51 | |
2553895068 | Identify the following prefix of location : Dextr/o | right | 52 | |
2553895069 | Identify the following prefix of location: Sinister/o | left | 53 | |
2553895070 | Identify the following prefix of location : Ab- | away from | 54 | |
2553895071 | Identify the following prefix of location: Ad- | toward; near | 55 | |
2553895072 | Identify the following prefix of location : Dia- | Through; complete | 56 | |
2553895073 | Identify the following prefix of location : Per- | Through | 57 | |
2553895074 | Identify the following prefix of location : Trans- | through; across | 58 | |
2553895075 | Identify the following prefix of time : Ante- | before; forward | 59 | |
2553895076 | Identify the following prefix of time : Pre- | Before, in front of | 60 | |
2553895077 | Identify the following prefix of time : Pro- | Before, in front of | 61 | |
2553895078 | Identify the following prefix of time :Post- | after, behind | 62 | |
2553895079 | Identify the following prefix of number : Mon/o | one; single | 63 | |
2553895080 | Identify the following prefix of number : Bi- | two, twice | 64 | |
2553895081 | Identify the following prefix of number :Tri- | Three | 65 | |
2553895082 | Identify the following prefix of number : Quadri- | Four | 66 | |
2553895083 | Identify the following prefix of number : Poly- | Many, much | 67 | |
2553895084 | What does the term "suffix" mean and where does come from? | 1. to fasten underneath 2. Latin word subfigure | 68 | |
2553895085 | What are some of the common suffixes for diseases and meaning? | 1. -itis-inflammation 2. -oma-tumor 3. -pathy- disease of | 69 | |
2553895086 | identify the following suffix :-gram | a record of data | 70 | |
2553895087 | identify the following suffix: -graph | instrument for recording data | 71 | |
2553895088 | identify the following suffix: -graphy | act of recording data | 72 | |
2553895089 | Identify the following suffix: -meter | Instrument of measuring | 73 | |
2553895090 | Identify the following suffix: -scope | instrument for viewing or examining | 74 | |
2553895091 | identify the following suffix: -scopy | examination of | 75 | |
2553895092 | identify the following suffix: -centesis | puncture, tap | 76 | |
2553895093 | identify the following suffix: -desis | binding, fusion | 77 | |
2553895094 | identify the following suffix: -ectomy | excision, surgical removal | 78 | |
2553895095 | identify the following suffix: -pexy | surgical fixation | 79 | |
2553895096 | identify the following suffix: -plasty | plastic repair, plastic surgery, reconstruction | 80 | |
2553895097 | identify the following suffix: -rraphy | surgical repair, suture | 81 | |
2553895098 | identify the following suffix: -stomy | surgical creation of an opening | 82 | |
2553895099 | identify the following suffix: -tome | Instrument for incising (cutting) | 83 | |
2553895100 | identify the following suffix: -tomy | incision, cutting | 84 | |
2553895101 | Identify the following suffix: - tripsy | crushing | 85 | |
2553895102 | What is the standard body position and what is it? | 1. anatomical position 2. an upright, face-forward position with the arms by the side and palms facing forward. The feet are parallel and slightly apart | 86 | |
2553895103 | What does Anterior or Ventral mean? | toward the front of the body | 87 | |
2553895104 | What does Posterior or Dorsal mean? | toward the back of the body | 88 | |
2553895105 | What does Medial mean? | Towards the mid line of the body | 89 | |
2553895106 | What does Lateral mean? | Toward the side of the body | 90 | |
2553895107 | What does Proximal mean? | nearer to the point of attachment or to the given reference point | 91 | |
2553895108 | what does Distal mean? | farther from the point of attachment or from a given reference point | 92 | |
2553895109 | What does Superior (cranial) mean? | above; toward the head | 93 | |
2553895110 | What does Inferior (caudal) mean? | below; toward the lower end of the spine | 94 | |
2553895111 | what does Superficial (external)? | Closer to the surface of the body | 95 | |
2553895112 | What does Deep (internal)? | Closer to the center of the body | 96 | |
2553895113 | What does Sagittal plane mean? | cuts through the mid line of the body from the front to back and divides the body into right and left sections | 97 | |
