MRHI 221 Coding 3 Exam | Questions and Answers (Complete Solutions)

MRHI 221 Coding 3 Exam | Questions and Answers (Complete Solutions) The second character of the ICD-10-PCS coding system defines the ___________. Body System Right myringotomy with placement of pressure equalization tube. A myringotomy incision was made and the middle ear was suctioned. A T-tube was then placed without difficulty. What is the correct ICD-10-PCS code? 099770Z Which of the following alphabetic letters are not used in ICD-10-PCS coding? I and O If multiple procedures are performed that are defined by distinct objectives during a single operative episode, then Multiple procedure codes are used The first character of the ICD-10-PCS coding system defines the Section The third character, or the Root Operation, defines the Objective of the procedure Drainage of skin abscess on left buttock What is the correct ICD-10-PCS code? 0H98XZZ The ICD-10-PCS coding system is comprised of how many parts? Two How many characters are in each ICD-10-PCS code? Seven One of 34 possible _______ can be assigned to each axis of classification in the seven- character code. Values An external approach is used when procedures: Are performed directly on the skin or mucous membrane Which of the following characters of the ICD-10-PCS coding system specified an additional attribute of the procedure? Qualifier Mitral valve replacement using porcine tissue, open What is the correct ICD-10-PCS code? 02RG08Z Bilateral direct inguinal herniorrhaphy, open What is the correct ICD-10-PCS code? 0YQA0ZZ Choose the correct ICD-10-PCS Code for the following scenario: Intravenous infusion of anti-inflammatory medication for treatment of ulcerative colitis. 3E00X3Z Choose the correct code assignment (ICD-10-CM and ICD-10-PCS) for the following scenario: 65-year-old with Viral carditis. A right and left diagnostic cardiac catheterization was performed. B33.20 ; 4A023N8 The patient is a 67-year-old female admitted to the hospital from the emergency room. She reported that she had nausea and vomiting and a fever for the last two days. She had been eating poorly for at least three days and within the last 12 hours started having chills, racing heart, and shortness of breath. She noticed a strong odor and dark color in her urine. The complete blood count (CBC) on admission had a result of 24,000 white cells with a shift to the left. Other laboratory tests confirmed an electrolyte imbalance, with hyponatremia and hypokalemia. The urinalysis showed to many white blood cells to count and many bacteria present. She was admitted for intravenous antibiotics and rehydration fluids to correct the electrolyte imbalance. The patient had been undergoing chemotherapy for recently diagnosed metastatic carcinoma in her axillary lymph nodes. The patient had breast cancer diagnosed and treated five years ago with surgery and chemotherapy. Her diagnosis on admission was acute sepsis with a suspected urinary tract infection as the cause. A urine culture and two blood cultures were positive for Klebsiella gram-negative organism. After the initiation of the IV fluids and antibiotics, the patient improved and was able to eat more ambulate. She had no vomiting or diarrhea. The repeat urinalysis and blood counts showed values that were approaching a normal range. The oncologist examined the patient in the hospital and determined her next chemotherapy session would be delayed by two weeks to allow the patient to recover from this infection and regain her strength. Both the attending physician and the oncologist agreed that the patient's final diagnosis was sepsis due to underlying urinary tract infection, both due to Klebsiella gram-negative organism infection, hyponatremia, hypokalemia, and history of breast cancer with metastatic disease in the axillary lymph nodes. The patient was discharged home with home care nurses to visit the next day. A41.59, N39.0, B96.1, E87.1, E87.6, C77.3, Z85.3 This 25-year-old homeless patient was admitted with difficulty breathing. She has AIDS and is the 21st week of pregnancy. Workup shows Pneumocystis carinnii pneumonia. What codes (ICD-10-CM Code(s) with POA Indicator and MS-DRG) are assigned? O98.712-Y, B20-Y, O99.512-Y, B59-Y, Z3A.21-Y, Z59.0, MS-DRG 