Answers
Assign code(s) for the following diagnosis: Congestive heart failure due to
hypertension.
I10 Essential (primary) hypertension
I11.9 Hypertensive heart disease without heart failure
I11.0 Hypertensive heart disease with heart failure
I50.9 Heart failure, unspecified
I50.1 Left ventricular failure
I50.20 Unspecified systolic (congestive) heart failure
I50.21 Acute systolic (congestive) heart failure
I50.22 Chronic systolic (congestive) heart failure
I50.23 Acute on chronic systolic (congestive) heart failure
a.I10, I50.9
b.I11.0
c.I50.23, I10
d.I11.0, I50.9 - (answers)d Heart conditions are assigned a combination code
when a causal relationship is stated (due to hypertension) or implied
(hypertensive). Use an additional code to identify the type of heart failure in
those patients with heart failure (ICD-10-CM Official Guidelines for Coding and
Reporting 2016b, 41).
Assign the best answer to complete the following sentence. The CPT codes for
treatment of fractures:
,a.Use the terminology "manipulation" rather than "reduction" of fracture
b.Include internal fixation in all codes
c.Do not include application of cast
d.Do not differentiate between open and closed treatment; CPT only specifies the
site of the fracture - (answers)a Manipulation refers to the attempted reduction
or restoration of a dislocated joint or fracture (Smith 2015, 84)
In CPT, if a patient has two lacerations of the arm that are repaired with simple
closures, the coder would assign:
a.Two CPT codes expressing each laceration repair
b.One CPT code for the largest laceration
c.One CPT code, adding the lengths of the lacerations together
d.One CPT code for the most complex closure - (answers)c When multiple wounds
are repaired with the same closure type (for example, simple), lengths of the
wounds in the same classification and from all anatomical sites that are grouped
together into the same code descriptor should be added together (Smith 2015,
67).
Patient admitted for laparoscopic repair of right diaphragmatic hernia. Assign the
ICD-10-PCS procedure code for this surgery.
0BQR4ZZ Repair right diaphragm, percutaneous endoscopic approach
0BQROZZ Repair right diaphragm, open approach
0BQS4ZZ Repair left diaphragm, percutaneous endoscopic approach
0BQSOZZ Repair left diaphragm, open approach
,a.0BQR4ZZ
b.0BQR0ZZ
c.0BQS4ZZ
d.0BQS0ZZ - (answers)a Surgery is the only treatment for diaphragmatic hernias.
ICD-10-PCS code 0BQR4ZZ, is used for laparoscopic repair of diaphragmatic hernia
(Garvin 2015, 192, 284)
When trying to determine if documentation is present to substantiate status
asthmaticus, the coder should review the record for what terms and phrases?
a.Intractable pneumonia
b.Refractory asthma and severe, intractable wheezing
c.Airway obstruction relieved by bronchodilators
d.Limited but pronounced wheezing - (answers)b Status asthmaticus is defined as
continual wheezing in spite of therapy (Leon-Chisen 2013, 230).
Gastrointestinal bleeding can manifest as:
a.Hematemesis, which indicates acute upper gastrointestinal hemorrhage
b.Petechia
c.Vomiting
d.Constipation, which indicates upper or lower gastrointestinal hemorrhage -
(answers)a Gastrointestinal bleeding manifests itself in several ways. These are
hematemesis, melena, occult bleeding, hematochezia (Leon-Chisen 2013, 244).
Which types of pacemaker devices have a unique ICD-10-PCS code.
, a.Dual chamber rate responsive
b.Single chamber, single chamber rate responsive, and dual chamber
c.Multiple chamber
d.Multiple chamber rate responsive - (answers)b The three types of pacemakers
are single chamber, single chamber rate responsive, and dual chamber. A single
chamber uses a single lead; a dual chamber requires two leads, one in the atrium
and one in the ventricle. The leads should also be coded (Leon-Chisen 2013, 416-
418).
Mechanical ventilation codes require consideration of which of the following?
a.The time when a tracheal tube is inserted
b.The replacement of an endotracheal tube
c.The start time of endotracheal tube insertion followed by mechanical ventilation
d.Mechanical ventilation during surgery - (answers)c Codes for mechanical
ventilation indicate whether the patient was on mechanical ventilation for less
than 24 hours, 24-96 consecutive hours and greater than 96 consecutive hours.
The start time for calculating the duration begins with the start time of
endotracheal tube insertion as the best method, followed by mechanical
ventilation or the time that a patient who is on mechanical ventilation is
admitted. The time ends with discontinuance of mechanical ventilation (Leon-
Chisen 2013, 239-240).
Abbreviations can be a source of patient safety issues due to misinterpretation
and miscommunication. Abbreviations in the health record:
a.Are not permitted by Joint Commission standards
b.Should have only one meaning