30+ Senior Medical Coder Interview Questions and Answers

Answering questions related to secondary cancers, DM-HTN-CKD linkage scenario, ICD 10 Updates, Code sequencing, and DM manifestations.

• Secondary cancers refer to the spread of cancer from one part of the body to another

• DM-HTN-CKD linkage scenario refers to the relationship between diabetes, hypertension, and chronic kidney disease

• ICD 10 Updates refer to the latest updates in the International Classification of Diseases coding system

• Code sequencing is the process of determining...read more

Immunoglobulin vaccine is coded as J06.9 - Unspecified acute upper respiratory infection

• Code the administration of immunoglobulin as J06.9

• Immunoglobulin is used to treat acute upper respiratory infections

• J06.9 is an unspecified code, so additional information may be needed

Aftercare, follow up, and late effect are different terms used in medical coding to describe the status of a patient's condition.

• Aftercare refers to the care provided to a patient after the treatment of a disease or injury has been completed.

• Follow up refers to the ongoing monitoring of a patient's condition after treatment to ensure that the condition does not recur or worsen.

• Late effect refers to a condition that arises as a result of a previous disease or injury, but which...read more

Major changes in 2021 guidelines include time-based coding and updates to E&M table and classification.

• Time-based coding allows for billing based on the amount of time spent with the patient.

• E&M table now includes 3 elements and further classification for more accurate coding.

• There are now 2 scenarios for determining the level of E&M coding.

• Examples of time-based coding include prolonged services and counseling.

• Examples of updated E&M classification include new patient visits...read more

TKO hydration is coded as 96360.

• TKO stands for To Keep Open and is a type of intravenous fluid administration.

• The code for TKO hydration is 96360.

• This code is used for the initial hour of hydration administration.

• Additional hours of hydration administration are coded as 96361.

Secondary MI refers to a heart attack that occurs as a result of another medical condition or event.

• It is not the primary cause of the heart attack

• Examples include a blood clot or severe anemia

• It is important to identify the underlying cause to prevent future occurrences

GC and GE modifiers are used for different purposes in E&M coding.

• GC modifier is used to indicate that a service was performed for a Medicare patient for whom a screening mammogram was performed within the past 12 months.

• GE modifier is used to indicate that a service was performed for a Medicare patient for whom a screening colonoscopy was performed within the past 10 years.

• GC modifier is used with preventive services, while GE modifier is used with diagnostic services.

• GC mod...read more

The functional unit of the kidney is the nephron. The human body system is the urinary system.

• The nephron is responsible for filtering blood and producing urine in the kidneys

• The urinary system consists of the kidneys, ureters, bladder, and urethra

• It helps regulate blood pressure, electrolyte balance, and red blood cell production

Moderate sedation is a type of sedation where the patient is in a state of depressed consciousness but can still respond to verbal commands.

• Moderate sedation is also known as conscious sedation.

• During moderate sedation, the patient is typically given medications to help them relax and reduce anxiety.

• Patients under moderate sedation may still be able to maintain their own airway and breathe on their own.

• Examples of procedures where moderate sedation is commonly used include co...read more

ICD guidelines for hypertension and diabetes are important for accurate coding.

• ICD guidelines provide specific codes for hypertension and diabetes based on severity and complications.

• For hypertension, ICD-10-CM codes range from I10 to I15 depending on the type and severity of the condition.

• For diabetes, ICD-10-CM codes range from E08 to E13 depending on the type, complications, and control of the condition.

• ICD guidelines also provide coding instructions for related conditions...read more

Pulmonary embolism is a blockage in the pulmonary artery, while DVT is a blood clot in a deep vein.

• Pulmonary embolism occurs when a blood clot travels to the lungs and blocks the pulmonary artery.

• DVT usually occurs in the legs, but can also occur in other parts of the body.

• Both conditions can be life-threatening and require immediate medical attention.

• Symptoms of pulmonary embolism include shortness of breath, chest pain, and coughing up blood.

• Symptoms of DVT include swelling...read more

A trigger point is a sensitive area in the muscles or tissues that can cause pain or discomfort when stimulated.

• Trigger points are often found in areas of muscle tension or overuse.

• They can be felt as knots or tight bands in the muscle.

• Trigger points can be caused by muscle injuries, stress, or poor posture.

