CCS study set May 2022 QUESTIONS WITH COMPLETE SOLUTIONS

What factors of the APR-DRG system allow for capturing the extent of the patient's conditions and expected loss of life while an inpatient? a. Severity of illness and risk of mortality b. Severity of diagnosis and risk of morbidity c. Complications and comorbidities d. Hospital acquired conditions and present on admission Correct Answer: a. Which of the following heart failure codes is considered an MCC? a. I50.9 Heart failure, unspecified b. I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure c. I50.32 Chronic diastolic (congestive) heart failure d. I50.20 Unspecified systolic (congestive) heart failure Correct Answer: b. Medically unlikely edits are used to identify: a. Pairs of procedure codes that should not be billed together b. Maximum units of services for a HCPCS code c. Diagnoses that don't meet medical necessity d. Procedure and gender discrepancies Correct Answer: b. A patient was admitted to the hospital with unstable angina and congestive heart failure. The unstable angina is treated with nitrates, and intravenous Lasix is given to manage the heart failure. What is the appropriate coding action? a. Assign only the code for the congestive heart failure b. Assign the codes for the unstable angina and CHF, sequence either 1st c. Query the physician about which diagnosis to code d. Assign only the code for the unstable angina Correct Answer: b. A 64 year old female was discharged with the final diagnosis of acute renal failure & hypertension. What coding guidelines applies? a. Use combination code of hypertension & chronic renal failure b. Use separate codes for hypertension & chronic renal failure c. Use separate codes for hypertension & acute renal failure d. Use combination code for hypertension & acute renal failure Correct Answer: c. If a patient undergoes an open biopsy for a frozen section immediately before the definitive surgery, how should this be coded with ICD-10-PCS codes? a. Definitive surgery only b. Open biopsy only c. Exploratory surgery d. Open biopsy and definitive surgery Correct Answer: d. Medicare's identification of medically necessary services is outlined in: a. Program transmittals