781 Excision of basal cell carcinoma of upper lip. 0CB0XZZ Choose the correct code assignment for the following scenario: 44-year-old male with dyspnea and swelling on the left side of his neck was seen today in Dr. Smith's office. Dr. Smith suspected cancer and requests that the patient have a CT scan of the neck. The patient will have a CT scan completed on Thursday and will follow-up with Dr. Smith in 1 week. R06.00, R22.1 Excision of malignant melanoma from skin of right ear 0HB2XZZ Plaque radiation of left eye, single port D8Y0FZZ Choose the correct code assignment for the following scenario: 36-year-old female with carcinoma of her left breast nipple. An open excision of the left breast nipple was performed. C50.012, 0HBU0ZZ Choose the correct code assignment for the following scenario: 12-year-old male with carcinoma of his right descended testicle. A right orchiectomy was completed. C62.11, 0VT90ZZ This patient was admitted for chemotherapy due to a primary hepatocellular carcinoma of the transplanted liver. What codes are assigned? Z51.11, T86.49, C80.2, C22.0 Lymph node open biopsy by excision, right axilla 07B50ZX Bone marrow needle extraction biopsy, iliac 07DR3ZX Choose the correct code assignment for the following scenario: 27-year-old admitted with anemia who has a transfusion via a peripheral vein of nonautologous packed red blood cells. D64.9, 30233N1 Choose the correct code assignment for the following scenario: 33-year-old seen for anemia. A diagnostic EGD was performed and it was determined that the anemia is due to blood loss from a chronic gastric ulcer. D50.0, K25.4, 0DJ08ZZ An 8-year-old male hemophiliac is admitted with acute blood loss anemia following uncontrolled bleeding. He was given four units of packed red blood cells via the peripheral vein. While in the hospital he also received his regular preventive infusion of clotting factors. Which of the following answers would be correct? D62, D66, 30233N1, 30233V1 Transfusion of antihemophilic factor, (nonautologous) via arterial central line 30263V1 What is the ICD-10-PCS code for the following scenario? MRI of thyroid gland, contrast unspecified BG34YZZ What is the ICD-10-PCS code for the following scenario? Total excision of pituitary gland, open 0GT00ZZ Scenario Stereotactic gamma beam radiosurgery, parathyroid gland tumor DG24JZZ Choose the correct code assignment for the following scenario: 24-year-old with an adenomatous goiter of her thyroid with thyrotoxicosis has an open thyroidectomy completed without any complications. E05.20, 0GTK0ZZ Choose the correct code assignment for the following scenario: Morbidly obese 39-year-old female with Pickwickian Syndrome is admitted for a gastric banding. An extraluminal laparoscopic gastric banding was completed without any problems. E66.2, 0DV64CZ The parents of a 16-year-old boy accompanied him to the hospital for admission for the insertion of a totally implantable insulin infusion pump and injection of insulin. The patient has had type 1 diabetes mellitus since the age of 11 years. The insertion of the pump into the subcutaneous tissue of his abdomen was successful. On numerous occasions during the admission, the patient's diabetes had been uncontrolled with various types and dosages of insulin that were administered through the pump. The patient was discharged and will return to the hospital's diabetic clinic in one week with his parents for insulin pump titration and training. For the next week the pump will run with saline. E10.65, 0JH80VZ Choose the correct code assignment for the following scenario: 18-year-old with marijuana abuse and current intoxication is brought into today for a crisis intervention. F12.120, GZ2ZZZZ The patient presents for alcohol detoxification and rehabilitation. He has a 12-year alcohol dependence which is consistent with a high level of daily alcohol consumption. On the second day of admission, he began experiencing withdrawal symptoms of sweating and nausea. On the third day, the sweating became more profuse, and he developed irregular tremors and tachycardia. The delirium tremors were managed medically. The patient did not experience any seizures. Hallucinations abated by day 4. By day 5, the patient was resting more