question

an indirect hernia occurswhen the protrusion is through the inguinal ring into the inguinal canal; this is different from a direct hernia. True or False.

answer

true

question

atherectomy is the removal of plaque from the vessel. True or False.

answer

true. aherectomy uses same code as PTCA

question

deep vein thrombosis (dvt) is a blood clot that forms deep ina vein, usually in the leg or hip. T or F?

answer

True

question

spinal stenosis is the widening or ruptureof the spinal cord. T or F?

answer

false

question

in the diagnostic statement "diabetic foot ulcer" what condition should be assigned as the principal diagnosis? a. the ulcer b. the diabetes mellitus c. either condition d. the circumstances of the admission will determine which condition is classified as the principal diagnosis

answer

b. diabetes mellitus is the principal diagnosis a cause and effect relationship must be established for that rule to apply (manifestation of the underlying disease) 707.15 is the diabetic foot ulcer and there is a note that states: code if applicable any causal condition first which in this case is diabetes mellitus

question

select the correct code for diverticulosis of the colon a. 562.11 b. 562.00 c. 562.10 d. 562.12

answer

c. 562.10 diverticula, colon

question

a patient is admitted from a nursing home with cough and fever. The pat. has ahistory of dysphagia and hemiparesis due to previous CVA. Sputum cultures reveal Pseudomonas. Patient went into acute respiratory failure after admission. discharge diagnosis: Pseudomonas pneumonia. a. 780.60, 482.1, 48.20, 438.82 b. 482.1, 518.81, 438.20, 438.82 c. 482.1, 518.81, 438.20, 787.20, 438.82

answer

c. 482.1 (pneumonia due to pseudomonas), 518.81 (acute respiratory failure), 438.20 (late effect hemiplegia affecting unspecified side), 787.20 (dysphagia unspecified ..type of dysphagia), 438.82 (late effect of cerebrovasculara disease)

question

a patient is admitted for a total hip replacement b/c of osteoarthritis of the right hip. Patient has had a left hip replacement. What codes are applicable? a. 714.0, V43.65, 00.86 b. 715.95, V43.64, 81.51 c. 715.35, V43.64, 81.51

answer

c. 715.35 (osteoarthritis), V43.64 (status code: organ or tissue replaced by other means, joint V43.64 hip) 81.51 (total hip replacement)

question

a patient is admitted with Crohn's of the large bowel. A right hemicolectomy is performed with temporary ascending colostomy. The patient is malnourished and was dehydrated on admission. Postoperatively, the patients potassium levels are monitored, and the hypokalemia is treated with K-Dur. What codes are applicable? a. 555.9, 261, 276.51, 276.8, 45.73, 46.11 b. 263.9, 555.1, 276.51, 276.8, 45.73, 46.11 c. 555.1, 263.9, 276.51, 276.7, 45.73, 46.11 d. 555.1, 263.9, 276.51, 276.8, 45.73, 46.11

answer

d. 555.1 (Crohn's Disease of large bowel) 263.9 (malnourishment which is NOT a crohn's symptom) 276.51 (dehydration which is NOT a crohn's symptom) 276.8 (hypokaemia) 45.73 (hemicolectomy) 45.61 (colostomy)

question

What is the correct code assignment for extrinsic asthma with acute exacerbation and status asthmaticus? a. 493.02 b. 493.21 c. 493.01 d. 493.02, 493.01

answer

c. 493.01 coding guideline states that it is inappropriate to use a fifth digit of 2 with a 5th digit of 1. Use 5th digit 1 even if both conditions exist.

question

patient comes to the hospital for repair of an abdominal aortic aneurysm. The repair is performed endovascularly. What codes are applicable? a. 441.3, 39.71 b. 441.4, 38.44 c. 441.3, 38.44 d. 441.4, 39.71

answer

d. 441.4 (repair of an abdominal aortic aneurysm) 39.71 (endovascular implantation of other graft in abdominal aorta)

question

malignant hypertention with hypertensiveheart disease and congestive heart failure is coded: a. 401.0, 402.01, 428.0 b. 402.01, 428.9 c. 428.0, 402.11 d. 402.01, 428

answer

d. 402.01 (hypertensive heaart disease, malignant) 428.0 (type of heart failure ... CHF) Note: to use 402 it must be stated heart disease due to hypertension or implied hypertension. Causal relationship must be stated. Minimum of 2 codes from 402.x1 and 428.0.

