QUESTIONS & ANSWERS.
World Healh Organization (WHO) - CORRECT ANSWER Who publishes the ICD-10 code set
What is ICD-10 used for in the US? - CORRECT ANSWER Classify morbidity data from IP and OP records,
physician offices, and National Canter for a health Statistics surveys, reimbursement purposes, and
greater specificity of diagnoses.
Who updates and approves the ICD-10 code sets? - CORRECT ANSWER AHA, AHIMA, CMS, and NCHS
Who publishes coding clinic? - CORRECT ANSWER AHA (American Hospital Association)
Which act requires all providers to use the same code sets, healthcare transactions, and identifiers? -
CORRECT ANSWER HIPAA
HIPAA requires which code sets to report clinical information? - CORRECT ANSWER CPT, HCPCS, ICD-10-
CM, National Drug Codes
How many characters long is an ICD 10 CM code? - CORRECT ANSWER 3-7
When assigning a code, which hierarchy is followed? - CORRECT ANSWER 1. Coding guidelines
2. Alphabetic Index
3. Tabular List
Can coding clinic supersede Official guidelines, alphabetic index, or tabular list? - CORRECT ANSWER No
Does CMS endorse coding clinic? - CORRECT ANSWER Yes
,What is coding advice in coding clinic based on? - CORRECT ANSWER The statistical classification scene
of ICD-10-CM and definitions specified in UHDDS.
How long are subcategories in ICD-10-CM? - CORRECT ANSWER Four or 5 characters
What does an ICD-10-PCS code need to reflect? - CORRECT ANSWER The procedure performed and the
physician's intent or objective for the procedure.
What does a whipple procedure consist of? - CORRECT ANSWER Pancreaticoduodenectomy
What does the first character in a PCS code describe? - CORRECT ANSWER General category or section of
the procedure being described (medical, surgical, ancillary)
What does the second character in a PCS code describe? - CORRECT ANSWER Body system or region
within the body that is the focus of the procedure
What does the third character in a PCS code describe? - CORRECT ANSWER Root operation or the intent
of the procedure
What does the fourth character of a PCS code describe? - CORRECT ANSWER Body part, or specific part
of the body system on which the procedure is performed.
What does the fifth character of a PCS code describe? - CORRECT ANSWER Approach or technique used
to reach the site of the procedure
How many approaches are there in ICD-10-PCS? - CORRECT ANSWER Seven
What does the sixth character in a PCS code describe? - CORRECT ANSWER Whether a device was
implanted, the type of device, and it's purpose
What does the seventh character of a PCS code describe? - CORRECT ANSWER Qualifier - which is unique
for different procedures that completes the picture of the code
,What is the purpose of the DRG system? - CORRECT ANSWER For creating national and world healthcare
statistics.
What is the DRG system designed to promote? - CORRECT ANSWER International comparability in the
collection, processing, clarification, and presentation of healthcare statistics.
What is one of the most difficult aspects of CDI? - CORRECT ANSWER The separation of an inferred
condition from the application of the most specific ICD 10 code,
In coding guidelines, what does the term provider mean? - CORRECT ANSWER Physician or any qualified
healthcare practitioner legally accountable for establishing a patient's diagnosis
Can specificity of a debridement come from a wound nurse's note? - CORRECT ANSWER Yes
What do coding guidelines say about signs and symptoms? - CORRECT ANSWER They are not to be used
as principal diagnosis when a related definitive diagnosis has been established.
What do combination codes represent? - CORRECT ANSWER Two interrelated condition ms that may
only require one code, a manifestation code, or a secondary complication code
What is a late effect code? - CORRECT ANSWER A condition which is a complication of a precious
condition
What does UHDDS define the principal diagnosis as? - CORRECT ANSWER The condition established after
study to be chiefly responsible for occasioning the admission
What is one purpose of UHDDS? - CORRECT ANSWER It helps hospitals report inpatient data in a
standardized manner
Data elements and definitions associated with the UHDDS are found in what resource? - CORRECT
ANSWER Federal register 1985
, If a threatened condition is documented and you cannot find it in the code book index, what code do
you assign? - CORRECT ANSWER A code for the existing underlying condition and not the condition
described as impending or threatened
If a condition is bilateral but there is no bilateral code, what do you assign? - CORRECT ANSWER A code
for both left and right.
Guidance that states hospitals should ensure complete and accurate coding that results in correct
reporting of patient conditions, assignment of appropriate MS-DRG, and ultimately maximum
reimbursement comes from where? - CORRECT ANSWER Federal Register 1985
If a patient presents with multiple conditions, what guideline do you follow and where does it come
from? - CORRECT ANSWER Any of the presenting conditions can be principal diagnosis - UHDDS
Which organization provides direction that hospitals should ensure complete and accurate coding that
results in correct reporting of patient conditions, assignment of appropriate MS-DRG, and ultimately
maximum reimbursement for care provided to the patient? - CORRECT ANSWER The Federal Register
Surgical complication codes require - CORRECT ANSWER Documentation that links the condition to the
previous event
Timeframe required for coding surgical complications - CORRECT ANSWER No timeframe needed
HIV can be coded in these situations - CORRECT ANSWER Provider documents patient is HIV positive
WITH SYMPTOMS or has an HIV related illness
Zika virus - CORRECT ANSWER Cannot be coded if it is suspected. MUST be confirmed.
Neoplasm guideline for anemia due to chemo - CORRECT ANSWER Anemia due to chemo is PDX if they
are admitted for blood transfusions without any other care