• They can refer pain to other areas of the body, known as referred pain.

• Treatment for trigger points may include massage, stretching, or injections.

Echocardiogram is a common diagnostic tool for heart failure.

• Echocardiogram uses sound waves to create images of the heart's structure and function.

• It can show the size of the heart chambers, how well the heart is pumping, and if there are any abnormalities.

• Other diagnostic tools for heart failure include MRI, CT scan, and blood tests.

• Examples: Echocardiogram, MRI, CT scan

To search codes using icd 10 book, follow these pointers:

• Identify the main term of the diagnosis

• Locate the main term in the alphabetic index

• Verify the code in the tabular list

• Use additional codes if necessary

ICD and HCPCS are coding systems used in healthcare to classify medical diagnoses, procedures, and services for billing and statistical purposes.

• ICD stands for International Classification of Diseases and is used to classify medical diagnoses and diseases.

• HCPCS stands for Healthcare Common Procedure Coding System and is used to classify medical procedures and services.

• ICD codes are used for diagnosis coding while HCPCS codes are used for procedure coding.

• ICD codes are updated...read more

The ED Guidelines 2023 are updated guidelines for emergency department coding and billing.

• The ED Guidelines 2023 provide updated information on coding and billing practices specific to emergency department services.

• These guidelines may include changes in documentation requirements, coding conventions, and reimbursement policies.

• Medical coders need to stay updated on the ED Guidelines 2023 to ensure accurate coding and billing for emergency department services.

I have chosen Aquity Solutions for their reputation for accuracy, efficiency, and advanced technology in medical coding.

• Aquity Solutions has a strong reputation for accuracy in medical coding

• They are known for their efficiency in processing medical codes

• Aquity Solutions utilizes advanced technology to streamline the coding process

Diabetes mellitus guidelines provide recommendations for the management and treatment of diabetes.

• Diabetes guidelines focus on monitoring blood sugar levels regularly

• Diet and exercise play a crucial role in managing diabetes

• Medications such as insulin or oral hypoglycemic agents may be prescribed based on individual needs

• Regular check-ups with healthcare providers are important for monitoring progress and adjusting treatment plans

• Guidelines also emphasize the importance of pa...read more

The cardiovascular system is responsible for circulating blood throughout the body, delivering oxygen and nutrients to cells.

• Consists of the heart, blood vessels, and blood

• Heart pumps blood through arteries to deliver oxygen and nutrients to cells

• Veins carry deoxygenated blood back to the heart for reoxygenation

• Capillaries allow for exchange of nutrients and waste products between blood and tissues

I will bring my extensive experience in medical coding, attention to detail, and dedication to accuracy to excel in this role.

• I have X years of experience in medical coding, including proficiency in ICD-10 and CPT coding systems.

• I am detail-oriented and have a proven track record of maintaining accuracy in coding and documentation.

• I am dedicated to staying current on industry regulations and guidelines to ensure compliance and accuracy in coding practices.

• I have strong commun...read more

New updates in E/M and ICD guidelines include changes to documentation requirements and code selection criteria.

• Updates to Evaluation and Management (E/M) guidelines focus on reducing administrative burden and improving patient care.

• Changes to ICD guidelines may include new codes, revisions to existing codes, and updates to coding conventions.

• Medical coders need to stay current with these updates to ensure accurate coding and billing practices.

• For example, the 2021 updates to...read more

I process the chart by reviewing the patient's medical records, assigning appropriate codes to diagnoses and procedures, and ensuring accuracy and compliance.

• Review the patient's medical records to identify diagnoses and procedures

• Assign appropriate medical codes based on documentation

• Ensure accuracy and compliance with coding guidelines and regulations

• Communicate with healthcare providers for clarification or additional information

• Update patient records with coded informatio...read more

CT scan and MRI are common diagnostic tools for CVA.

• CT scan can show bleeding or blockages in the brain

• MRI can provide detailed images of the brain to detect ischemic strokes

• Angiography can help identify blood vessel abnormalities

CVA stands for cerebrovascular accident, commonly known as a stroke.

• CVA is a medical emergency that occurs when blood flow to the brain is interrupted.

• There are two types of CVA: ischemic and hemorrhagic.

• Symptoms of CVA include sudden weakness or numbness in the face, arm, or leg, difficulty speaking or understanding speech, and severe headache.

