HCS-D Exam Questions & Answers
100% Updated!
The physician documents Alzheimer's dementia and the nurse lists dementia then
Alzheimer's, since she feels the dementia has more of an impact on the POC -
ANSWERSA. List the diagnoses as the nurse did, since it is the assessing clinician's
responsibility to determine the sequencing.
B. Sequence Alzheimer's followed by dementia. It is not necessary to contact the
assessing clinician, since this is coding guidelines.
C. Follow the coding guidelines for etiology/manifestation pairing and contact the
assessing clinician for approval to make the changes.
C
There is a discrepancy in physician documentation regarding the type of ulcer on the
patient's left lower leg. The primary care physician states it is a diabetic ulcer and the
consulting vascular surgeon states it's a stasis ulcer. The assessing nurse lists diabetic
ulcer as a diagnosis and completes the data items for stasis ulcer on the OASIS. What
should you do? - ANSWERSA. Code the ulcer as both diabetic and stasis
B. Do not code this until the physician is notified regarding the discrepancy and confirms
the type of ulcer.
C. Code diabetic ulcer, since this is what the primary care physician documented and
the assessing clinician listed.
B
A patient was referred to your agency for SN and PT due to increased dyspnea and
weakness. The physician's office nurse filled out the F2F with these diagnoses, the
physician signed and dated it and it was faxed to the agency. There is no other
physician documentation. The nurse who did the SOC assessment noted the patient
was started on a new bronchodilator and documented exacerbation of COPD as the
primary diagnosis. Which of the following should you do? - ANSWERSA. Consult with
the assessing nurse to see if exacerbation of COPD was confirmed by the physician.
B. Code dyspnea and weakness, instead of exacerbation COPD, since they are listed
on the F2F.
C. Code exacerbation of COPD, as documented by the nurse, because this is noted as
the focus of care in the summary on the OASIS and the patient is on a new
bronchodilator.
A
The physician documented anxiety depression on a patient admitted for uncontrolled
hypertension. The depression screening was negative and the patient denied feeling
depressed at SOC. The admitting nurse listed the diagnosis as HTN (I10), depression
(F32.A), anxiety (F41.9) and there will be interventions on POC for these diagnoses.
You know that the code for anxiety depression is F41.8, which is not what the nurse
,coded. What should you do? - ANSWERSA. Code both depression and anxiety, just ad
the admitting nurse did.
B. Code anxiety depression (F41.8), since this is what the MD documented, and contact
the assessing nurse for approval.
C. Code anxiety, but not depression, since the depression screening was negative and
the patient denied feeling depressed.
B
The physician does not agree with two of the diagnoses listed on the POC. He crossed
them out and refused to sign it. The RAP and OASIS have already been submitted.
What needs to be done? - ANSWERSA. Re-print the POC with the same diagnoses,
since the assessing clinician says the patient definitely has these, and ask the medical
director to sign it.
B. Make the appropriate corrections to the POC and re-send it to the certifying physician
for signature. Since neither of these diagnoses are case-mix, it is not necessary to do
anything regarding the OASIS or billing.
C. Correct the diagnoses on the POC and the claim. Re-send the POC to the physician
and re-submit the claims, if the codes affect the case-mix, following the agency's
correction policy.
C
Orders may only be taken from? - ANSWERSMD; Medical doctor
DO; doctor of osteopathic medicine
DPM; doctor of podiatric medicine
ARNP; nurse practitioner
PA; Physician assistant
CNS; clinical nurse specialist
A dash following the category or subcategory means? - ANSWERSAn incomplete code
Home health care services for continuation of IV antibiotics. Post discharge after
infection of right total joint prosthesis. - ANSWERST84.51XA; infection and
inflammatory reaction due to internal right hip prosthesis, initial encounter
* antibiotics is active treatment
Home health physical therapy services. Status post repair of left hip fracture with routine
healing. No post-op complications. - ANSWERSS72.002D; Fracture of unspecified part
of neck of left femur, subsequent encounter for closed fracture with routine healing
Home care for routine dressing changes and care of healing wound. Post-op wound
infection previously treated in acute care hospitalization. No longer receiving antibiotics.
