Renee's Certified Coding Specialist (CCS) Ex am Preparation 2022 – COMPLETE SOLUTIONS Diagnostic -related groups (D RGs) and ambulatory patient classifications (APCs) are similar in that they are both: a. Determined by HCPCS codes b. Focused on hospital outpatients c. Focused on hospital inpatients d. Prospective payment systems - ✔✔d. Prospective payment systems ** Bo th are types of prospective payment systems (Casto and Forrestal 2015, 6). A patient is treated for esophageal varices with hemorrhage due to cirrhosis. The diagnostic codes that would be assigned are: I85.01 Esophageal varices with bleeding I85.11 Secondary esophageal varices with bleeding K74.60 Unspecified cirrhosis of liver - ✔✔d. K74.60, I85.11 K74.60: Unspecified cirrhosis of liver I85.11:Secondary esophageal varices with bleeding **The patient has cirrhosis of the liver with resultin g bleeding esophageal varices. Cirrhosis of liver is sequenced first followed by the code for the bleeding esophageal varices (HHS 2017, Section I.A.13, 11). Assign the code(s) for endoscopic sinusotomy with bilateral anterior ethmoidectomy. 31231 Nasal e ndoscopy, diagnostic, unilateral or bilateral (separate procedure) 31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior) −50 Bilateral procedurea. a. 31254 b. 31254 -50 c. 31254, 31254 d. 31231 - ✔✔b. 31254 -50 31254 Nasal/sinus endo scopy, surgical; with ethmoidectomy, partial (anterior) −50 Bilateral procedurea. ** A code for the anterior ethmoidectomy is assigned and to denote the bilateral procedure, a modifier of -50 is added (CPT Assistant Winter 1993, 23; Jan. 1997, 4; Sept. 1 997, 10; Oct. 1997, 5; Dec. 2001, 6; May 2003, 5). The sinusotomy is not coded separately, as it is a diagnostic procedure. The most common language used for both data definition language and data manipulation language is: a. Unified modeling language b. JAVA c. Perl d. Structured query language - ✔✔d. Structured query language ** Structured query language (SQL) is used commonly for data language and data definitions (Sharp 2016, 184). An ethmoidectomy removes: - ✔✔infected tissue and bone in the ethmoid sinuses that blocks natural drainage. The surgeon views your ethmoid sinuses with an endoscope, a thin flexible tube with a very small camera and light at the end of it. Documentation f rom the nursing or other allied health professionals' notes can be used to establish which of the following diagnoses: a. Body mass index (BMI) b. Malnutrition c. Aspiration pneumonia d. Fatigue - ✔✔a. Body mass index (BMI) ** The physician must establis h the diagnosis —obesity or morbid obesity —and the additional information can be pulled from ancillary documentation to establish the correct code assignment for body mass index (BMI) (Leon -Chisen 2017, 168). A 55 -year -old patient has hypertensive heart di sease with congestive heart failure. What code would be assigned? a. I15.8, Other secondary hypertension b. I11.0, Hypertensive heart disease with heart failure and I50.9, Heart failure, unspecified c. I50.9, Heart failure, unspecified and I15.0, Renovasc ular hypertension d. N18.6, End stage renal disease - ✔✔b. I11.0, Hypertensive heart disease with heart failure and I50.9, Heart failure, unspecified ** There is a cause and effect relationship established between the hypertension and the congestive heart failure. A separate code for the congestive heart failure is assigned based on the "code also" note (HHS 2017, Section I.C.9.a., 40). A surgeon would like to undertake a research study on his patients with stage II malignant melanoma of the back, who hav e undergone wide excision of the melanoma. What work processes and associated software could be used to provide this information? a. Obtain a summary of the cases from the cancer registry, import them into a spreadsheet, and provide to the surgeon. b. Obt ain a summary of the cases from the chart completion software, import them into a spreadsheet, and provide to the surgeon. c. Obtain a summary of the cases from the master patient index, import them into a spreadsheet, and provide to the surgeon. d. Obtain a summary of the cases from the transcription tracking software, import them into a spreadsheet, and provide to the surgeon. - ✔✔a. Obtain a summary of the cases from the cancer registry, import them into a spreadsheet, and provide to the surgeon . **The cancer registry can be used to undertake studies in addition to reporting cases to a central registry (Sharp and Madlock -Brown 2016, 173). A facility located near a national park has a significant number of snake bites, and patients receive treat ment with antivenom in urgent -care settings. Sometimes a patient is admitted to the hospital after several days. Can the urgent -care setting 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 can be requested if the physician needs it for continuity of care, but an entire list of patients cannot be provided. b. A list of names could be provided. c. No information can be obtained under any circumstances. d. A lis t of patients may be available after consultation with the national park ranger. - ✔✔a. Only the names of patients who are admitted to the hospital can be requested if the physician needs it for continuity of care, but an entire list of patients cannot be provided. **Only records that are required for care or authorized by the patient can be released by the urgent -
care facility to the acute -care facility (Brodnik 2012, 225; Rinehart -Thompson 2016b, 243 -247). What diagnoses and procedures should be report ed for recurrent left inguinal hernia with laparoscopic repair? K40.30 Unilateral inguinal hernia, with obstruction, without gangrene, not specified as recurrent K40.31 Unilateral inguinal hernia, with obstruction, without gangrene, recurrent K40.91 Unila teral inguinal hernia, without mention of obstruction or gangrene, recurrent 49520 Repair recurrent inguinal hernia, any age; reducible 49521 Repair recurrent inguinal hernia, any age; incarcerated or strangulated 49651 Laparoscopy, surgical; repair recurr ent inguinal hernia a. K40.91, 49520
care facility to the acute -care facility (Brodnik 2012, 225; Rinehart -Thompson 2016b, 243 -247). What diagnoses and procedures should be report ed for recurrent left inguinal hernia with laparoscopic repair? K40.30 Unilateral inguinal hernia, with obstruction, without gangrene, not specified as recurrent K40.31 Unilateral inguinal hernia, with obstruction, without gangrene, recurrent K40.91 Unila teral inguinal hernia, without mention of obstruction or gangrene, recurrent 49520 Repair recurrent inguinal hernia, any age; reducible 49521 Repair recurrent inguinal hernia, any age; incarcerated or strangulated 49651 Laparoscopy, surgical; repair recurr ent inguinal hernia a. K40.91, 49520
