Revenue Cycle Management Ch. 6 ICD-10-CM Coding Questions & Answers

Implementation of ICD-10-CM and ICD-10-PCS resulted in the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) becoming a ______ classification system. - ANSWERSlegacy The NCHS and CMS publish general equivalence ________ (abbreviated ____), to facilitate the location of corresponding diagnosis codes between ICD-9-CM and ICD-10-CM. - ANSWERSmappings GEMs ICD-9-CM was the classification (or coding) system used since the year ____ in the United States to classify inpatient and outpatient/provider-based office diagnoses (Volumes 1 and 2) and inpatient procedures (Volume 3). - ANSWERS1979 Because ICD-9-CM was over 30 years old, it contained ________ and obsolete terminology, used outdated codes that produced inaccurate and limited data, and was inconsistent with current medical practice. - ANSWERSoutdated When an ICD-9-CM code maps to a single ICD-10-CM code, reviewing the tabular list to validate the code is optional. a. True b. False - ANSWERSFalse Use the diagnosis GEM depicted in the following table to complete each statement. ICD-10-CM code A88.1 maps to ICD-9-CM code(s) - ANSWERS078.81 Use the diagnosis GEM depicted in the following table to complete each statement. ICD-9-CM code 078.81 maps to ICD-10-CM code(s) - ANSWERSA88.1 Use the diagnosis GEM depicted in the following table to complete each statement. ICD-9-CM code 078.88 maps to ICD-10-CM code(s) - ANSWERSA74.89 Use the diagnosis GEM depicted in the following table to complete each statement. ICD-10-CM code A74.89 maps to ICD-9-CM code(s) - ANSWERS078.88 Use the diagnosis GEM depicted in the following table to complete each statement. ICD-10-CM code R11.11 maps to ICD-9-CM code(s) - ANSWERS078.82 The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes and classifies _______ data from _________ and _________ records. - ANSWERSdisease inpatient outpatient The International Classification of Diseases, 10th Revision, Procedure Classification System (ICD-10-PCS) codes and classifies _________ data from _________ records only. - ANSWERSprocedure inpatient The Centers for Medicare and Medicaid Services (CMS) abbreviates ICD-10-CM and ICD-10-PCS as ___-__-__/___. - ANSWERSICD-10-CM/PCS ICD-10-CM includes many more codes and applies to more users than ICD-9-CM because it is designed to collect data on every type of health care encounter, which includes _________, __________, _______, home health care, and long-term care. - ANSWERSinpatient outpatient hospice ICD-10-CM also enhances accurate payment for services rendered and facilitates __________ of medical processes and outcomes. - ANSWERSevaluation The intent of ICD-10-CM is to describe the ________ picture of the patient, which means codes are more precise than those needed for ICD-9-CM's statistical groupings and trend analysis. - ANSWERSclinical ICD-10-CM codes require up to _ characters, are entirely alphanumeric, and have unique coding conventions. - ANSWERS7 ICD-10-CM uses a disease index to initially locate codes for conditions, and a _______ ____ to verify codes. - ANSWERSTabular List ICD-10-CM and ICD-10-PCS incorporate much greater __________ and clinical information (when compared with previous classification systems, such as ICD-9-CM). - ANSWERSspecificity ICD-10-CM and ICD-10-PCS provide codes to allow for the comparison of _________ and _________ data. - ANSWERSmortality morbidity The reporting of ICD-9-CM diagnosis codes on Medicare claims was originally mandated by the Medicare ____________ Coverage Act of 1988. - ANSWERSCatastrophic The reporting of ICD-10-CM/PCS codes was mandated by _____ (acronym) of 1996 (Administrative Simplification title). - ANSWERSHIPAA Reporting ICD-10-CM codes on submitted claims ensures the _______ _________ of procedures and services provided to patients during an encounter, which is defined as "the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury." - ANSWERSmedical necessity The face-to-face contact between a patient and a health care provider who assesses and treats the patient's condition is a(n) _________. - ANSWERSencounter The criteria used to determine medical necessity include _______, _____, ________, and _____. - ANSWERSpurpose scope