ICD-10 Exam Questions & Answers Latest Updated

Under the Relative Value __________ systems values are assigned to each service and are determined on the basis of the resources necessary to the physician’s performance of the service. - Answer Unit The __________ charge historically was specific for each physician, but in 1993, the charge for a service was the same for all physicians within a locality, regardless of the specialty. - Answer Limiting For co-surgeons, Medicare pays __________% of the global fee, dividing the payment equally between the two surgeons. - Answer 125 Specific regulations for Medicare are contained in the _______ Only Manual. - Answer Internet Within an HMO, there is usually an individual who has been assigned to monitor the services provided to the patient both inside the facility and outside the facility. This person is known as the _________. - Answer Gatekeeper In this model of HMO, the HMO directly employs the physicians: ________ Model - Answer Staff In this model of HMO, the HMO contracts with the physician to provide the service at a set fee: _______ Practice Associations. - Answer Individual The Medicare _________ Contractors do the paperwork for Medicare and are usually insurance companies that have bid for a contract with CMS to handle the Medicare program for a specific area. - Answer Administrative Identify this acronym: CMS Correct! - Answer Centers for Medicare and Medicaid Services Identify this acronym: QIO - Answer Quality Improvement Organizations Identify this acronym: RBRVS - Answer Resource Based Relative Value Scale Identify this acronym: OBRA - Answer Omnibus Budget Reconciliation Identify this acronym: MAAC - Answer Maximum Actual Allowable Charge Identify this acronym: OIG - Answer Office of the Inspector General Identify this acronym: DHHS - Answer Department of Health and Human Services In the role as a medical coder, it is your responsibility to ensure that you code __________ and completely to optimize reimbursement for services provider. - Answer Accurately The ______________ is a national dollar amount that is applied to all services paid on the basis of the MFS. - Answer conversion factor The amount determined by multiplying the RVU weight by the geographic index and the conversion factor is called the __________ amount. - Answer free schedule For endoscopic procedures, Medicare allows the full value of the highest valued endoscopy, plus the difference between the next highest endoscopy and the __________ endoscopy. - Answer highest The provider or facility is ___________ when the payment goes directly to the patient. - Answer nonparticipating Under the RBRVS, the unit value is termed ____________ Value Unit. - Answer relative ICD-10-CM codes have a maximum of five characters. - Answer False The letter N is assigned as a fifth character placeholder for certain six-character codes. - Answer False The ICD-10-CM, the WHO version, does not include a procedure classification. - Answer true The National Center for Health Statistics is responsible for developing the procedure classification ICD-10-PCS. - Answer false Notable improvements in the content and format of the ICD-10-CM include expansion of signs and symptoms codes. - Answer false There are 10 times more codes in the ICD-10-CM than in ICD-9-CM. - Answer false All ICD-10-CM codes have seven characters. - Answer false The I-10 has instructional notations to provide guidance. - Answer true There are 21 chapters in the ICD-10-CM. - Answer true Initial office visit for dysphasia First-listed diagnosis:_____________ ICD-10-CM Code:______________ - Answer Dysphasia and R47.02 New patient presents with lower extremity edema and was examined by the physician, who determined the symptoms were due to an exacerbation of congestive heart failure First-listed diagnosis:____________ ICD-10-CM Code:____________ - Answer congestive heart failure and I50.9 Patient was admitted as an outpatient for an arthroscopic knee procedure to remove a loose body in the right knee First-listed diagnosis:___________ ICD-10-CM Code:__________ - Answer Loose body in right knee and M23.41 Patient was admitted to Observation due to fainting, no cause was identified. First-listed diagnosis:_____________ ICD-10-CM Code:___________ Other diagnosis:__________ Other Code:______________ - Answer Observation, Z03.89, syncope, R55 An established patient was admitted for pain management following biopsy of the kidney for stage 4 chronic kidney disease. First-listed diagnosis:____________ ICD-10-CM Code:________ Other diagnosis:________ Other Code:___________ - Answer Stage IV CK, N18.4, Postoperative pain, G89.18 A new patient was seen by a pulmonologist for preoperative clearance for a surgery scheduled in two days. The patient has emphysema and is scheduled to have an endarterectomy for severe carotid stenosis on the right. First-listed diagnosis:______ ICD-10-CM Code:________ Other diagnosis 1:________ Other code 1:__________ Other diagnosis 2:________ Other code 2:__________ - Answer preoperative exam, Z01.811, right carotid stenosis, I65.21, emphysema, J43.9 Patient had an outpatient cystoscopy. The preoperative diagnosis is hematuria. Postoperative diagnosis is hematuria due to bladder cancer. First-listed diagnosis:________ ICD-10-CM Code:_________ - Answer Bladder cancer and C67.9 Exposure to lead ICD-10-CMZ Code: . - Answer Z77.011 Personal history of benign neoplasm of the brain ICD-10-CM Z Code: - Answer Z86.011 Kidney transplant status: Z Code: - Answer Z94.0 The Uniform Hospital Discharge Data