Questions with complete solutions
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QUESTIONS AND ANSWERS
1.
Identify the CPT code for a 42-year-old diagnosed with ESRD who requires home
dialysis for the month of April.
a. 90965
b. 90964
c. 90966
d. 90970. ANSWER -Correct Answer: C
Dialysis, end-stage renal disease. Code 90966 is for end-stage renal disease (ESRD)
related services for home dialysis per full month for patients 20 years of age and older
(Smith 2012, 227).
2.
Exceptions to the consent requirement include:
,a. Medical emergencies
b. Provider discretion
c. Implied consent
d. Informed consent. ANSWER -Correct Answer: A
The law permits a presumption of consent during emergency situations, regardless of
whether the patient is an adult or minor (Brodnik et al. 2009, 99).
3.
An 80-year-old female is admitted with fever, lethargy, hypotension, tachycardia,
oliguria, and elevated WBC. The patient has more than 100,000 organisms of
Escherichia coli per cc of urine. The attending physician documents "urosepsis." How
should the coder proceed to code this case?
a. Code sepsis as the principal diagnosis with urinary tract infection due to E. coli as
secondary diagnosis.
b. Code urinary tract infection with sepsis as the principal diagnosis.
c. Query the physician to ask if the patient has septicemia because of the
symptomatology.
,d. Query the physician to ask if the patient had septic shock so that this may be used
as the principal diagnosis.. ANSWER -Correct Answer: C
The term "urosepsis" is a nonspecific term. If that is the only term documented, only
code 599.0 should be assigned based on the default for the term in the ICD-9-CM
index, in addition to the code for the causal organism, if known. Septicemia results
from the entry of pathogens into the bloodstream. Symptoms include spiking fever,
chills, and skin eruptions in the form of petechiae or purpura. Blood cultures are
usually positive; however, a negative culture does not exclude the diagnosis of
septicemia. Several other clinical indications and symptomology could indicate the
diagnosis of septicemia. Only the physician can diagnose the condition based on
clinical indications. Query the physician when the diagnosis is not clear to the coder
(Schraffenberger 2012, 79-81, 251).
4.
What is the correct CPT code assignment for destruction of internal hemorrhoids
with use of infrared coagulation?
a. 46255
b. 46930
c. 46260
d. 46945. ANSWER -Correct Answer: B
, Index main term: Destruction, hemorrhoid, thermal. Thermal includes infrared
coagulation (Kuehn 2012, 27, 163).
5.
Identify the two-digit modifier that may be reported to indicate a physician performed
the postoperative management of a patient, but another physician performed the
surgical procedure.
a. -22
b. -54
c. -32
d. -55. ANSWER -Correct Answer: D
Modifiers are appended to the code to provide more information or to alert the payer
that a payment change is required. Modifier -55 is used to identify the physician
provided only postoperative care services for a particular procedure (Kuehn 2012, 292,
295).
6.
Which of the following organizations is responsible for updating the procedure
classification of ICD-9-CM?