question

the correct code assignment(s) for pneumonia due to the RSV organism is (are): a. 486 and 079.6 b. 480.1 c. 466.11 d. 079.6

answer

b. 480.1 (pneumonia, due to, respiratory syncytial virus) RSV is included in the 480.1 code so 079.6 is not needed

question

a patient is admitted to rule out lupusnephritis.The patient was diagnosed with lupus 5 years ago. A percutaneous left kidney biopsy is performed and lupusnephritis is confirmed. The patient has iron-deficiency anemia and is chushingoid from long-term steroid use. What codes are applicable? a. 583.81, 710.0, 255.0, E932.0, 280.9, 55.23 b. 710.0, 581.81, 255.0, V58.65,E932.0, 285.9, 55.23 c. 710.0, 583.81,V58.65, 280.9, E932.0, 55.24 d. 710.0, 583.81, 255.0, V58.65, E932.0, 280.9, 55.23

answer

d. 710.0 (systemic lupus erythematous) 583.81 (nephritis and nephropathy,not specified as acute or chronic, in diseases classified elsewhere) 255.0 (chrushings syndrome) v58.65 (long term steeroid use) E932.0 (drugs causing adverse effects / adrenal corticol steroids) 280.9 (iron deficiency anemia) 55.23 (percutaneous left kidney biopsy)

question

reflux esophagitis a. 530.81 b. 530.11 c. 530.10 d. 530.89

answer

b. 530.11

question

acute peptic ulcer of stomach with perforation a. 533.10 b. 531.50 c. 533.60 d. 531.10

answer

ulcer, stomach, acute, with, perforation 531.1x d. 531.10 (without mention of obstruction)

question

a patient is admitted with chest pain and is ruled in for an NSTEMI. The patient has a history of a CABG and PTCA with stent placement. Patient is taking medications for hypertension, CAD, and CHF. what codes are applicable? a. 410.70, 414.01, 402.90, 428.0, V45.81, V45.82 b. 786.50, 410.71, 414.00, 410.9, 428.30, V45.81, V45.82 c. 410.71, 402.90, 414.00, 786.50, 428.0, V45.81, V45.82 d. 410.71, 414.00, 401.9, 428.0, V45.81, V45.82

answer

d. 410.71 (NSTEMI ruled in) 414.00 (CAD in patient with previous CABG and unspecified artery) 401.9 (hypertension) 428.0 (CHF not specified as hypertensive or due to hypertension) v45.81 status aortocoronary bypass v45.82 PTCA

question

Code ____ is coded for personal history of malignant neoplasm of the GI tract, unspecified: a. V10.00 b. V10.03 c. V10.07 d. V47.3

answer

a. V10.0

question

patient was admitted with acute on chronic systolic and diastolic congestive heart failure. What code(s) is (are) applicable? a. 428.43, 428.0 b. 428.0, 428.41 c. 428.41, 428.0 d. 428.0

answer

a. 428.43, 428.0 failure, heart, combined systolic and diastolic, acute on chronic 428.43 + add code for CHF (428.0)

question

patient is admitted with hematochezia. A colonoscopy is performed and diverticulitis, colitis, and colonic polyps are discovered. What codes are applicable? a. 578.1, 562.13, 211.3, 558.9, 45.23 b. 562.13, 211.3, 558.9, 45.23 c. 562.11, 578.1, 211.3, 45.23 d. 578.1, 211.3, 562.11, 558.9, 45.23

answer

d. 578.1 (hematochezia) 211.3 (colonic polyps) 562.11 (diverticulitis) 558.9 (colitis) 45.23 (colonoscopy) There is no statement that the hematochezia is due to the diveerticulitis, colitis or polyps. Therefore the hematochezia is coded first according to the Section II guidelines related to a symptom and multiple contrasting or comparative conditions. Additionally, the diverticulitis and colitis would be coded without mention of hemorrhage.

question

a patient is admitted with hypoxemia and acute respiratory failure. The patient has COPD and is being treated for an acute exacerbation. The patient is untubated in the ER and is transferred to ICU and maintained on mechanical ventilation for 24 hours. The patient has a history of diabetes and diastolic congestive heart failure. What codes are applicable? a. 518.81, 491.21, 250.00, 428.30, 428.0, 96.71, 96.04 b. 799.02, 518.81, 496, 250.00, 428.0, 96.71, 96.04 c. 493.20, 518.83, 496, 250.00, 428.30, 428.0, 96.72, 96.04 d. 518.81, 493.20, 250.01, 428.0, 96.76, 96.04

answer

a. 518.81 (acute respiratory failure) 491.21 (copd) 250.00 (diabetes) 428.30 (diastolic CHF) 428.0 (CHF) 96.71 (mechanical ventilation) 96.04 (intubation) Hypoxemia is not coded because it is an integral part of ARF. Acute respiratory failure is the principal diagnosis.