Set (UHDDS) applies to outpatient coding. - Answer false It is acceptable to report probable diagnoses in the outpatient setting - Answer false Always begin the search in the Index of the I-10. - Answer true A patient presents with a complaint of fatigue, weight gain, and constipation. Thyroid function studies were ordered. In this case, it is correct to report thyroid studies results. - Answer true When a patient is admitted for observation for a medical condition, assign a code for the medical condition as the first-listed diagnosis. - Answer true The Factors Influencing Health Status and Contact with Health Services codes are Z00-Z99. - Answer true An example of an Index location for Z codes would be: admission, aftercare, attention. - Answer true The maximum number of characters in an I-10 code is six. - Answer false For patients receiving diagnostic services only during an encounter, sequence first the diagnosis, condition, problem, or other reason for the encounter shown in the medical record to be chiefly responsible for the outpatient services provided during the encounter. - Answer true If a postoperative diagnosis is different from the preoperative diagnosis, list the preoperative diagnosis first. - Answer false When separate codes exist to identify acute and chronic conditions, and both conditions are documented, the acute code is sequenced first. - Answer true It is acceptable to use only the Alphabetic Index to assign I-10 codes. - Answer false When sequencing codes for residuals, the residual is sequenced second preceded by a late effect code. - Answer false When there are seven characters available for assignment, you must assign all seven characters. - Answer true According to the Official Guidelines for Coding and Reporting, even when a definitive diagnosis is stated, you should still report the symptoms of the condition. - Answer false Patient has rheumatoid arthritis and anemia. The anemia is integral to the rheumatoid arthritis. - Answer false A combination code is a single code used to classify all of the following EXCEPT - Answer a compound fracture “Code, if applicable, any causal condition first,†notes indicate that this code may be assigned as a first-listed diagnosis when the causal condition is: - Answer unknown or not applicable If there is a 7th character to assign for an I-10 code, but there are only five characters in the terminal code, the 6th character would be which of the following? - Answer x This instructional note in the Tabular of the I-10 directs the coder regarding sequencing. - Answer code first The medical record documents: residual foreign body in the femur due to a fall from a ladder onto a metal fixture that embedded in the bone. Which of the following would be the correct residual and cause? - Answer Residual: Foreign body of femur; Cause: Fall from ladder Assuming that the patient presented with the list of complaints and diagnosis listed below, identify the diagnosis that should be reported in addition to the condition in bold typeface for question 12: Urinary tract infection - Answer rectal bleeding Assuming that the patient presented with the list of complaints and diagnosis listed below, identify the diagnosis that should be reported in addition to the condition in bold typeface for question 13: Upper respiratory tract infection - Answer frequent urination Diagnosis: Abruptio placentae in the third trimester with disseminated intravascular coagulationIndex: Abruptio placentae ________ with afibrinogenemia O45.01- coagulation defect O45.00- specified NEC O45.09- disseminated intravascular coagulation O45.02- hypofibrinogenemia O45.01- specified NEC O45.8-Tabular: O45.02 Premature separation of placenta with disseminated intravascular coagulationO45.021 Premature separation of placenta with disseminated intravascular coagulation, first trimesterO45.022 Premature separation of placenta with disseminated intravascular coagulation, second trimesterO45.023 Premature separation of placenta with disseminated intravascular coagulation, third trimesterO45.029 Premature separation of placenta with disseminated intravascular coagulation, unspecified trimester Index: Abruptio placentae, what is the code in the Index?__________ What is the correct ICD-10-CM diagnosis code?_____________ - Answer O45.9 and O45.023 Urinary tract infection due to Escherichia coli ICD-10-CM Codes: - Answer B96.20 and N39.0 Aseptic meningitis in leptospirosis ICD-10-CM Code: - Answer A27.81 Dehydration due to pneumonia ICD-10-CM Codes: - Answer E86.0 and J18.9 Staphylococcus aureus cellulitis of the face ICD-10-CM Codes: - Answer B95.61 and L03.211 or B95.61 Arthritis following pathological fracture of the right femur three years ago ICD-10-CM Codes - Answer M16.7 or M84.451S, M16.7 Gastroenteritis due to Salmonella ICD-10-CM Code: - Answer A02.0 Hypertension with end-stage renal disease ICD-10-CM Codes: - Answer I12.0 or N18.6 and I12.0 Gastroenteritis due to Norwalk virus ICD-10-CM Code: - Answer A08.11 Pneumocystis pneumonia in a patient with HIV ICD-10-CM Codes - Answer B59 and B20 Epilepsy Acute respiratory insufficiency UTI Bilateral pneumonia due to MRSA Mental retardation Providencia stuartii (gram-negative bacilli) infection - Answer G40.909 J80 N39.0 J15.212 F79 B96.89 Providencia stuartii (gram-negative bacilli) infection - Answer yes ________ coding applies when one code fully describes the conditions and/or manifestations, and ________ coding applies when it takes more than one code to fully describe the condition, circumstance, or manifestation, and