- ANSWERST81.41XD; infection following a procedure, superficial incisional surgical
site, subsequent encounter
, Home care treatment with wound VAC dressing changes. Deep right lower quadrant
stab wound of the abdomen extending into peritoneal cavity. - ANSWERSS31.613A;
Laceration without foreign body of abdomen extending into peritoneal cavity
*Wound VAC is active treatment
Home care treatment for post-surgical management of biliary T-tube wound care and
dressing changes. Previously hospitalized for cholecystectomy with biliary T-tube
insertion. - ANSWERSZ48.01; Encounter for change of removal of surgical wound
dressing
Z48.815; Encounter for surgical aftercare following surgery on the digestive system
*Routine wound care and dressing changes are not active treatment
Brackets mean... - ANSWERSEnclose synonyms, alternative wording or explanatory
phases
Parentheses mean - ANSWERSSupplementary words that may be present or absent in
the statement of a disease or procedure without affecting the code to which it is
assigned
*Nonessential modifiers; do not affect the code selection
Nonessential modifiers - ANSWERSSubterms or subentries following a main term
except when a nonessential modifier and a subentry are mutually exclusive. The
subentry takes precedence
Excludes 1 - ANSWERSNot coded here, meaning the codes should never be used at
the same time as the code above the Excludes 1. The exception is when the two codes
are unrelated.
Excludes 2 - ANSWERSNot included here, meaning the condition excluded is not part
of the condition represented by the code but the patient may have both conditions at the
same time. Can use both codes together when appropriate.
Etiology/manifestation - ANSWERSEtiology must be coded first followed by the
manifestation
In diseases classified elsewhere - ANSWERSCan never be the first listed code and
must be listed following the underlying condition
And refers to - ANSWERS"And" or "or"
With or in refers to - ANSWERS"Associated with" or "due to"
Signs and symptoms - ANSWERSShould not be coded if it is considers to be integral of
a condition
100% Updated!
The physician documents Alzheimer's dementia and the nurse lists dementia then
Alzheimer's, since she feels the dementia has more of an impact on the POC -
ANSWERSA. List the diagnoses as the nurse did, since it is the assessing clinician's
responsibility to determine the sequencing.
B. Sequence Alzheimer's followed by dementia. It is not necessary to contact the
assessing clinician, since this is coding guidelines.
C. Follow the coding guidelines for etiology/manifestation pairing and contact the
assessing clinician for approval to make the changes.
C
There is a discrepancy in physician documentation regarding the type of ulcer on the
patient's left lower leg. The primary care physician states it is a diabetic ulcer and the
consulting vascular surgeon states it's a stasis ulcer. The assessing nurse lists diabetic
ulcer as a diagnosis and completes the data items for stasis ulcer on the OASIS. What
should you do? - ANSWERSA. Code the ulcer as both diabetic and stasis
B. Do not code this until the physician is notified regarding the discrepancy and confirms
the type of ulcer.
C. Code diabetic ulcer, since this is what the primary care physician documented and
the assessing clinician listed.
B
A patient was referred to your agency for SN and PT due to increased dyspnea and
weakness. The physician's office nurse filled out the F2F with these diagnoses, the
physician signed and dated it and it was faxed to the agency. There is no other
physician documentation. The nurse who did the SOC assessment noted the patient
was started on a new bronchodilator and documented exacerbation of COPD as the
primary diagnosis. Which of the following should you do? - ANSWERSA. Consult with
the assessing nurse to see if exacerbation of COPD was confirmed by the physician.
B. Code dyspnea and weakness, instead of exacerbation COPD, since they are listed
on the F2F.
C. Code exacerbation of COPD, as documented by the nurse, because this is noted as
the focus of care in the summary on the OASIS and the patient is on a new
bronchodilator.
A
The physician documented anxiety depression on a patient admitted for uncontrolled
hypertension. The depression screening was negative and the patient denied feeling
depressed at SOC. The admitting nurse listed the diagnosis as HTN (I10), depression
(F32.A), anxiety (F41.9) and there will be interventions on POC for these diagnoses.
You know that the code for anxiety depression is F41.8, which is not what the nurse
,coded. What should you do? - ANSWERSA. Code both depression and anxiety, just ad
the admitting nurse did.
B. Code anxiety depression (F41.8), since this is what the MD documented, and contact
the assessing nurse for approval.
C. Code anxiety, but not depression, since the depression screening was negative and
the patient denied feeling depressed.
B
The physician does not agree with two of the diagnoses listed on the POC. He crossed
them out and refused to sign it. The RAP and OASIS have already been submitted.
What needs to be done? - ANSWERSA. Re-print the POC with the same diagnoses,
since the assessing clinician says the patient definitely has these, and ask the medical
director to sign it.
B. Make the appropriate corrections to the POC and re-send it to the certifying physician
for signature. Since neither of these diagnoses are case-mix, it is not necessary to do
anything regarding the OASIS or billing.
C. Correct the diagnoses on the POC and the claim. Re-send the POC to the physician
and re-submit the claims, if the codes affect the case-mix, following the agency's
correction policy.
C
Orders may only be taken from? - ANSWERSMD; Medical doctor
DO; doctor of osteopathic medicine
DPM; doctor of podiatric medicine
ARNP; nurse practitioner
PA; Physician assistant
CNS; clinical nurse specialist
A dash following the category or subcategory means? - ANSWERSAn incomplete code
Home health care services for continuation of IV antibiotics. Post discharge after
infection of right total joint prosthesis. - ANSWERST84.51XA; infection and
inflammatory reaction due to internal right hip prosthesis, initial encounter
* antibiotics is active treatment
Home health physical therapy services. Status post repair of left hip fracture with routine
healing. No post-op complications. - ANSWERSS72.002D; Fracture of unspecified part
of neck of left femur, subsequent encounter for closed fracture with routine healing
Home care for routine dressing changes and care of healing wound. Post-op wound
infection previously treated in acute care hospitalization. No longer receiving antibiotics.
- ANSWERST81.41XD; infection following a procedure, superficial incisional surgical
site, subsequent encounter
, Home care treatment with wound VAC dressing changes. Deep right lower quadrant
stab wound of the abdomen extending into peritoneal cavity. - ANSWERSS31.613A;
Laceration without foreign body of abdomen extending into peritoneal cavity
*Wound VAC is active treatment
Home care treatment for post-surgical management of biliary T-tube wound care and
dressing changes. Previously hospitalized for cholecystectomy with biliary T-tube
insertion. - ANSWERSZ48.01; Encounter for change of removal of surgical wound
dressing
Z48.815; Encounter for surgical aftercare following surgery on the digestive system
*Routine wound care and dressing changes are not active treatment
Brackets mean... - ANSWERSEnclose synonyms, alternative wording or explanatory
phases
Parentheses mean - ANSWERSSupplementary words that may be present or absent in
the statement of a disease or procedure without affecting the code to which it is
assigned
*Nonessential modifiers; do not affect the code selection
Nonessential modifiers - ANSWERSSubterms or subentries following a main term
except when a nonessential modifier and a subentry are mutually exclusive. The
subentry takes precedence
Excludes 1 - ANSWERSNot coded here, meaning the codes should never be used at
the same time as the code above the Excludes 1. The exception is when the two codes
are unrelated.
Excludes 2 - ANSWERSNot included here, meaning the condition excluded is not part
of the condition represented by the code but the patient may have both conditions at the
same time. Can use both codes together when appropriate.
Etiology/manifestation - ANSWERSEtiology must be coded first followed by the
manifestation
In diseases classified elsewhere - ANSWERSCan never be the first listed code and
must be listed following the underlying condition
And refers to - ANSWERS"And" or "or"
With or in refers to - ANSWERS"Associated with" or "due to"
Signs and symptoms - ANSWERSShould not be coded if it is considers to be integral of
a condition
