Adams: Adams' Coding and Reimbursement, 3rd Edition
Chapter 1: Diagnostic Coding: International Classification Diseases,
Ninth Revision, Clinical Modification (ICD-9-CM)
Test Bank
COMPLETION
1. A patient is admitted to the hospital with severe flank pain and hematuria. A urinalysis is
done and it is positive for Escherichia coli. The discharge summary states acute
pyelonephritis.
ICD-9-CM ____________________
ANS: 590.10
PTS: 1
2. The patient delivered vaginally November 1, and an emergency curettage was performed
November 3 for postpartum hemorrhage due to retained placental fragments.
ICD-9-CM ____________________
ANS: 666.22, V27.0
PTS: 1
3. A 23-year-old man has a suspicious 0.5-cm lesion on his shoulder. The dermatologist
excises the lesion in his office. A microscopic pathology report showing a squamous cell
carcinoma with positive borders is sent to the patient’s family physician. The family
physician refers the patient again to the dermatologist, who re-excises the site (previous
wound size 1.0 cm, including skin margins) and performs a simple primary closure of the
wound.
ICD-9-CM ____________________
ANS: 173.6
PTS: 1
4. A 44-year-old woman with a history of breast cancer complains to her internist about
shortness of breath. Her visit includes an expanded problem-focused history, a detailed
examination, and low-complexity decision making. A chest x-ray taken in the office shows a
small pleural effusion on the right lung. The physician performs a thoracentesis, draws off
the fluid, and sends it for cytology and chemistry analysis.
ICD-9-CM ____________________
ANS: 511.9, V10.3
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Some material was previously published.
,Test Bank 1-2
PTS: 1
5. A general surgeon attempts a laparoscopic cholecystectomy on a 44-year-old woman
suffering from acute cholecystitis with gallstones but no obstruction because of an unusual
anatomic variation. However, the physician aborts the laparoscopic procedure and completes
the cholecystectomy via an open laparotomy.
ICD-9-CM ____________________
ANS: 574.00, V64.4
PTS: 1
6. A 71-year-old woman presents with acromegaly and multiple medical problems
associated with the disease. An MRI shows a large pituitary macroadenoma, and surgery is
elected. The patient undergoes a microscopic transsphenoidal pituitary adenectomy with
insertion of a lumbar subarachnoid drain. The right thigh is opened, and a muscle and fascia
plug is taken from the fascia lata. The graft is placed in the sella. The floor of the sella is
reconstructed with a piece of bone and is covered with Gelfoam and fat. The wound is closed
and dressed, and the lumbar drain is removed.
ICD-9-CM ____________________
ANS: 227.3, 253.0
PTS: 1
7. A 26-year-old woman with amenorrhea and galactorrhea is referred by her gynecologist to
the neurosurgeon for further workup. MRI and endocrine studies reveal a microadenoma of
the pituitary. Surgery is elected, and the patient undergoes exposure provided by the
otorhinolaryngologist. Transnasal excision of a pituitary tumor is performed by the
neurosurgeon.
ICD-9-CM ____________________
ANS: 227.3
PTS: 1
8. The ophthalmologist repairs two horizontal muscles for alternating esotropia and
performs a lid retraction repair at an outpatient hospital surgical suite.
ICD-9-CM ____________________
ANS: 378.05, 374.41
PTS: 1
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Some material was previously published.
,Test Bank 1-3
9. A 64-year-old patient presents with severe headaches and blackouts. Previous EEG and
CT scans are negative. An interventional radiologist performs bilateral common carotid and
left vertebral artery (cerebral) angiography. A retrograde right femoral approach is used.
Selective catheterization of the right common carotid artery, the left common carotid artery,
and, subsequently, the left vertebral artery is performed. In addition, photographic
subtractions of the AP view are obtained on the vertebral run. The radiologist interprets the
images and concludes that the patient has cerebral atherosclerosis.
ICD-9-CM ____________________
ANS: 437.0
PTS: 1
10. A patient presents to a urology clinic with a history of chronic calculus in the pelvis of
the kidney. His history also includes allergies and a reaction to ionic contrast. He is sent to a
local hospital as an outpatient and is injected with a bolus 100 cc of low osmolar contrast
material, and an intravenous pyelogram (IVP) is performed. Because the left calyx and ureter
are not visible, a limited ultrasound is performed.
ICD-9-CM ____________________
ANS: 592.0, V15.08
PTS: 1
11. A 48-year-old woman presents to her internal medicine physician with complaints of
upper abdominal pain, chills, and fever. In addition, she is noted to be jaundiced. Liver
function tests, including serum albumin, total bilirubin, and alkaline phosphatase, are
performed. Bilirubin and alkaline phosphatase are elevated. The diagnosis is extrahepatic
biliary duct obstruction. The patient is referred to a general surgeon.
