question

1.) Diabetes mellitus 2.) 250

answer

1.) A chronic disorder of impaired carbohydrate, protein and fat metabolism? 2.) Code category?

question

1.) 4th digit = presence of complications 5th digit = whether diabetes is out of control 2.) Diabetes mellitus Type II

answer

1.) Diabetes is classified on 2 axis: 4th digit = ? 5th digit = ? 2.) "diabetes" noted in chart without further specification defaults to__________?

question

1.) False. "uncontrolled diabetes mellitus" or "diabetes mellitus out of control" must be specifically stated in the medical record in order to code for uncontrolled diabetes. 2.) False. In the absence of further specificity, this should be coded as 790.2 (abnormal glucose)

answer

1.) True/False? "poorly controlled" or "poor control" in chart indicates uncontrolled diabetes. 2.) True/False "borderline diabetes" without further specification should be coded as diabetes mellitus.

question

Diabetes Mellitus Type I

answer

Described as ketosis-prone or juvenile diabetes & characterized by the body's failure to produce insulin at all or an absolute decrease in insulin production. Requires regular insulin injections.

question

Diabetes Mellitus Type II

answer

Described as ketosis resistant or "adult-onset" diabetes & characterized by the body's inability to adequately utilize insulin. Patients may or may not require insulin.

question

a.) type II diabetes mellitus b.) type I diabetes mellitus

answer

For patients with type (a.)________ ? diabetes mellitus who routinely use insulin, V58.67 (Long term [current] use of insulin) is required unless insulin is only given temporarily to bring blood sugar under control. For patients with type (b.)________? diabetes mellitus, the use of the V58.67 code is optional.

question

Type II

answer

a diagnosis of "Diabetes" not further specified in a medical record defaults to_________?

question

1.) Mechanical complication due to insulin pump )996.57) 2.) Poisoning by insulins and antidiabetic agents (962.3)

answer

1.) Malfunction of an insulin pump codes to_________? 2.) An overdose of insulin as a result of pump malfunction codes to____________?

question

Secondary Diabetes

answer

Diabetes that results from therapy such as the removal of the pancreas, infection,poisoning or use of certain medications.

question

1.) 249 + E code if applicable 2.) 249.00 (secondary diabetes without mention of complication, not states as uncontrolled, or unspecified) + E932.0 (Adverse effect of therapuetic use of adrenal cortical steroids)

answer

1.) Secondary diabetes that is drug induced, chemically induced, due to the postcarcinoma state of the pancreas, or due to infection is coded is coded to category_________? 2.) Example: "steroid induced diabetes mellitus due to prolonged use of corticosteroids for an unrelated condition" is coded as________?

question

4th digit = presence of complications 5th digit = whether diabetes is out of control

answer

Category 249 for secondary diabetes is classified on 2 axis: 4th digit identifies______? 5th digit identifies______?

question

1.) 1st code 251.3 (postsurgical hypoinsulinemia) followed by 249 (secondary diabetes) and V88.11/V88.12 (acquired total/partial absence of pancreas) as an additional code. 2.) 251.3 + 249.00 + V88.11

answer

1.) secondary diabetes due to pancreatectomy? 2.) E.g. "postpancreatectomy dibetes mellitus"

question

1.) 249.1x - 249.3x and 250.1x - 250.3x 2.) 249.4x - 249.8x and 250.4x - 250.8x 3.) as many as necessary to identify all associated diabetic contions the patient may have.

answer

1.) code range for acute metablolic complications of diabetes mellitus, secondary, types I & II? 2.) code range for long-term complications of diabetes mellitus, secondary, types I & II? 3.) How many codes from these categories vcn be assigned?

question

1st code diebetes millitus (category 250) followed by additional 250 codes identifying complications/manifestations (unless manifestation is included in the basic code)

answer

Sequencing rules for complications/manifestations in: type I/type 2 diabetes.

question

1.) Sequencing of is based on the reason for the encounter. A code is also assigned for underlying condition that caused the dibetes (sequencing of this code also depends on the reason for encounter). 2.) (a.) code from category 249 is sequenced 1st. (b.) carcinoma (157.9) should be sequenced 1st.

answer

1.) Sequencing rules for complications/manifestations in secondary diabetes? 2. ) E.g. for a patient with secondary diabetes mellitus (249.x) post-inoperable cancer of the pancreas (157.9) how would the following be sequenced? a.) pt. is being seen by endocrinologist for tx. of diabetes? b.) pt. is being seen for tx. of carcinoma of pancreas?

question

1.) diabetic ketoacidosis (DKA) 2.) hyperosmolarity with/without coma 3.) other coma

answer

Acute metabolic complications of diabetes include? (3 dxs)

question

1.) 249.1x/250.1x, type I, uncontroled. 2.) Diabetes with other coma, 249.3x/250.3x

answer

Acute metabolic complications of diabetes: 1.) Diabetic ketoacidosis (DKA) codes to ______, is found mainly in type ____ diabetes and is, by definition________? 2.) Diabetes with hyperosmoarity is typically found in type _____ diabetes and codes to_____? 3.) This category includes patients with ketoacidosis who have progressed to a comatose state and also includes hypoglycemic coma in a patient with diabetes and insulin coma not otherwise specified. It codes to ______?

question

1.) Diabetes code (249/250.xx) + manifestation/complication code. 2.) 3 codes: Diabetes code (249/250.xx) + 403/404 code to id hypertensive kidney disease + 3rd code 585.x to id stage of chronic kidney disease (CKD) 3.) False. Senile cataracts are not true diabetic cataracts.

answer

1.) Sequencing rule for diabetes with chronic complications including: renal, ocular, nervous, and peripheral vascular, and other? 2.) Sequencing rule for diabetes with hypertensive kidney disease and chronic kidney disease stage x (I-V)? 3.) True/False? Senile cataracts with diabetes are true manifestations of diabetes & the same as snowflake (diabetic) cataracts.

question

1.) 646.0x assigned 1st + additional code for diabetes (249/250) 2.) 775.0 (Syndrome of infant of diabetic mother) or 775.1 (Neonatal diabetes mellitus) is assigned only if such condition is documented. 3.) V30 + V18.0 (family history, diabetes) +V29.3 (obsevation/evaluation) if additional surveillance is required.

answer

1.) Sequencing rule for diabetes mellitus complicating pregnancy? (648.0x). 2.) 1.) Sequencing/coding rule for transient decrease in blood sugar or hyperglycemia in infants born to a diabetic mother? 3.) Sequencing/coding rule for normal infants born to a diabetic mother?

question

1.) 249.3x/250.3x or 249.8x/250.8x 2.) 251.0 (coma), 251.1 (no coma), & 251.2 (NOS) 3.) E code added to indicate the responsible drug 4.) Poisoning (962.3) + E code for drug

answer

1.) Codes for hypoglycmic reactions in patients with diabetes mellitus with or without coma? 2.) Codes for hypoglycmic reactions in non-diabetic patients with or without coma? 3.) Hypoglycemic shock or coma from insulin used as prescribed? 4.) Hypoglycemic shock or coma from incorrect use of insulin?

question

Category 278 + additional V code (V85.x) for BMI if it is documented. It is appropriate to use nurse/nutritionists notes for 2.) BMI only. Overweight/Obesity coding must be based on physicians diagnosis.

answer

1.) Coding sequencing rule for overweight/obesity? 2.) For what part of this can nurse/nutritionist notes be used?

question

Complication as principle dx. + additional code for cystic fibrosis (277.0x). Because there is no known cure for cystic fibrosis, most therapy is directed towards the complications & admission for cystic fibrosis itself is not common.

answer

Coding/sequencing rule for admission due to complications of cystic fibrosis with pulmonary involvement?

question

1.) 294.2x with 5th digit denoting with/without behavioral disturbance. 2.) Dementia in this case is coded to 294.1x. The underlying disease is coded first. - e.g. 331.0 (Alzheimer's) + 294.1x (dementia.

answer

1.) Coding/sequencing rule for "dementia" not specified? 2.) Coding/sequencing rule for dementia due to physiological effects of underlying disease or condition - e.g. "dementia due to Alzheimer's"?

question

1.) 311 2.) False. A diagnosis of "major depression" of "affective disorder" must be documented in the chart. "Depression" listed without further specificity is not enough.

answer

1.) "depression" documented in the medical record without further specification defaults to code_________? 2.) True/False? "Depression" (see above) is the same as an affective disorder such as major depression and can be coded accordingly.

question

Use 316 code first to designate that physiological disorder is psychogenic in nature. e.g. 316 (psychological factor) + 427.2 (asthma)

answer

Coding/sequencing rule for psychogenic diseases. e.g. psychogenic asthma?

question

False. These are coded differently in ICD-9-CM and can not be used interchangeably.

answer

True/False in ICD-9-CM "abuse" and "dependence" are synonymous and may be used and coded interchangeably?

question

1.) 291 & 292 2.) 291.0, 291.3, & 291.81 3.) 291.81 (withdrawal) + 303.91 (chronic alcoholism)

answer

1.) Alcohol-induced mental disorders are classified in category_____? and drug induced mental disorders are classified in category ________ respectively? 2.) Subcategories for withdrawal include _______? 3.) How are these are sequenced? - e.g. ""withdrawal due to chronic alcoholism"?

question

1.) Psychosis coded 1st + substance abuse/dependence code. 2.) Principle dx. should be the substance abuse/dependence code.

answer

What should be the principle dx. in the following cases: 1.) Pt. admitted with a dx. of substance related psychosis? 2.) Pt. admitted for detox or rehab with no indication of withdrawal or psychotic symptoms?

question

1.) Either condition may be designated as principle dx. 2.) Physical condition is coded 1st + substance abuse/dependence code. 3.) Follow the usual guidelines for selecting principle dx.

answer

What should be the principle dx. in the following cases: 1.) pt admitted for detox or rehab of both drug and alcohol abuse or dependence. Both are treated. 2.) Pt. with a diagnosis of substance abuse or dependence is admitted for tx/eval. of a physical complaint related to the substance use? 3.) Pt. with a diagnosis of substance abuse or dependence is admitted because of an unrelated condition?

question

"yellow bag"

answer

Slang/short for detoxification for a patient who is physically dependent on drugs/alcohol using thiamine and multivitamins for nutrition as well as other medications?

question

Anemia

answer

A condition in which blood is deficient in the amount of hemoglobin in red blood cells or in the volume of red blood cells.

question

Only when a diagnosis of "anemia" is specified by the Physician in the diagnostic report.

answer

Anemia can only be coded when_______?

question

Aplastic Anemia

answer

A condition in which there is a deficiency of red blood cells because the bone marrow is failing to produce them.

question

1.) 280 2.) 281; the specific type of deficiency, e.g., B12 vitamin deficiency.

answer

1.) Iron-deficiency anemias are classified in category______? 2.) Other deficiency anemias are coded in category_______ with the 4th digit indicating ______?

question

False. It is important to distinguish between anemia due to chronic and anemia due to acute blood loss because the two conditions have entirely different codes in ICD-9-CM.

answer

True/False? Anemia due to chronic blood loss and anemia due to acute blood loss code to the same category.

question

Acute blood-loss anemia.

answer

_______ results from a sudden, significant loss of blood over a brief period of time may be due to trauma, laceration, or rupture of abdominal viscera where no external blood loss is noted. A diagnosis of this must be supported by physician documentation.

question

Do not code unless the doctor specifies "hemorrhage as a complication of surgery."

answer

Hemorrhage as a complication of surgery can only be coded in the 998.11 (complications of surgery) if _______?

question

False. Acute blood-loss anemia should not be coded as a post operative complication unless the Physician identifies as such.

answer

True/False? Acute blood-loss anemia that occurs following surgery implies that it is a complication of the procedure.

question

1.) 285.9 (anemia, unspecified). 2.) 285.1 (acute post-hemorrhagic anemia). 3.) 280.0

answer

1.) When post operative anemia is documented without specification of acute blood-loss it codes to______? 2.) When post operative anemia is due to acute blood-loss it codes to_______? 3.) When the diagnostic statement does not indicate whether the blood-loss anemia is acute or chronic it codes to_______?

question

First code for anemia (285.xx) + code for chronic condition e.g., 1.) Anemia (285.xx) + chronic kidney disease (585). 2.) Anemia (285.xx) + code for neoplasm or malignancy 3.) Anemia (285.xx) + code for chronic condition.

answer

Coding/sequencing rule for anemia and chronic conditions: 1.) Anemia and chronic kidney disease. 2.) Anemia and neoplastic disease. 3.) Anemia of other chronic disease.

question

True. Anemia due to chemotherapy induces changes that are generally short term and not truely aplastic.

answer

True/False? Anemia due to chemotherapy should not be confused with aplastic anemia due to anti-neoplastic chemotherapy.

question

Pancytopenia (284.19)

answer

When a patient has anemia neutropenia and thrombocytopenia only one code for ________ is assigned?

question

1.) Cickle-cell anemia/disease (282.6x) 2.) Cickle-cell trait (282.5) 3.) Hb-SS disease with crisis (282.62) + an additional code to report the type of crisis e.g., acute chest syndrome, splenic, sequestration, etc...).

answer

1.) When a child receives cickle-cell genes from both parents. 2.) When a child receives cickle-cell genes from one parent. 3.) Coding/sequencing when vaso-occlusive crisis or other crisis present with cickle-cell?

question

1.) Thalassemia (282.4x). 2.) Thalassemia minor 3.) Thalassemia major

answer

1.) A genetic blood disorder resulting from a defect in a gene that controls production of one of the hemoglobin proteins. 2.) When the above identified genetic trait is inherited by one parent its called_____? 3.) When the above identified genetic trait is inherited by both parents its called_____?

question

1.) The physician specifically documents a diagnosis of hemorrhagic disorder due to circulating anti-coagulants. 2.) False. Bleeding from these medications does not necessarily indicate that a hemorrhagic disorder due to intrinsic circulating anti-coagulants is present. 3.) In the above situation, code for the condition and associated hemorrhage is assigned with an additional E code to indicate the responsible medication.

answer

1.) Subcategory 286.5x to indicate acquired hemophelia or other hemorrhagic disorders due to intrinsic circulating anti-coagulants is only assigned when_______? 2.) True/False? Subcategory 286.5x can be assigned for bleeding in a patient who is being treated with Coumadin, Heparin, or other anti-coagulants. 3.) How is the above coded?

question

First code hematemesis (578.0) + an additional code E 934.2 to indicate Coumadin as the responsible agent. Do not assign code 286.5x.

answer

Code the following: A patient is admitted following multiple episodes of hematemesis secondary to Coumadin therapy. No significant pathology was discovered. The Coumadin was discontinued and no recurrence of the bleeding occurs.

question

1.) Whether the WBC count is low or elevated. 2.) False. Physician concurrence regarding the significant of the laboratory results should be confirmed before assigning (288.xx) codes.

answer

1.) Diseases that affect white blood cell counts (WBCs) (288.xx) are classified on the basis of ______? 2.) True/False? Codes for the above conditions can be assigned on the basis of laboratory findings alone.

ICD-9-CM Test 4 – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards