Medical Coding Certification Exam Preparation 2nd Edition By Stewart – Exam Bank

Medical Coding Certification Exam Preparation 2nd Edition By Stewart – Exam Bank

Medical Coding, 2e (Stewart)
Chapter 6 Anesthesia

1) The word “anesthesia” means:
A) Without feeling
B) Without movement
C) Without sensation
D) Without response

2) The type of anesthesia used is determined by the:
A) surgical procedure and condition of the patient
B) surgical procedure and specialty of the surgeon
C) condition of the patient and age of the patient
D) condition of the patient and availability of nurse anesthetists

3) The name of the physician whose specialty is to administer medication to achieve loss of sensation is:
A) Pharmacologist
B) Anesthetist
C) Anesthesiologist
D) Anesthetizer

4) The acronym for the American Society of Anesthesiologists is:
A) AmSAn
B) ASA
C) AmSA
D) ASAT

5) The three components of the reimbursement formula of time-based general anesthesia services are:
A) Total time of anesthesia care, modifying factors, and physician specialty
B) Base units, total time of anesthesia care, and modifying factors
C) Modifying factors, total time of surgery, and basic units
D) Basic units, total time of surgery, and physician specialty

6) What is the appropriate abbreviation for base units?
A) B
B) BU
C) BaU
D) Bun

7) (T) is the abbreviation for:
A) Total time of anesthesia care
B) Total modifying factors
C) Total base units
D) Total time of procedure

8) RVG stands for:
A) Reasonable Value and Guidelines
B) Relative Value Guidelines
C) Reasonable Value Guide
D) Relative Value Guide

9) The units of value which are the beginning of the formula for assigning a cost/revenue value to an anesthesia service are:
A) relative value guide
B) qualifying circumstances
C) medical direction
D) base unit

10) A female patient presents for scheduled otoscopy (00124), tympanotomy (00126) and middle ear biopsy (00120). The Base Unit Value for each code is as follows: 00120 – 5, 00124 – 4, 00126 – 4. Which of the following is the most appropriate code assignment to report the anesthesia required for the above procedures?
A) 00120, 00124, and 00126 may be reported
B) 00120 and 00124 may be reported
C) 00120 only may be reported
D) 00126 only may be reported

11) For anesthesia services, time begins when:
A) The patient is identified in the pre-operating room
B) The patient is being prepared for anesthesia by the anesthesiologist
C) The patient is determined to be successfully under anesthesia administered by the anesthesiologist
D) The patient’s surgical procedure has begun

12) For anesthesia services, time ends when:
A) The anesthesiologist determines the patient is successfully under anesthesia
B) The patient’s surgical procedure has ended
C) The surgeon is no longer attending the patient
D) The anesthesiologist is no longer attending the patient

13) The component of the reimbursement formula that begins when the patient is being prepared for anesthesia and ends when the patient is no longer being attended by the anesthesiologist is:
A) Time
B) Base unit
C) Relative Value Unit
D) CPT code

14) Per ASA recommendation, ________ minutes equal 1 unit:
A) 30
B) 15
C) 25
D) 35
15) Reporting time as well as base units for the primary anesthesia service allows for capture of what?
A) Additional work provided by the anesthesiologist
B) Any modifying circumstances that would signify an increase in reimbursement
C) Additional work provided by the surgeon
D) Physical status and qualifying circumstances

16) Physical status and Qualifying Circumstances are all of the following except:
A) Two types of modifiers
B) Two categories of modifying factors
C) Modifying factors that have units of value assigned
D) Modifiers that extend the time of anesthesia services

17) The formula B + T + M is known as the:
A) base unit conversion
B) relative value unit
C) anesthesia reimbursement formula
D) physician reimbursement formula

18) Modifiers that are used with all anesthesia procedure codes to rank the physical condition of the patient and the level of anesthesia complexity inherent to each ranking are:
A) physical-status modifiers
B) status modifiers
C) post-anesthesia care units
D) qualifying circumstances

19) The following is the correct range of physical-status modifiers that adds additional units to an anesthesia code:
A) P1-P6
B) P3-P6
C) P1-P5
D) P3-P5

20) Physical-status modifier P6 signifies:
A) A patient with severe systemic disease
B) A moribund patient who is not expected to survive without the operation
C) A declared-brain-dead patient whose organs are being removed for donor purposes
D) A normal, healthy patient

21) A declared-brain-dead patient whose organs are being removed for donor purposes is represented by physical-status modifier:
A) P1
B) P2
C) P5
D) P6

22) A normal, healthy patient is represented by physical-status modifier:
A) P1
B) P2
C) P3
D) P4

23) Physical-status modifier P1 signifies:
A) A declared-brain-dead patient whose organs are being removed for donor purposes
B) A patient with mild systemic disease
C) A patient with severe systemic disease
D) A normal, healthy patient

