CCS Final Questions & Answers Correct!!
1. The index of the ICD-10-CM indicates the following:
Failure, failed
renal N19
acute N17.9
chronic N18.9
The medical record states the patient has chronic renal failure and has now been
admitted with acute renal failure. Which represents the correct sequence?
A. N18.9, N17.9
B. N17.9, N18.9
C. N19, N17.9
D. Either A or B - ANSWERSB. N17.9, N18.9
2. A 4-year-old patient presents to the ED with her mother. The patient is an asthmatic
with dyspnea and is in obvious distress. The mother states that the child's asthma was
in good control until later in the day, when she began to develop problems breathing.
For the last 4 hours, the mother had administered the child's albuterol inhalant with no
marked improvement. The ED physician directed administration of a nebulizer treatment
of albuterol, 3 mL of 0.083%. The documentation indicates asthma with an acute
exacerbation. After the initial treatment, the patient began to rapidly improve and was
discharged.
J45.22 Mild intermittent asthma with status asthmaticus
J45.901 Unspecified asthma with acute exacerbation
,J44.9 Chronic obstructive pulmonary disease
J45.21 Mild intermittent asthma with acute exacerbation
A. J45.22, 99283
B. J45.901, 99284
C. J44.9, 99285
D. J45.21, 99284 - ANSWERSB. J45.901. The diagnosis is with acute exacerbation, as
documented in the report.
3. A patient presents to the emergency department with the chief complaint of nausea
and recurrent vomiting with dehydration. The nausea with vomiting is listed first in the
final diagnoses section of the report. Upon reviewing the medical record, the coder
notes that the patient was described as having dehydration secondary to viral
pharyngitis with possible ketoacidosis and received infusion therapy. The patient is a
type 1 diabetic who has had no complaints with diabetes for the past 6 years, until
perhaps now. The patient also has asthma that is stable at this time. The patient was
discharged home. The diagnosis(es) would be:
E10.9 Diabetes mellitus without mention of complication, type I (juvenile
type), not stated as uncontrolled
E10.10 Diabetes with ketoacidosis, type I (insulin dependent type) (juvenile type),
uncontrolled
E86.9 Volume depletion
E86.0 Dehydration
J02.9 Acute pharyngitis
J45.909 Asthma, - ANSWERSA. E86.0, R11.2, J02.9, E10.9, J45.909. E86.0 reports
the dehydration, R11.2
reports the nausea with vomiting, J02.9 reports the pharyngitis, E10.9 reports the type I
diabetes, J45.09 reports the asthma. The patient's dehydration was the focus on the ER
visit so is the first-listed diagnosis
4. A 42-year-old female presents to the emergency room stating that she has significant
abdominal discomfort and is supposed to have an upper gastrointestinal series at 8 AM
,tomorrow morning. She has a gastric ulcer, and the abdominal pain is due to this ulcer.
The emergency department physician assesses the patient and orders an abdominal x-
ray. The patient's physician is in the hospital for rounds and is called to the ED to
assume the care of this patient.
R10.9 Abdominal pain, unspecified site
R10.84 Abdominal pain, generalized
K25.9 Gastric ulcer, unspecified as acute or chronic, without mention of
hemorrhage, perforation, or obstruction
K25.4 Gastric ulcer, chronic or unspecified with hemorrhage without mention of
obstruction or perforation
A. K25.9
B. K25.4
C. R10.9, K25.4
D. R10.84, K25.9 - ANSWERSA. K25.9. The ED physician assessed the patient and
K25.9
reports a gastric ulcer that was not specified as acute or chronic
and had no mention of hemorrhage, perforation, or obstruction.
5. According to the ICD-9-CM Official Guidelines for Coding and Reporting Section
I.B.12., regarding reporting late effects indicate that residual is sequenced
_________and the late effect code is sequenced _________.
A. second, first
B. first, second
C. first or second, first or second
D. none of the above - ANSWERSB. first, second. According to the guidelines, the
condition or nature of the late effect (the residual) is sequenced first, and the late effect
code is sequenced second.
6. Hospital outpatient surgery
, The surgeon performed a split-thickness autograft, both thighs to the abdomen
measuring 45 × 21 cm because of the patient's nonhealing surgical wound (skin and
subcutaneous tissue). Which codes would you use to report the facility services?