comfortably, and plans for rehabilitation were initiated. The patient expressed a desire to reduce his alcohol abuse to a "controlled" level. A motivational treatment plan was developed and implemented, with the short-term goal of assisting the patient in reaching a stable level of use; that is, controlled drinking and a long-range goal of motivating the patient to accept a goal of total abstinence. Initially, the patient actively participated in the program, but his motivation waned, and he left the program after signing out Against Medical Advice (AMA) without meeting any of the rehabilitation goals. Which of the following code sets most accurately reflects this case scenario? F10.231, HZ2ZZZZ, HZ37ZZZ What is the ICD-10-PCS code for the following scenario? Family counseling for substance abuse treatment HZ63ZZZ What is the ICD-10-PCS code for the following scenario? Individual 12-step psychotherapy for substance abuse HZ53ZZZ What is the ICD-10-PCS code for the following scenario? Cognitive-behavioral psychotherapy, individual GZ58ZZZ What is the ICD-10-PCS code for the following scenario? Group cognitive-behavioral counseling for substance abuse HZ42ZZZ In the following case scenario, a 26-year-old white male was admitted after being transferred from the outpatient evaluation service with severe homicidal and suicidal ideation. Admitting diagnosis was severe major depressive disorder with psychotic features. The patient uses cannabis weekly. Pharmacologic treatment was initiated and suicide precautions were instituted. After a thorough neuropsychological, personality, and behavioral psychologic evaluation, the risks and benefits of ECT were reviewed. Due to the severity of the psychotic episode and the patient's delusional state, it was determined that ECT was warranted. Extensive efforts were made to secure informed consent from the patient, and a course of single seizure unilateral ECT was begun. ECT was administered three times per week, and the course of therapy was completed in a three-week period. On the fourth treatment of ECT, postictal observation was notable for cardiac arrhythmia, which subsided without sequelae. Otherwise, the patient tolerated the therapy well and responded quickly with resolution of the psychotic features and overall improvement in the acute phase of his depressive disorder. Suicide precautions could be lifted after the fifth treatment with ECT. After establishing adequate therapeutic levels of lithium, the patient was discharged to be managed as an outpatient. Discharge Diagnosis: Severe major depressive disorder with suicidal ideation, stabilized after a course of ECT. Which is the correct code set for reporting this case scenario? F32.3, R45.851, R45.850, F12.90, GZB0ZZZ, GZ3ZZZZ, GZ11ZZZ, GZ13ZZZ This is a 71-year-old female admitted with a complaint of right-sided weakness. She denies any fever, shortness of breath, cough, headaches, or chest pain. Patient has NIDMM, controlled by diet. Patient currently smokes a half pack of cigarettes per day. Mild right-sided paralysis was found on physical examination. Patient is right-handed. Gadolinium-enhanced brain MRI demonstrated subacute middle cerebral artery infarct in the left basal ganglia. Discharged diagnosis was CVA—subacute infarct. Physical therapy and speech therapy for her hemiparalysis and dysphasia started and will continue at the rehabilitation facility where she was transferred. I63.512, G81.91, R47.02, E11.9, F17.210, B030Y0Z Choose the correct code assignment for the following scenario: 36-year-old admitted today for a Morton's Neuroma on his left foot. He was taken to the OR where removal of the Morton's Neuroma from the 3-4 and 4-5 interspaces of the left foot was completed without any complications. G57.62, 01BG0ZZ This is one of multiple hospital admission for this 37-year-old white male with a history of meningoencephalitis 20 years ago. He developed obstructive hydrocephalus as a late effect/sequela and underwent ventriculoperitoneal shunting of the right lateral ventricle using a high-pressure valve. The patient is now complaining of numbness in his right leg, headaches, and diplopia. The patient had a low osmolar CT head scan which showed a slight increase in the hydrocephalus involving the