ICD-9-CM ____________________
ANS: 576.2
PTS: 1
12. An ACTH stimulation panel for adrenal insufficiency was performed by an outpatient
hospital laboratory. Three cortisol levels were obtained.
ICD-9-CM ____________________
ANS: 255.41
PTS: 1
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Some material was previously published.
, Test Bank 1-4
13. A 32-year-old man presented to the cardiologist with a complaint of recent onset of
palpitations. He was referred from his family physician for assumption of care. The
cardiologist reviewed past and present social and medical histories and records. After a
detailed system review failed to reveal any abnormality, the cardiologist prescribed a 24-hour
Holter monitor. The cardiologist supplied the monitor with hook-up and recording and
performed a review and interpretation of the microprocessor-based analysis. The analysis and
report were supplied by another facility. The cardiologist diagnosed stress-induced ectopic
atrial beats and discussed a course of therapy with the patient upon follow-up visit. The
follow-up visit lasted approximately 20 minutes.
ICD-9-CM ____________________
ANS: 785.1, 427.61
PTS: 1
14. After completing a course of antibiotics, an 18-month-old established patient returns for
follow-up on acute suppurative otitis media with rupture of the eardrum. The acute infection
has resolved; however, the perforation has not healed. It is noted that this child is behind on
his immunizations, so DTaP-HIB, MMR, and oral polio vaccines are given.
ICD-9-CM ____________________
ANS: 384.20, V06.3, V06.4, V03.81
PTS: 1
15. A patient with advanced gastric cancer receives palliative chemotherapy in the form of
Adriamycin. The patient first receives an IV infusion of 1000 cc of D5W for hydration and
Kytril as an antiemetic. Adriamycin then is administered intravenously with the push
technique.
ICD-9-CM ____________________
ANS: 151.9, V58.1
PTS: 1
SHORT ANSWER
1. Combination Codes
a. Pneumonia due to Haemophilus influenzae ____________________
b. Candidiasis of the mouth ____________________
c. Hypertensive cerebrovascular disease ____________________
d. Closed fracture of the tibia and fibula ____________________
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Some material was previously published.
Chapter 1: Diagnostic Coding: International Classification Diseases,
Ninth Revision, Clinical Modification (ICD-9-CM)
Test Bank
COMPLETION
1. A patient is admitted to the hospital with severe flank pain and hematuria. A urinalysis is
done and it is positive for Escherichia coli. The discharge summary states acute
pyelonephritis.
ICD-9-CM ____________________
ANS: 590.10
PTS: 1
2. The patient delivered vaginally November 1, and an emergency curettage was performed
November 3 for postpartum hemorrhage due to retained placental fragments.
ICD-9-CM ____________________
ANS: 666.22, V27.0
PTS: 1
3. A 23-year-old man has a suspicious 0.5-cm lesion on his shoulder. The dermatologist
excises the lesion in his office. A microscopic pathology report showing a squamous cell
carcinoma with positive borders is sent to the patient’s family physician. The family
physician refers the patient again to the dermatologist, who re-excises the site (previous
wound size 1.0 cm, including skin margins) and performs a simple primary closure of the
wound.
ICD-9-CM ____________________
ANS: 173.6
PTS: 1
4. A 44-year-old woman with a history of breast cancer complains to her internist about
shortness of breath. Her visit includes an expanded problem-focused history, a detailed
examination, and low-complexity decision making. A chest x-ray taken in the office shows a
small pleural effusion on the right lung. The physician performs a thoracentesis, draws off
the fluid, and sends it for cytology and chemistry analysis.
ICD-9-CM ____________________
ANS: 511.9, V10.3
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Some material was previously published.
,Test Bank 1-2
PTS: 1
5. A general surgeon attempts a laparoscopic cholecystectomy on a 44-year-old woman
suffering from acute cholecystitis with gallstones but no obstruction because of an unusual
anatomic variation. However, the physician aborts the laparoscopic procedure and completes
the cholecystectomy via an open laparotomy.
ICD-9-CM ____________________
ANS: 574.00, V64.4
PTS: 1
6. A 71-year-old woman presents with acromegaly and multiple medical problems
associated with the disease. An MRI shows a large pituitary macroadenoma, and surgery is
elected. The patient undergoes a microscopic transsphenoidal pituitary adenectomy with
insertion of a lumbar subarachnoid drain. The right thigh is opened, and a muscle and fascia
plug is taken from the fascia lata. The graft is placed in the sella. The floor of the sella is
reconstructed with a piece of bone and is covered with Gelfoam and fat. The wound is closed
and dressed, and the lumbar drain is removed.
