AND VERIFIED ANSWERS (100% CORRECT
ANSWERS) A+ GRADED | ALREADY PASSED!!
A patient is admitted from the ED with a diagnosis of weakness and
anemia. After further treatment with PRBCs, GI consult and endoscopy,
the physician includes the following diagnoses in the d/c summary:
anemia, suspected bleeding gastric ulcer, and GERD. What is the post
appropriate Pdx?
A. Bleeding Gastric Ulcer
B. Anemia
C. GERD
D. Weakness - ANSWER -A. Bleeding gastric ulcer
Rationale: Although anemia is treated with PRBC, the anemia is d/t the
ulcer. GERD is ancillary to the ulcer and not the cause of symptoms.
Weakness if a symptom likely d/t the blood loss.
*Official Guidelines for Coding and Reporting, Section I.A.15, and
Coding clinic, Third Quarter 2017, p. 27
A patient is admitted with new-onset seizures. Head CT reveals a mass
in the occipital region. The physician documents possible brain tumor,
and the patient is transferred to another hospital for further workup.
What is the most appropriate diagnosis?
,A. Seizure
B. Neoplasm of occipital region
C. Head mass
D. Head tumor - ANSWER -B. Neoplasm of occipital region
Rationale: Per the Official Guidelines for Coding and Reporting Section
II.H Uncertain Diagnoses, the seizure is a symptom of the possible brain
tumor. Head mass and head tumor are not as specific as neoplasm of
occipital region.
A hospital's base rate, or blended rate, is:
1. Calculated annually
2. Dependent on indirect costs for graduate medical education and new
technology
3. Adjusted based on number of low-income patients
4. Adjusted based on capital profits
A. 1 & 2
B. 2 & 3
C. 1, 2, & 3
D. 1, 2, 3, and 4 - ANSWER -C. 1, 2, & 3
,Rationale: According to CMS, base rates are calculated annually and
include adjustments for operating expenses and capital expenses,
including graduate medical education and care for the indigent.
The final MS-DRG assigned to a patient's medical record should:
A. Reflect the amount of time the physician spent with the patient
B. Depend on the patient's length of stay
C. Be assigned by the physician
D. Reflect the patient's severity of illness (SOI) and the resources used in
the patient's care - ANSWER -D. Reflect the patient's severity of illness
(SOI) and the resources used in the patient's care.
Rationale: Per CMS, based on documentation of conditions being
monitored and treated during the inpatient admission, coding
professionals translate the documentation into ICD-19-CM/PCS codes
that group to the final MS-DRG regardless of the patient's length of stay
or the amount of time a provider spend providing care. The final MS-
DRG is assigned after discharge.
A patient is admitted from the ED with a diagnosis of acute respiratory
failure and aspiration pneumonia due to an overdose of pain
medication. What is the most appropriate Pdx?
A. Acute respiratory failure
B. Aspiration pneumonia
C. Poisoning related to medication
, D. Reflect adverse effect of medication - ANSWER -C. Poisoning related
to medication
Rationale: When coding a poisoning or reaction to the improper use of
a medication (ex. overdose, wrong substance given or taken in error,
wrong rout of administration), first assign the appropriate code from
categories T36-T50.
A patient is admitted with pneumonia, stage 1 chronic renal failure,
chronic anemia, and COPD. While hospitalized, the patient received IV
abx, inhalers, O2, IVFs at 50ml/hr., and iron tablets. Which conditions
should be coded?
A. PNA only
B. PNA and COPD only
C. PNA, COPD, anemia
D. PNA, CKD stage 1, anemia, COPD - ANSWER -D. PNA, CKD stage 1,
anemia, COPD
Rationale: Documentation and clinical indicators support that the
documented acute condition is PNA, which is being treated with abx,
inhalers, and O2. CKD stage 1, COPD and anemia are chronic conditions
that are documented and may influence treatment of PNA, but they
would not be the Pdx. See Official Guidelines for Coding and Reporting,
Section II.