HCS-D Practice #6 Exam 100% Solved!!
1. Patient is admitted to HH with acute on chronic diastolic heart failure, and has
documentation of congestive heart failure due to hypertension. How would you code
this?
a. I11.0, I50.33
b. I11.0, I50.33, I50.9
c. I11.9, I50.31, I50.9
d. I50.33, I50.9, I10 - ANSWERSa. I11.0, I50.33
**The heart failure is documented as due to HTN, so code from Category I11 is used for
hypertensive heart disease. Instructional note states to use additional code for the heart
failure, so that code follows the I11.0 code. The type of heart failure is specified as
acute on chronic diastolic, the code I50.33 includes the congestive heart failure so the
I50.9 code is not needed.
2. The patient does not have diabetes. How should hyperglycemia be coded?
a. E11.65
b. R73.09
c. R73.03
d. R73.9 - ANSWERSd. R73.9
3. The patient has agranulocytosis due to chemotherapy used to treat prostate cancer.
Agranulocytosis is the focus of care.
a. D70, C61
b. D70.1, T45.1x5D, C61
c. D70.1, C61
d. D70.2, T45.1x5D, C61 - ANSWERSb. D70.1, T45.1x5D, C61
4. The patient's suprapubic catheter ostomy continues to bleed a week and half after
surgery and the physician has documented cystostomy hemorrhage. Instructions are to
care for the cystostomy, pack the surrounding area and teach catheter care. How
should this be coded?
a. N99.510
b. N99.518, Z93.50
c. N99.510, Z43.5
d. N99.512 - ANSWERSc. N99.510, Z43.5
**5. 62 year old male admitted to home care following radical prostatectomy for prostate
CA, will require post op assessment and instruction in care of foley catheter and
,procedure for intermittent catheterizations, CA is resolved by surgery (removal of
prostate) and no further treatment planned. How would this be coded?
a. Z48.816 - C61 - Z46.6
b. Z48.816 - Z46.6 - Z85.46
c. Z46.6 - Z48.3 - Z85.46
d. Z48.3 - Z46.6 - Z85.46 - Z90.79 - ANSWERSd. Z48.3 - Z46.6 - Z85.46 - Z90.79
** Aftercare following surgery for neoplasm should be chosen when surgery is related to
any neoplasm, not the aftercare for the body system (Z48.81-). Z85.46 can be found
under history, personal and the absence code can be found under absence.
**6. The physician documents Parkinson's and dementia. How should this be coded?
a. G20, F03.90
b. F03.90, G20
c. G20, F02.80
d. G31.83, F02.80 - ANSWERSc. G20, F02.80
**Parkinson's and Parkinsonism are both coded G20. Referencing dementia in the
index, there is an assumed link between Parkinson's and Parkinsonism with dementia.
In this case, the physician stated Parkinson's so G20, F02.80 is correct. Also reference
the 'Code first underlying condition' note at F02.
7. Patient admitted to home health with a diagnosis of Strep B pneumonia and acute
exacerbation of COPD, with orders for IV antibiotics for 4 weeks via PICC line. How
would you code this?
a. J44.0, J15.3, Z45.2, Z79.2
b. J44.1, J44.0, J15.3, Z45.2, Z79.2
c. J44.1, J15.8, B95.1, Z45.2, Z79.2
d. J13, Z45.2, Z79.2 - ANSWERSc. J44.1, J15.8, B95.1, Z45.2, Z79.2
8. Some infections such as bladder infections and wound infections require that the
infectious agent be coded as an additional code. Choose the correct codes to identify a
surgical wound with a Staph aureus infection with antibiotics.
a. T81.4xxA, B95.61
b. A41.01, T81.4xxA
c. T81.4xxA, A49.01
d. T81.4xxD, A41.01 - ANSWERSa. T81.4xxA, B95.61
9. Patient with Septic arthritis of the right ankle. Cultures indicate pneumococcal
infection and the nurse will administer IV antibiotics and draw labs weekly via PICC.
How would this be coded?