2553895114 | What does Frontal (coronal) plane mean? | cuts at a right angle to the mid line cut , from side to side and divides the body into front (anterior) and Back (posterior) sections | 98 | |
2553895115 | What does Transverse (horizontal) plane mean? | cuts horizontally through the body and separates the body into upper (superior) and lower (inferior) sections | 99 | |
2553895116 | The structure of the human body falls into how many categories? | 4 | 100 | |
2553895117 | What are the categories of the human body? | 1. Cells 2. Tissues 3. Organs 4. Systems | 101 | |
2553895118 | What is a cell? | A basic unit of all living things | 102 | |
2553895119 | What are 4 components of a cell and what do they do? | 1. cell membrane- forms the boundary of the cell 2. cytoplasm- make up the body of the cell 3. Nucleus- the small, round structure in the center of the cell 4. Chromosomes- located in the nucleus of the cell; they contain genes determining hereditary characteristics | 103 | |
2553895120 | What are 4 types of tissue and what do they do? | 1. Muscle tissue- produces movement 2. Nerve tissue- conducts impulses to and from the brain 3. Connective tissue - connects and supports various body structures: Adipose (fat) and osseous (bone) 4. Epithelial tissue- found in the skin, lining of the blood vessels, respiratory, intestinal, urinary tracts, and other body systems | 104 | |
2553895121 | What are organs? | two or more kinds of tissue together performing special body functions | 105 | |
2553895122 | What are systems? | a group of organs working together to perform a complex body function | 106 | |
2553895123 | What is cytology? | Study of cells including the formation, structure and function of cells | 107 | |
2553895124 | What does the acronym RNA mean and what does it do? | 1. Ribonucleic acid 2. Contained within the nucleus, is transcribed from DNA by enzymes and plays a crucial role in protein synthesis | 108 | |
2553895125 | What is a gene? | Specific segment of base pairs in chromosomes; functional unit of heredity | 109 | |
2553895126 | What is mitosis? | Cells divide and multiply to form two cells | 110 | |
2553895127 | How many cavities does the body have? | 5 | 111 | |
2553895128 | What are the 5 types of body cavities and what is in the space? | 1. cranial cavity- inside the skull, or cranium, containing the brain 2. Spinal (Vertebral canal)- inside the spinal column containing the spinal cord 3. Thoracic or chest cavity- the space containing the heart, lungs, esophagus, trachea, bronchi, and thymus 4. Abdominal cavity- the space containing the lower portion of the esophagus, the stomach, intestines (excluding the sigmoid colon and rectum) kidneys, liver, gallbladder, pancreas, spleen and ureters 5. Pelvic cavity- the space containing the urinary bladder, certain reproductive organs, part of the large intestine, and the rectum | 112 | |
2553895129 | How many types of membranes are there in the human body? | 5 | 113 | |
2553895130 | What are 5 types of membranes in the human body? | 1. Mucous Membrane 2. Serous Membrane 3. Synovial Membrane 4. Meninges | 114 | |
2553895131 | What is the mucous membrane composed of? | Epithelium overlaying a layer of connective tissue called Lamina Propria | 115 | |
2553895132 | What is the job of epithelium in mucous membranes? | It is involved in absorption and secretion | 116 | |
2553895133 | Where do mucous membranes line? | The interior walls of the organs and tubes opening to the outside of the body | 117 | |
2553895134 | What is the serous membrane composed of? | A layer of simple squamous epithelium overlaying a layer of loose connective tissue. | 118 | |
2553895135 | What does the serous membrane support? | internal organs | 119 | |
2553895136 | What does the serous membrane compartmentalize? | The large cavities to hinder spread of infection | 120 | |
2553895137 | What does the serous membrane line? | Cavities including the thoracic cavity and internal organs | 121 | |
2553895138 | What is synovial membrane composed of? | Connective tissue | 122 | |
2553895139 | What do synovial membranes line? | Joint cavities | 123 | |
2553895140 | What do synovial membranes do? | 1. secrete synovial fluid into the joint cavity 2. lubricates the ends of of bones so they move freely | 124 | |
