Question 1
10 out of 10 points
A type 2 diabetic patient with diabetic retinopathy visits his ophthalmologist for
blurred vision. After performing a visual acuity test and a dilated eye exam, the
provider states the patient has macular edema. Applying the coding concept from
ICD-10-CM Coding guideline I.C.4.a., what ICD-10-CM code is reported?
Selected Answer: a.
E11.311
Answers: a.
E11.311
b.
E11.321
c.
E08.311
d.
E10.311
Response Rationale: According to ICD-10-CM Official Coding Guidelines, Section
Feedback: I.C.4.a the diabetes codes are combination codes that include the
type of diabetes, the body system affected, and the complications
affecting that body system. To locate the codes in the ICD-10-CM
code book, look in the ICD-10-CM Alphabetic Index for Diabetes,
diabetic/with/retinopathy/with macular edema E11.311. Verify code
choice in the Tabular List.
Question 2
0 out of 10 points
A 22-year-old female is admitted to ICU for acute renal (kidney) failure due to sepsis
(causal organism unknown).
Applying the coding concept from ICD-10-CM guideline I.C.1.d.1.b, what ICD-10-CM
codes are reported (in the correct sequencing)?
, Selected Answer: b.
N17.9, R65.20, A41.9
Answers: a.
A41.9, R65.20, N17.9
b.
N17.9, R65.20, A41.9
c.
R65.21, A41.9, N17.9
d.
N17.9, R65.21, A41.01
Response Rationale: ICD-10-CM guideline I.C.1.d.1.b indicates: The coding of
Feedback: severe sepsis requires a minimum of two codes. First, a code for the
underlying systemic infection, followed by a code from subcategory
R65.2, Severe sepsis. If the causal organism is not documented,
assign code A41.9, Sepsis, unspecified organism, for the infection.
Additional codes(s) for the associated acute organ dysfunction are
also required (if present). The first code to report is sepsis; look for
the main term Sepsis in the ICD 10-CM Alphabetic Index referring you
to code A41.9. Next, look for Sepsis/with organ dysfunction (acute)
(multiple) referring you to code R65.20. For the last code, look for
Failure/renal/acute referring you to code N17.9. In the Tabular List you
will find an instructional note under subcategory R65.2 indicating
what codes should be reported first and what codes should be
reported as additional codes.
Question 3
10 out of 10 points
A 45 year-old female with ovarian cancer visits her oncologist to receive an injection
of Procrit®. The Procrit® has been prescribed to her for treatment of her anemia
resulting from antineoplastic chemotherapy treatment. Applying the coding concept
from ICD-10-CM guidelines I.C.2.c.2. What ICD-10-CM codes should be reported?
Selected Answer: a.
, D64.81, C56.9, T45.1X5A
Answers: a.
D64.81, C56.9, T45.1X5A
b.
D64.81, C56.9
c.
C56.9, D64.81
d.
T45.1X5A, D64.81, C56.9
Response Rationale: According to ICD-10-CM guidelines 1.C.2.c.2., because the
Feedback: treatment is directed at the anemia associated with chemotherapy,
and the treatment is only for the anemia, the anemia should be
sequenced first, followed by the appropriate codes for the neoplasm
and the adverse effect (T45.1X5). Look in the ICD 10-CM Alphabetic
Index for Anemia/due to (in) (with)/antineoplastic chemotherapy
(D64.81). According to guideline 1.C.2.c.2. the malignancy is reported
secondarily followed by code T45.1X5. Look in the ICD-10-CM Table of
Neoplasms for ovary and report the code from the Malignant Primary
column (C56.-). In the Tabular List, C56.9 is reported because the
laterality is not stated. Next, to locate T45.1X5 look in the Table of
Drugs and Chemicals for Antineoplastic NEC and selecting the code
from the Adverse effect column (T45.1X5). In the Tabular List,
T45.1X5 requires a 7th character extender. A is selected because this
is considered active treatment.
Question 4
10 out of 10 points
A patient presents with right ear pain and fever. The provider diagnoses acute otitis
media. What ICD-10-CM code(s) is/are reported?
Selected Answer: d.
H66.91
, Answers: a.
H92.01, R50.9
b.
H66.90
c.
H92.01
d.
H66.91
Response Rationale: Look in the ICD-10-CM Alphabetic Index for Otitis
Feedback: (acute)/media/acute, subacute H66.90. In reviewing the Tabular List,
H66.90 is unspecified and there are more specific codes that indicate
laterality. The 5th character 1 indicates the right ear. Right ear pain
(H92.01) and fever (R50.9) are signs/symptoms for the acute otitis
media and not separately reported (refer to ICD-10-CM guideline
I.B.5).
Question 5
10 out of 10 points
Applying the coding concept from ICD-10-CM guideline I.C.9.a.5, how do you code
hypertensive retinopathy?
Selected Answer: d.
Sequencing is based on the reason for the encounter.
Answers: a.
First code the hypertension, then the retinopathy.
b.
First code the retinopathy, then the heart disease.
c.
