ICD-10 CM Coding Practice
Questions and Answers, Exams
of Nursing Assured A+
Certified Pass
A 27 year-old man with a 25-year history of type 1 diabetes is admitted to the ICU
with diabetic ketoacidosis brought on by his infection by the H1N1 influenza virus
with a URI. Which codes best report how his consulting endocrinologist reported
his condition?
A. E13.10, J09.X2
B. J10.1, E10.10
C. E10.10, J10.1
D. J09.X2, E13.10 - ANSWERS-C
This patient is a type 1 diabetic with ketoacidosis due to H1N1 influenza virus with
URI. Because the endocrinologist is treating the DKA that is reported first. Look in
the Alphabetic Index for Diabetes/type 1/with/ketoacidosis referring you to
E10.10. Next, look for Influenza/novel (2009) H1N1 influenza (see also Influenza,
due to, identified influenza virus NEC). Look for Influenza/due to/identified
influenza virus NEC/with/respiratory manifestations referring you to NEC J10.1.
Verify codes in the Tabular List.
The patient just turned 50 and is here today for a screening colonoscopy. During
the procedure, two polyps are found and removed from the ascending colon with
a snare technique. How is this reported?
,A. Z12.11, D12.2
B. D12.2
C. Z12.11
D. D12.2, Z12.11 - ANSWERS-A
ICD-10-CM guidelines, Section I.C.21.c.5, indicates: A screening code may be a first
listed code if the reason for the visit is specifically the screening exam...Should a
condition be discovered during the screening then the code for the condition may
be assigned as an additional diagnosis. For the question the screening Z code is
reported first, followed by the code for the polyps. Look in the ICD-10-CM
Alphabetic Index for Screening/colonoscopy referring you to Z12.11 and
Polyp/colon/ascending referring you to D12.2. Verify codes in the Tabular List
Four years post hepatic transplant, the patient is diagnosed with combined
hepatocellular carcinoma and cholangiocarcinoma of the liver. Code the patient's
condition.
A. T86.49, C80.2, C22.0, C22.1
B. C22.8, C22.1, T86.49, C80.2
C. C80.2, C22.0, C22.1
D. C22.8, C80.2 - ANSWERS-A
ICD-10-CM Coding Guideline, I.C.2.r. indicates malignant neoplasm associated with
transplanted organ, which indicates this situation requires three codes. When a
transplanted organ is compromised, the complication is the first code reported.
Look in the ICD-10-CM Alphabetic Index for
Complication/transplant/liver/specified type referring you to T86.49-. Next report
C80.2 Malignant neoplasm associated with transplanted organ, followed by codes
, to report the carcinoma. Look in the Alphabetic Index for Carcinoma (malignant)
(see also Neoplasm, malignant, by site). Look in the Table of Neoplasms for
Neoplasm/liver/primary/Malignant Primary column referring you to C22.8 and
Neoplasm/cholangiole/Malignant Primary column referring you to C22.21. Verify
codes in the Tabular List.
The site of the patient's cellulitis is within the fold of redundant skin in his apron
of fat. It covers approximately 20 cm of skin. A swab from the site was cultured
and found to be methicillin resistant staphylococcus aureus.
A. B95.62, L03.311
B. A49.02, L03.311
C. L03.311, B95.62
D. L03.311, A49.02 - ANSWERS-C
The "apron of fat" is belly fat that creates a redundancy of skin along the hip line
of an obese person's front torso, part of the "trunk." This scenario requires two
codes: one to report the cellulitis, and one to report the infective agent causing
the cellulitis. Look in the ICD-10-CM Alphabetic Index for
Cellulitis/trunk/abdominal wall referring you to L03.311. Verify code in the Tabular
List. The notes under Infections of the skin and subcutaneous tissue indicate to
use an additional code (B95-B97) to identify infectious agent. Look in the
Alphabetic Index for Infection/staphylococcal/as cause of disease classified
elsewhere/aureus/methicillin resistant (MRSA) referring you to B95.62. Verify in
the Tabular List. MRSA is more difficult to treat than methicillin susceptible staph
(MSSA), and this differentiation is clinically significant. See ICD-10-CM guidelines
I.C.1.e.1.b. for further MRSA infection guidance.