2553895141 | What are meninges composed of? | 3 connective tissue membranes | 125 | |
2553895142 | Where are meninges found? | Located within the dorsal cavity | 126 | |
2553895143 | What do the meninges do? | They serve as a protective covering | 127 | |
2553895144 | what does the cutaneous membrane consist of | a thin outer layer of stratified squamous epithelium attached to a thicker underlying layer of connective tissue. | 128 | |
2553895145 | What does the cutaneous membrane form? | the outer covering of the body | 129 | |
2553895146 | What is another term for cutaneous membrane? | skin | 130 | |
2553895147 | What is connective tissue? | A number of different tissues with common features. | 131 | |
2553895148 | What is the purpose of connective tissue? | Provides a framework to support the entire body by cartilage and bones | 132 | |
2553895149 | What are the four general groups of connective tissue? | 1. Bone 2. Adipose tissue 3. Cartilage 4. Blood | 133 | |
2553895150 | The largest organ system in the body is comprised of what 3 structures? | 1. skin 2. hair 3. Nail | 134 | |
2553895151 | What is largest organ system called? | integumentary system | 135 | |
2553895152 | The integumentary system structures work together to provide what functions within the body? | 1. Protection from injury, fluid loss, and microorganism 2. Temperature regulation 3. Fluid balance-excretion 4. Sensation | 136 | |
2553895153 | What 2 layers make up the human skin? | 1. Dermis 2. Epidermis | 137 | |
2553895154 | Where is the dermis located? | It is located under the epidermis. | 138 | |
2553895155 | The dermis contains many important structures nourishing and innervating the skin, what are they? | 1. Vessels carrying blood and lymph 2. Nerves and nerve endings 3. Glands 4. Hair follicles | 139 | |
2553895156 | What lies underneath the dermis? | subcutaneous layer | 140 | |
2553895157 | What is another name for subcutaneous layer? | hypodermis | 141 | |
2553895158 | The subcutaneous layer is not considered ______ | a layer of skin. | 142 | |
2553895159 | Subcutaneous tissue is mostly composed of __________ | fatty or adipose tissue plus some areolar tissue | 143 | |
2553895160 | Define cutaneous | Pertaining to the skin | 144 | |
2553895161 | Define dermatology | the study of the skin | 145 | |
2553895162 | Define dermatologist | Physician specializing in diseases of the skin and subcutaneous tissue | 146 | |
2553895163 | Define decubitus | Pressure ulcer/bedsore | 147 | |
2553895164 | Define ecchymosis | Condition in which blood seeps into the skin causing discoloration | 148 | |
2553895165 | Define hypodermic | Pertaining to under the skin | 149 | |
2553895166 | Define intradermal | Pertaining to within the skin | 150 | |
2553895167 | Define jaundice | Yellowness of skin | 151 | |
2553895168 | Define melanin | Pigment giving color to the skin | 152 | |
2553895169 | Define melanoma | Pigmented tumor of the skin | 153 | |
2553895170 | Define pediculosis | Infestation with lice | 154 | |
2553895171 | Define subcutaneous | Pertaining to below the skin | 155 | |
2553895172 | Define tinea | Ringworm; a fungal infection of the skin | 156 | |
2553895173 | Define alopecia | Loss of hair | 157 | |
2553895174 | Define hair papilla | Knoblike indentation at the bottom of the hair follicle containing the bloody supply to hair root | 158 | |
2553895175 | The musculoskeletal system is made up of____________ | a systems of muscles, joints, tendons, ligament | 159 | |
2553895176 | What does the muscloskeletal system provide? | It provides movement, form, strength and protection | 160 | |
2553895177 | Bones are composed of what? | They are composed of rigid connective tissue | 161 | |
2553895178 | Bones provide what functions? | 1. Form the skeleton 2. Provide the chief means of support for the body 3. Provide the mechanism for motion 4. Protect vital organs 5. Serve as a production factory for blood cells 6. Store calicum, phosphorus, and magnesium salts | 162 | |
2553895179 | What are the seven classifications of bones? | 1. Long 2. Tubular 3. Short 4. seasmoid 5. Cuboidal 6. Flat 7. irregular | 163 | |
2553895180 | What is cartilage? | It is a type of flexible connective tisssue | 164 | |
