CCS Prep Exam 1
1. 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).
2. A 7-year-old patient was admitted to the emergency department for treat- ment of
shortness of breath.The patient is given epinephrine and nebulizer treatments. The
shortness of breath and wheezing are unabated following treatment. What diagnosis
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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).
3. . A patient is admitted with a high temperature, lethargy, hypotension, tachy- cardia,
oliguria, and elevated WBC. The patient also has more than 100,000 organisms of
Escherichia coli per cc of urine. The attending physician docu- ments "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,
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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).
4. 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 coro- nary artery. The patient
also underwent a repositioning of the mammary artery
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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 An- swer: 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).
5. 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: Correct Answer: C
A colonoscopy is an examination of the entire colon, from the rectum to the cecum that may
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