evidence value Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Acariasis infestation. - ANSWERSB88.0 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Costen's complex. - ANSWERSM26.69 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. ST elevation myocardial infarction, anterior wall, involving left main coronary artery. - ANSWERSI21.01 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Malaria with hepatitis. - ANSWERSB54, K75.9 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Acute lymphangitis. - ANSWERSL03.91 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Absence of menstruation. - ANSWERSN91.2 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Arterial atheroembolism. - ANSWERSI75.89 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Cataract in hypoparathyroidism. - ANSWERSE20.9, H28 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Acromegaly. - ANSWERSE22.0 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Cirrhosis due to Wilson's disease. - ANSWERSE83.01 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Keratoconjunctivitis in exanthema. - ANSWERSB09 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Appendicitis with perforation. - ANSWERSK35.2 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Abnormal acid-base balance. - ANSWERSE87.4 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. Parietoalveolar pneumopathy. - ANSWERSJ84.09 Assign ICD-10-CM codes to each diagnostic statement, interpreting coding conventions. GM2 gangliosidosis, juvenile. - ANSWERSE75.09 or oat cell carcinoma of the right lung with spread to the brain, the primary site is _____ ____, and the secondary site is _____. - ANSWERSright lung, brain For metastatic carcinoma from right breast (female), the primary site is _____ ______, and the secondary site is _______. - ANSWERSright breast, unknown For metastatic carcinoma from right kidney to bone, the primary site is _____ ______, and the secondary site is ____. - ANSWERSright kidney, bone For metastatic malignant melanoma of bone, the primary site is ____, and the secondary site is ____. - ANSWERSskin, bone For frontal lobe brain cancer, the primary site is _______, and the secondary site is _____. - ANSWERSunknown, brain Oat cell carcinoma of the right lung with spread to the brain. - ANSWERSC34.91, C79.31 Metastatic carcinoma from right breast (female). - ANSWERSC50.911, C79.9 Metastatic carcinoma from right kidney to bone. - ANSWERSC64.1, C79.51 Metastatic malignant melanoma of bone. - ANSWERSC43.9, C79.51 Brain cancer. - ANSWERSC80.1, C79.31 Adverse reaction to pertussis vaccine, initial encounter. - ANSWERST50.A15A Cardiac arrhythmia caused by interaction between prescribed ephedrine and wine (accident), initial encounter. - ANSWERST44.991A, T51.0X1A, I49.9 Stupor, due to overdose of Nytol (suicide attempt), initial encounter. - ANSWERST45.0X2A, R40.1 High blood pressure due to prescribed Albuterol, initial encounter - ANSWERSR03.0, T48.6X5A Rash due to combining prescribed amoxicillin with prescribed Benadryl, initial encounter. - ANSWERSL27.0, T36.0X1A, T45.0X1A The ICD-10-CM alphabetical listing of main terms or conditions printed in boldfaced type that may be expressed as nouns, adjectives, or eponyms is called the _____ to Diseases and Injuries. - ANSWERSIndex The _____ of Drugs and Chemicals contains adverse effects and poisonings associated with medicinal, chemical, and biological substances. - ANSWERSTable Main terms in the ICD-10-CM index are listed in alphabetical order, which means a single______ between words in a main term is ignored when locating main terms in the ICD-10-CM indexes. - ANSWERShyphen When numerical characters and words appear under a main term, they are listed in __________ order. - ANSWERSalphabetic Main terms are printed in boldfaced type and followed by the _______ code. - ANSWERSdefault Words contained in parentheses after a main term, which do not have to be included in the diagnostic statement for the code number listed after the parentheses to be assigned, are called ____________ modifiers. - ANSWERSnonessential Subterms that qualify the main term by listing alternative sites, etiology, or clinical status are called _________ modifiers. - ANSWERSessential