CCS SAMPLE MULTIPLE CHOICE
1. A patient was discharged from the hospital with a diagnosis of bronchial asthma.
Upon reviewing the record, the coder notes the patient was described as having
prolonged and intractable wheezing, airway obstruction not relieved by bronchodilators,
and a decreased PAO2 lab value. The physician should be queried to determine
whether the code for ___________is appropriate as the principal diagnosis:
A. Acute viral Bronchitis
B. COPD
C. Respiratory failure
D. Status asthmaticus - Answers -D. Status asthmaticus
2. A patient was admitted to the hospital with severe dehydration and malnutrition. His
blood sugar was elevated. The patient is a known alcohol abuser. Intravenous fluid
replacement was given to hydrate the patient, who signed out against medical advice
after two days. Final diagnoses were: severe dehydration with malnutrition and adult-
onset diabetes vs. early cirrhosis associated with alcoholism. The principal diagnosis is:
A. Adult-onset diabetes
B. Alcohol abuse
C. Cirrhosis of liver due to alcoholism
D. Severe dehydration - Answers -D. Severe dehydration
3. A patient is admitted to the hospital to undergo a radical mastectomy for recurrent
carcinoma of the breast (Previously, she had elected to have a lumpectomy). The
attending physician lists hx of atrial fibrillation as a secondary diagnosis. The patient is
currently not on any medication. For medical clearance prior to surgery, the patient is
seen by a consultant, who says that the patient was satisfactory for the procedure. The
coder should:
A. Report atrial fibrillation as a current condition, because it was documented by the
physician in the history.
B. Code atrial fibrillation as a current condition, because the patient was seen by a
consultant for surgical clearance.
C. Add the code for observation for suspected cardiovascular condition
D. Omit reporting the code for atrial fibrillation, because it was not treated and did not
affect the course of treatment. - Answers -D. Omit reporting the code for atrial
fibrillation, because it was not treated and did not affect the course of treatment.
4. A patient has liver metastasis due to adenocarcinoma of the rectum which was
resected
two years ago. The patient has been receiving radiotherapy to the liver with some relief
of pain. The patient is being admitted at this time for management of severe anemia due
to the malignancy. The principal diagnosis listed on this admission is:
, A. Liver metastasis
B. Adenocarcinoma of the rectum
C. Anemia
D. Admission for radiotherapy - Answers -A. Liver metastasis
5. The first character of an ICD-10-CM code is:
A. Always a number
B. Always a letter
C. Can be either a number or letter
D. None of the above - Answers -B. Always a letter
6. A patient undergoing hemodialysis for renal disease in the outpatient unit of a
hospital develops what is believed to be heartburn. After a few hours of observation, he
is admitted to the hospital for further care. The consulting cardiologist diagnoses this
patient's condition as unstable angina. What is the principal diagnosis for the hospital
stay?
A. Complication of dialysis
B. Heartburn
C. Renal disease
D. Unstable angina - Answers -D. Unstable angina
7. A patient was being treated for gastric ulcer with hemorrhage, cirrhosis of liver and
esophageal varices. Of the following medications, which would indicate a possible
complication or comorbid condition that would impact DRG reimbursement?
A. Bactrim®, 1 tablet q.i.d.
B. Darvocet-N®, 100 mg prn
C. HydroDIURIL®, 50 mg PO daily
D. Tagamet®, 300 mg IM q 6 hrs - Answers -A. Bactrim®, 1 tablet q.i.d.
8. Which of the following would be assigned to code I11.0, Hypertensive heart disease
with heart failure.
a. Left heart failure with benign hypertension
b. Hypertensive cardiomegaly with CHF
c. Congestive heart failure due to hypertension
d. All of the above would be assigned to code I11.0 - Answers -d. All of the above would
be assigned to code I11.0
18. The patient is in the 29th week of pregnancy and has deep venous thrombosis of
the left tibial vein.
