A patient was discharged from the same-day-surgery unit with the following diagnoses:
posterior subcapsular mature incipient senile cataract right eye, diabetes mellitus,
hypertension, and was treated for mild acute renal failure. Which codes are correct?
E11.9 -Type 2 diabetes mellitus without complications
E11.29 -Type 2 diabetes mellitus with other diabetic kidney complication H25.9 -
Unspecified age-related cataract
H25.21 -Age-related cataract, morgagnian type, right eye
H25.041 -Posterior subcapsular polar age-related cataract, right eye
,I10-Essential hypertension
112.9 -Hypertensive chronic kidney disease with stage 1 through stage 4, or unspecified
chronic kidney disease N17.9 -Acute kidney failure, unspecified
a. H25.21, E11.29, 112.9, N17.9
b. H25.041, E11.9, 110, N17.9
c. H25.9, E11.29, 112.9, N17.9
d. H25.041, E11.9, !12.9
Give this one a try later!
b
The patient has posterior subcapsular mature incipient senile cataract right
eye, diabetes mellitus (with no designated causal relationship to the
cataracts), hypertension, acute renal failure. The hypertension is not related to
the renal failure as it is acute and not chronic. Because of this, a combination
code for hypertension and chronic renal failure is not coded (HHS 2014,
Section I.B.9, 14).
A patient has a principal diagnosis of pneumonia (118.9) (MS-DRG 195).
Which of the following may legitimately change the coding of the pneumonia in
accordance with the UHDDS and relevant clinical documentation?
a. Sputum culture reflects growth of normal flora.
b. Patient has a positive gram stain.
c. Patient is found to have dysphagia with aspiration.
d. Patient has nonproductive sputum.
Give this one a try later!
, c
Patient is found to have dysphagia with aspiration is the correct answer
because it changes the coding to aspiration pneumonia and would result in
MS-DRG 179 RESPIRATORY INFECTIONS & INFLAMMATIONS W/0 CC/MCC,
which has a weight of 0.9718 (Medicare Grouper Version Used: 31). This is in
comparison to MS-DRG 0195, SIMPLE PNEUMONIA & PLEURISY W/0
CC/MCC MDC: 04 which has a DRG weight of 0.6978 (Medicare Grouper
Version Used: 31).
Inpatient:
A 30-year-old patient was seen in the emergency department for recurrent epileptic
seizures. The patient also had tic douloureux.
Give this one a try later!
ICD-10-CM: G40.909, G50.0
(Schraffenberger 2013,158-159).
The patient was admitted from the emergency department because of chest pain.
Following blood work, it was determined that the patient had elevated CPKs and MB
enzymes. The EKG shows nonspecific ST changes.
What type of diagnosis might this indicate?
a. Unstable angina
b. Myocardial infarction
c. Congestive heart failure
d. Mitral valve stenosis
posterior subcapsular mature incipient senile cataract right eye, diabetes mellitus,
hypertension, and was treated for mild acute renal failure. Which codes are correct?
E11.9 -Type 2 diabetes mellitus without complications
E11.29 -Type 2 diabetes mellitus with other diabetic kidney complication H25.9 -
Unspecified age-related cataract
H25.21 -Age-related cataract, morgagnian type, right eye
H25.041 -Posterior subcapsular polar age-related cataract, right eye
,I10-Essential hypertension
112.9 -Hypertensive chronic kidney disease with stage 1 through stage 4, or unspecified
chronic kidney disease N17.9 -Acute kidney failure, unspecified
a. H25.21, E11.29, 112.9, N17.9
b. H25.041, E11.9, 110, N17.9
c. H25.9, E11.29, 112.9, N17.9
d. H25.041, E11.9, !12.9
Give this one a try later!
b
The patient has posterior subcapsular mature incipient senile cataract right
eye, diabetes mellitus (with no designated causal relationship to the
cataracts), hypertension, acute renal failure. The hypertension is not related to
the renal failure as it is acute and not chronic. Because of this, a combination
code for hypertension and chronic renal failure is not coded (HHS 2014,
Section I.B.9, 14).
A patient has a principal diagnosis of pneumonia (118.9) (MS-DRG 195).
Which of the following may legitimately change the coding of the pneumonia in
accordance with the UHDDS and relevant clinical documentation?
a. Sputum culture reflects growth of normal flora.
b. Patient has a positive gram stain.
c. Patient is found to have dysphagia with aspiration.
d. Patient has nonproductive sputum.
Give this one a try later!
, c
Patient is found to have dysphagia with aspiration is the correct answer
because it changes the coding to aspiration pneumonia and would result in
MS-DRG 179 RESPIRATORY INFECTIONS & INFLAMMATIONS W/0 CC/MCC,
which has a weight of 0.9718 (Medicare Grouper Version Used: 31). This is in
comparison to MS-DRG 0195, SIMPLE PNEUMONIA & PLEURISY W/0
CC/MCC MDC: 04 which has a DRG weight of 0.6978 (Medicare Grouper
Version Used: 31).
Inpatient:
A 30-year-old patient was seen in the emergency department for recurrent epileptic
seizures. The patient also had tic douloureux.
Give this one a try later!
ICD-10-CM: G40.909, G50.0
(Schraffenberger 2013,158-159).
The patient was admitted from the emergency department because of chest pain.
Following blood work, it was determined that the patient had elevated CPKs and MB
enzymes. The EKG shows nonspecific ST changes.
What type of diagnosis might this indicate?
a. Unstable angina
b. Myocardial infarction
c. Congestive heart failure
d. Mitral valve stenosis
