CCDS PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION

CCDS PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION 1) Bleeding gastric ulcer - ANSWER A patient is admitted from the emergency department (ED) with a diagnosis of weakness and anemia. After admission and further treatment with packed red blood cells (PRBC), GI consult, and endoscopy, the physician includes the following diagnoses in the discharge summary: anemia, suspected bleeding gastric ulcer, and GERD. What would be the most appropriate principle diagnosis? Bleeding gastric ulcer Anemia GERD Weakness 2) Neoplasm of occipital region - ANSWER A patient is admitted with new-onset seizures. Head CT reveals a mass in the occipital region. The physician documents possible brain tumor, and the patient is transferred to another hospital for further workup. What would be the most appropriate principal diagnosis based upon this documentation? Seizure Neoplasm of occipital region Head mass Head tumor 3) Calculated annually A. Dependent upon indirect costs for graduate medical education and new technology B. Adjusted based upon number of low-income patients cared for - ANSWER A hospital's base rate or blended rate is: C. Calculated annually D. Dependent upon indirect costs for graduate medical education and new technology E. Adjusted based upon number of low-income patients cared for F. Not adjusted based upon capital expenses 4) Reflect the severity of illness (SOI) and resource consumption of the patient's care - ANSWER The final MS-DRG assigned to a patient's medical record should: Reflect the amount of time the physician spent with the patient Depend upon the patient's length of stay Be assigned by the physician Reflect the severity of illness (SOI) and resource consumption of the patient's care 5) Poisoning - ANSWER A patient is admitted from the emergency department with the diagnosis of acute respiratory failure due to overdose of pain medication and an aspiration pneumonia. What is the principal diagnosis? Acute respiratory failure Aspiration pneumonia Poisoning Adverse effect of medication 6) All of the conditions should be coded - ANSWER A patient is admitted with pneumonia, stage 1 chronic renal failure, chronic anemia, and COPD, While hospitalized the patient receives IV antibiotics, inhalers, oxygen, IV fluids at 50ml/hr, and iron tablets. Keeping the guidelines for coding of secondary diagnoses in mind, which condition should be coded? Pneumonia only Pneumonia and COPD only Pneumonia, COPD, and anemia All of the conditions should be coded 7) Fractured ulna - ANSWER Which of the following is an example of a hospital-acquired condition? Fat embolism IV phlebitis Pneumonia Fractured ulna 8) C. A diagnosis that is listed as possible in the history and physical - ANSWER Which of the following is an example of documentation that would meet the present on admission criteria for coding? A. A diagnosis that is indicated in the history and physical and ruled out in the discharge summary B. A diagnosis found in a previous medical record C. A diagnosis that is listed as possible in the history and physical D. An acute condition identified on the third day of admission 9) Colon cancer - ANSWER A patient is admitted with abdominal pain and the history and physical indicated a diagnosis of probable colon cancer. On day two, the physician documents acute renal failure in the progress notes and the patient receives IV fluids. The discharge summary lists possible metastatic colon cancer and acute renal failure. The principal diagnosis would be: Colon cancer Acute renal failure Abdominal pain Metastatic neoplasm of the colon 10) 1,2, and 3 A. Include identification of the patient's SOI B. Identify conditions that are present on admission C. Support medical necessity - ANSWER Accurate documentation should: D. Include identification of the patient's SOI E. Identify conditions that are present on admission F. Support medical necessity 1 and 2 2 and 3 1 and 3 1,2, and 3 11) Anemia - ANSWER A patient with a history of metastatic lung cancer is directly admitted from the doctor's office with a diagnosis of anemia secondary to chemotherapy. The patient receives two units of prbcs and is discharged. What is the most appropriate principal diagnosis? Respiratory neoplasm Anemia Admission for chemotherapy Admission for blood transfusion 12) GI hemorrhage - ANSWER A patient is admitted from the ED with rectal bleeding secondary to Coumadin toxicity. The physician documents that