ICD-10-CM UNIT 2 EXERCISES – Flashcards

What is the coding and sequencing for the diagnosis "Late onset of Alzheimer's dementia with behavioral disturbance?" A. G30.1, F02.81 B. G30.1, F02.80 C. F02.81, G30.1 D. F02.80, G30.1

What is the coding for the diagnosis "Use, abuse and dependence on hallucinogens with hallucinogen-induced anxiety disorder?" A. F16.980, F16.180, F16.280 B. F16.280 C. F16.280, F41.9 D. F16.180, F16.280

A patient is admitted to the medical unit of the hospital for treatment of uncontrolled hypertension. She smokes up to five cigarettes a day. A psychiatric consultation is requested. The psychiatrist's diagnoses are "tobacco use" and "depression." What is the diagnosis coding and sequencing for this scenario? A. I10, F17.210, F32.0 B. I10, Z72.0, F32.9 C. I10, F17.210, F32.9 D. I10, F17.208, F32.81

Which term is defined as the use of prescribed medications used to treat certain mental disorders? A. Psychotherapy B. Drug dependence C. GAF D. Pharmacotherapy

DSM-5 is used for reimbursement under PPS for psychiatric admissions. A. True B. False

How are inpatient psychiatric facilities and distinct part units paid for inpatient psychiatric services rendered to Medicare beneficiaries? A. A flat fee for the whole stay based on Medicare average cost per case for a case in that MS-DRG B. A per diem rate based on reasonable costs as reported on the institutional cost report C. The IPF PPS per diem rate adjusted for facility and patient factors D. The IPPS MS-DRG rate assigned to the case

A 30-year-old woman is admitted to County Hospital with an acute exacerbation of chronic paranoid schizophrenia. She had been hallucinating and believed her husband was trying to kill her because she is "no good." On admission to the mental health unit, she responds well to Clozaril therapy. The patient's type 2 diabetes is also brought under better control during this hospitalization with a strict diet and a change in her oral diabetes medication. Which is the correct principal diagnosis and sequencing for this case? A. F20.0, E11.9 B. F20.5, E11.9 C. F23, E11.8 D. F20.5, E11.8

Which of these conditions is NOT coded in the F20 to F29 code block? A. Paraphrenic schizophrenia B. Atypical schizophrenia C. Post-schizophrenic depression D. Borderline schizophrenia

Serious mental disorders such as schizophrenia and bipolar disorder result in functional impairment which substantially interfere with or limit one or more major life activities. A. True B. False

Erica's college roommate brought her to the ED at the local hospital because she is experiencing significant and unusual signs of anger and mistrust. This behavior is effecting her participation in classes. She is diagnosed with paranoid schizophrenia that has been aggravated by recent alcohol abuse. What is the diagnosis coding and sequencing for this case? A. F20.0, F10.10 B. F22, F10.159 C. F23, F10.20 D. F20.89, F10.230

The main difference between alcohol abuse and alcoholism is a physical dependence on alcohol. A. True B. False

The provider documents that a patient has "ETOH dependence, hasn't had a drink in 5 years." What is the best action for a coder to take? A. Assign code F10.20 B. Query the provider to determine if reporting the code for remission is appropriate C. Assign code F10.21 D. Do not assign a code, because the patient does not have a diagnosis

Family members bring a patient to the ED. She has missed 3 days of work and is teary and admits drinking more than usual the previous night. Her BAL is 15 mg/100 mL. Although she is currently not under the influence of alcohol, the doctor gives her a diagnosis of "alcohol dependence with alcohol-induced mood disorder, bipolar disorder, mild, current episode depressed." What is the coding and sequencing for this visit? A. F10.24, Y90.0 B. F10.220, Y90.0 C. F10.24, F31.31, Y90.0 D. F10.220, F31.31, Y90.0

A patient with alcohol dependence is displaying symptoms of alcohol withdrawal. Which symptoms typically suggest alcohol withdrawal? Select all that apply. A. Irritability B. Leg pain C. Enlarged pupils D. Nausea and vomiting E. Chest pain F. Headache

A patient has taken a medication that depresses the central nervous system (CNS), along with alcohol. When consumed with alcohol, what effect do CNS depressants have? A. They counteract the alcohol's effects. B. They reduce the alcohol's effects. C. They neutralize the alcohol's effects. D. They intensify the alcohol's effects

After a celebration during which a man consumes several pitchers of beer, he is brought to the ED. He is stuporous, and his BAL is 225 mg/100 mL. He receives a diagnosis of "accidental toxic effect of alcohol, alcohol abuse, severely intoxicated, intoxication delirium." Which codes should be assigned for this diagnosis? A. T51.0X1A, F10.120, Y90.7 B. T51.0X2A, F10.221, Y90.7 C. T51.0X1A, F10.121, Y90.7 D. T51.0X4A, F10.121, Y90.7

A patient with a history of depression is admitted on Monday for evaluation of week long epigastric pain described as "severe." It came on suddenly while watching TV. The pain was constant but did have periods of worsening, radiating to the back. It was not responsive to acetaminophen, hydrocodone, or omeprazole as prescribed by her primary care. She also takes citalopram. On the day before admission, she had 2 episodes of vomiting "dark, maroon blood with clots," which was not preceded by emesis without blood. She denied former or current use of alcohol, tobacco, nonsteroidal anti-inflammatory drugs, or herbal supplements and also had experienced no early satiety or weight loss. Upon further questioning of alcohol use she stated she typically had 1 to 2 glasses of wine a few nights a week with dinner. Because she hadn't been feeling well, she had one glass of wine yesterday. Intravenous pantoprazole is administered. An esophagogastroduodenoscopy (EGD) reveals no active bleeding. Gastric biopsy specimens reveal moderate active chronic gastritis and H pylori. She was started on treatment for the H.pylori. She was advised to refrain from social drinking at this time as it may be a contributing factor in the gastritis. What is the diagnosis coding for this case? A. K29.21, F10.94 B. K29.71, F32.9, Z72.89 C. K29.20, A04.8, F32.9, F10.20 D. K29.50, A04.8, F32.9, Z72.89

A patient is admitted with hallucinations, acute abdominal pain, and highly elevated liver enzyme levels. She had just signed out against medical advice from an alcohol rehabilitation center and immediately went to a bar and drank heavily. Her diagnosis is "acute pancreatitis due to relapse of alcohol dependence with hallucinations, intoxicated." What is the coding and sequencing for this case? A. K85.20, F10.251, F10.229 B. K86.1, F10.251, F10.229 C. K85.20, F10.259, F10.229 D. K86.1, F10.151, F10.251

Which medications are used to treat alcohol dependence? Select all that apply. A. Disulfiram B. Naltrexone C. Acamprosate D. Campral E. Depade F. ReVia

For a patient, the doctor has documented alcohol use, abuse, and dependence. According to the coding guidelines, which code or codes should be assigned? A. Only the code for dependence B. Only the code for alcohol use C. Only the code for alcohol abuse D. The codes for alcohol use, abuse, and dependence

A patient has widespread metastatic carcinoma that is terminal. He is admitted to a hospice unit for supportive care. What code category is used to report this type of care? A. Z08 B. Z15 C. Z51 D. Z40

A 55-year-old woman is admitted for continued evaluation of shortness of breath and persistent cough. She has a personal history of a malignant neoplasm of the right breast, removed via mastectomy 18 months ago. A metastasis to the right lung is diagnosed and a partial lobectomy is performed. What are the coding and sequencing for the diagnoses in this scenario? A. C34.91, C50.911 B. C78.01, Z85.3 C. C78.00, Z85.3 D. C34.91, Z85.3

A patient is admitted with pneumonia. The patient also has a documented leukemia that is stated to be "in remission." In addition to reporting the pneumonia, this case is reported with a Z code to reflect the personal history of leukemia. A. True B. False

A patient is admitted for chemotherapy. She previously had surgery for removal of a right ovarian cancer. How is this case coded and sequenced? A. C56.1, Z51.11 B. Z51.11, C56.9 C. Z08, C56.1, Z85.43 D. Z51.11, C56.1

Prophylactic organ removal is performed when the organ has a malignancy and, as a result, it is surgically removed. A. True B. False

Codes from Chapter 21 (Z codes) are for use only on inpatient encounters. A. True B. False

A 67 year old patient diagnosed with prostate cancer that is castrate resistant is admitted for malignancy related pain. Despite treatment withthe androgen deprivation therapy (ADT) drug leuprorelin, the patient has a rise in serum levels of prostate-specific antigen (PSA). How is this case coded and sequenced? A. C61, R97.21, Z79.818 B. G89.3, C79.82, R97.21, Z19.2 C. C63.9, G89.3, Z19.2, Z79.818 D. G89.3 ,C61, R97.21, Z19.2, Z79.818

Certain Z codes may be reported only as the principal or first-listed diagnosis. The exception is when multiple encounters occur on the same day and the medical records for the encounters are combined. Which of these codes can be reported only as a principal diagnosis for an inpatient when reporting situations with malignant neoplasms? Select all that apply. A. Z08 B. Z15.01 C. Z51.0 D. Z51.12 E. Z51.5 F. Z80.0

A patient is admitted for a double mastectomy. She has a family history of breast cancer and has been tested for genetic susceptibility to malignant neoplasm of breast. The test came back positive for the susceptibility, and the patient elected to have a mastectomy as a preventive measure for breast cancer. How is this case coded and sequenced? A. Z40.01, C50.911, C50.912, Z80.3, Z15.01 B. Z15.01, Z40.01, Z80.3 C. Z80.3, Z15.01 D. Z40.01, Z15.01, Z80.3

A 6-year-old child is brought to the ED by his mother. Three weeks ago he was treated for a streptococcal throat infection. He is still complaining of a sore throat and has been lethargic. The boy looks pale and his throat is still red. Pus and petechiae previously noted are absent. The child had been experiencing nose bleeds the past couple of days. He is admitted for further workup because he has a history of acute lymphoblastic leukemia, and his physician is concerned that he may be out of remission. Upon further workup, the boy is diagnosed with an acute viral upper respiratory infection. His leukemia remains in remission. What is the coding for this case? A. C91.01, Z85.6 B. J06.9, Z85.6 C. C91.01, J06.9 D. J06.9, C91.01

What type of Z codes are used to explain continuing surveillance after completed treatment for a malignant neoplasm? A. Aftercare B. Follow-up C. History (of) D. Status

A male patient is sent to the ED from his oncologist's office after becoming dizzy and lightheaded. He states that he has primary right upper lobe lung cancer and was to begin his chemotherapy session when he began to feel bad. He has a long history of type 2 diabetes with accompanying neuropathy. He has been insulin dependent for the past 3 years. The ED examination reveals the patient to be hypoglycemic. He is admitted for control of his diabetes. Which is the coding and sequencing for this case? A. C34.11, E11.649, E11.40, Z79.4 B. E11.649, E11.40, C34.11, Z79.4 C. E11.40, C34.11, Z79.4 D. R73.09, E11.40, E16.2, C34.11

The patient presents to the ED severely dehydrated with nausea and vomiting. She has a history of type 1 diabetes mellitus, taking 15 units of NPH and 10 units of regular insulin in the morning and 10 units of NPH and 5 units of regular insulin in the evening. She has also experienced increased urination and polydipsia. The patient's blood sugar level exceeds 600 mg/dL. She is admitted to the intensive care unit (ICU) with diabetic ketoacidosis (DKA) and dehydration. Which is the coding and sequencing for this case? A. E10.9, E86.0, R11.2 B. R11.2, E10.10 C. E10.10, E86.0 D. E10.10, E86.0, Z79.4

A patient is admitted for management of his hyperosmolar, nonketotic state due to steroid-induced diabetes mellitus, which he acquired due to long-term use of corticosteroids. He discontinued the steroids several years ago, but he continues to have problems. His diabetes is managed with insulin, but his blood sugar levels have continued to climb. Family members were concerned and brought him to the ED. He is admitted with diabetic hyperosmolar state. What is the coding and sequencing for this case? A. E09.00, T38.0X5S, Z79.4 B. T38.0X5A, E09.00, Z79.4 C. T38.3X1S, Z79.4 D. E87.0, T38.3X1A

The provider has just assessed a patient and diagnosed her with diabetes mellitus. Which signs and symptoms characterize diabetes mellitus? Select all that apply. A. Unexplained weight loss B. Excessive thirst C. Tingling or numbness in the hands or feet D. Loss of appetite E. Fever F. Abdominal pain

A 58-year-old male with type 1 diabetes is admitted directly from his physician's office for evaluation and management of his diabetic left foot ulcer with muscle necrosis. As a result of diabetes, the patient also has stage 2 kidney disease and peripheral angiopathy. What is the coding and sequencing for this case? A. E08.621, E08.22, L97.503 B. E10.621, E10.22, E10.51 C. L97.523, E10.621, E10.22, E10.51 D. E10.621, L97.523, E10.22, N18.2, E10.51

Family members bring a girl, age 16, to the ED after she collapsed. They state she has type 1 diabetes and has used an insulin pump for several years. She had been doing well until earlier in the day when she complained of feeling weak. Shortly after that, she collapsed. Evaluation in the ED shows the insulin pump had malfunctioned and was not dispensing enough insulin. She is admitted to the ICU for treatment of a ketoacidotic coma caused by underdosing related to insulin pump failure. What is the coding and sequencing for this case? A. T85.611A, T38.3X6A, E10.65 B. E10.11, T85.614A, E16.1 C. T38.3X6A, E10.11 D. T85.614A, T38.3X6A, E10.11

A 42-year-old male is admitted for acute exacerbation of his chronic pancreatitis. He has suffered from chronic pancreatitis for several years and has an extensively damaged pancreas. As a result of this, he developed diabetes mellitus, for which he has been taking insulin for 2 years. What is the coding and sequencing for this case? A. E08.00, K85.90 B. K85.90, K86.1, E08.9, Z79.4 C. E08.9, K85.90, Z79.4 D. K85.90, E08.8, Z79.4

For a newly admitted patient, the provider documents a diagnosis of "diabetes due to previous pancreatectomy." What code should be listed first? A. E08, Diabetes mellitus due to underlying condition B. E89.1, Postprocedural hypoinsulinemia C. E13, Other Specified Diabetes Mellitus D. E10, Type 1 Diabetes Mellitus

A mother brings in her son, age 5, for treatment of symptomatic encephalopathy associated with functional hyperinsulinism. He was diagnosed with the condition 2 years ago. He is admitted for control and management of his blood glucose level. What is the coding for this case? A. E15, G93.40 B. E16.1 C. E16.1, G94 D. G93.40, E15

A pregnant patient has type 2 gestational diabetes controlled by diet. What is the coding for this condition? A. O24.410 B. E11.9 C. E11.49 D. O24.420

Depending on clinical conditions, a person may be considered a diabetic if his or her blood glucose is consistently above 125 mg/dL. A. True B. False

Which of the following can assist in controlling type 2 diabetes? Select all that apply. A. Diet changes B. Oral medications C. Insulin D. Physical activity E. Pancreatic transplant F. Weight control