10 out of 10 points
A type 2 diabetic patient with diabetic retinopathy visits his ophthalmologist for
blurred vision. After performing a visual acuity test and a dilated eye exam, the
provider states the patient has macular edema. Applying the coding concept from
ICD-10-CM Coding guideline I.C.4.a., what ICD-10-CM code is reported?
Selected Answer: a.
E11.311
Answers: a.
E11.311
b.
E11.321
c.
E08.311
d.
E10.311
Response Rationale: According to ICD-10-CM Official Coding Guidelines, Section
Feedback: I.C.4.a the diabetes codes are combination codes that include the
type of diabetes, the body system affected, and the complications
affecting that body system. To locate the codes in the ICD-10-CM
code book, look in the ICD-10-CM Alphabetic Index for Diabetes,
diabetic/with/retinopathy/with macular edema E11.311. Verify code
choice in the Tabular List.
Question 2
0 out of 10 points
A 22-year-old female is admitted to ICU for acute renal (kidney) failure due to sepsis
(causal organism unknown).
Applying the coding concept from ICD-10-CM guideline I.C.1.d.1.b, what ICD-10-CM
codes are reported (in the correct sequencing)?
, Selected Answer: b.
N17.9, R65.20, A41.9
Answers: a.
A41.9, R65.20, N17.9
b.
N17.9, R65.20, A41.9
c.
R65.21, A41.9, N17.9
d.
N17.9, R65.21, A41.01
Response Rationale: ICD-10-CM guideline I.C.1.d.1.b indicates: The coding of
Feedback: severe sepsis requires a minimum of two codes. First, a code for the
underlying systemic infection, followed by a code from subcategory
R65.2, Severe sepsis. If the causal organism is not documented,
assign code A41.9, Sepsis, unspecified organism, for the infection.
Additional codes(s) for the associated acute organ dysfunction are
also required (if present). The first code to report is sepsis; look for
the main term Sepsis in the ICD 10-CM Alphabetic Index referring you
to code A41.9. Next, look for Sepsis/with organ dysfunction (acute)
(multiple) referring you to code R65.20. For the last code, look for
Failure/renal/acute referring you to code N17.9. In the Tabular List you
will find an instructional note under subcategory R65.2 indicating
what codes should be reported first and what codes should be
reported as additional codes.
Question 3
10 out of 10 points
A 45 year-old female with ovarian cancer visits her oncologist to receive an injection
of Procrit®. The Procrit® has been prescribed to her for treatment of her anemia
resulting from antineoplastic chemotherapy treatment. Applying the coding concept
from ICD-10-CM guidelines I.C.2.c.2. What ICD-10-CM codes should be reported?
Selected Answer: a.
, D64.81, C56.9, T45.1X5A
Answers: a.
D64.81, C56.9, T45.1X5A
b.
D64.81, C56.9
c.
C56.9, D64.81
d.
T45.1X5A, D64.81, C56.9
Response Rationale: According to ICD-10-CM guidelines 1.C.2.c.2., because the
Feedback: treatment is directed at the anemia associated with chemotherapy,
and the treatment is only for the anemia, the anemia should be
sequenced first, followed by the appropriate codes for the neoplasm
and the adverse effect (T45.1X5). Look in the ICD 10-CM Alphabetic
Index for Anemia/due to (in) (with)/antineoplastic chemotherapy
(D64.81). According to guideline 1.C.2.c.2. the malignancy is reported
secondarily followed by code T45.1X5. Look in the ICD-10-CM Table of
Neoplasms for ovary and report the code from the Malignant Primary
column (C56.-). In the Tabular List, C56.9 is reported because the
laterality is not stated. Next, to locate T45.1X5 look in the Table of
Drugs and Chemicals for Antineoplastic NEC and selecting the code
from the Adverse effect column (T45.1X5). In the Tabular List,
T45.1X5 requires a 7th character extender. A is selected because this
is considered active treatment.
Question 4
10 out of 10 points
A patient presents with right ear pain and fever. The provider diagnoses acute otitis
media. What ICD-10-CM code(s) is/are reported?
Selected Answer: d.
H66.91
, Answers: a.
H92.01, R50.9
b.
H66.90
c.
H92.01
d.
H66.91
Response Rationale: Look in the ICD-10-CM Alphabetic Index for Otitis
Feedback: (acute)/media/acute, subacute H66.90. In reviewing the Tabular List,
H66.90 is unspecified and there are more specific codes that indicate
laterality. The 5th character 1 indicates the right ear. Right ear pain
(H92.01) and fever (R50.9) are signs/symptoms for the acute otitis
media and not separately reported (refer to ICD-10-CM guideline
I.B.5).
Question 5
10 out of 10 points
Applying the coding concept from ICD-10-CM guideline I.C.9.a.5, how do you code
hypertensive retinopathy?
Selected Answer: d.
Sequencing is based on the reason for the encounter.
Answers: a.
First code the hypertension, then the retinopathy.
b.
First code the retinopathy, then the heart disease.
c.
