AAPC CPC Chapter 4 Exam Questions with Verified Solutions Latest Update (Graded A+)

AAPC CPC Chapter 4 Exam Questions with Verified Solutions Latest Update (Graded A+) HIV Can only be coded if confirmed case true or false? - Answers True, you can only code HIV if case is confirmed Does confirmation of HIV require documentation of positive serology or culture? - Answers No, the providers diagnostic statement that the patient is HIV Positive or has and HIV related illness is sufficient. Proper sequencing for HIV depends on what? - Answers The reason for the admission or encounter. If a patient is admitted for an HIV related condition what is coded first? - Answers B20, HIV followed by additional diagnosis codes for all reported HIV related conditions. What conditions are always considered HIV related conditions? - Answers Kaposi's sarcoma, lymphoma, pneumocystis cabrini pneumonia, cryptococcal meningitis, and cytomegalovirus disease. These conditions are consider opportunistic infections. What is coded first with HIV disease admitted for unrelated condition such as fracture? - Answers The code for the unrelated condition would be first, and then B20, and any additional dx codes for all reported HIV related conditions. Code Z21 Asymptomatic human immunodeficiency virus infection status is applied when? - Answers Patient is HIV positive, but does not have any documented symptoms of HIV related illness. Do not use if term AIDS is used. Code R75 Inconclusive laboratory evidence of human immunodeficiency virus is used when? - Answers Inconclusive HIV serology, and no definitive diagnosis or manifestation of the illness. True or False. After a patient has developed HIV related illness the patients condition should be assigned B20 on every subsequent admission//encounter? - Answers True, never assign R75 or Z21 to a patient with an earlier diagnosis of AID or symptomatic HIV What is the sequence for HIV infection in pregnancy, childbirth and the puerperium? - Answers First would be code from subcategory O98.7-Human immunodeficiency virus disease complicating pregnancy, childbirth, and puerperium, followed by B20, and the codes for HIV related illness, and Z3A for weeks gestation What sequence for patients with asymptomatic HIV infection status admitted or presenting for a healthcare encounter during pregnancy? - Answers O98.7 followed by Z21, and Z3A for weeks gestation What code is used for a patient being seen to determine HIV status? - Answers Z11.4, encounter for screening for human immunodeficiency virus, code signs and symptoms, Z71.7 HIV counseling if provided A patient has toxic shock syndrome caused by staphylococcus aureus what would be the sequence? - Answers A48.3 Toxic shock syndrome followed by the organism that caused B95.61 Methicillin susceptible staphylococcus aureus infection A patient has penicillin resistant pneumonia what would be the sequence? - Answers J18.9 Pneumonia, followed by Z16.11 Resistance to penicillins. What is the appropriate code for sepsis when the tie of infection or causal organism is not further specified? - Answers A41.9 Sepsis unspecified organism True or False. The code R65.2 should be assigned when there is no acute organ dysfunction documented. - Answers False, R65.2 Severe sepsis should not be assigned unless severe sepsis or an associated acute organ dysfunction is documented. Should negative or inconclusive blood cultures and sepsis preclude a diagnosis of sepsis in patients with clinical evidence of the condition? - Answers No, however the provider should be queried Urosepsis - Answers a nonspecific term it is not to be considered synonymous with sepsis. It has no default code in the alpha index, provider must be queried for clarification. Sepsis with organ dysfunction - Answers If a patient has sepsis and associated acute organ dysfunction or multiple organ dysfunction, follow instructions for severe sepsis. Acute organ dysfunction not clearly associated with the sepsis - Answers Do not code from severe sepsis R65.2, If not clear query the provider. Coding sequence for Severe Sepsis - Answers Code underlying systemic infection first if causal organism is not documented assign A41.9, Then subcategory from R65.2, and then the associated acute organ dysfunction. Can Severe sepsis R65.20-R65.21 be sequenced first? - Answers No, this would always be sequenced following the underlying cause. If patient was admitted for bladder cancer, and cause of kidney failure was from bladder cancer not the sepsis how would this be coded? - Answers C67.9 Bladder cancer, N17.9 Kidney failure, A41.9 Sepsis unspecified What is the sequence for coding septic shock? - Answers A41.9 Code for systemic infection, followed by code R65.21 Severe sepsis with septic shock or code T81.12 Postprocedural septic shock, and any additional codes for acute organ dysfunctions Septic Shock - Answers Refers to circulatory failure associated with severe sepsis. It represents a type of acute organ dysfunction. Cannot be assigned as a principle diagnosis. If severe sepsis is present on admission and meets principle diagnosis how would this be coded? - Answers Underlying systemic infection should be first A41.9, then severe sepsis R65.2 If severe sepsis develops during an encounter how would this be coded? - Answers The underlying systemic infection A41.9 and severe sepsis R65.2 would be secondary diagnoses. If reason for admission is both sepsis or severe sepsis and a localized infection such as pneumonia or cellulitis what would be the sequence? - Answers code for underlying s