then sequencing of multiple codes may have to be considered. - Answer Combination, multiple When a bacteria becomes resistant to an antibiotic, it is known as all BUT this. - Answer composite ________ is a circulatory failure that represents a type of organ dysfunction. - Answer septic shock Which myocardial infarction type is most severe? - Answer STEMI The Guidelines instruct the coder to assume that there is this type of relationship between hypertension and chronic kidney disease reported with category N18 - Answer cause-and-effect ________ hypertension is a continuous, mild blood pressure elevation that can usually be controlled by medication. - Answer Benign ________ is an inherited bone growth that causes hearing loss and is reported with category codes H80. - Answer Otosclerosis ________ is inward turning (inversion) of the eyelid. - Answer Entropion ________ is the pulling away (eversion) of the eyelid. - Answer Ectropion Gastroesophageal reflux ICD-10-CM Code: - Answer K21.9 Pustular, generalized psoriasis ICD-10-CM Code: - Answer L40.1 Staphylococcus aureus arthritis of the right wrist joint ICD-10-CM Codes: - Answer M00.031 or B95.61 and M00.031 or B95.61 Pain in the neck ICD-10-CM Code: - Answer M54.2 Rheumatoid arthritis ICD-10-CM Code: - Answer M06.9 Dermatitis due to poison ivy ICD-10-CM Code: - Answer L23.7 Pressure ulcer of left hip, stage 3, with full-thickness skin loss and damage of subcutaneous tissue ICD-10-CM Code - Answer L89.223 Cellulitis of scalp ICD-10-CM Code: - Answer L03.811 Barrett’s esophagus with high-grade dysplasia ICD-10-CM Code: - Answer K22.711 Recurrent, bilateral inguinal hernia with obstruction ICD-10-CM Code: - Answer K40.01 Which of the following are two general and important considerations when assigning a gastrointestinal code? - Answer hemorrhage and perforation If the medical documentation supports active bleeding of a gastric ulcer, the physician must identify this about the bleeding before a combination code may be assigned. - Answer source Which of the following would NOT be assigned with codes from Chapter 12 of the I-10? - Answer bone marrow A stage 3 pressure ulcer involves which of the following? - Answer up to fascia A stage 1 pressure ulcer involves which of the following? - Answer epidermis Most codes in Chapter 13, Diseases of the Musculoskeletal System and Connective Tissue, have these designations: - Answer site and laterality Infectious arthropathies are reported with M00-M02 based on these two main divisions: - Answer direct and indirect What is another term meaning pyogenic arthritis? - Answer both a and b If the patient is receiving active treatment of a pathologic fracture, you would assign this 7th character: - Answer A This category of codes would NOT be included in the blocks of the Digestive System. - Answer kideny Congenital arachnoid cyst of the brain. ICD-10-CM Code: - Answer Q04.6 Two-year-old diagnosed with fragile X syndrome. ICD-10-CM Code: - Answer Q99.2 Abnormal mammogram. ICD-10-CM Code: - Answer R92.8 First- and second-degree burn, right foot, 9%, due to bonfire flames Second degree ICD-10-CM code: _____ Extent ICD-10-CM code: _________ X ICD-10-CM code for exposure to fire: _________ - Answer T25.221A, T31.0â€"9%, X03.0XXA Female patient in her first trimester is seen for a routine prenatal check. The patient had preexisting stage 1 hypertensive chronic kidney disease that is documented to be complicating her pregnancy. a. Hypertensive chronic kidney disease complicating pregnancy. ICD-10-CM Codes: _______(one pregnancy code, then one hypertension code) b. Hypertensive kidney disease with chronic kidney disease, stage 1 through 4. ICD-10-CM Code: _________c. Stage of chronic kidney disease. ICD-10-CM Code: ____________ - Answer O09.891 or O10.211, I12.9, N18.1 Newborn female delivered in hospital by cesarean section. Newborn diagnosed with Down syndrome. a. Live-born status ICD-10-CM Code: ______ b. Down syndrome ICD-10-CM Code: _______ c. Mental retardation ICD-10-CM Code: _______ - Answer Z38.01, Q90.9, F79 A complication during pregnancy, childbirth, or the puerperium is considered to be a complication unless the attending physician specifically documents that the complicating condition neither: - Answer affects the pregnancy nor is affected by the pregnancy The Chapter 15, Pregnancy, Childbirth and the Puerperium, codes are only used on this medical record: - Answer mother Outcome of delivery is only used on this medical record: - Answer mother The trimesters are calculated from the ________. - Answer LMP The peripartum period is defined as: - Answer last month of pregnancy to 5 months postpartum This pregnancy is one in which the fertilized ovum implants outside the uterus, usually in the fallopian tube. - Answer ectopic pregnancy This type of diabetes mellitus is a condition in which little or no insulin is produced by the body and is controlled by the administration of insulin. - Answer type 1 Trisomy ________ is the name for Down syndrome because the syndrome is due to a cell having an excess chromosome. - Answer 21 A ________ is defined as an objective evidence of disease that can be observed by the physician. - Answer sign If there is a first- and second-degree burn of the same area, you would report: - Answer only the second-degree code 95199 - Answer Medicine 78999 - Answer Radiology 81099 - Answer Pathology/Labratory 00144 - Answer Anesthesia Category - Answer First division in the CPT Subsection - Answer Third division in the CPT Section - Answer Fourth division in the CPT