Questions and Answers, Exams
of Nursing Assured A+
Certified Pass
A 27 year-old man with a 25-year history of type 1 diabetes is admitted to the ICU
with diabetic ketoacidosis brought on by his infection by the H1N1 influenza virus
with a URI. Which codes best report how his consulting endocrinologist reported
his condition?
A. E13.10, J09.X2
B. J10.1, E10.10
C. E10.10, J10.1
D. J09.X2, E13.10 - ANSWERS-C
This patient is a type 1 diabetic with ketoacidosis due to H1N1 influenza virus with
URI. Because the endocrinologist is treating the DKA that is reported first. Look in
the Alphabetic Index for Diabetes/type 1/with/ketoacidosis referring you to
E10.10. Next, look for Influenza/novel (2009) H1N1 influenza (see also Influenza,
due to, identified influenza virus NEC). Look for Influenza/due to/identified
influenza virus NEC/with/respiratory manifestations referring you to NEC J10.1.
Verify codes in the Tabular List.
The patient just turned 50 and is here today for a screening colonoscopy. During
the procedure, two polyps are found and removed from the ascending colon with
a snare technique. How is this reported?
,A. Z12.11, D12.2
B. D12.2
C. Z12.11
D. D12.2, Z12.11 - ANSWERS-A
ICD-10-CM guidelines, Section I.C.21.c.5, indicates: A screening code may be a first
listed code if the reason for the visit is specifically the screening exam...Should a
condition be discovered during the screening then the code for the condition may
be assigned as an additional diagnosis. For the question the screening Z code is
reported first, followed by the code for the polyps. Look in the ICD-10-CM
Alphabetic Index for Screening/colonoscopy referring you to Z12.11 and
Polyp/colon/ascending referring you to D12.2. Verify codes in the Tabular List
Four years post hepatic transplant, the patient is diagnosed with combined
hepatocellular carcinoma and cholangiocarcinoma of the liver. Code the patient's
condition.
A. T86.49, C80.2, C22.0, C22.1
B. C22.8, C22.1, T86.49, C80.2
C. C80.2, C22.0, C22.1
D. C22.8, C80.2 - ANSWERS-A
ICD-10-CM Coding Guideline, I.C.2.r. indicates malignant neoplasm associated with
transplanted organ, which indicates this situation requires three codes. When a
transplanted organ is compromised, the complication is the first code reported.
Look in the ICD-10-CM Alphabetic Index for
Complication/transplant/liver/specified type referring you to T86.49-. Next report
C80.2 Malignant neoplasm associated with transplanted organ, followed by codes
, to report the carcinoma. Look in the Alphabetic Index for Carcinoma (malignant)
(see also Neoplasm, malignant, by site). Look in the Table of Neoplasms for
Neoplasm/liver/primary/Malignant Primary column referring you to C22.8 and
Neoplasm/cholangiole/Malignant Primary column referring you to C22.21. Verify
codes in the Tabular List.
The site of the patient's cellulitis is within the fold of redundant skin in his apron
of fat. It covers approximately 20 cm of skin. A swab from the site was cultured
and found to be methicillin resistant staphylococcus aureus.
A. B95.62, L03.311
B. A49.02, L03.311
C. L03.311, B95.62
D. L03.311, A49.02 - ANSWERS-C
The "apron of fat" is belly fat that creates a redundancy of skin along the hip line
of an obese person's front torso, part of the "trunk." This scenario requires two
codes: one to report the cellulitis, and one to report the infective agent causing
the cellulitis. Look in the ICD-10-CM Alphabetic Index for
Cellulitis/trunk/abdominal wall referring you to L03.311. Verify code in the Tabular
List. The notes under Infections of the skin and subcutaneous tissue indicate to
use an additional code (B95-B97) to identify infectious agent. Look in the
Alphabetic Index for Infection/staphylococcal/as cause of disease classified
elsewhere/aureus/methicillin resistant (MRSA) referring you to B95.62. Verify in
the Tabular List. MRSA is more difficult to treat than methicillin susceptible staph
(MSSA), and this differentiation is clinically significant. See ICD-10-CM guidelines
I.C.1.e.1.b. for further MRSA infection guidance.
