A patient is admitted with hemoptysis. A bronchoscopy with transbronchial biopsy of the
lower lobe was undertaken that revealed squamous cell carcinoma of the right lung.
Which conditions should be identified as present on admission?
C34.30Malignant neoplasm of lower lobe, unspecified bronchus or lung
C34.31Malignant neoplasm of lower lobe, right bronchus or lung
P26.9Unspecified pulmonary hemorrhage originating in the perinatal period
R04.2Hemoptysis
a. C34.31, R04.2
,b. R04.2
c. C34.31
d. C34.30, P26.9, R04.2
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Correct Answer: C
The diagnosis after study (lung cancer) was present on admission. The
symptom (hemoptysis) of the carcinoma should not be assigned and
therefore, will not have a POA indicator. Code P26.9 would not be assigned
because it is not diagnosed and only applies to the perinatal period (CMS
2020a, Appendix I, 117-121).
A 64-year-old female is admitted to the hospital with nausea, vomiting, and edema. Lab
values indicate the patient has dehydration. The patient takes Lisinopril as prescribed
along with Levothyroxine for hypothyroidism. On the discharge summary, the final
diagnoses of acute renal failure, hypothyroidism and dehydration are documented. What
discrepancy should a coding professional note in this documentation?
a. There is not enough detail in the documentation to assign the dehydration.
b. There is no explanation for the patient's vomiting.
c. There is no correlating diagnosis for the Lisinopril.
d. The nausea, vomiting, and edema are indicative of chronic renal failure not acute.
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Correct Answer: C
The patient should have a diagnosis related to taking the medication
Lisinopril, which is usually hypertension (Brinda 2020, 186-187).
,Medicare reimbursement depends on all of the following, except:
a. The correct designation of the principal diagnosis
b. The number of codes that are assigned
c. The presence or absence of additional codes that represent complications,
comorbidities, or major complications/comorbidities
d. Procedures performed
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Correct Answer: B
While the presence or absence of additional codes that represent
complications, comorbidities, or major complications/comorbidities are all
important to determine the MS-DRG as part of Medicare Acute Inpatient
Prospective Payment System, the number of codes is not a factor (Leon-
Chisen 2020, 573-574; Rinehart-Thompson 2020a, 271-272).
Which of the following make a query compliant?
a. Keeping the question vague so the physician has an opportunity to use his discretion
when responding
b. Explaining why the requested diagnosis is necessary to achieve a higher
reimbursement
c. Addressing the impact the query has on quality indicators
d. Providing a concise presentation of facts and clinical indicators
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Correct Answer: D
Coders should give a concise, clear statement of the reason for the query and
supply supporting clinical indicators (AHIMA 2019c).
, Medicare exerts control of provider reimbursement through adjustment of this
component of the resource-based relative value scale (RBRVS).
a. Conversion factor
b. Geographic adjustment
c. Relative value unit
d. Practice expense
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Correct Answer: A
The conversion factor is Medicare's method for directly controlling provider
reimbursement as it is a constant that is applied across the board for all
providers (Casto 2018, 143).
An urgent care facility located near a national park treats a significant number of patients
with snake bites. Patients receive treatment with antivenom. On occasion, a patient must
later be admitted to the hospital. Can the urgent care facility provide the hospital with a
list of names of patients treated with snake antivenom?
a. Only the names of patients who are admitted to the hospital for continuation of care
could be provided.
b. A full list of names could be provided.
c. No information can be obtained under any circumstances.
d. A list of patients may be available after consultation with the medical director.
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lower lobe was undertaken that revealed squamous cell carcinoma of the right lung.
Which conditions should be identified as present on admission?
C34.30Malignant neoplasm of lower lobe, unspecified bronchus or lung
C34.31Malignant neoplasm of lower lobe, right bronchus or lung
P26.9Unspecified pulmonary hemorrhage originating in the perinatal period
R04.2Hemoptysis
a. C34.31, R04.2
,b. R04.2
c. C34.31
d. C34.30, P26.9, R04.2
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Correct Answer: C
The diagnosis after study (lung cancer) was present on admission. The
symptom (hemoptysis) of the carcinoma should not be assigned and
therefore, will not have a POA indicator. Code P26.9 would not be assigned
because it is not diagnosed and only applies to the perinatal period (CMS
2020a, Appendix I, 117-121).
A 64-year-old female is admitted to the hospital with nausea, vomiting, and edema. Lab
values indicate the patient has dehydration. The patient takes Lisinopril as prescribed
along with Levothyroxine for hypothyroidism. On the discharge summary, the final
diagnoses of acute renal failure, hypothyroidism and dehydration are documented. What
discrepancy should a coding professional note in this documentation?
a. There is not enough detail in the documentation to assign the dehydration.
b. There is no explanation for the patient's vomiting.
c. There is no correlating diagnosis for the Lisinopril.
d. The nausea, vomiting, and edema are indicative of chronic renal failure not acute.
Give this one a try later!
Correct Answer: C
The patient should have a diagnosis related to taking the medication
Lisinopril, which is usually hypertension (Brinda 2020, 186-187).
,Medicare reimbursement depends on all of the following, except:
a. The correct designation of the principal diagnosis
b. The number of codes that are assigned
c. The presence or absence of additional codes that represent complications,
comorbidities, or major complications/comorbidities
d. Procedures performed
Give this one a try later!
Correct Answer: B
While the presence or absence of additional codes that represent
complications, comorbidities, or major complications/comorbidities are all
important to determine the MS-DRG as part of Medicare Acute Inpatient
Prospective Payment System, the number of codes is not a factor (Leon-
Chisen 2020, 573-574; Rinehart-Thompson 2020a, 271-272).
Which of the following make a query compliant?
a. Keeping the question vague so the physician has an opportunity to use his discretion
when responding
b. Explaining why the requested diagnosis is necessary to achieve a higher
reimbursement
c. Addressing the impact the query has on quality indicators
d. Providing a concise presentation of facts and clinical indicators
Give this one a try later!
Correct Answer: D
Coders should give a concise, clear statement of the reason for the query and
supply supporting clinical indicators (AHIMA 2019c).
, Medicare exerts control of provider reimbursement through adjustment of this
component of the resource-based relative value scale (RBRVS).
a. Conversion factor
b. Geographic adjustment
c. Relative value unit
d. Practice expense
Give this one a try later!
Correct Answer: A
The conversion factor is Medicare's method for directly controlling provider
reimbursement as it is a constant that is applied across the board for all
providers (Casto 2018, 143).
An urgent care facility located near a national park treats a significant number of patients
with snake bites. Patients receive treatment with antivenom. On occasion, a patient must
later be admitted to the hospital. Can the urgent care facility provide the hospital with a
list of names of patients treated with snake antivenom?
a. Only the names of patients who are admitted to the hospital for continuation of care
could be provided.
b. A full list of names could be provided.
c. No information can be obtained under any circumstances.
d. A list of patients may be available after consultation with the medical director.
Give this one a try later!
