CERTIFIED CODING SPECIALIST ANSWERS AND
QUESTIONS SET A+
✔✔A patient is admitted and diagnosed with fever and urinary burning. The discharge
diagnosis is Escherichia coli, urinary tract infection. Which of the following represents
the correct diagnoses and appropriate sequence of those conditions?
a. Fever, urinary burning, urosepsis
b. Fever, urinary burning, sepsis
c. Escherichia coli, urinary tract infection
d. Urinary tract infection, Escherichia coli - ✔✔d. Urinary tract infection, Escherichia coli
**Symptoms are not coded when a definitive diagnosis is present on discharge. The
patient has a discharge diagnosis of urinary tract infection. The organism (E. coli) is
coded with a secondary diagnosis code (B96.20) which is to be added as an additional
code to identify the bacterial agent (HHS 2017, Section II.A., 100).
✔✔Normal twin delivery at 30 weeks. Both babies were delivered vaginally and were
liveborn. What conditions should have codes assigned?
O30.003 Twin pregnancy, unspecified number of placenta and unspecified number of
amniotic sacs, third trimester
O30.009 Twin pregnancy, unspecified number of placenta and unspecified number of
amniotic sacs, unknown trimester
O60.14X0 Preterm labor third trimester with preterm delivery third trimester, not
applicable or unspecified
O80 Encounter for full-term uncomplicated delivery
Z3A.30 30 weeks gestation of pregnancy
Z37.0 Single live birth
Z37.2 Twins, both liveborn
a. O80, Z3A.30, Z37.0
b. O30.003, Z3A.30, Z37.2
c. O60.14X0, O30.003, Z3A.30, Z37.2
d. O80, O30.009, Z3A.30, Z37.2 - ✔✔c. O60.14X0, O30.003, Z3A.30, Z37.2
, O60.14X0:Preterm labor third trimester with preterm delivery third trimester, not
applicable or unspecified
O30.003:Twin pregnancy, unspecified number of placenta and unspecified number of
amniotic sacs, third trimester
Z3A.30: 30 weeks gestation of pregnancy
Z37.2: Twins, both liveborn
**Codes must reflect the twin gestation as well as preterm labor and delivery.
Additionally a code from O30- must be coded with multiple gestations (Leon-Chisen
2017, 323, 327).
✔✔A patient is admitted with acute respiratory failure, hypertension, and congestive
heart failure. The patient was intubated upon admission to the hospital. What are the
correct diagnosis codes and sequencing?
I10 Essential hypertension
I50.9 Heart failure, unspecified
J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.20 Acute and chronic respiratory failure, unspecified whether with hypoxia or
hypercapnia
a. J96.00, I10, I50.9
b. I50.9, J96.00, I10
c. J96.20, I10, I50.9
d. I50.9, J96.20, I10 - ✔✔a. J96.00, I10, I50.9
J96.00: Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
I10: Essential hypertension
I50.9: Heart failure, unspecified
**The patient was admitted and treated for the respiratory failure. The other conditions
present are also coded (Leon-Chisen 2017, 232-234; HHS 2017, Section I.C.10.b., 48).
✔✔A quality improvement study showed that newborn codes associated with maternal
conditions are not being coded as often as they should. What HIM software could be
used to identify the mother's chart so it can be reviewed at the time the newborn record
is coded?
a. Birth certificate registry or master patient index
QUESTIONS SET A+
✔✔A patient is admitted and diagnosed with fever and urinary burning. The discharge
diagnosis is Escherichia coli, urinary tract infection. Which of the following represents
the correct diagnoses and appropriate sequence of those conditions?
a. Fever, urinary burning, urosepsis
b. Fever, urinary burning, sepsis
c. Escherichia coli, urinary tract infection
d. Urinary tract infection, Escherichia coli - ✔✔d. Urinary tract infection, Escherichia coli
**Symptoms are not coded when a definitive diagnosis is present on discharge. The
patient has a discharge diagnosis of urinary tract infection. The organism (E. coli) is
coded with a secondary diagnosis code (B96.20) which is to be added as an additional
code to identify the bacterial agent (HHS 2017, Section II.A., 100).
✔✔Normal twin delivery at 30 weeks. Both babies were delivered vaginally and were
liveborn. What conditions should have codes assigned?
O30.003 Twin pregnancy, unspecified number of placenta and unspecified number of
amniotic sacs, third trimester
O30.009 Twin pregnancy, unspecified number of placenta and unspecified number of
amniotic sacs, unknown trimester
O60.14X0 Preterm labor third trimester with preterm delivery third trimester, not
applicable or unspecified
O80 Encounter for full-term uncomplicated delivery
Z3A.30 30 weeks gestation of pregnancy
Z37.0 Single live birth
Z37.2 Twins, both liveborn
a. O80, Z3A.30, Z37.0
b. O30.003, Z3A.30, Z37.2
c. O60.14X0, O30.003, Z3A.30, Z37.2
d. O80, O30.009, Z3A.30, Z37.2 - ✔✔c. O60.14X0, O30.003, Z3A.30, Z37.2
, O60.14X0:Preterm labor third trimester with preterm delivery third trimester, not
applicable or unspecified
O30.003:Twin pregnancy, unspecified number of placenta and unspecified number of
amniotic sacs, third trimester
Z3A.30: 30 weeks gestation of pregnancy
Z37.2: Twins, both liveborn
**Codes must reflect the twin gestation as well as preterm labor and delivery.
Additionally a code from O30- must be coded with multiple gestations (Leon-Chisen
2017, 323, 327).
✔✔A patient is admitted with acute respiratory failure, hypertension, and congestive
heart failure. The patient was intubated upon admission to the hospital. What are the
correct diagnosis codes and sequencing?
I10 Essential hypertension
I50.9 Heart failure, unspecified
J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.20 Acute and chronic respiratory failure, unspecified whether with hypoxia or
hypercapnia
a. J96.00, I10, I50.9
b. I50.9, J96.00, I10
c. J96.20, I10, I50.9
d. I50.9, J96.20, I10 - ✔✔a. J96.00, I10, I50.9
J96.00: Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
I10: Essential hypertension
I50.9: Heart failure, unspecified
**The patient was admitted and treated for the respiratory failure. The other conditions
present are also coded (Leon-Chisen 2017, 232-234; HHS 2017, Section I.C.10.b., 48).
✔✔A quality improvement study showed that newborn codes associated with maternal
conditions are not being coded as often as they should. What HIM software could be
used to identify the mother's chart so it can be reviewed at the time the newborn record
is coded?
a. Birth certificate registry or master patient index
