CCS Exam prep 1 2019 Questions & Answers |
Questions with 100% Correct Answers | Verified |
Updated 2024
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
Targeted cancer therapies are drugs or other substances that block the growth and spread of
cancer by interfering with specific molecules involved in tumor growth and progression.
Herceptin is a type of targeted cancer therapy also referred to as a monoclonal antibody
(National Cancer Institute 2018).
, A lpatient lhas lfindings lsuggestive lof lchronic lobstructive lpulmonary ldisease l(COPD) lon lchest
lx- lray. lThe lattending lphysician lmentions lthe lx-ray lfinding lin lone lprogress lnote lbut lno
lmedication, ltreatment, lor lfurther levaluation lis lprovided. lThe lcoder lshould:
a. Query lthe lattending lphysician lregarding lthe lx-ray lfinding
b. Code lthe lcondition lbecause lthe ldocumentation lreflects lit
c. Question lthe lradiologist lregarding lwhether lto lcode lthis lcondition
d. Use la lcode lfrom labnormal lfindings lto lreflect lthe lcondition l✔✔Correct lAnswer: lA
Query lthe lattending lphysician lregarding lthe lclinical lsignificance lof lthe lfindings land lrequest
lthat lappropriate ldocumentation lbe lprovided. lThis lis lan lexample lof la lcircumstance lwhere
lthe lchronic lcondition lmust lbe lverified. lAll lsecondary lconditions lmust lmeet lthe lUHDDS
ldefinitions; lit lis lnot lclear lif lCOPD ldoes l(CMS l2018a, lSection lIII, l105-106).
If la lpatient lundergoes lan linpatient lprocedure land lthe lfinal lsummary ldiagnosis lis ldifferent
lfrom lthe ldiagnosis lon lthe lpathology lreport, lthe lcoder lshould:
a. Code lonly lfrom lthe ldischarge ldiagnoses
b. Code lthe ldiagnosis lreflected lon lthe lpathology lreport
c. Code lthe lmost lsevere lsymptom
d. Query lthe lattending lphysician las lto lthe lfinal ldiagnosis l✔✔Correct lAnswer: lD
Coding lstrictly lfrom lthe lpathology lreport lis lnot lappropriate las lthe lcoder lis lassigning la
ldiagnosis lwithout lthe lattending lphysician's lcorroboration. lIt lis ltherefore lappropriate lto
lquery lthe lphysician l(CMS l2018a, lSection lIII, l105-106).
Questions with 100% Correct Answers | Verified |
Updated 2024
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
Targeted cancer therapies are drugs or other substances that block the growth and spread of
cancer by interfering with specific molecules involved in tumor growth and progression.
Herceptin is a type of targeted cancer therapy also referred to as a monoclonal antibody
(National Cancer Institute 2018).
, A lpatient lhas lfindings lsuggestive lof lchronic lobstructive lpulmonary ldisease l(COPD) lon lchest
lx- lray. lThe lattending lphysician lmentions lthe lx-ray lfinding lin lone lprogress lnote lbut lno
lmedication, ltreatment, lor lfurther levaluation lis lprovided. lThe lcoder lshould:
a. Query lthe lattending lphysician lregarding lthe lx-ray lfinding
b. Code lthe lcondition lbecause lthe ldocumentation lreflects lit
c. Question lthe lradiologist lregarding lwhether lto lcode lthis lcondition
d. Use la lcode lfrom labnormal lfindings lto lreflect lthe lcondition l✔✔Correct lAnswer: lA
Query lthe lattending lphysician lregarding lthe lclinical lsignificance lof lthe lfindings land lrequest
lthat lappropriate ldocumentation lbe lprovided. lThis lis lan lexample lof la lcircumstance lwhere
lthe lchronic lcondition lmust lbe lverified. lAll lsecondary lconditions lmust lmeet lthe lUHDDS
ldefinitions; lit lis lnot lclear lif lCOPD ldoes l(CMS l2018a, lSection lIII, l105-106).
If la lpatient lundergoes lan linpatient lprocedure land lthe lfinal lsummary ldiagnosis lis ldifferent
lfrom lthe ldiagnosis lon lthe lpathology lreport, lthe lcoder lshould:
a. Code lonly lfrom lthe ldischarge ldiagnoses
b. Code lthe ldiagnosis lreflected lon lthe lpathology lreport
c. Code lthe lmost lsevere lsymptom
d. Query lthe lattending lphysician las lto lthe lfinal ldiagnosis l✔✔Correct lAnswer: lD
Coding lstrictly lfrom lthe lpathology lreport lis lnot lappropriate las lthe lcoder lis lassigning la
ldiagnosis lwithout lthe lattending lphysician's lcorroboration. lIt lis ltherefore lappropriate lto
lquery lthe lphysician l(CMS l2018a, lSection lIII, l105-106).