, a. M00.171, B96.5, Z45.2, Z79.2
b. A41.89, M00.871
c. M13.871, A41.89
d. M00.171, Z51.81, Z79.2, Z45.2 - ANSWERSd. M00.171, Z51.81, Z79.2, Z45.2
10. The patient is being admitted for therapy for profuse weakness after a long stay in
the rehab unit after a long stay in ICU for critical illness myopathy. The doctor
documents CIM. The coder should:
a. Code critical illness myopathy as that is what the doctor has documented.
b. Code therapy first and then the critical illness myopathy.
c. Code critical illness myopathy and muscle weakness to support therapy.
d. Code muscle weakness because the patient cannot have critical illness myopathy at
home. - ANSWERSa. Code critical illness myopathy as that is what the doctor has
documented.
**11. An elderly female had asked her son to take her walking through her large flower
garden that she used to keep. She commented how it was "grown-up" with weeds. The
evening after her walk, she developed an intense itching on her right ankle. She put
lotion on it, and went to bed that evening. When she awoke the next morning, her
bilateral lower extremities were covered in red blisters, and were itching. She went to
see the physician since she has diagnoses of DM and PVD. Upon examination, it is
determined she has allergic contact dermatitis with hypersensitivity from poison oak and
prescribes her a high dose Medrol dose pak. Home Health is to monitor for infection of
the open wound areas, and monitor blood sugar related to the prednisone pack. How
would this be coded?
a. L23.7, S91.001D, E11.51, Z79.5
b. L23.7, E11.51
c. L23.7, E11.9, I73.9, Z79.52
d. S91.001D, E11.9, I73.89 - ANSWERSb. L23.7, E11.51
**The allergic contact dermatitis is coded first. Her diabetes and PVD (PVD is arterial)
are assumed related and are impacting the POC. Long term use steroids (impacting the
diabetes) is not coded because the dose pack would not be considered long term.
**12. A patient is admitted to home health for physical therapy related to charcot's joint
with documented 'unknown etiology' of the right shoulder, left ankle, and right foot. He
also has a comorbidity of diabetes. How would this be coded?
a. E11.610, M14.611, M14.672, M14.671
b. A52.16
c. E11.610
d. M14.611, M14.672, M14.671, E11.9 - ANSWERSd. M14.611, M14.672, M14.671,
E11.9
1. Patient is admitted to HH with acute on chronic diastolic heart failure, and has
documentation of congestive heart failure due to hypertension. How would you code
this?
a. I11.0, I50.33
b. I11.0, I50.33, I50.9
c. I11.9, I50.31, I50.9
d. I50.33, I50.9, I10 - ANSWERSa. I11.0, I50.33
**The heart failure is documented as due to HTN, so code from Category I11 is used for
hypertensive heart disease. Instructional note states to use additional code for the heart
failure, so that code follows the I11.0 code. The type of heart failure is specified as
acute on chronic diastolic, the code I50.33 includes the congestive heart failure so the
I50.9 code is not needed.
2. The patient does not have diabetes. How should hyperglycemia be coded?
a. E11.65
b. R73.09
c. R73.03
d. R73.9 - ANSWERSd. R73.9
3. The patient has agranulocytosis due to chemotherapy used to treat prostate cancer.
Agranulocytosis is the focus of care.
a. D70, C61
b. D70.1, T45.1x5D, C61
c. D70.1, C61
d. D70.2, T45.1x5D, C61 - ANSWERSb. D70.1, T45.1x5D, C61
4. The patient's suprapubic catheter ostomy continues to bleed a week and half after
surgery and the physician has documented cystostomy hemorrhage. Instructions are to
care for the cystostomy, pack the surrounding area and teach catheter care. How
should this be coded?
a. N99.510
b. N99.518, Z93.50
c. N99.510, Z43.5
d. N99.512 - ANSWERSc. N99.510, Z43.5
**5. 62 year old male admitted to home care following radical prostatectomy for prostate
CA, will require post op assessment and instruction in care of foley catheter and
,procedure for intermittent catheterizations, CA is resolved by surgery (removal of
prostate) and no further treatment planned. How would this be coded?
a. Z48.816 - C61 - Z46.6
b. Z48.816 - Z46.6 - Z85.46
c. Z46.6 - Z48.3 - Z85.46
d. Z48.3 - Z46.6 - Z85.46 - Z90.79 - ANSWERSd. Z48.3 - Z46.6 - Z85.46 - Z90.79
** Aftercare following surgery for neoplasm should be chosen when surgery is related to
any neoplasm, not the aftercare for the body system (Z48.81-). Z85.46 can be found
under history, personal and the absence code can be found under absence.