• Treatment for CVA depends on the type and severity of the stroke, but may include medication, surgery, or rehabilitation.

• Prevention o...read more

HCC guidelines are a set of rules and criteria used in medical coding to determine the severity of a patient's health conditions.

• HCC stands for Hierarchical Condition Categories.

• These guidelines are used in risk adjustment models to calculate payments for Medicare Advantage plans.

• They help identify and prioritize chronic conditions that require ongoing medical attention.

• HCC codes are assigned based on the presence of specific diagnoses and associated factors.

• Documentation mus...read more

Critical care involves the treatment of patients with life-threatening conditions requiring constant monitoring and intervention.

• Critical care is provided in specialized units such as intensive care units (ICUs) or emergency departments.

• Patients in critical care often have severe injuries, illnesses, or complications that require close attention from a multidisciplinary team of healthcare professionals.

• Treatment in critical care may include advanced life support measures, suc...read more

ICD-10 guidelines are regularly updated to ensure accurate coding and billing for medical services.

• ICD-10 guidelines provide a standardized system for coding medical diagnoses and procedures

• Updates to the guidelines are made to reflect changes in medical terminology and technology

• ICD-10 guidelines are used for billing purposes and to track healthcare trends and outcomes

• Examples of recent updates include new codes for COVID-19 and changes to codes for mental health conditions

Body systems refer to the different organs and tissues that work together to perform specific functions in the body.

• There are 11 major body systems, including the circulatory, respiratory, digestive, nervous, and endocrine systems.

• Each system is made up of specific organs and tissues that work together to perform a specific function.

• For example, the respiratory system includes the lungs, trachea, and bronchi, which work together to bring oxygen into the body and remove carbon...read more

Disease conditions and complications refer to the various illnesses and issues that can arise in patients.

• Disease conditions are the primary illnesses or health issues affecting a patient.

• Complications are additional problems that can arise as a result of the primary disease or its treatment.

• Examples include diabetes as a disease condition and diabetic neuropathy as a complication.

• Understanding disease conditions and complications is crucial for accurate medical coding.

The 2022 coding guidelines provide updates and changes to the coding process for medical professionals.

• The guidelines include new codes for COVID-19 vaccines and monoclonal antibodies.

• There are also changes to the evaluation and management codes.

• The guidelines emphasize the importance of accurate and complete documentation.

• Medical coders must stay up-to-date with the latest changes to ensure compliance and accuracy.

ICD-10 coding clinic updates provide guidance on coding complex medical cases.

• ICD-10 coding clinic updates are published quarterly by CMS.

• They provide guidance on coding complex medical cases.

• Updates include new codes, coding guidelines, and coding scenarios.

• Clinic updates help coders stay up-to-date with changes in medical coding.

• Examples of recent updates include guidance on COVID-19 coding and telehealth services.

ICD-10-CM general guidelines are rules for coding medical diagnoses and procedures.

• ICD-10-CM guidelines provide instructions for selecting the correct diagnosis code

• Guidelines also cover sequencing codes, combination codes, and other coding conventions

• Guidelines are updated annually and coders must stay current with changes

• Examples of guidelines include using additional codes for complications and comorbidities

• Guidelines also address coding for newborns, injuries, and poisoni...read more

HCC coding guidelines are used to identify and code chronic conditions for risk adjustment purposes.

• HCC stands for Hierarchical Condition Categories

• HCC coding is used to determine a patient's risk score for Medicare Advantage plans

• HCC codes are based on chronic conditions and their severity

• Documentation must support the HCC code assigned

• HCC coding is updated annually

MDM tables are used in medical coding to document the complexity of medical decision-making.

• MDM tables help coders determine the level of service for evaluation and management (E/M) visits.

• They include elements such as number of diagnoses or management options, amount and complexity of data reviewed, and risk of complications or morbidity.

• Coders use MDM tables to assign the appropriate E/M code based on the documented medical decision-making complexity.

• Examples of MDM tables ...read more

Scenarios of PCS involve assigning codes to procedures performed on patients.

• PCS stands for Procedure Coding System

• Assigning codes accurately is crucial for proper billing and reimbursement

• Examples of PCS scenarios include assigning codes for surgeries, endoscopies, and other medical procedures