HCS-D Practice #5 100% Solved!
1. Sepsis is a systemic inflammatory reaction to an infection and may be coded in
homecare.
a. False, sepsis is an infection.
b. False, because sepsis is an acute condition that only occurs in the hospital.
c. False, sepsis is a systemic inflammatory reaction to an infection and may not be
coded in homecare.
d. True, and the inflammatory reaction can continue to cause problems even after the
infection is resolved. - ANSWERSd. True, and the inflammatory reaction can continue to
cause problems even after the infection is resolved.
2. Chapter 13 codes that represent laterality include the site of the:
a. Joint
b. Bone
c. Muscle
d. All of the Above - ANSWERSd. All of the Above
3. Patient admitted to HH for observation and assessment of his unstable angina. He
had a CABG 2 years ago and cardiac catheterization shows CAD but the bypass grafts
are patent. He also has documented atrial fibrillation and HTN. How would you code
this?
a. I25.110, I20.0, I48.1, I10
b. I20.0, I48.91, I10, Z95.1
c. I25.110, I48.91, I10, Z95.1
d. I25.700, I10, I48.91 - ANSWERSc. I25.110, I48.91, I10, Z95.1
4. The physician documented an infected surgical wound in the abdomen after an
appendectomy, and coded S31.613A. What is the incorrect statement regarding this
coding?
a. We do not have to query the physician for the type of wound.
b. Trauma wounds or open wounds codes are never to be used for surgical wounds or
surgical complications.
c. We have to code what the physician codes.
d. The coder should use the description in the documentation to code, not the code
itself. - ANSWERSc. We have to code what the physician codes.
**We code according to physician documentation, not the coding.
5. How should pneumonia due to an unspecified organism be coded?
,a. J18.0
b. J16.8
c. J18.1
d. J18.9 - ANSWERSd. J18.9
6. A patient is seen for right upper quadrant pain. He is morbidly obese and is 5'-7" and
weighs 300lbs. How would this be coded?
a. R10.11, E66.2, Z68.43
b. R10.11, E66.01, Z68.42
c. R10.10, E66.09
d. R10.12, E66.0, Z68.42 - ANSWERSb. R10.11, E66.01, Z68.42
7. Which of the following is NOT assumed related, or due to, diabetes?
a. neuropathic arthropathy
b. Atherosclerotic heart disease
c. myasthenia
d. renal tubular degeneration - ANSWERSb. Atherosclerotic heart disease
**ASHD is not assumed related because it is not specifically listed under the convention
'with' in the index under diabetes.
8. 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. I11.9, I50.31, I50.9
b. I11.0, I50.33
c. I50.33, I50.9, I10
d. I11.0, I50.33, I50.9 - ANSWERSb. 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.
9. The physician documented that the diabetes is uncontrolled. Which of the following is
the correct statement regarding uncontrolled diabetes?
a. Code Type 2 diabetes with hyperosmolarity
b. Add a 6th character for uncontrolled
c. Code E11.65
d. Query whether the patient has hyperglycemia, hypoglycemia or both - ANSWERSd.
Query whether the patient has hyperglycemia, hypoglycemia or both
, **There is no special character or digit for uncontrolled. "Uncontrolled" can mean
hyperglycemia or hypoglycemia
10. The patient has secondary diabetes and polyneuropathy. What is the correct
coding?
a. E08.42
b. G63, E11.9
c. E13.9, G62.9
d. E13.42 - ANSWERSd. E13.42
11. The physician documented severe obesity but did not document the BMI. What
should you do?
a. Document and code the BMI to match the physician's statement of severe obesity.
b. Leave the code off if the physician didn't document the BMI
c. Code BMI based on the clinician's calculations. - ANSWERSc. Code BMI based on
the clinician's calculations.
12. Patient is admitted to home health for wound care to her atherosclerotic ulcer of the
left ankle. Upon assessment, the nurse documents necrosis of muscle tissue is present.
The patient also has left non-dominant hemiplegia from a stroke 4 years ago. How
would you code this?
a. I70.243, L97.323, I69.954
b. I70.243, L97.323, I69.354
c. I70.243, I69.354
d. I70.233, I97.323, I69.354 - ANSWERSb. I70.243, L97.323, I69.354
**The atherosclerosis of native arteries of left leg with an ulcer is coded to L70.243 - the
L70.233 is incorrect because it is the right leg. The instructional note at L70.24 states to
use additional code to identify the severity of the ulcer, which can be coded based on
the clinician's documentation. The correct code for the stroke deficit is I69.354 - the
I69.9 should not be used per the Excludes 1 note under I69.9 category.
