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HCS-D Practice #5 Questions and Answers|Latest Update

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HCS-D Practice #5 Questions and Answers|Latest Update 11. The physician documented severe obesity but did not document the BMI. What should you do? a. Document and code the BMI to match the physician's statement of severe obesity. b. Leave the code off if the physician didn't document the BMI c. Code BMI based on the clinician's calculations. Correct Answ_c. Code BMI based on the clinician's calculations

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HCS-D Practice #5 Questions and
Answers|Latest Update

11. The physician documented severe obesity but did not document the BMI. What should you

do?




a. Document and code the BMI to match the physician's statement of severe obesity.

b. Leave the code off if the physician didn't document the BMI


c. Code BMI based on the clinician's calculations. Correct Answ_c. Code BMI based on the

clinician's calculations.




12. Patient is admitted to home health for wound care to her atherosclerotic ulcer of the left

ankle. Upon assessment, the nurse documents necrosis of muscle tissue is present. The patient

also has left non-dominant hemiplegia from a stroke 4 years ago. How would you code this?




a. I70.243, L97.323, I69.954

b. I70.243, L97.323, I69.354

c. I70.243, I69.354


d. I70.233, I97.323, I69.354 Correct Answ_b. I70.243, L97.323, I69.354

,**The atherosclerosis of native arteries of left leg with an ulcer is coded to L70.243 - the

L70.233 is incorrect because it is the right leg. The instructional note at L70.24 states to use

additional code to identify the severity of the ulcer, which can be coded based on the clinician's

documentation. The correct code for the stroke deficit is I69.354 - the I69.9 should not be used

per the Excludes 1 note under I69.9 category.




13. To find the code for use of supplemental oxygen, look under ________ in the alphabetical

index.




a. use of, oxygen, supplemental

b. oxygen, dependence on

c. dependence, supplemental oxygen


d. status, supplemental oxygen Correct Answ_c. dependence, supplemental oxygen




14. Patient with fractured right hip and osteoporosis. Hip replacement was performed. History

states that the patient fell when getting up from his chair. Admitted to home health for therapy.




a. M80.051D, Z96.641

b. Z47.1, M81.0, Z96.641

,c. S72.001D, M81.0, Z96.641


d. M84.451D, Z96.641 Correct Answ_a. M80.051D, Z96.641




**A code from category M80, not a traumatic fracture code, should be used for any patient with

known osteoporosis who suffers a fracture, even if the patient had a minor fall or trauma, if that

fall or trauma would not usually break a normal, healthy bone. Z codes are not used for fractures.

The fracture should be coded with 7th character D. Joint prosthesis status is added.




15. The patient is being admitted for anemia related to cancer. How should this be coded?




a. Cancer first, then the anemia

b. Skilled care for anemia is not covered under the home health or hospice benefit so would

never be coded first.

c. Anemia first, then the cancer


d. The anemia is not coded, because it is part of the cancer Correct Answ_a. Cancer first,

then the anemia




16. 73 year old male admitted to home care with exacerbation of heart failure due to he ran out of

Lasix and couldn't afford to refill the prescription, is also wheelchair bound. How would this be

coded?

, a. I50.9, T50.1x6D, Z91.120, Z99.3

b. I50.9, T50.1xx6, Z99.3

c. I50.9, T50.1x6, Z91.120, Z99.3


d. I50.9, Z91.120, Z99.3 Correct Answ_a. I50.9, T50.1x6D, Z91.120, Z99.3




**This scenario follows the coding sequencing for underdosing. Z99.3 is found under

dependence, on, wheelchair.




17. A combative patient with Alzheimer's Dementia is admitted. On SOC assessment, it is noted

that the patient has urinary and fecal incontinence related to dementia, and wears adult diapers.

The patient has a diaper rash in the genital and anal area, and the daughter admits, she can only

get her dad to let her change his diaper a couple of times a day due to the combativeness. The

nurse calls and discusses options with the physician, which includes providing a zinc based

ointment to put on the area at each diaper change. How would the coder assign codes to this

patient?




a. G30.9, F02.81, L22, R39.81, R15.9

b. F03.91, L22, R39.81, R15.9

c. G30.8, F03.91, R21, R39.81, R15.9

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