24) Physical-status modifier P2 signifies:
A) A patient with severe systemic disease
B) A patient with mild systemic disease
C) A normal, healthy patient
D) A declared-brain-dead patient whose organs are being removed for donor purposes

25) A patient with mild systemic disease is represented by physical-status modifier:
A) P2
B) P3
C) P4
D) P5

26) A patient with severe systemic disease is represented by physical-status modifier:
A) P2
B) P3
C) P4
D) P5

27) Physical-status modifier P3 represents:
A) A patient with severe systemic disease
B) A patient with mild systemic disease
C) A normal, healthy patient
D) A declared-brain-dead patient whose organs are being removed for donor purposes

28) A patient with severe systemic disease that is a constant threat to life is denoted by using the physical-status modifier:
A) P6
B) P5
C) P4
D) P3

29) Physical-status modifier P4 represents which level of severity:
A) A patient with severe systemic disease
B) A patient with mild systemic disease
C) A patient with severe systemic disease that is a constant threat to life
D) A declared-brain-dead patient whose organs are being removed for donor purposes

30) Physical-status modifier P5 signifies which of the following about the patient:
A) A moribund patient who is not expected to survive without the operation
B) A patient with mild systemic disease
C) A patient with severe systemic disease
D) A declared-brain-dead patient whose organs are being removed for donor purposes

31) A moribund patient who is not expected to survive without the operation is denoted by using physical-status modifier:
A) P6
B) P5
C) P4
D) P3

32) Which of the following physical-status modifiers do not add any additional units to an anesthesia code to which it/they are appended?
A) P1 and P5
B) P2-P5
C) P1, P2, and P5
D) P1, P2, and P6

33) Codes used to report challenging circumstances in which anesthesia may be provided are called:
A) Physical-status modifiers
B) Qualifying-circumstance modifiers
C) Anesthesia-specific modifiers
D) Medical direction modifiers

34) Qualifying-circumstance modifiers can be used to describe all of the following scenarios except:
A) extreme patient age
B) emergency situations in which a history of previous anesthesia response is not available
C) conditions under which a surgical procedure is performed
D) amount of surgeries performed at one time

35) A condition defined as existing when delay in treatment would lead to significant increase in the threat of life or body part is called a(n):
A) emergency
B) ambulatory circumstance
C) triage
D) highly-stressful circumstance

36) Qualifying-circumstance modifier 99100 is defined as:
A) Anesthesia for patient of extreme age: younger than 1 year old and older than 70
B) Anesthesia complicated by utilization of total body hypothermia
C) Anesthesia complicated by utilization of controlled hypotension
D) Anesthesia complicated by emergency conditions

37) In the definition of qualifying-circumstance modifier 99100, “extreme age” is specified as:
A) Less than 6 months old and older than 70
B) Less than 1 year old and older than 75
C) Less than 1 year old and older than 70
D) Less than 6 months old and older than 75

38) Qualifying-circumstance modifier 99100 will add ________ additional units to an anesthesia CPT code:
A) 1
B) 2
C) 4
D) 5

39) The following qualifying-circumstance modifier(s) add(s) one (1) additional unit to an anesthesia CPT code:
A) 99140
B) 99135
C) 99140 and 99100
D) 99100

40) Qualifying-circumstance modifiers 99116 and 99135 add ________ additional units to an anesthesia CPT code.
A) 6
B) 5
C) 4
D) 8

41) Anesthesia complicated by utilization of total body hypothermia is described by qualifying-circumstance modifier:
A) 99140
B) 99116
C) 99135
D) 99100

42) Qualifying-circumstance modifier 99116 describes anesthesia that is complicated by what condition being induced in the patient?
A) Hypotension
B) Hyperthermia
C) Hypothermia
D) Hypertension

43) Qualifying-circumstance modifier 99116 adds how many additional units to an anesthesia code when appended?
A) 4
B) 5
C) 3
D) 6

44) 99135 is a qualifying-circumstances modifier that describes:
A) Anesthesia for patient of extreme age: younger than 1 year old and older than 70
B) Anesthesia complicated by utilization of total body hypothermia
C) Anesthesia complicated by utilization of controlled hypotension
D) Anesthesia complicated by emergency conditions

45) Qualifying-circumstances modifier 99135 adds ________ additional units to the anesthesia CPT code to which it is appended:
A) 3
B) 5
C) 2
D) 1

46) Qualifying-circumstance modifier 99135 describes anesthesia that is complicated by what condition being induced in the patient?
A) Hypotension
B) Hyperthermia
C) Hypothermia
D) Hypertension

47) Qualifying-circumstances code 99140 is used to describe situations that are:
A) emergencies
B) not otherwise reportable due to third-party payer guidelines
C) not covered by Medicare/Medicaid
D) affected by the availability of an appropriate specialist

48) 99140 is the only qualifying-circumstances modifier that adds ________ additional units to the anesthesia CPT code to which it is appended:
A) 4
B) 3
C) 2
D) 5

49) A fourteen-year-old patient is brought to the Emergency Room by his mother after his foot was caught in the lawnmower blade while mowing the yard. Upon emergent examination, it was determined that reattachment surgery had to be performed immediately on digits T3 and T4 to prevent loss of the digits. The anesthesia provided for this service would be described by the appropriate anesthesia CPT code and qualifying-circumstance modifier:
A) 99100
B) 99116
C) 99135
D) 99140

50) A seventy-five-year-old patient is identified in the pre-op room and brought to the surgical suite for bypass coronary artery surgery. The anesthesia provided for this service would be described by the appropriate anesthesia CPT code and qualifying-circumstance modifier:
A) 99100
B) 99116
C) 99135
D) 99140

51) An otherwise-healthy five-year-old patient is identified in the pre-op area and brought back for surgical tonsillectomy. What physical-status modifier(s) and/or qualifying-circumstance modifier(s) would be used?
A) P6 and 99100
B) P1 and 99100
C) P1, P6, and 99100
D) P1

52) The acronym for a Certified Registered Nurse Anesthetist is:
A) CRNA
B) CNA
C) CRNAN
D) CRU

53) Modifiers which identify the provider or level of supervision provided by an anesthesiologist are located in:
A) CPT (HCPCS Level I)
B) HCPCS Level II
C) Appendix A
D) Tabular List

54) A CRNA is:
A) An assistant to the specialty surgeon
B) A nurse anesthetist acting under the direction of an anesthesiologist
C) An anesthesiologist who performs expanded duties
D) Reimbursed at a higher rate than an anesthesiologist

55) To identify that the service was provided by an anesthesiologist, a coder should append modifier:
A) QK
B) QY
C) AA
D) AD

56) There are ________ anesthesia-specific modifiers:
A) 4
B) 6
C) 7
D) 5

57) CRNA service without medical direction by a physician is indicated by modifier:
A) QX
B) QZ
C) QT
D) QY

58) Anesthesia-specific modifier AA is defined as:
A) Medical direction of 2, 3, or 4 concurrent anesthesia procedures involving qualified individuals
B) Medical supervision by a physician; more than 4 concurrent anesthesia procedures
C) CRNA service with medical direction by a physician
D) Anesthesia services performed personally by an anesthesiologist

59) A forty-six-year-old patient is waiting to be induced into anesthesia. Two CRNAs were originally scheduled to administer anesthesia to this patient, under supervision of an anesthesiologist. The CRNAs are still attending to another patient and the supervising anesthesiologist has to administer anesthesia for this patient. This would be reported using the following anesthesia-specific modifier:
A) AD
B) QK
C) QY
D) AA

60) When an anesthesiologist is supervising the concurrent anesthesia procedures of 2, 3, or 4 procedures involving qualified individuals it is denoted by using:
A) A physical-status modifier
B) A qualifying-circumstances modifier
C) A HCPCS Level II code
D) An anesthesia-specific HCPCS Level II modifier

61) When an anesthesiologist is supervising the concurrent anesthesia procedures of 2, 3, or 4 procedures involving qualified individuals it is denoted by using:
A) AD
B) QX
C) QZ
D) QK

62) Anesthesia-specific modifier QY signifies:
A) Medical direction of one CRNA by an anesthesiologist
B) Medical direction of 2, 3, or 4 concurrent anesthesia procedures involving qualified individuals
C) Medical supervision by a physician; more than 4 concurrent anesthesia procedures
D) CRNA service with medical direction by a physician

63) One remaining surgical procedure is scheduled in the surgical suite for the day. The attending anesthesiologist prepares the day’s documentation while remaining available for one CRNA that provides anesthesia administration for today’s last case. When billing for this anesthesia service, the coder should use modifier ________ to describe the anesthesiologist’s role in providing anesthesia.
A) AD
B) AA
C) QY
D) QK

64) Medical direction, as it applies to anesthesia services, is:
A) CRNA formulation of an anesthesia treatment plan
B) Preparing a surgical site for tracheotomy carried out by a qualified provider
C) Physician involvement with and direction of anesthesia carried out by a qualified provider
D) Formal treatment planning between the surgical provider and anesthesia provider

65) All of the following are requirements of Medical Direction except:
A) Attend to patients throughout the entirety of the surgical procedure
B) Remain physically present and available for emergencies
C) Set the anesthesia plan
D) Complete preanesthetic examination and evaluation

66) Attending to patients during the most demanding procedures of the anesthesia plan is a component of:
A) Airway management
B) Post-anesthesia care
C) Medical direction
D) Monitored anesthesia care

67) Endotracheal through existing tracheotomy, or via a mask, or nasal cannula are examples of the type of method of:
A) Airway management
B) Post-anesthesia care
C) Medical direction
D) Monitored anesthesia care

68) Intubation is:
A) Placement of a flexible tube into the trachea to maintain an open airway or allow for ventilation of the lungs during anesthesia
B) Removal of a flexible tube previously placed in the trachea for airway management
C) The unit where the patient is monitored by a nurse specializing in postsedation care
D) Physician involvement with and direction of anesthesia carried out by a qualified provider

69) Removal of a flexible tube previously placed in the trachea for airway management is:
A) Intubation
B) Extubation
C) Medical direction
D) Moderate/Conscious sedation

70) The abbreviation for postanesthesia care unit is:
A) PCU
B) PTACU
C) PACU
D) PC Unit

71) The end of anesthesia time, from a coding perspective, is:
A) The final, significant surgical procedure performed during the surgical case
B) Transfer of the patient to the inpatient hospital room
C) Transfer of the patient to the post-anesthesia care unit
D) Extubation of the patient

72) The three types of sedation are:
A) general, airway management, and monitored
B) moderate (conscious), general, and monitored
C) general and monitored
D) conscious and general

73) The two types of anesthesia sedation services reported with an Anesthesia section code of the CPT manual are:
A) general and monitored
B) general and moderate (conscious)
C) monitored and conscious
D) general and endotracheal

74) The key to understanding when to report general anesthesia and when to report MAC is knowing:
A) The specialty of the anesthesia care provider
B) The extent of the surgical procedure performed
C) The modifiers that apply to the circumstances of the service
D) The patient’s airway management

75) The surgeon performing the surgical procedure typically also performs this type of anesthesia:
A) Moderate (conscious) sedation
B) General anesthesia
C) Monitored anesthesia care
D) Surgical anesthesia

76) Monitored anesthesia care is when:
A) The patient’s airway is managed by a qualified provider
B) The qualified provider remains bedside throughout the surgical procedure
C) An anesthesiologist provides the service
D) The patient manages his/her own airway throughout the procedure

77) This method of anesthesia requires that the patient’s airway is managed by the anesthesiologist or qualified person providing the service:
A) Monitored anesthesia care
B) Qualified anesthesia services
C) General anesthesia
D) Conscious sedation

78) Intraoperatively, a forty-two-year-old female patient’s anesthesia service was converted from MAC to general anesthesia due to her inability to control her airway. This service is coded as:
A) MAC with the appropriate physical status and qualifying-circumstance modifiers
B) General anesthesia with the appropriate physical status and qualifying-circumstance modifiers
C) Oxygen administration only
D) MAC with oxygen administration

79) All forms of sedation – moderate (conscious), general, and monitored anesthesia – will have documentation of ________ during anesthesia.
A) Catheterization
B) Hypotension utilization
C) Oxygen status
D) Unplanned activity

80) Conscious, or moderate sedation codes are located in this section of the CPT manual:
A) Medicine
B) Anesthesia
C) Surgery
D) Appendix C

81) MAC-specific modifier QS indicates:
A) MAC airway management
B) MAC service
C) MAC for a patient who has a history of a severe cardiopulmonary condition
D) MAC service with use of hypothermic induction

82) MAC for a deep, complex, complicated, or markedly invasive surgical procedure is represented by modifier:
A) QS
B) G7
C) G8
D) G9

83) MAC for a patient who has a history of a severe cardiopulmonary condition is communicated by using modifier:
A) QT
B) QS
C) G8
D) G9

84) All of the following are considered part of the work of an anesthesia service and are not coded separately except:
A) Usual monitoring services
B) Insertion of Swan-Ganz
C) Preoperative and postoperative visits
D) Administration of fluids and/or blood

85) Preoperative and postoperative visits:
A) May be coded separately from a routine anesthesia service
B) Are only coded when procedures are performed for postoperative pain management
C) Do not have separate CPT codes in the manual
D) Are typically not coded separately from a routine anesthesia service

86) All of the following are not considered to be part of an anesthesia service and should be billed and coded in addition to the anesthesia service documented except:
A) Administration of fluids and/or blood
B) Insertion of central venous catheter
C) Insertion of an intra-arterial catheter
D) Procedures performed for postoperative pain management

87) The main term for anesthesia services in the CPT manual is:
A) Sometimes Anesthesia, sometimes the body region
B) Always the body region
C) Always Anesthesia
D) Sometimes the body region, sometimes the type of anesthesia given