the patient had a recent increase in Coumadin dosage due to low PT/PTT. The patient also has a history of COPD and CHF. What is the most appropriate principal diagnosis? GI hemorrhage Coumadin toxicity COPD CHF 13) Infected knee prosthesis - ANSWER A patient comes to the ED with fever, chills, and knee pain. Documentation states that the patient's admission is for knee prosthesis removal due to infection. What is the principal diagnosis? (Do not include the procedure) Fever Sepsis Infected knee prosthesis Knee pain 14) Septic joint - ANSWER A patient is admitted with pain in the lower extremity. The physician documents cellulitis due to septic joint. X-ray indicates possible osteomyelitis. What is the principal diagnosis? Pain Cellulitis Osteomyelitis Septic joint 15) A sign and symptom code should only be used if no definitive diagnosis is determined. - ANSWER Which guideline provides the direction for the correct assignment of the principal diagnosis? Probable/possible conditions should always be assigned over a symptom diagnosis Always code the most severe condition as principal The coder can link the symptom to the most appropriate condition A sign and symptom code should only be used if no definitive diagnosis is determined 16) Utilize a combination code with the individual codes listed as secondary - ANSWER A patient is admitted with hypertensive heart failure and chronic kidney disease (CKD). Appropriate code assignment would: Identify individual codes for each condition Identify the most appropriate combination code Require a query for a link between the conditions Utilize a combination code with the individual codes listed as secondary 17) 1,2, and 3 A. Coding guidelines stating that if two conditions meet the criteria for principal diagnosis, either condition can be sequenced first B. Coding guidelines indicating chapter-specific guidelines C. Understanding of the UDHHS definition of a principal diagnosis - ANSWER A patient is admitted with exacerbation of COPD, acute respiratory failure, and acute renal failure. Appropriate sequencing of the conditions would be based upon: D. Coding guidelines stating that if two conditions meet the criteria for principal diagnosis, either condition can be sequenced first E. Coding guidelines indicating chapter-specific guidelines F. Understanding of the UDHHS definition of a principal diagnosis 18) 2. ICD-10 code B20 should only be assigned in confirmed cases of HIV A. ICD-10 code B20, if sequenced as a secondary diagnosis, qualifies as an MCC B. Coding is specific to the reason for admission - ANSWER Which of the following are included in chapter-specific guidelines for the coding of HIV? 1. ICD-10 code B20 should be sequenced as principal diagnosis in all cases 2. ICD-10 code B20 should only be assigned in confirmed cases of HIV 3. HIV status must be confirmed by a blood test 4. ICD-10 code B20, if sequenced as a secondary diagnosis, qualifies as an MCC 5. Coding is specific to the reason for admission 1,2, and 3 1,3, and 5 2,3, and 4 2,4, and 5 19) The systemic infection is always sequenced as principal diagnosis - ANSWER Appropriate sequencing for a patient with urinary tract infection (UTI), pneumonia, and sepsis, all present on admission, recognizes that: The systemic infection is always sequenced as principal diagnosis The systemic infection is always sequenced as secondary diagnosis The ICD-10 code for SIRS should be sequenced as principal diagnosis Documented organ failure is necessary before one can code sepsis 20) Bone metastasis - ANSWER A patient is admitted with back pain documented as secondary to metastatic colon cancer. During the hospitalization, the patient undergoes a bone scan and the physician documents new bone metastasis of the spine. An oncology consult is completed and radiation therapy is recommended. The patient refuses further care, receives pain control, and is then discharged to hospice. The principal diagnosis is: Metastatic colon cancer Pain Palliative care 21) 1 and 4 A. Documentation of Type 1 or Type 2 diabetes B. Documentation of any manifestations of the diabetes - ANSWER When coding a medical record that includes diabetes and manifestations of diabetes, it is important to remember that specificity of coding for diabetes is dependent upon: C. Documentation of Type 1 or Type 2 diabetes D. Documentation of whether the diabetes is controlled E. Documentation of the patient's blood sugar levels F. Documentation of any manifestations of the diabetes