Chapter 4 — Quiz

Twenty-four questions. All documentation is constructed.


Multiple choice

1. The primary source of diagnosis codes in an office note is the:

  • A. chief complaint
  • B. review of systems
  • C. assessment
  • D. past medical history

2. A code may be assigned when the documentation supports it:

  • A. in the coder's clinical judgment
  • B. without inference about what the provider meant
  • C. after a verbal confirmation from the provider
  • D. if the order is present

3. A separately dated and signed entry adding new information, with the original entry intact, is a(n):

  • A. amendment
  • B. addendum
  • C. late entry
  • D. attestation

4. A signature attestation statement may not be used to:

  • A. identify the author of an unsigned note
  • B. supply a missing signature on an order
  • C. authenticate an entry
  • D. state that the author furnished the service

5. Cloned documentation is problematic primarily because it:

  • A. is longer than necessary
  • B. may document things that did not happen, obscures change, and creates a detectable pattern
  • C. violates HIPAA
  • D. cannot be electronically signed

6. In the outpatient setting, a diagnosis documented as "probable" is:

  • A. coded as if confirmed
  • B. not coded; code the signs, symptoms, or reason for the encounter
  • C. always queried
  • D. coded with the unspecified code for that condition

7. Which is a leading query?

  • A. One presenting clinical indicators with several reasonable options
  • B. One that names the financial consequence of the answer
  • C. One offering "clinically undetermined"
  • D. One retained in the record

8. The body of an operative report, rather than its heading, must be read because it may disclose:

  • A. the surgeon's name
  • B. conversion to an open procedure, additional procedures, and specimens taken
  • C. the date of service
  • D. the preoperative diagnosis

9. Since 2021, which is not a factor in selecting an office visit level?

  • A. medical decision making
  • B. total time on the date of the encounter
  • C. review of systems
  • D. risk of complications

10. The set of records used to make decisions about individuals, which patients may access under HIPAA, is the:

  • A. legal health record
  • B. designated record set
  • C. audit trail
  • D. superbill

11. A discharge summary alone is insufficient for inpatient coding because:

  • A. it is not signed
  • B. a condition documented in a progress note and omitted from the summary is still documented
  • C. it does not contain diagnoses
  • D. it is written by a resident

12. The correct response to discovering thin documentation while assembling records for an audit is to:

  • A. have the provider add what they remember
  • B. send what you have
  • C. delay the response until documentation improves
  • D. submit only the strongest charts

13. For a drug administered in the office, the documentation must include:

  • A. the drug only
  • B. the drug and route only
  • C. the drug, the dose administered, the route, and any amount discarded
  • D. the manufacturer

14. A patient's HPI states they "were told by another doctor" that they have a condition. The assessment does not mention it. You should:

  • A. code the condition
  • B. not code it — a patient's report of a prior diagnosis is not a provider's diagnosis
  • C. code it as history
  • D. query for permission to code it

15. In an electronic health record, an amended note's audit trail is:

  • A. inaccessible after signing
  • B. discoverable, and part of the record's story
  • C. deleted after 30 days
  • D. relevant only to IT

Short answer

16. State, in one sentence, what a code is a description of.

17. Name the seven steps of the note-reading method, in order.

18. Name the three kinds of inference the code-assignment rule forbids, with an example of each.

19. Give five circumstances that justify a query.

20. Explain why "read the assessment first, then read backward" is better practice than reading a note front to back.

21. (Chapter 1) A coder is told by a manager to select a higher level of service than the documentation supports. Name what the coder is and is not responsible for, and state what protects them.

22. A note documents a knee injection with no laterality stated anywhere. Write the compliant query in one or two sentences.

23. (Chapter 3) A diagnostic test claim is reviewed and the ordering provider's signed order cannot be produced. State the outcome and why clinical appropriateness does not save it.

24. Using Figure 4.2, name the four elements supporting modifier 25 and the section each is in.


Answer key **1.** C. **2.** B. **3.** B. **4.** B — attestation authenticates; it cannot add content and cannot supply a missing signature on an order. **5.** B. **6.** B. **7.** B. **8.** B. **9.** C — review of systems and past/family/social history were removed as level drivers for office visits in the 2021 revision. **10.** B. **11.** B. **12.** B. **13.** C. **14.** B. **15.** B. **16.** A code is a description of what a provider **wrote**, not of what a provider did. **17.** Signature and date → assessment → plan → read backward for support → look for what is missing → look for what is contradicted → decide (code or query). **18.** **From the diagnosis:** a patient with diabetes and chronic kidney disease does not thereby have diabetic kidney disease; the linkage must be documented. **From the order:** a test ordered is not a test performed. **From clinical knowledge:** a coder who knows a procedure necessarily involves a step still needs the step documented. **19.** The record documents a condition in one place and contradicts it in another; a diagnosis is implied by findings and treatment but never stated; specificity the code set requires is absent (laterality, stage, type, acuity, linkage); a procedure's documentation omits an element the code distinguishes; the clinical picture and the documented diagnosis do not fit each other. **20.** Because reading front to back turns the note into a search for a code, and a coder who has already formed a candidate reads the rest of the note as confirmation. Reading the assessment first fixes the provider's conclusion, and everything after it is then read as **evidence for or against** that conclusion rather than as raw material for one. **21.** A coder is responsible for accuracy — that the code reflects the documentation and that the reasoning can be reconstructed. A coder is **not** responsible for the clinical decision, the coverage determination, the practice's revenue, or the content of the note. What protects them: the code is their professional attestation; whistleblower protections exist for reporting; and — practically — documenting the query, the response, and the basis for the code assigned. "My manager told me to" is not a defense. **22.** Model answer: *"The procedure note documents an intra-articular knee injection. The laterality is not specified in the procedure note, the assessment, or the examination for this encounter. Please document which knee was injected."* (No code named. No preferred answer signaled. Answerable either way.) **23.** The claim fails on review. A signed order from the treating provider is a **separate requirement** from the documentation of the service, and its absence is an independent defect. The test may have been entirely appropriate; the requirement is not about appropriateness, and there is no retrospective cure that does not amount to creating the order after the fact. **24.** (1) Three chronic conditions each separately assessed with a plan — **Assessment items 1, 2, 3**. (2) Prescription drug management, three medications reviewed and continued — **medications list plus Assessment 1, 2, 3**. (3) Two laboratory tests ordered with stated clinical reasons — **Assessment 1 and 3**. (4) A new problem with its own history, examination, and independent management decision — **HPI paragraph 2, the musculoskeletal examination, and Assessment 4**. Elements 1 through 3 have nothing to do with the knee, which is the entire argument.