AAPC CIC Practice Test

Answer choices

1. A. The common bile duct carries urine from the kidney to the bladder.
2. B. The common bile duct returns venous blood from the liver to the heart, when the documented anatomy and procedure are interpreted in the context of the complete inpatient medical record.
3. C. The common bile duct carries pancreatic enzymes directly into the stomach.
4. D. The common bile duct carries bile from the liver/gallbladder region toward the duodenum.

Wrong-answer review

• A. The common bile duct carries urine from the kidney to the bladder.: Urine travels through the urinary system, not the common bile duct.
• B. The common bile duct returns venous blood from the liver to the heart, when the documented anatomy and procedure are interpreted in the context of the complete inpatient medical record.: Venous blood does not travel through bile ducts.
• C. The common bile duct carries pancreatic enzymes directly into the stomach.: The common bile duct terminates in the duodenal region, not the stomach.

Answer choices

1. A. Both are always paid under the same MS-DRG.
2. B. Observation is paid under IPPS only when it lasts longer than eight hours, after diagnoses, procedures, and patient status are finalized for submission under the applicable Medicare methodology.
3. C. Observation is generally paid under outpatient rules, whereas qualifying acute inpatient admissions are paid under IPPS/MS-DRG methodology.
4. D. Inpatient payment is selected whenever outpatient payment would be lower.

Answer choices

1. A. Automatically deny the service because more than three CT scans are never covered.
2. B. Seek clinical documentation that explains why another CT is reasonable and necessary for this patient's current condition.
3. C. Approve the service because a physician order alone establishes medical necessity.
4. D. Change the order to a lower-cost study without contacting the treating team.

Answer choices

1. A. Targeted education on the inpatient uncertain-diagnosis rule, correction of affected claims, and follow-up sampling.
2. B. Remove all uncertain diagnoses from inpatient claims to create consistency, during final review under the facility's documented policies for accurate, supported inpatient code assignment.
3. C. Stop auditing the topic because uncertainty is inherently subjective.
4. D. Allow each coder to choose whichever rule they learned first.

Answer choices

1. A. The colon malignancy, the treated acute blood loss anemia, the colon resection, and the blood transfusion.
2. B. Only the malignancy and colon resection because postoperative conditions and transfusions are never coded.
3. C. Only the anemia and transfusion because they occurred later and consumed additional resources.
4. D. The malignancy and anemia, but no procedures because procedures are represented only through the MS-DRG, after the coder reviews the full admission-to-discharge record and finalizes all reportable case elements.

Answer choices

1. A. Percutaneous drainage of the pleural cavity.
2. B. Open surgical removal of a lung lobe.
3. C. Endoscopic visualization of the tracheobronchial airways.
4. D. Radiographic imaging of the coronary arteries.

Answer choices

1. A. A second code may be required to fully describe the condition, but the 'code also' note itself does not establish sequencing.
2. B. The code named in the note must always be sequenced first.
3. C. The code named in the note must always be sequenced second.
4. D. The note is optional and may be ignored whenever one code is more specific.

Answer choices

1. A. The letters I and O are excluded from the PCS character set to avoid confusion with 1 and 0.
2. B. I and O are reserved for future root operations.
3. C. I and O may appear only in the qualifier position.
4. D. I and O are used only in the ancillary sections.

Answer choices

1. A. Code only the patient's respiratory symptoms because two uncertain diagnoses cancel each other out, after the coder evaluates the diagnosis in context of the full encounter and final provider statements.
2. B. Select whichever diagnosis produces the higher MS-DRG because both are uncertain.
3. C. Code the comparative/contrasting diagnoses as if confirmed and sequence according to the circumstances; if no sequencing direction exists, either may be first.
4. D. Query is mandatory in every case involving two comparative inpatient discharge diagnoses.

Answer choices

1. A. The sample is risk-focused rather than representative, so its error rate cannot automatically be generalized to the entire claim population.
2. B. There is no problem because high-paying DRGs are always representative.
3. C. The audit is invalid because risk-based sampling is prohibited.
4. D. The audit must include exactly the same number of every DRG to be valid, after the complete health record is reviewed under the facility's documented compliance and claim-correction process.