15100 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or one percent
of body area of infants and children (except 15050)
15101; each additional 100 sq cm, or each additional one percent of body area of
infants and children, or part there of (List separately in addition to code for primary
procedure)
T81.4XXA Infected postoperative wound
L76.82 Other postprocedural complication of skin
T81.89XA Other specified complications of a procedure
A. 15100 × 10, T81.4XXA
B. 15100, 15101 × 9, T81.89XA
C. 15100, 15101 × 8, L76.82
D. 15100, T81.89XA, L76.82 - ANSWERSB. 15100 is the correct code for the first 100
sq cm or less, and 15101 × 9 for the remaining 845 sq cm (in this case, 45 × 21 = 945
sq cm). The code
T81.89XA describes a nonhealing surgical wound (skin) which is the reason for the
procedure (see Coding Clinic).
7. A 59-year-old female is brought to the ED by ambulance with tachycardia and acute
alcohol intoxication. The patient has been seen in the ED on several previous occasions
with significant intoxication and has had multiple admissions for acute intoxication. She
is an episodic alcoholic. She has a medical history that includes fairly well controlled
hypertension and current tobacco abuse (cigarettes) with questionable COPD. The
patient is placed on cardiac monitoring. The ED physician assesses the condition of the
patient and administers an intravenous solution of 1 liter of 5% dextrose and 0.45%
sodium chloride, 2 g of magnesium sulfate, 1 mg of folate, and 100 mg of thiamine.
Intramuscular Ativan is also administered. The physician reassesses the patient several
times over the next 3 hours. The patient's heart rate returns to normal, and the patient is
discharged.
F10.229 Acute alcoholism, episodic, uncomplicated - ANSWERSD. R00.0, F10.229,
I10, F17.210. R00.0 (tachycardia) is the first-listed diagnosis. It is the primary reason for
services that were rendered in the ED (refer to ICD-10-CM Official Guidelines for
Coding and Reporting, Section IV, H). The acute alcoholism is reported for the acute
alcohol intoxication with F10.229, because although it is a major consideration in the
1. The index of the ICD-10-CM indicates the following:
Failure, failed
renal N19
acute N17.9
chronic N18.9
The medical record states the patient has chronic renal failure and has now been
admitted with acute renal failure. Which represents the correct sequence?
A. N18.9, N17.9
B. N17.9, N18.9
C. N19, N17.9
D. Either A or B - ANSWERSB. N17.9, N18.9
2. A 4-year-old patient presents to the ED with her mother. The patient is an asthmatic
with dyspnea and is in obvious distress. The mother states that the child's asthma was
in good control until later in the day, when she began to develop problems breathing.
For the last 4 hours, the mother had administered the child's albuterol inhalant with no
marked improvement. The ED physician directed administration of a nebulizer treatment
of albuterol, 3 mL of 0.083%. The documentation indicates asthma with an acute
exacerbation. After the initial treatment, the patient began to rapidly improve and was
discharged.
J45.22 Mild intermittent asthma with status asthmaticus
J45.901 Unspecified asthma with acute exacerbation
,J44.9 Chronic obstructive pulmonary disease
J45.21 Mild intermittent asthma with acute exacerbation
A. J45.22, 99283
B. J45.901, 99284
C. J44.9, 99285
D. J45.21, 99284 - ANSWERSB. J45.901. The diagnosis is with acute exacerbation, as
documented in the report.
3. A patient presents to the emergency department with the chief complaint of nausea
and recurrent vomiting with dehydration. The nausea with vomiting is listed first in the
final diagnoses section of the report. Upon reviewing the medical record, the coder
notes that the patient was described as having dehydration secondary to viral
pharyngitis with possible ketoacidosis and received infusion therapy. The patient is a
type 1 diabetic who has had no complaints with diabetes for the past 6 years, until
perhaps now. The patient also has asthma that is stable at this time. The patient was
discharged home. The diagnosis(es) would be:
E10.9 Diabetes mellitus without mention of complication, type I (juvenile
type), not stated as uncontrolled
E10.10 Diabetes with ketoacidosis, type I (insulin dependent type) (juvenile type),
uncontrolled
E86.9 Volume depletion
E86.0 Dehydration
J02.9 Acute pharyngitis
J45.909 Asthma, - ANSWERSA. E86.0, R11.2, J02.9, E10.9, J45.909. E86.0 reports
the dehydration, R11.2
reports the nausea with vomiting, J02.9 reports the pharyngitis, E10.9 reports the type I
diabetes, J45.09 reports the asthma. The patient's dehydration was the focus on the ER
visit so is the first-listed diagnosis
4. A 42-year-old female presents to the emergency room stating that she has significant
abdominal discomfort and is supposed to have an upper gastrointestinal series at 8 AM
,tomorrow morning. She has a gastric ulcer, and the abdominal pain is due to this ulcer.
