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Updated 2025
This patient was admitted for chemotherapy due to a primary hepatocellular
carcinoma of the transplanted liver. What codes are assigned?
a. Z51.11, C22.0
b. Z51.11, C22.0, C80.2
c. Z51.11, T86.49, C80.2, C22.0
d. T86.49, C80.2, C22.0 ✔✔Correct Answer: C
Code T86.49 should be assigned for complication of liver transplant along with
code C80.2 for malignancy associated with organ transplant. A malignant
neoplasm of a transplanted organ should be coded as a transplant complication
(CMS 2018a, Section I.C.2.r., 34).
A 7-year-old patient was admitted to the emergency department for treatment of
shortness of breath. The patient is given epinephrine and nebulizer treatments. The
shortness of breath and wheezing are unabated following treatment. What
diagnosis should be suspected?
a. Acute bronchitis
b. Acute bronchitis with chronic obstructive pulmonary disease
,c. Asthma with status asthmaticus
d. Chronic obstructive asthma ✔✔Correct Answer: C
"Status asthmaticus is an acute asthmatic attack in which the degree of bronchial
obstruction is not relieved by the usual treatment, such as by epinephrine or
aminophylline" (Schraffenberger and Palkie 2018, 346-347).
. A patient is admitted with a high temperature, lethargy, hypotension, tachycardia,
oliguria, and elevated WBC. The patient also has more than 100,000 organisms of
Escherichia coli per cc of urine. The attending physician documents "urosepsis."
What is the next step for the coder?
a. Code sepsis as the principal with a secondary diagnosis of urinary tract
infection due to E. coli.
b. Code urinary tract infection with sepsis as a secondary diagnosis.
c. Query the physician to determine if the patient is being treated for sepsis,
highlighting the clinical signs and symptoms.
d. Ask the physician whether the patient had septic shock so that this may be
used as the principal diagnosis. ✔✔Correct Answer: C
The term urosepsis is a nonspecific term. It has no default code in the Alphabetic
Index. Should providers use this term, they must be queried for clarification (CMS
2018a, Section I.C.1.d., 22).
During a coronary artery bypass surgery, the patient underwent saphenous bypass
grafts; from the aorta to the left anterior descending branch of the left main
coronary artery, and the left posterior descending of the left main coronary artery.
,The patient also underwent a repositioning of the mammary artery to the right
coronary artery. Choose the best description for this procedure.
a. Three aortocoronary grafts
b. Two aortocoronary grafts and one mammary-coronary graft
c. Two aortocoronary grafts and two saphenous bypass grafts
d. Three aortocoronary grafts and one mammary-coronary graft ✔✔Correct
Answer: B
It is rare for only one coronary artery to be bypassed, and it is also fairly common
to perform both an internal mammary-coronary artery bypass and an aortocoronary
bypass at the same operative episode (Schraffenberger and Palkie 2018, 324-326).
According to CPT, an endoscopy that is undertaken to the level of the
midtransverse colon would be coded as a:
a. Proctosigmoidoscopy
b. Sigmoidoscopy
c. Colonoscopy
d. Proctoscopy ✔✔orrect Answer: C
, A colonoscopy is an examination of the entire colon, from the rectum to the cecum
that may include the terminal ileum. In general, a colonoscopy examines the colon
to a level of 60 cm or higher (Smith 2018, 135-136).
Infusion of Herceptin, a monoclonal antibody used for treatment of breast cancer in
patients carrying a certain mutation of the HER2 gene, is classified as:
a. Chemotherapy
b. Radiotherapy
c. Molecular Targets
d. Immunotherapy ✔✔Correct Answer: C
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sand sspread sof scancer sby sinterfering swith sspecific smolecules sinvolved sin stumor
sgrowth sand sprogression.
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santibody s(National sCancer sInstitute s2018).
s
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sprovided. sThe scoder sshould:
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