a) O22.33, I82.442, Z3A.29
b) O22.33
1. A patient was discharged from the hospital with a diagnosis of bronchial asthma.
Upon reviewing the record, the coder notes the patient was described as having
prolonged and intractable wheezing, airway obstruction not relieved by bronchodilators,
and a decreased PAO2 lab value. The physician should be queried to determine
whether the code for ___________is appropriate as the principal diagnosis:
A. Acute viral Bronchitis
B. COPD
C. Respiratory failure
D. Status asthmaticus - Answers -D. Status asthmaticus
2. A patient was admitted to the hospital with severe dehydration and malnutrition. His
blood sugar was elevated. The patient is a known alcohol abuser. Intravenous fluid
replacement was given to hydrate the patient, who signed out against medical advice
after two days. Final diagnoses were: severe dehydration with malnutrition and adult-
onset diabetes vs. early cirrhosis associated with alcoholism. The principal diagnosis is:
A. Adult-onset diabetes
B. Alcohol abuse
C. Cirrhosis of liver due to alcoholism
D. Severe dehydration - Answers -D. Severe dehydration
3. A patient is admitted to the hospital to undergo a radical mastectomy for recurrent
carcinoma of the breast (Previously, she had elected to have a lumpectomy). The
attending physician lists hx of atrial fibrillation as a secondary diagnosis. The patient is
currently not on any medication. For medical clearance prior to surgery, the patient is
seen by a consultant, who says that the patient was satisfactory for the procedure. The
coder should:
A. Report atrial fibrillation as a current condition, because it was documented by the
physician in the history.
B. Code atrial fibrillation as a current condition, because the patient was seen by a
consultant for surgical clearance.
C. Add the code for observation for suspected cardiovascular condition
D. Omit reporting the code for atrial fibrillation, because it was not treated and did not
affect the course of treatment. - Answers -D. Omit reporting the code for atrial
fibrillation, because it was not treated and did not affect the course of treatment.
4. A patient has liver metastasis due to adenocarcinoma of the rectum which was
resected
two years ago. The patient has been receiving radiotherapy to the liver with some relief
of pain. The patient is being admitted at this time for management of severe anemia due
to the malignancy. The principal diagnosis listed on this admission is:
, A. Liver metastasis
B. Adenocarcinoma of the rectum
C. Anemia
D. Admission for radiotherapy - Answers -A. Liver metastasis
5. The first character of an ICD-10-CM code is:
A. Always a number
B. Always a letter
C. Can be either a number or letter
D. None of the above - Answers -B. Always a letter
6. A patient undergoing hemodialysis for renal disease in the outpatient unit of a
hospital develops what is believed to be heartburn. After a few hours of observation, he
is admitted to the hospital for further care. The consulting cardiologist diagnoses this
patient's condition as unstable angina. What is the principal diagnosis for the hospital
stay?
A. Complication of dialysis
B. Heartburn
C. Renal disease
D. Unstable angina - Answers -D. Unstable angina
7. A patient was being treated for gastric ulcer with hemorrhage, cirrhosis of liver and
esophageal varices. Of the following medications, which would indicate a possible
complication or comorbid condition that would impact DRG reimbursement?
A. Bactrim®, 1 tablet q.i.d.
B. Darvocet-N®, 100 mg prn
C. HydroDIURIL®, 50 mg PO daily
D. Tagamet®, 300 mg IM q 6 hrs - Answers -A. Bactrim®, 1 tablet q.i.d.
8. Which of the following would be assigned to code I11.0, Hypertensive heart disease
with heart failure.
a. Left heart failure with benign hypertension
b. Hypertensive cardiomegaly with CHF
c. Congestive heart failure due to hypertension
d. All of the above would be assigned to code I11.0 - Answers -d. All of the above would
be assigned to code I11.0
18. The patient is in the 29th week of pregnancy and has deep venous thrombosis of
the left tibial vein.
a) O22.33, I82.442, Z3A.29
b) O22.33
