CCS Exam Study Questions with Complete Solutions | 100% Correct

CCS Exam Study Questions with Complete Solutions | 100% Correct malicious software - Answer ️️ -backdoor A female patient is diagnosed with congestive heart failure. Which of the following will increase the MS-DRG weight if present on admission? Atrial fibrillation Stage III pressure ulcer Blood loss anemia Coronary artery disease - Answer ️️ -Stage III pressure ulcer MS-DRG 291 (weight = 01.5010) for congestive heart failure with stage III pressure ulcer would optimize the MS-DRG. MS-DRG 293 (weight = 0. 6756) is assigned for congestive heart failure alone, with atrial fibrillation, with blood loss anemia, and with coronary artery disease all remain the same (Medicare Grouper Version 29-10/11) A 70-year-old patient was admitted with pneumonia. The history and physical documented that the patient has a history of diabetes, hypertension, and migraine headache about 10 years ago without recurrence. The patient was administered IV antibiotics, metformin, and Altace during the hospitalization. Which conditions would be reported at the time of discharge? - Answer ️️ - Pneumonia, diabetes, and hypertension A patient is admitted for chest pain. The patient was stabilized and discharged. In a subsequent admission, the patient was admitted as an outpatient for a left heart catheterization, coronary arteriography using two catheters and left ventricular angiography. The patient was found to have arteriosclerotic heart disease. The patient has no history of cardiac surgery. The appropriate sequencing of ICD-9 and CPT codes for the outpatient catheterization would be: 411.1-Intermediate coronary syndrome (unstable angina) 413.9- Other and unspecified angina pectoris 414.00-Coronary atherosclerosis of unspecified type of vessel, native or graft 414.01-Coronary atherosclerosis of native coronary artery 786.50-Chest pain, unspecified 93452-Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed 93453-Combined right and left heart - Answer ️️ -414.01, 93458 Code 414.01 is assigned to show coronary artery disease in a native coronary artery and is used when a patient has coronary artery disease and no history of coronary bypass graft (CABG) surgery (Schraffenberger 2012, 190-192). Code 93458 includes intraprocedural injection(s) for left ventricular/left atrial angiography, imaging supervision, and interpretation when performed (AMA CPT Professional Edition 2013, Cardiac Catheterization Guidelines, 500-503). According to CPT, an endoscopy that is undertaken to the level of the midtransverse colon would be coded as a - Answer ️️ -colonoscopy A chest x-ray done to evaluate a chronic cough revealed a asymptomatic compression fracture of a lumbar vertebrae. No further evaluation was undertaken. The coder should: Not assign a code for an acute condition but assign a code for chronic compression fracture Assign a code for pathologic lumbar compression fracture Assign a code for acute traumatic vertebral fracture Not assign a code for this condition - Answer ️️ -Not assign a code for this condition Do not assign a code for this condition because this is a frequent condition in the elderly, is asymptomatic, and there is no documentation of treating the condition so it should not be coded (Brown 2012, 33). A patient is admitted with hypotension due to dobutamine taken, administered, and prescribed correctly. How should this be coded? - Answer ️️ -Code 458.2, Iatrogenic hypotension, should be assigned to describe this condition. This code should be assigned when hypotension develops as a result of any type of medical care. Assign code E941.2, Sympathomimetics (adrenergics), to indicate that it is an adverse effect of the drug MS-DRG assignment is based on information that includes - Answer ️️ -Diagnoses (principal and secondary); Surgical procedures (principal and secondary; Discharge disposition or status; Presence of major or other complications and comorbidities (MCC or CC as secondary diagnosis) These elements are used to determine the MS-DRG) MS-DRG assignment goes through four steps: - Answer ️️ -Pre-MDC assignments, MDC determination, Medical/surgical determination, and refinement If a patient has an excision of a malignant lesion of the skin, the CPT code is determined by the body area from which the excision occurs and the - Answer ️️ -Diameter of the lesion as well as the margins excised as described in the operative report The operative report should be reviewed for the body part involved with the lesion. The total size of the excised area, including margins, is needed for accurate coding. The pathology report typically provides the specimen size rather than the lesion or excised size. Because the specimen tends to shrink, this is not an accurate measurement according to the intent of the code assignment The case-mix index for the information provided above is: MS-DRG Weight Number of Patients MS-DRG 193, Simple pneumonia and pleurisy age >17 w/ CC; WEIGHT 3.0; # of patients 10 MS-DRG 195, Simple pneumonia without MCC or CC 2.0; 10 MS-DRG 192, Chronic obstructive pulmonary disease w/o CC 1.0; 10 - Answer ️️ -2.0 The case mix is defined as a methods of grouping patients. MS-DRGs are often used to determine case mix in hospitals. The case-mix index is the average MS-DRG weight based on the specific patient group and is determined by multiplying the DRG weights by the number of patients and then divided by the total number of patients: 30 + 20 + 10 = 60 / 30 = 2.0 75-year-old woman is admitted to the hospital after tripping and falling at home. She underwent an open reduction with internal fixation of the femur. Which of the following would be important to capture in addition to diagnostic codes? - Answer ️️ -E codes for Cause of Injury, Place of Occurrence, Activity, and Status External cause of injury codes are used to provide information about how an injury occurred, the intent (intentional or unintentional), provide information about where the injury occurred, and the status of the person at the time the injury occurred. In the case of a person who seeks care for an injury or other health condition that resulted from an activity, or when an activity contributed to the injury or health condition, activity codes are used to describe the activity During an ambulatory surgery visit for excision of a malignant melanoma of the right forearm, the attending surgeon listed history of benign breast cyst, history of hypertension currently on Tenormin, and a current hammer toe. Which conditions are to be coded? - Answer ️️ - Malignant melanoma of forearm, hypertension Assign codes for malignant melanoma of forearm, hypertension. Code chronic conditions if they affect the patient's treatment. The hypertension was being treated with a current medication and for this reason the hypertension is coded Chronic conditions must be _____ by physician - Answer ️️ -This is an example of a circumstance where the chronic condition must be verified. All secondary conditions must meet the UHDDS definitions Determining medical necessity for outpatient services includes all the following - Answer ️️ - Local coverage determinations (LCDs) National coverage determinations (NCDs) Diagnoses linked to procedures by claims-processing software tests ensuring that the procedure is cross-referenced, or linked, correctly to an acceptable diagnosis code for that service the fee schedule and the current National Correct Coding Initiatives edits. Other valuable resources are Medicare's Carrier Manual, Medicare's National Coverage Determinations Manual, and local coverage determinations (LCDs) A patient was admitted to the emergency department with chest pain, and was diagnosed with aborted myocardial infarction with acute myocardial ischemia. There was no prior cardiac surgery. The cardiac enzymes were normal. The appropriate coding of the diagnosis for this case is: - Answer ️️ -411.81 Acute coronary occlusion