question

a patient is admitted to the hospital with ARF due to dehydration. The patient is treated with IV fluids and has a medical history of mitral valve regurgitation and CAD. The patient has had a PTCA with stent placement in the past. What codes are applicable? a. 276.51, 584.9, 424.0, 414.01, V45.81 b. 584.9, 276.51, 424.0, 414.01, V45.82

answer

b. 584.9 (ARF) 276.51 (dehydrtion) 424.0 mitral valve regurgitation history 414.01 CAD V45.82 PTCA with stent placement status According to codingclinic, if acute renal failure is specified as due to dehydration, the acute renal failure is listed as the principal diagnosis and not the dehydration. Also unspecified CAD would be coded to 414.01 if a patient has not had a previous CABG.

question

an 83 year old woman with severe back pain is admitted. CT shows osteoporosis and possible compression fracture of the lumbar spine. The patient is seen by inteerventional radiology, and a percutaneous vertebroplasty is performed. she has a medical history of right bundle branch block and takes medication for reflux esophagitis. She is a smoker. Discharge diagnosis: pathologic fracture of lumbar vertebra due to senile osteoporsis. a. 733.13, 733.01, 530.11, 426.4, 305.1, 81.65 b. 733.01, 733.13, 530.11, 426.4, 305.1, 81.65

answer

a. 733.13 pathological fracture of vertebrae 733.01 senile osteoporosis (must be stated as such) 530.11 reflux esophagitis 426.4 right bundle branch block 305.1 tobacco use disorder 81.65 percutaneous vertebroplasty coding clinic advises that if a pathologic fracture is specified as due to senile osteoporosis the pathologic fracture is listed as principal diagnosis

question

a patient is admitted to the hospital for fluid overload due to noncompliance with attending renal dialysis sessions. patient has stage V CKD. hemodialysis was performed. What codes? a. 276.69, 585.6, V45.12, 39.95 b. 585.6, 276.61, V45.12, 39.95 c. 276.61, 585.6, V45.11, 54.98

answer

a. 276.69 overload, fluid 585.6 CKD, stage V V45.12 noncompliance 39.95 hemodialaysis

question

achilles tenosynovitis on the right:

answer

tenosynovitis,foot directs you to code 727.06. Tabular confirms this code.

question

DJD, generalized

answer

DJD = degenerative joint disease degeneration, degenerative, joint disease. a cross reference note states "see also" osteoarthrosis. An entry for multiple results in the code 715.09. DJD generalized is the same thing as DJD of multiple joints. Code: 715.09

question

gangrenous diabetic ulcer of right foot due to peripheral circulatory disorder.

answer

250.70 diabetes with peripheral circulatory disorders (use additional code to identify manifestation, as : diabetic, gangrene (785.4) peripheral angiopathy 443.81) 785.4 gangrene 707.15 ulcer on right foot The presence of gangrene is key in this diagnostic statement. The alphabetic index for Diabetes, gangrene directs you to the codes 250.7x (785.4). You also have to add a code for the ulcer of the foot. diabetes would always be listed firt for a diabetic disease or condition. Remember, that the diabetes has to be specified as "uncontrolled" "out of control" in order to use the 5th digit of "2". Since 250.70 is listed as "diabetes with peripheral circulatory disorders" there is no need to add a separate code for peripheral circulatory disorder.

question

patient has CHF, cariomegaly, and hypertension

answer

428.0 congestive heart failure 429.3 cardiomegaly 401.9 hypertension, unspecfied The CHF is not specified as hypertensive or due to hypertensin. So we cannot use a code from 402, hypertensive heart disease. As listed by the physician we also would not list the hypertension as principal since it is not the underlying cause.

question

chronic obstructive asthma with status asthmaticus

answer

493.21 asthma, chronic obstructive pulmonary disease. the fifth digit "1" reflects the status asthmaticus

question

admission for physical and occupational rehabilitation because of monoplegia of the right arm and right leg, each affecting dominant side. Patient suffered a nontraumatic extradural hemorrhage one month ago.