The emergency department physician assesses the patient and orders an abdominal x-
ray. The patient's physician is in the hospital for rounds and is called to the ED to
assume the care of this patient.
R10.9 Abdominal pain, unspecified site
R10.84 Abdominal pain, generalized
K25.9 Gastric ulcer, unspecified as acute or chronic, without mention of
hemorrhage, perforation, or obstruction
K25.4 Gastric ulcer, chronic or unspecified with hemorrhage without mention of
obstruction or perforation
A. K25.9
B. K25.4
C. R10.9, K25.4
D. R10.84, K25.9 - ANSWERSA. K25.9. The ED physician assessed the patient and
K25.9
reports a gastric ulcer that was not specified as acute or chronic
and had no mention of hemorrhage, perforation, or obstruction.
5. According to the ICD-9-CM Official Guidelines for Coding and Reporting Section
I.B.12., regarding reporting late effects indicate that residual is sequenced
_________and the late effect code is sequenced _________.
A. second, first
B. first, second
C. first or second, first or second
D. none of the above - ANSWERSB. first, second. According to the guidelines, the
condition or nature of the late effect (the residual) is sequenced first, and the late effect
code is sequenced second.
6. Hospital outpatient surgery
, The surgeon performed a split-thickness autograft, both thighs to the abdomen
measuring 45 × 21 cm because of the patient's nonhealing surgical wound (skin and
subcutaneous tissue). Which codes would you use to report the facility services?
15100 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or one percent
of body area of infants and children (except 15050)
15101; each additional 100 sq cm, or each additional one percent of body area of
infants and children, or part there of (List separately in addition to code for primary
procedure)
T81.4XXA Infected postoperative wound
L76.82 Other postprocedural complication of skin
T81.89XA Other specified complications of a procedure
A. 15100 × 10, T81.4XXA
B. 15100, 15101 × 9, T81.89XA
C. 15100, 15101 × 8, L76.82
D. 15100, T81.89XA, L76.82 - ANSWERSB. 15100 is the correct code for the first 100
sq cm or less, and 15101 × 9 for the remaining 845 sq cm (in this case, 45 × 21 = 945
sq cm). The code
T81.89XA describes a nonhealing surgical wound (skin) which is the reason for the
procedure (see Coding Clinic).
7. A 59-year-old female is brought to the ED by ambulance with tachycardia and acute
alcohol intoxication. The patient has been seen in the ED on several previous occasions
with significant intoxication and has had multiple admissions for acute intoxication. She
is an episodic alcoholic. She has a medical history that includes fairly well controlled
hypertension and current tobacco abuse (cigarettes) with questionable COPD. The
patient is placed on cardiac monitoring. The ED physician assesses the condition of the
patient and administers an intravenous solution of 1 liter of 5% dextrose and 0.45%
sodium chloride, 2 g of magnesium sulfate, 1 mg of folate, and 100 mg of thiamine.
Intramuscular Ativan is also administered. The physician reassesses the patient several
times over the next 3 hours. The patient's heart rate returns to normal, and the patient is
discharged.
F10.229 Acute alcoholism, episodic, uncomplicated - ANSWERSD. R00.0, F10.229,
I10, F17.210. R00.0 (tachycardia) is the first-listed diagnosis. It is the primary reason for
services that were rendered in the ED (refer to ICD-10-CM Official Guidelines for
Coding and Reporting, Section IV, H). The acute alcoholism is reported for the acute
alcohol intoxication with F10.229, because although it is a major consideration in the