2553895181 | (T/F) Cartilage is nonvascular or has no blood vessels | True | 165 | |
2553895182 | What is cartilage is made of? | It is made of a matrix of chondrocytes, collagen, cells called proteoglycans depending on the type of cartilage | 166 | |
2553895183 | Joints and articulating surfaces provide what? | A connection between two or more parts of skeleton | 167 | |
2553895184 | Joints are classified according to what? | They are classified according to the type of connective tissue at the articulating surfaces | 168 | |
2553895185 | What are the 3 types of joints? | 1. fibrous 2. cartilaginous 3. Synovial | 169 | |
2553895186 | What are the characteristics of synovial joints? | 1. Articular cartilage that covers the bone ends 2. Joint cavity lined with synovial membrane 3. Joint capsule of fibrous connective tissue that surrounds and provides stability of the joint 4. Accessory ligament that give reinforcement | 170 | |
2553895187 | The human skeleton is divided in which 2 parts | 1. Axial 2. Appendicular | 171 | |
2553895188 | What does the axial skeleton consist of? | It consists of the skull, hyoid/cervical spine, ribs, sternum, vertebrae, sacrum | 172 | |
2553895189 | What does the appendicular skeleton consist of | It consistes of the shoulder girdle, pelvic girdle, extremities | 173 | |
2553895190 | What are 3 types of muscles found in the body | 1. Skeletal Muscle 2. Cardiac Muscle 3. Smooth Muscle | 174 | |
2553895191 | What is skeletal muscle? | Also called striated muscle, it is attached to the skeleton by tendons; contraction of skeletal muscle is under voluntary control | 175 | |
2553895192 | What is cardiac muscle? | Also called heart muscle, it contains interlocking involuntary striated muscles as well as smooth muscle, which allow the electrical impulses to pass quickly across the muscle fibers | 176 | |
2553895193 | What is smooth muscle? | Found in the walls of all the hollow organs of the body except the heart. Its condtraction reduces the size of these structures; movement generally is considered involunatry | 177 | |
2553895194 | Define ankylosis | Condition of stiffening of joint | 178 | |
2553895195 | Define arthralgia | pain in joint | 179 | |
2553895196 | Define arthritis | inflammation of joint | 180 | |
2553895197 | Define arthrodesis | It is the surgical fixation of a joint | 181 | |
2553895198 | Define arthropathy | joint disease | 182 | |
2553895199 | Define bursitis | Inflammation of bursa | 183 | |
2553895200 | Define carpal | Petaining to the wrist bones | 184 | |
2553895201 | Define chondral | Pertaining to cartilage | 185 | |
2553895202 | Define chondralgia | Pain around and in the cartilage | 186 | |
2553895203 | Define coccygeal | Pertaining to coccyx | 187 | |
2553895204 | Define connective tissue | Tissue connecting or binding together | 188 | |
2553895205 | Define dactylic | Pertaining to finger or toe | 189 | |
2553895206 | Define femoral | Pertaining to femur or thigh bone | 190 | |
2553895207 | Define iliac | Pertaining to the ilium | 191 | |
2553895208 | Define kyphosis | abnormal curvature of thoracic spine (humpback) | 192 | |
2553895209 | Define lordosis | Abnormal anterior curvature of spine usually lumbar | 193 | |
2553895210 | Define metacarpal | They are the bones of the hand | 194 | |
2553895211 | Define osteoblast | It is a bone-forming cell | 195 | |
2553895212 | Define osteocarcinoma | It is a cancerous tumor of bone | 196 | |
2553895213 | Define osteochondritis | Inflammation of bone and cartilage | 197 | |
2553895214 | Define osteopenia | It is a lower than average bone density, can be a precursor to osteporosis | 198 | |
2553895215 | Define osteoporosis | A disease of bones that leads to reduced bone mass and an increased risk of fracture. | 199 | |
2553895216 | Define osteorrhaphy | The surgical suturing or joining of fragments of broken bone, usually by wiring them together. | 200 | |
2553895217 | Define Patellar | Pertaining to patella | 201 | |
2553895218 | Define Phalangeal | Bones of fingers and toes | 202 | |
2553895219 | Define Scoliosis | Lateral Curvature of spine | 203 | |
2553895220 | Define Sternotomy | surgical incision of sternum | 204 | |
2553895221 | Define Tendonitis | Inflammation of tendon | 205 |