answer

V57.89 multiple rehab procedures 438.31 late effect, monoplegia upper limb affecting dominant side 438.41 late effect, monoplegia lower limb affecting dominant side The reason is rehab so it is first listed (principal). code late effects of a CVA

question

patient was admitted with aspiration pneumonia, as well as Klebsiella pneumoniae

answer

507.0 pneumonitis due to inhalation of food or vomitus 482.0 pneumonia due to Klebsiella pneumoniae

question

a patient is admitted for spinal fusion resulting from lumbar stenosis. The patient has a medical history of restless legs syndrome and GERD. The patient is taken to the OR; via posterior approach a lumbar laminectomy with posterior lumbar spinal fusion using interbody fusion device at L2-L5 levels is performed. What are the codes?

answer

724.02 spinal stenosis, other than cervical, lumbar region without neurogenic claudication 333.94 restless leg syndrome (RLS) 530.81 GERD 81.07 lumbar and lumbosacral fusion of the posterior column, posterior technique 81.63 fusion or refusion of 4-8 vertebrae 84.51 insertion of interbody spinal fusion device Lumbar stenosis is the reason for the encounter so this is principal diagnosis. The codes required for the procedures include code 81.07, posterior lumbar spinal fusion, code 81.63, number of vertebrae fused, and code 84.51 for the interbody spinal fusion device.

question

cholelithiasis with acute and chronic cholecystitis

answer

574.00 (calculus of gallbladder with acute cholecystitis 574.10 calculus of gallbladder with other cholecystitis

question

preinfarction angina

answer

angina, preinfarctional 411.1 angina that evolves into a myocardial infarction in the hospital setting would not be assigned a separate code.

question

chronic congestive diastolic heart failure

answer

428.32 failure, heart, diastolic, chronic 428.32 428.0 CHF, unspecified

question

alcoholic gastritis with hemorrhage in patient who is a binge drinker

answer

535.31 gastritis, alcoholic, firfth digit of 1 indicates hemorrhage 303.92 other and unspecified alcohol dependence fifth digit "2" episodic, binge, occasional use

question

a patient with chronic myasthenia gravis suffers an acute exacerbation and develops acute respiratory failure. The patient is admitted to the hospital to treat the respiratory failure.

answer

518.81 acute respiratory failure 358.01 chronic myasthenia gravis acute exacerbation The reason for the admission is respiratory failure which makes it principal diagnosis.

question

patient was admitted with occlusion of cerebral arteries rsulting in infarction. Patient has history of previous CVA 1 year ago with residual hemiplegia affecting dominant side.

answer

434.91 occlusion, artery, erebral 434.9x (unspecified) 434.91 is default 438.21 late effect, hemiplegia/hemiparesis, heimplegia affecting dominant side The reason for admission is the occlusion which is the principal diagnosis.

question

gastric ulcer

answer

531.90 ulcer, stomach with fifth digit "0" indicates there was no mention of obstructin in the source document used.

question

acute exacerbation of chronic obstructive pulmonary disease

answer

491.21 disease, pulmonary, obstructive (chronic), with acute exacerbation

question

Crohn's disease of the small bowel

answer

555.0 disease, crohn's ... instructional note to see enteritis, regional .. a "see" note means to look it up

question

pneumonia due to gram-negative anaerobic organisms

answer

pneumonia, gram negative bacteria, anaerobic Code: 482.81 (physician documentation must be present)

question

bilateral inguinal hernia, recurrent

answer

550.93 hernia, inguinal with fifth digit of "3" indicates that both the right and the left sides are involved

question

osteoarthritis of the neck with cord compression

answer

osteoarthritis, spine,spinal 721.90 with "see also spondylosis" ... spondylosis with myelopathy NEC (cord compression) 721.91 ...721.9x is sponylosis unspecified stie ... this is of the neck. Code 721.1

question

acute MI, inferolateral wall with third dgree atrioventricular block

answer

infarct, myocardial (acute), inferolater (wall) 410.2x 410.21, 426.0 (atrioventricular block Physicians usually do not state that a MI is an initial episoe or subsequent episode of care. In these exercises it is safe to assume that an admission for an acute infarction is an initial episode of care unless there is a reference to a previous infarction. since we basically do inpatient coding in this class a 5th digit of "0" would not usually be acceptable in a hospital. Normally a medical record would include a HPI. )