**6. The physician documents Parkinson's and dementia. How should this be coded?
a. G20, F03.90
b. F03.90, G20
c. G20, F02.80
d. G31.83, F02.80 - ANSWERSc. G20, F02.80
**Parkinson's and Parkinsonism are both coded G20. Referencing dementia in the
index, there is an assumed link between Parkinson's and Parkinsonism with dementia.
In this case, the physician stated Parkinson's so G20, F02.80 is correct. Also reference
the 'Code first underlying condition' note at F02.
7. Patient admitted to home health with a diagnosis of Strep B pneumonia and acute
exacerbation of COPD, with orders for IV antibiotics for 4 weeks via PICC line. How
would you code this?
a. J44.0, J15.3, Z45.2, Z79.2
b. J44.1, J44.0, J15.3, Z45.2, Z79.2
c. J44.1, J15.8, B95.1, Z45.2, Z79.2
d. J13, Z45.2, Z79.2 - ANSWERSc. J44.1, J15.8, B95.1, Z45.2, Z79.2
8. Some infections such as bladder infections and wound infections require that the
infectious agent be coded as an additional code. Choose the correct codes to identify a
surgical wound with a Staph aureus infection with antibiotics.
a. T81.4xxA, B95.61
b. A41.01, T81.4xxA
c. T81.4xxA, A49.01
d. T81.4xxD, A41.01 - ANSWERSa. T81.4xxA, B95.61
9. Patient with Septic arthritis of the right ankle. Cultures indicate pneumococcal
infection and the nurse will administer IV antibiotics and draw labs weekly via PICC.
How would this be coded?
, a. M00.171, B96.5, Z45.2, Z79.2
b. A41.89, M00.871
c. M13.871, A41.89
d. M00.171, Z51.81, Z79.2, Z45.2 - ANSWERSd. M00.171, Z51.81, Z79.2, Z45.2
10. The patient is being admitted for therapy for profuse weakness after a long stay in
the rehab unit after a long stay in ICU for critical illness myopathy. The doctor
documents CIM. The coder should:
a. Code critical illness myopathy as that is what the doctor has documented.
b. Code therapy first and then the critical illness myopathy.
c. Code critical illness myopathy and muscle weakness to support therapy.
d. Code muscle weakness because the patient cannot have critical illness myopathy at
home. - ANSWERSa. Code critical illness myopathy as that is what the doctor has
documented.
**11. An elderly female had asked her son to take her walking through her large flower
garden that she used to keep. She commented how it was "grown-up" with weeds. The
evening after her walk, she developed an intense itching on her right ankle. She put
lotion on it, and went to bed that evening. When she awoke the next morning, her
bilateral lower extremities were covered in red blisters, and were itching. She went to
see the physician since she has diagnoses of DM and PVD. Upon examination, it is
determined she has allergic contact dermatitis with hypersensitivity from poison oak and
prescribes her a high dose Medrol dose pak. Home Health is to monitor for infection of
the open wound areas, and monitor blood sugar related to the prednisone pack. How
would this be coded?
a. L23.7, S91.001D, E11.51, Z79.5
b. L23.7, E11.51
c. L23.7, E11.9, I73.9, Z79.52
d. S91.001D, E11.9, I73.89 - ANSWERSb. L23.7, E11.51
**The allergic contact dermatitis is coded first. Her diabetes and PVD (PVD is arterial)
are assumed related and are impacting the POC. Long term use steroids (impacting the
diabetes) is not coded because the dose pack would not be considered long term.
**12. A patient is admitted to home health for physical therapy related to charcot's joint
with documented 'unknown etiology' of the right shoulder, left ankle, and right foot. He
also has a comorbidity of diabetes. How would this be coded?
a. E11.610, M14.611, M14.672, M14.671
b. A52.16
c. E11.610
d. M14.611, M14.672, M14.671, E11.9 - ANSWERSd. M14.611, M14.672, M14.671,
E11.9