13. To find the code for use of supplemental oxygen, look under ________ in the
alphabetical index.
a. use of, oxygen, supplemental
b. oxygen, dependence on
c. dependence, supplemental oxygen
d. status, supplemental oxygen - ANSWERSc. dependence, supplemental oxygen
1. Sepsis is a systemic inflammatory reaction to an infection and may be coded in
homecare.
a. False, sepsis is an infection.
b. False, because sepsis is an acute condition that only occurs in the hospital.
c. False, sepsis is a systemic inflammatory reaction to an infection and may not be
coded in homecare.
d. True, and the inflammatory reaction can continue to cause problems even after the
infection is resolved. - ANSWERSd. True, and the inflammatory reaction can continue to
cause problems even after the infection is resolved.
2. Chapter 13 codes that represent laterality include the site of the:
a. Joint
b. Bone
c. Muscle
d. All of the Above - ANSWERSd. All of the Above
3. Patient admitted to HH for observation and assessment of his unstable angina. He
had a CABG 2 years ago and cardiac catheterization shows CAD but the bypass grafts
are patent. He also has documented atrial fibrillation and HTN. How would you code
this?
a. I25.110, I20.0, I48.1, I10
b. I20.0, I48.91, I10, Z95.1
c. I25.110, I48.91, I10, Z95.1
d. I25.700, I10, I48.91 - ANSWERSc. I25.110, I48.91, I10, Z95.1
4. The physician documented an infected surgical wound in the abdomen after an
appendectomy, and coded S31.613A. What is the incorrect statement regarding this
coding?
a. We do not have to query the physician for the type of wound.
b. Trauma wounds or open wounds codes are never to be used for surgical wounds or
surgical complications.
c. We have to code what the physician codes.
d. The coder should use the description in the documentation to code, not the code
itself. - ANSWERSc. We have to code what the physician codes.
**We code according to physician documentation, not the coding.
5. How should pneumonia due to an unspecified organism be coded?
,a. J18.0
b. J16.8
c. J18.1
d. J18.9 - ANSWERSd. J18.9
6. A patient is seen for right upper quadrant pain. He is morbidly obese and is 5'-7" and
weighs 300lbs. How would this be coded?
a. R10.11, E66.2, Z68.43
b. R10.11, E66.01, Z68.42
c. R10.10, E66.09
d. R10.12, E66.0, Z68.42 - ANSWERSb. R10.11, E66.01, Z68.42
7. Which of the following is NOT assumed related, or due to, diabetes?
a. neuropathic arthropathy
b. Atherosclerotic heart disease
c. myasthenia
d. renal tubular degeneration - ANSWERSb. Atherosclerotic heart disease
**ASHD is not assumed related because it is not specifically listed under the convention
'with' in the index under diabetes.
8. 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. I11.9, I50.31, I50.9
b. I11.0, I50.33
c. I50.33, I50.9, I10
d. I11.0, I50.33, I50.9 - ANSWERSb. 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.
9. The physician documented that the diabetes is uncontrolled. Which of the following is
the correct statement regarding uncontrolled diabetes?
a. Code Type 2 diabetes with hyperosmolarity
b. Add a 6th character for uncontrolled
c. Code E11.65
d. Query whether the patient has hyperglycemia, hypoglycemia or both - ANSWERSd.
Query whether the patient has hyperglycemia, hypoglycemia or both
, **There is no special character or digit for uncontrolled. "Uncontrolled" can mean
hyperglycemia or hypoglycemia
10. The patient has secondary diabetes and polyneuropathy. What is the correct
coding?
a. E08.42
b. G63, E11.9
c. E13.9, G62.9
d. E13.42 - ANSWERSd. E13.42
11. The physician documented severe obesity but did not document the BMI. What
should you do?
a. Document and code the BMI to match the physician's statement of severe obesity.
b. Leave the code off if the physician didn't document the BMI
c. Code BMI based on the clinician's calculations. - ANSWERSc. Code BMI based on
the clinician's calculations.
12. Patient is admitted to home health for wound care to her atherosclerotic ulcer of the
left ankle. Upon assessment, the nurse documents necrosis of muscle tissue is present.
The patient also has left non-dominant hemiplegia from a stroke 4 years ago. How
would you code this?
a. I70.243, L97.323, I69.954
b. I70.243, L97.323, I69.354
c. I70.243, I69.354
d. I70.233, I97.323, I69.354 - ANSWERSb. I70.243, L97.323, I69.354
**The atherosclerosis of native arteries of left leg with an ulcer is coded to L70.243 - the
L70.233 is incorrect because it is the right leg. The instructional note at L70.24 states to
use additional code to identify the severity of the ulcer, which can be coded based on
the clinician's documentation. The correct code for the stroke deficit is I69.354 - the
I69.9 should not be used per the Excludes 1 note under I69.9 category.
13. To find the code for use of supplemental oxygen, look under ________ in the
alphabetical index.
a. use of, oxygen, supplemental
b. oxygen, dependence on
c. dependence, supplemental oxygen
d. status, supplemental oxygen - ANSWERSc. dependence, supplemental oxygen