ICD-9-CM ____________________
ANS: 227.3, 253.0
PTS: 1
7. A 26-year-old woman with amenorrhea and galactorrhea is referred by her gynecologist to
the neurosurgeon for further workup. MRI and endocrine studies reveal a microadenoma of
the pituitary. Surgery is elected, and the patient undergoes exposure provided by the
otorhinolaryngologist. Transnasal excision of a pituitary tumor is performed by the
neurosurgeon.
ICD-9-CM ____________________
ANS: 227.3
PTS: 1
8. The ophthalmologist repairs two horizontal muscles for alternating esotropia and
performs a lid retraction repair at an outpatient hospital surgical suite.
ICD-9-CM ____________________
ANS: 378.05, 374.41
PTS: 1
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Some material was previously published.
,Test Bank 1-3
9. A 64-year-old patient presents with severe headaches and blackouts. Previous EEG and
CT scans are negative. An interventional radiologist performs bilateral common carotid and
left vertebral artery (cerebral) angiography. A retrograde right femoral approach is used.
Selective catheterization of the right common carotid artery, the left common carotid artery,
and, subsequently, the left vertebral artery is performed. In addition, photographic
subtractions of the AP view are obtained on the vertebral run. The radiologist interprets the
images and concludes that the patient has cerebral atherosclerosis.
ICD-9-CM ____________________
ANS: 437.0
PTS: 1
10. A patient presents to a urology clinic with a history of chronic calculus in the pelvis of
the kidney. His history also includes allergies and a reaction to ionic contrast. He is sent to a
local hospital as an outpatient and is injected with a bolus 100 cc of low osmolar contrast
material, and an intravenous pyelogram (IVP) is performed. Because the left calyx and ureter
are not visible, a limited ultrasound is performed.
ICD-9-CM ____________________
ANS: 592.0, V15.08
PTS: 1
11. A 48-year-old woman presents to her internal medicine physician with complaints of
upper abdominal pain, chills, and fever. In addition, she is noted to be jaundiced. Liver
function tests, including serum albumin, total bilirubin, and alkaline phosphatase, are
performed. Bilirubin and alkaline phosphatase are elevated. The diagnosis is extrahepatic
biliary duct obstruction. The patient is referred to a general surgeon.
ICD-9-CM ____________________
ANS: 576.2
PTS: 1
12. An ACTH stimulation panel for adrenal insufficiency was performed by an outpatient
hospital laboratory. Three cortisol levels were obtained.
ICD-9-CM ____________________
ANS: 255.41
PTS: 1
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Some material was previously published.
, Test Bank 1-4
13. A 32-year-old man presented to the cardiologist with a complaint of recent onset of
palpitations. He was referred from his family physician for assumption of care. The
cardiologist reviewed past and present social and medical histories and records. After a
detailed system review failed to reveal any abnormality, the cardiologist prescribed a 24-hour
Holter monitor. The cardiologist supplied the monitor with hook-up and recording and
performed a review and interpretation of the microprocessor-based analysis. The analysis and
report were supplied by another facility. The cardiologist diagnosed stress-induced ectopic
atrial beats and discussed a course of therapy with the patient upon follow-up visit. The
follow-up visit lasted approximately 20 minutes.
ICD-9-CM ____________________
ANS: 785.1, 427.61
PTS: 1
14. After completing a course of antibiotics, an 18-month-old established patient returns for
follow-up on acute suppurative otitis media with rupture of the eardrum. The acute infection
has resolved; however, the perforation has not healed. It is noted that this child is behind on
his immunizations, so DTaP-HIB, MMR, and oral polio vaccines are given.
ICD-9-CM ____________________
ANS: 384.20, V06.3, V06.4, V03.81
PTS: 1
15. A patient with advanced gastric cancer receives palliative chemotherapy in the form of
Adriamycin. The patient first receives an IV infusion of 1000 cc of D5W for hydration and
Kytril as an antiemetic. Adriamycin then is administered intravenously with the push
technique.
ICD-9-CM ____________________
ANS: 151.9, V58.1
PTS: 1
SHORT ANSWER
1. Combination Codes
a. Pneumonia due to Haemophilus influenzae ____________________
b. Candidiasis of the mouth ____________________
c. Hypertensive cerebrovascular disease ____________________
d. Closed fracture of the tibia and fibula ____________________
Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.
Some material was previously published.