fourth ventricle. Impression was shunt malfunction. He is admitted this time for VP shunt revision. An incision just behind the patient's ear was made to access the valve which was noted to be obstructed. The valve and catheter present in the cerebral ventricle were replaced and reconnected to the existing catheter draining the fluid into the peritoneal cavity. The system was functioning well prior to closure. Which of the following is the correct code assignment? T85.09XA, G91.1, G09, 00W600Z, B0201ZZ What is the ICD-10-PCS code for the following scenario? Ulnar nerve release by fasciotomy, left arm 01N40ZZ What is the ICD-10-PCS code for the following scenario? Shunting of intrathecal cerebrospinal fluid to peritoneal cavity using synthetic shunt 00160J6 Penetrating keratoplasty of right cornea with donor matched cornea for transplant, percutaneous approach. 08R83KZ Laser coagulation of right retinal vessel hemorrhage, percutaneous. 085G3ZZ Removal of foreign body (glass) from left cornea 08C9XZZ Lamellar keratoplasty, onlay supplement type, right cornea, using autograft 08U8X7Z Nonincisional, transnasal placement of a restrictive stent in right lacrimal duct. 08VX7DZ Endoscopic partial nasal turbinectomy 09BL8ZZ Forceps removal of a foreign body in the right nostril. 09CKXZZ Stapedectomy (removal of entire stapes), right ear 09T90ZZ Endoscopic drainage of the left ethmoid sinus. 099V4ZZ Reattachment of a severed right ear. 09M0XZZ Excision of cholesteatoma, left middle ear A) 09C60ZZ B) 09B24ZZ C) 09B6XZZ D) 09B50ZZ E) 09B60ZX F) None of the above Dual chamber cardiac pacemaker of right ventricle and right atrium 0JH606Z; 02H63JZ; 02HK3JZ Phlebotomy of left median cubital vein for polycythemia vera 059C3ZZ Percutaneous insertion of central venous catheter infusion device, left subclavian vein 05H633Z Percutaneous suture exclusion of left atrial appendage, via femoral artery access 02L73ZK PTCA, via femoral approach, two vessels with the insertion of drug-eluting stent into same two vessels 027135Z Left heart catheterization with division of bundle of HIS. 02883ZZ Open occlusion of left atrial appendage, using extraluminal pressure clips 02L70CK 27-year-old admitted with ARDS. Patient was placed on continuous positive airway pressure for 48 hours. J80 ; 5A09457 A ventilator-dependent patient (due to emphysema) is admitted to the hospital at 10 a.m. on January 1. He is admitted for dehydration and is placed on the hospital's ventilator upon admission. That patient is discharged January 6 at 1 p.m. What is the appropriate code assignment? E86.0 ; J43.9 ; Z99.11 ; 5A1955Z The patient was admitted with increasing shortness of breath, weakness, and non-productive cough. Treatment included oxygen therapy and a bronchoscopy of the left and right bronchus. Final diagnoses listed as acute respiratory insufficiency and acute exacerbation of chronic obstructive pulmonary disease (COPD). Which of the following is the correct diagnostic code assignment? J44.1 ; 0BJ08ZZ Bronchoscopic excision of lesion of right upper lobe of the lung 0BBC8ZZ Thoracotomy with exploration of mediastinum 0WJC0ZZ Thoracotomy with resection of left lower lobe of lung 0BTJ0ZZ Left inguinal herniorrhaphy with mesh (synthetic material) 0YU60JZ IORT of colon, 3 ports DDY5CZZ Incision and drainage of external anal abscess 0D9QXZZ 37-year-old admitted for a right inguinal hernia. Patient was taken to the OR where an open repair of the right inguinal hernia using synthetic mesh repair material without any complications was performed. K40.90 ; 0YU50JZ 40-year-old with severe abdominal pain is brought to the ER. After examination in the ER she was admitted and taken to the OR for cholecystitis. A total laparoscopic cholecystectomy was performed and the discharge diagnosis was acute cholecystitis with calculus of gallbladder and bile duct. K80.62 ; 0FT44ZZ Colonoscopy with excision of colon polyp, descending colon and biopsy of sigmoid colon 0DBM8ZZ Excision of skin lesion, left lower arm 0HBEXZZ Right scalp advancement flap to right temple 0HX0XZZ Excisional debridement of subcutaneous tissue and fascia, buttock by open approach 0JB90ZZ Cosmetic augmentation mammoplasty, bilateral with synthetic material implanted for the augmentation