question

osteomyelitis, acute, of first and second metatarsi

answer

730.07 osteomyelitis, acute or subacute ... use 5th digit 7 ankle and foot

question

acute obstructive appendicitis

answer

540.9 appendicitis, acute note obstructive is a nonesential modifier

question

herniated disc, L4-5, with left lower extremity sciatica

answer

722.10 displacement, intervetrebal disc HNP = herniated nucleus pulposus

question

bilateral granulomatous hemorrhagic septic pneumonia

answer

486 nonessential modifiers: bilateral, granulomatous, hemorrhagic, septic

question

varicose ulcer, lower left leg with severe inflammation

answer

454.2 ulcer, varicose, inflammation

question

large abscess of right flank due to staphylococcus aureus

answer

682.2 abscess, flank 041.11 infection, staphylococcus aureus

question

chronic respiratory failure

answer

518.83 failure, respiration, chronic

question

pain in right TMJ

answer

524.62 pain, temporomandibular (joint)

question

mitral valve stenosis and aortic valve insufficiency

answer

396.1 stenosis, mitral, with aortic, insufficiency or incompetence OR' insufficiency, aortic, with mitral valve disease

question

patient is admitted with status asthmaticus. Patient was started on albuterol treatments. Patient has been intubated on previous admissions. Patient is positive for sickle cell trait and is on methadone for treatment of heroin dependence. What are the codes?

answer

493.91 asthma unspecified fifth digit "1" status asthmaticus 282.5 sickle cell trait 304.00 dependence, heroin "0" unspecified' 96.04 insertion, tube, endotracheal V46.9 unspecified machine dependence

question

degenerative disk disease of lumbar spine

answer

722.52 degeneration, intervertebral disc, lumbar

question

acute duodenal ulcer with bleeding

answer

532.00 ulcer, duodenum, acute, with hemorrhage with a fifth digit "0" reflects the fact tht there was no mention of an obstruction in the documentation

question

acute hepatitis and early cirrhosis of the liver due to chronic alcoholism

answer

571.1 hepatitis, acute, alcoholic 571.2alcoholic cirrhosis of liver 303.90 chronic alcoholism (unspecified with fifth digit of 0)

question

acute low back pain

answer

338.19 pain, acute (338 is acceptable as principal diagnosis) 724.2 pain, back, low

question

cerebral infarct due to stenosis of the vertebral artery

answer

434.91 infarct, cerebral 433.21 stenosis, artery, vertebral SEE narrowing, artery, vertebral 433.2x ... fifth digit 1 with cerebral infarction

question

atherosclerosis of left internal mammary artery bypass graft

answer

atherosclerosis refers me to arteriosclerosis, bypass graft, coronary artery, autologous artery (internal mammary) Code: 414.04

question

diverticulosis of the colon with diverticulitis and hemorrhage

answer

562.12 diverticulosis of colon with hemorrhage 562.13 diverticulitis, colon, with hemorrhage If a patient has diverticulitis it is assumed that they also have diverticulosis. code for diverticulosis, too. also, if diverticulosis w/o site mentioned it is assumed to be a condition of the colon.

question

postinfective bronchiectasis

answer

494.0 bronchiectasis (postinfection is a nonessential modifier)

question

ankylosis of right shoulder

answer

718.51 ankylosis, shoulder

question

osteoarthritis of the knees

answer

715.36 coding clinics state osteoarthrosis, localized, not specified whether primary or secondary, lower leg, is assigned for degenerative joint disease of the knee. The instructional note at the beginning of the index entry for osteoarthritis gives the fifth digit for knees (lower leg) as 6. remember that if osteoarthritis is specified as being "of the hip" "of the knees" or "of the shoulder" then that means it is localized so it has to be coded as osteoarthritis, localized.

question

benign renovascular hypertension

answer

405.11 see hypertension table/ hypertension, renovascular, benign)

question

E. Coli pneumonia

answer

482.82 pneumonia, escherichia coli

question

recurrent gangrenous inguinal hernia with obstruction

answer

550.01 hernia, inguinal, with gangrene (obstructed) 550.0x with fifth digit 1 for recurrent

question

staphylococcal pyogenic arthritis of the knees

answer

711.06 arthritis, pyogenic fifth digit 6 / knee (lower leg) 041.10 staphlococcal infection

question

benign hypertrophy of the prostate with nocturia times three

answer

600.01 hypertrophy, prostate, benign, with, other lower urinary tract symptoms 788.43 nocturia

ICD-9-CM Testing – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards