Adams: Adams' Coding and Reimbursement, 4th Edition
Chapter 01: Diagnostic Coding: International Classification of Diseases, 9th Revision,
Clinical Modification (ICD-9-CM)
Test Bank
COMPLETION
1. A patient is admitted to the hospital with severe flank pain and hematuria. A urinalysis is
performed; the result is positive for Escherichia coli. The discharge summary states acute
pyelonephritis.
ICD-9-CM ____________________
ANS: 590.10
2. The patient vaginally delivered an infant on November 1, and an emergency curettage was
performed on November 3 for postpartum hemorrhage as a result of retained placental fragments.
ICD-9-CM ____________________
ANS: 666.22, V27.0
3. A 23-year-old man has a suspicious 0.5-cm lesion on his shoulder. The dermatologist excises the
lesion in his office. A microscopic pathology report showing a squamous cell carcinoma with
positive borders is sent to the patient’s family physician. The family physician refers the patient
again to the dermatologist, who re-excises the site (previous wound size 1.0 cm, including skin
margins) and performs a simple primary closure of the wound.
ICD-9-CM ____________________
ANS: 173.6
4. A 44-year-old woman with a history of breast cancer complains to her internist about shortness
of breath. Her visit includes an expanded problem-focused history, a detailed examination, and
low-complexity decision-making. A chest x-ray examination taken in the office shows a small
pleural effusion on the right lung. The physician performs a thoracentesis, draws off the fluid,
and sends it for cytologic and chemistry analysis.
ICD-9-CM ____________________
ANS: 511.9, V10.3
5. A general surgeon attempts a laparoscopic cholecystectomy on a 44-year-old woman suffering
from acute cholecystitis with gallstones but no obstruction because of an unusual anatomic
variation. However, the physician aborts the laparoscopic procedure and completes the
cholecystectomy via an open laparotomy.
ICD-9-CM ____________________
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
, Test Bank 1-2
ANS: 574.00, V64.41
6. A 71-year-old woman presents with acromegaly and reports multiple medical problems
associated with the disease. A magnetic resonance image (MRI) shows a large pituitary
macroadenoma, and surgery is elected. The patient undergoes a microscopic transsphenoidal
pituitary adenectomy with insertion of a lumbar subarachnoid drain. The right thigh is opened,
and a muscle and fascia plug is taken from the fascia lata. The graft is placed in the sella. The
floor of the sella is reconstructed with a piece of bone and covered with Gelfoam® and fat. The
wound is closed and dressed, and the lumbar drain is removed.
ICD-9-CM ____________________
ANS: 227.3, 253.0
7. A gynecologist refers a 26-year-old woman with amenorrhea and galactorrhea to the
neurosurgeon for further workup. MRI and endocrine studies reveal a microadenoma of the
pituitary. Surgery is elected, and the patient undergoes exposure provided by the
otorhinolaryngologist. Transnasal excision of a pituitary tumor is performed by the
neurosurgeon.
ICD-9-CM ____________________
ANS: 227.3
8. The ophthalmologist repairs two horizontal muscles for alternating esotropia and performs a lid
retraction repair at an outpatient hospital surgical suite.
ICD-9-CM ____________________
ANS: 378.05, 374.41
9. A 64-year-old patient complains of severe headaches and blackout episodes. Previous
electroencephalographic (EEG) and computed tomographic (CT) scans are negative. An
interventional radiologist performs bilateral common carotid and left vertebral artery (cerebral)
angiography. A retrograde right femoral approach is used. Selective catheterization of the right
common carotid artery, the left common carotid artery, and, subsequently, the left vertebral artery
is performed. In addition, photographic subtractions of the anteroposterior (AP) view are
obtained on the vertebral run. The radiologist interprets the images and concludes that the patient
has cerebral atherosclerosis.
ICD-9-CM ____________________
ANS: 437.0
10. A patient presents to a urology clinic with a history of chronic calculus in the pelvis of the
kidney. His history also includes allergies and a reaction to ionic contrast. He is sent to a local
hospital as an outpatient and is injected with a bolus 100 cc of low osmolar contrast material, and
an intravenous pyelogram (IVP) is performed. Because the left calyx and ureter are not visible, a
limited ultrasound is performed.
ICD-9-CM ____________________
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
, Test Bank 1-3
ANS: 592.0, V15.08
11. A 48-year-old woman presents to her internal medicine physician with complaints of upper
abdominal pain, chills, and fever. In addition, she is noted to be jaundiced. Liver function tests,
including serum albumin, total bilirubin, and alkaline phosphatase, are performed. Bilirubin and
alkaline phosphatase levels are elevated. The diagnosis is extrahepatic biliary duct obstruction.
The patient is referred to a general surgeon.
ICD-9-CM ____________________
ANS: 576.2
12. An outpatient hospital laboratory performs an adrenocorticotropic hormone (ACTH) stimulation
panel for adrenal insufficiency. Three cortisol levels were obtained.
ICD-9-CM ____________________
ANS: 255.41
13. A 32-year-old man presented to the cardiologist with a complaint of recent onset of palpitations.
He was referred from his family physician for assumption of care. The cardiologist reviewed past
and present social and medical histories and records. After a detailed system review failed to
reveal any abnormality, the cardiologist prescribed a 24-hour Holter monitor. The cardiologist
supplied the monitor with hook-up and recording and performed a review and interpretation of
the microprocessor-based analysis. The analysis and report were supplied by another facility. The
cardiologist diagnosed stress-induced ectopic atrial beats and discussed a course of therapy with
the patient during a follow-up visit. The follow-up visit lasted approximately 20 minutes.
ICD-9-CM ____________________
ANS: 785.1, 427.61
14. After completing a course of antibiotics, an 18-month-old established patient returns for a
follow-up visit for an acute suppurative otitis media with rupture of the eardrum. The acute
infection has resolved; however, the perforation has not healed. It is noted that this child is
behind on his immunizations; therefore diphtheria tetanus acellular pertussis–Haemophilus
influenzae type b (DTaP-Hib), measles-mumps-rubella (MMR), and oral poliomyelitis vaccines
are administered.
ICD-9-CM ____________________
ANS: 384.20, V06.3, V06.4, V03.81
15. A patient with advanced gastric cancer receives palliative chemotherapy in the form of
Adriamycin. The patient first receives an intravenous (IV) infusion of 1000 cc of 5% dextrose in
water (D5W) for hydration and Kytril as an antiemetic. Adriamycin is then administered IV with
the push technique.
ICD-9-CM ____________________
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
, Test Bank 1-4
ANS: 151.9, V58.11
SHORT ANSWER
1. Combination codes:
A. Pneumonia due to Haemophilus influenzae. ____________________
B. Candidiasis of the mouth. ____________________
C. Hypertensive cerebrovascular disease. ____________________
D. Closed fracture of the tibia and fibula. ____________________
ANS:
A. 482.2
B. 112.0
C. 437.2
D. 823.82
2. Multiple coding:
A. Chronic prostatitis due to Streptococcus species. ____________________
B. Acute bronchitis due to Pseudomonas species. ____________________
C. Gangrene due to diabetes mellitus type I. ____________________
D. Amyloid cardiomyopathy. ____________________
ANS:
A. 601.1041.00
B. 466.0041.7
C. 250.71785.4
D. 277.39, 425.7
3. Uncertain and impending and/or threatened condition:
A. Threatened labor. ____________________
B. Threatened miscarriage. ____________________
C. Impending coronary syndrome. ____________________
D. Evolving stroke. ____________________
ANS:
A. 644.10
B. 640.00
C. 411.10
D. 434.91
4. Late effect:
A. Traumatic arthritis after a fracture of the left ankle 3 years earlier. ________________
B. Aphasia due to cerebrovascular accident 6 months earlier. ____________________
C. Sensorineural deafness due to previous meningitis. ____________________
ANS:
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Chapter 01: Diagnostic Coding: International Classification of Diseases, 9th Revision,
Clinical Modification (ICD-9-CM)
Test Bank
COMPLETION
1. A patient is admitted to the hospital with severe flank pain and hematuria. A urinalysis is
performed; the result is positive for Escherichia coli. The discharge summary states acute
pyelonephritis.
ICD-9-CM ____________________
ANS: 590.10
2. The patient vaginally delivered an infant on November 1, and an emergency curettage was
performed on November 3 for postpartum hemorrhage as a result of retained placental fragments.
ICD-9-CM ____________________
ANS: 666.22, V27.0
3. A 23-year-old man has a suspicious 0.5-cm lesion on his shoulder. The dermatologist excises the
lesion in his office. A microscopic pathology report showing a squamous cell carcinoma with
positive borders is sent to the patient’s family physician. The family physician refers the patient
again to the dermatologist, who re-excises the site (previous wound size 1.0 cm, including skin
margins) and performs a simple primary closure of the wound.
ICD-9-CM ____________________
ANS: 173.6
4. A 44-year-old woman with a history of breast cancer complains to her internist about shortness
of breath. Her visit includes an expanded problem-focused history, a detailed examination, and
low-complexity decision-making. A chest x-ray examination taken in the office shows a small
pleural effusion on the right lung. The physician performs a thoracentesis, draws off the fluid,
and sends it for cytologic and chemistry analysis.
ICD-9-CM ____________________
ANS: 511.9, V10.3
5. A general surgeon attempts a laparoscopic cholecystectomy on a 44-year-old woman suffering
from acute cholecystitis with gallstones but no obstruction because of an unusual anatomic
variation. However, the physician aborts the laparoscopic procedure and completes the
cholecystectomy via an open laparotomy.
ICD-9-CM ____________________
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
, Test Bank 1-2
ANS: 574.00, V64.41
6. A 71-year-old woman presents with acromegaly and reports multiple medical problems
associated with the disease. A magnetic resonance image (MRI) shows a large pituitary
macroadenoma, and surgery is elected. The patient undergoes a microscopic transsphenoidal
pituitary adenectomy with insertion of a lumbar subarachnoid drain. The right thigh is opened,
and a muscle and fascia plug is taken from the fascia lata. The graft is placed in the sella. The
floor of the sella is reconstructed with a piece of bone and covered with Gelfoam® and fat. The
wound is closed and dressed, and the lumbar drain is removed.
ICD-9-CM ____________________
ANS: 227.3, 253.0
7. A gynecologist refers a 26-year-old woman with amenorrhea and galactorrhea to the
neurosurgeon for further workup. MRI and endocrine studies reveal a microadenoma of the
pituitary. Surgery is elected, and the patient undergoes exposure provided by the
otorhinolaryngologist. Transnasal excision of a pituitary tumor is performed by the
neurosurgeon.
ICD-9-CM ____________________
ANS: 227.3
8. The ophthalmologist repairs two horizontal muscles for alternating esotropia and performs a lid
retraction repair at an outpatient hospital surgical suite.
ICD-9-CM ____________________
ANS: 378.05, 374.41
9. A 64-year-old patient complains of severe headaches and blackout episodes. Previous
electroencephalographic (EEG) and computed tomographic (CT) scans are negative. An
interventional radiologist performs bilateral common carotid and left vertebral artery (cerebral)
angiography. A retrograde right femoral approach is used. Selective catheterization of the right
common carotid artery, the left common carotid artery, and, subsequently, the left vertebral artery
is performed. In addition, photographic subtractions of the anteroposterior (AP) view are
obtained on the vertebral run. The radiologist interprets the images and concludes that the patient
has cerebral atherosclerosis.
ICD-9-CM ____________________
ANS: 437.0
10. A patient presents to a urology clinic with a history of chronic calculus in the pelvis of the
kidney. His history also includes allergies and a reaction to ionic contrast. He is sent to a local
hospital as an outpatient and is injected with a bolus 100 cc of low osmolar contrast material, and
an intravenous pyelogram (IVP) is performed. Because the left calyx and ureter are not visible, a
limited ultrasound is performed.
ICD-9-CM ____________________
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
, Test Bank 1-3
ANS: 592.0, V15.08
11. A 48-year-old woman presents to her internal medicine physician with complaints of upper
abdominal pain, chills, and fever. In addition, she is noted to be jaundiced. Liver function tests,
including serum albumin, total bilirubin, and alkaline phosphatase, are performed. Bilirubin and
alkaline phosphatase levels are elevated. The diagnosis is extrahepatic biliary duct obstruction.
The patient is referred to a general surgeon.
ICD-9-CM ____________________
ANS: 576.2
12. An outpatient hospital laboratory performs an adrenocorticotropic hormone (ACTH) stimulation
panel for adrenal insufficiency. Three cortisol levels were obtained.
ICD-9-CM ____________________
ANS: 255.41
13. A 32-year-old man presented to the cardiologist with a complaint of recent onset of palpitations.
He was referred from his family physician for assumption of care. The cardiologist reviewed past
and present social and medical histories and records. After a detailed system review failed to
reveal any abnormality, the cardiologist prescribed a 24-hour Holter monitor. The cardiologist
supplied the monitor with hook-up and recording and performed a review and interpretation of
the microprocessor-based analysis. The analysis and report were supplied by another facility. The
cardiologist diagnosed stress-induced ectopic atrial beats and discussed a course of therapy with
the patient during a follow-up visit. The follow-up visit lasted approximately 20 minutes.
ICD-9-CM ____________________
ANS: 785.1, 427.61
14. After completing a course of antibiotics, an 18-month-old established patient returns for a
follow-up visit for an acute suppurative otitis media with rupture of the eardrum. The acute
infection has resolved; however, the perforation has not healed. It is noted that this child is
behind on his immunizations; therefore diphtheria tetanus acellular pertussis–Haemophilus
influenzae type b (DTaP-Hib), measles-mumps-rubella (MMR), and oral poliomyelitis vaccines
are administered.
ICD-9-CM ____________________
ANS: 384.20, V06.3, V06.4, V03.81
15. A patient with advanced gastric cancer receives palliative chemotherapy in the form of
Adriamycin. The patient first receives an intravenous (IV) infusion of 1000 cc of 5% dextrose in
water (D5W) for hydration and Kytril as an antiemetic. Adriamycin is then administered IV with
the push technique.
ICD-9-CM ____________________
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
, Test Bank 1-4
ANS: 151.9, V58.11
SHORT ANSWER
1. Combination codes:
A. Pneumonia due to Haemophilus influenzae. ____________________
B. Candidiasis of the mouth. ____________________
C. Hypertensive cerebrovascular disease. ____________________
D. Closed fracture of the tibia and fibula. ____________________
ANS:
A. 482.2
B. 112.0
C. 437.2
D. 823.82
2. Multiple coding:
A. Chronic prostatitis due to Streptococcus species. ____________________
B. Acute bronchitis due to Pseudomonas species. ____________________
C. Gangrene due to diabetes mellitus type I. ____________________
D. Amyloid cardiomyopathy. ____________________
ANS:
A. 601.1041.00
B. 466.0041.7
C. 250.71785.4
D. 277.39, 425.7
3. Uncertain and impending and/or threatened condition:
A. Threatened labor. ____________________
B. Threatened miscarriage. ____________________
C. Impending coronary syndrome. ____________________
D. Evolving stroke. ____________________
ANS:
A. 644.10
B. 640.00
C. 411.10
D. 434.91
4. Late effect:
A. Traumatic arthritis after a fracture of the left ankle 3 years earlier. ________________
B. Aphasia due to cerebrovascular accident 6 months earlier. ____________________
C. Sensorineural deafness due to previous meningitis. ____________________
ANS:
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
