Medical Coding Training: CPC
2019Medical Coding Training: CPC Practical Application Workbook—Answer Key
DisclaimerThis course was current when it was published. Every reasonable effort has been made to assure the accuracy of the informationwithin these pages. The ultimate responsibility lies with readers to ensure they are using the codes, and following applicableguidelines, correctly. AAPC employees, agents, and staff make no representation, warranty, or guarantee that this compilation ofinformation is error-free, and will bear no responsibility or liability for the results or consequences of the use of this course. Thisguide is a general summary that explains guidelines and principles in profitable, efficient healthcare organizations.US Government RightsThis product includes CPT , which is commercial technical data and/or computer data bases and/or commercial computersoftware and/or commercial computer software documentation, as applicable, which was developed exclusively at private expenseby the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify,reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995),as applicable, for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provision of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and anyapplicable agency FAR Supplements, for non-Department of Defense Federal procurements.AMA DisclaimerCPT copyright 2018 American Medical Association. All rights reserved.Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part ofCPT , and the AMA is not recommendation their use. The AMA does not directly or indirectly practice medicine or dispensemedical services. The AMA assumes no liability for data contained or not contained herein.CPT is a registered trademark of the American Medical Association.Regarding HCPCS Level IIHCPCS Level II codes and guidelines discussed in this book are current as of press time. The 2017 code set for HCPCS Level IIwere unavailable when published.Clinical Examples Used in this BookAAPC believes it is important in training and testing to reflect as accurate a coding setting as possible to students and examinees.All examples and case studies used in our study guides, exams, and workbooks are actual, redacted office visit and procedurenotes donated by AAPC members.To preserve the real-world quality of these notes for educational purposes, we have not re-written or edited the notes to thestringent grammatical or stylistic standards found in the text of our products. Some minor changes have been made for clarity orto correct spelling errors originally in the notes, but essentially, they are as one would find them in a coding setting. 2018 AAPC2233 South Presidents Dr. Suites F-C, Salt Lake City, UT 84120800-626-2633, Fax 801-236-2258, www.aapc.comUpdated 10102018. All rights reserved.ISBN 978-1-626886-667CPC , CIC , COC , CPC-P , CPMA , CPCO , and CPPM are trademarks of AAPC.ii2019 Medical Coding Training: CPC Practical Application Workbook—Answer KeyCPT copyright 2018 American Medical Association. All rights reserved.
ContentsChapter 1The Business of Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Chapter 2Medical Terminology and Anatomy Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Chapter 3Introduction to ICD-10-CM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Chapter 4ICD-10-CM Coding Chapters 1–11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Chapter 5ICD-10-CM Coding Chapters 12–21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Chapter 6Introduction to CPT , Surgery Guidelines, HCPCS Level II, and Modifiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Chapter 7Integumentary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33Chapter 8Musculoskeletal System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Chapter 9Respiratory, Hemic, Lymphatic, Mediastinum, and Diaphragm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57Chapter 10Cardiovascular System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67Chapter 11Digestive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Chapter 12Urinary System and Male Genital System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93Chapter 13Female Reproductive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105CPT copyright 2018 American Medical Association. All rights reserved.www.aapc.comiii
Chapter 14Endocrine and Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117Chapter 15Eye and Ocular Adnexa, Auditory Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131Chapter 16Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143Chapter 17Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155Chapter 18Pathology and Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169Chapter 19Evaluation and Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181Chapter 20Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201iv2019 Medical Coding Training: CPC Practical Application Workbook—Answer KeyCPT copyright 2018 American Medical Association. All rights reserved.
Chapter1The Business of MedicineExercise 11.What type of profession, other than coding, might a skilled coder enter?Answer: Consultants, educators, medical auditors2.What is the difference between outpatient and inpatient coding?Answer: Outpatient coders focus on assigning CPT , HCPCS Level II, and ICD-10-CM codes. They work in provideroffices, outpatient clinics and facility outpatient departments. Outpatient facility coders also work with ambulatorypayment classifications (APCs).Inpatient hospital coding focuses on a different subset of skills, where coders work with ICD-10-CM and ICD-10-PCS.These coders also assign Medicare severity-diagnosis related groups (MS-DRGs) for reimbursement. Outpatient codersusually have more interaction throughout the day and must communicate well with providers; inpatient coders tend tohave less interaction throughout the day.3.What is a mid-level provider?Answer: Mid-level providers include physician assistants (PA) and nurse practitioners (NP). Mid-level providers are knownalso as physician extenders because they extend the work of a physician.4.Discuss the different parts of Medicare and what each program covers.Answer:llllllllMedicare Part A helps to cover inpatient hospital care, as well as care provided in skilled nursing facilities, hospicecare, and home healthcare.Medicare Part B covers two types of services: 1) Medically necessary provider services that are needed to diagnose ortreat a medical condition and that meet accepted standards of medical practice; and 2) preventive services to preventillness or detect it at an early stage. Medicare Part B is an optional benefit for which the patient pays a premium, anannual deductible and generally has a 20% co-insurance except for preventive services covered under healthcare law.Coders working in provider offices code mainly Medicare Part B claims.Medicare Part C, also called Medicare Advantage, combines the benefits of Medicare Part A, Part B and sometimesPart D. The plans are managed by private insurers approved by Medicare and may include preferred providerorganizations, health maintenance organizations, etc.Medicare Part D is a prescription drug coverage program available to all Medicare beneficiaries for a fee. Privatecompanies approved by Medicare provide the coverage.CPT copyright 2018 American Medical Association. All rights reserved.www.aapc.com1
The Business of Medicine5.Chapter 1Evaluation and management (E/M) services are often provided in a standard format. One such format is SOAP notes.What does SOAP represent?Answer:S—Subjective — The patient’s statement about his or her health, including symptoms.O— Objective — The provider assesses and documents the patient’s illness using observation, palpation, auscultation, andpercussion. Tests and other performed services may be documented here as well.A— Assessment — Evaluation and conclusion made by the provider. This is usually where the diagnosis(es) for the servicesare found.P— Plan — Course of action. Here, the provider will list the next steps for the patient, whether ordering additional tests,taking over the counter medications, etc.6.What are five tips for coding operative (OP) reports?Answer:1.Diagnosis code reporting — Use the post-operative diagnosis for coding unless there are further defined diagnoses oradditional diagnoses found in the body or op report findings. If a pathology report is available, use the findings from thepathology report for the diagnosis.2.Start with the procedures listed — One way to start the research process quickly is by focusing on the procedures listedin the header. Read the note in its entirety to verify the procedures performed. Procedures listed in the header may not belisted correctly and procedures documented within the body of the report may not be listed in the header at all; however, itis a place to start.3.Look for key words — Key words may include locations and involved anatomical structures, surgical approach, proceduremethod (debridement, drainage, incision, repair, etc.), procedure type (open, closed, simple, intermediate, etc.), size andnumber, and the surgical instruments used during the procedure.4.Highlight unfamiliar words — Research for understanding.5.Read the body — All reported procedures should be documented within the body of the report. The report’s body mayindicate a procedure was abandoned or complicated, possibly indicating the need for a different procedure code orreporting of a modifier.7.What is medical necessity and what tool can you refer to for the medical necessity of a service?Answer: The term medical necessity relates to whether a procedure or service is considered appropriate in a given circumstance. Tools to determine medical necessity include national coverage determinations (NCDs), local coverage determinations (LCDs), and commercial payer policies.8.What are common reasons Medicare may deny a procedure or service?Answer:llllll2Medicare doesn’t pay for the procedure/service to treat the patient’s condition.Medicare doesn’t pay for the procedure/service as frequently as proposed.Medicare doesn’t pay for experimental procedures/services.2019 Medical Coding Training: CPC Practical Application Workbook—Answer KeyCPT copyright 2018 American Medica
Clinical Examples Used in this Book AAPC believes it is important in training and testing to reflect as accurate a coding setting as possible to students and examinees. All examples and case studies used in our study guides, exams, and workbooks are actual, redacted office visit and procedure notes donated by AAPC members.
CPC builds upon the lessons learned from the CPC initiative, CMS’ largest investment in primary care to date. Notable changes include: - CPC CPC Track 1 CPC Track 2 Size 7 Regions; 500 practices 14 Regions; 2500 practices 14 Regions; 2500 practices Duration 4 y (2012-2016) 5 y (2017-2021) 5 y
Amstrad CPC 88 Dragon's Lair 2 - Escape from Singe's Castle (Europe) Amstrad CPC 89 Duel, The - Test Drive 2 (UK) (1989) Amstrad CPC 90 Edge Grinder (Europe) (Unl) Amstrad CPC 91 Elevator Action (UK) (1986) Amstrad CPC 92 Elite (F) (1986) Amstrad CPC 93 Erik The Viking (UK) (1985)
Candidates who wish to gain a CPC can either study in their own time or attend a training course at a CPC training centre. OCR does not endorse CPC training centres for the delivery of CPC training programmes although OCR approves centres to offer and invigilate the examination sessions. CPC
Technology Fellow Auriemma; William Diversified CPC International, Inc. President and CEO Burks; Dave Diversified CPC International, Inc. Executive Vice President Dowd; John Diversified CPC International, Inc. VP Corporate Marketing Frauenheim; Bill Diversified CPC International, Inc. Vice President, Operations Manner; Brock Diversified CPC .
ICD-10 will Change Everything Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, COBGC, CEMC, CDERC, CCS-P President & CEO. AAPC. Author of many AMA publications including: ICD-10 Implementation Guide, Make the Transition Manageable,” AMA Press
Medical Terminology: HLTH -8010A* or HHSC -1700 Microsoft Office 2016: CSFT -8063 or ITCS-1010. 2. Coding courses: Medical Coding I : HLTH -8102A Medical Coding II: HLTH -8103A. 1 Exam Prep course: CPC Study Night HLTH-8074 5.5 Hour proctored exam * Articulates to credit HHSC-1700 at Macomb via formal request
Private Pilot Tests CPC Practice Knowledge Test 1 8-A-1 CPC Practice Knowledge Test 2 8-A-23 Private Pilot Legends And Figures FIG. Instrument Rating Tests CPC Practice Knowledge Test 1 8-B-1 CPC Practice Knowledge Test 2 8-B-21 Instrument Rating Legends And Figures FIG. C
ICD-10 will Change Everything Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, COBGC, CEMC, CDERC, CCS-P President & CEO AAPC Author of many AMA publications including: ICD-10 Implementation Guide, Make the Transition Manageable,‖ AMA Press 2 Overview of ICD-10
