HCS-D Practice #2 Questions with Complete
Solutions
19. The patient was given a tracheostomy for pulmonary hygiene after aspiration pneumonia 5
months ago. The patient then developed an infection of the stoma with cellulitis followed by a
TE fistula. Skilled nursing will provide care to the ostomy until the infection is resolved so that
the TE fistula can be repaired. How should this be coded?
(QuestionID: 23910)
a. J95.02, L03.221, J95.04, Z87.01
b. J95.02, L03.8, Z95.04, Z87.01
c. Z43.0, L03.8, Z95.04, Z87.01
d. Z43.0, Z95.04, J69.0 Correct Answ_b. J95.02, L03.8, Z95.04, Z87.01
20. The physician has documented the primary site of the cancer as lung and then seven other
sites of metastasis. What is the coder's best action?
a. Code the primary site and all of the metastasis sites.
b. Code only the primary site and 5 of the secondary sites since there are only 6 spots on the
OASIS for diagnoses.
c. Use C80.0 for the disseminated cancer.
,d. Only code the primary site because coding the secondary sites is unnecessary. Correct
Answ_a. Code the primary site and all of the metastasis sites.
21. What is the best action when the physician documents diabetic ketoacidosis?
a. Query the provider as to type of diabetes.
b. Code type 2 diabetes with ketoacidosis since unspecified diabetes is coded as type 2
c. Do not code diabetic ketoacidosis because that would always be resolved
d. Code type 1 diabetes with ketoacidosis since ketoacidosis is rare in type 2 Correct
Answ_a. Query the provider as to type of diabetes
22. If the patient is admitted with sepsis and a related localized infection, the coder should:
a. Code the localized infection first because it caused the sepsis.
b. Code the underlying systemic infection (sepsis) first because the patient was admitted with
sepsis. Correct Answ_b. Code the underlying systemic infection (sepsis) first because the
patient was admitted with sepsis.
23. Adnexa refers to:
a. Anatomical parts associated with an organ
b. Optic nerve
,c. Abnormal ophthalmic conditions
d. None of the Above Correct Answ_a. Anatomical parts associated with an organ
24. The patient had surgery to excise a benign neoplasm of the brain. He will need no further
treatment to the tumor. The physician has ordered surgical wound care including dressing
changes. Appropriate codes include:
a. Z48.812, Z48.01, D33.2
b. Z48.3, Z48.01, D33.2
c. Z48.3, Z48.01, Z86.011
d. Z48.3, Z48.01, Z85.841 Correct Answ_c. Z48.3, Z48.01, Z86.011
25. Referral on a 27 year old male from MD office. Complaint of pain and stiffness to thoracic
spine. PMH: smokes current 1 pack/day; hyperlipidemia, CHF, obesity, ETOH dependence and
ankylosing spondylitis. Received steroid injections at MD visit and prescribed Cymbalta and
NSAIDS for pain management. How would this be coded?
a. M45.4, I50.9, F10.20, F17.210, E78.5, E66.09, Z72.0
b. M45.6, I50.30, F10.20, E66.02, E78.5, Z72.0
c. M45.5, I50.30, F10.20, Z72.0, E78.5, E66.09
, d. M45.4, I50.9, F10.20, F17.210, E78.5, E66.09 Correct Answ_d. M45.4, I50.9, F10.20,
F17.210, E78.5, E66.09
26. To find the code for use of supplemental oxygen, look under ________ in the alphabetical
index.
a. dependence, supplemental oxygen
b. oxygen, dependence on
c. status, supplemental oxygen
d. use of, oxygen, supplemental Correct Answ_a. dependence, supplemental oxygen
27. The patient has a large area that includes the right lower back, right buttock and right hip
covered with what the physician has classified as stage 2 pressure ulcers. The patient also has
CVA with right sided hemiparesis and is wheelchair bound. SN to perform wound care and
therapy to assist with mobility. How would this be coded?
a. L89.41, I69.351, Z99.3
b. L89.139, L89.319, L89.212
c. L89.132, L89.312, L89.212
d. L89.42, I69.351, Z99.3 Correct Answ_d. L89.42, I69.351, Z99.3
Solutions
19. The patient was given a tracheostomy for pulmonary hygiene after aspiration pneumonia 5
months ago. The patient then developed an infection of the stoma with cellulitis followed by a
TE fistula. Skilled nursing will provide care to the ostomy until the infection is resolved so that
the TE fistula can be repaired. How should this be coded?
(QuestionID: 23910)
a. J95.02, L03.221, J95.04, Z87.01
b. J95.02, L03.8, Z95.04, Z87.01
c. Z43.0, L03.8, Z95.04, Z87.01
d. Z43.0, Z95.04, J69.0 Correct Answ_b. J95.02, L03.8, Z95.04, Z87.01
20. The physician has documented the primary site of the cancer as lung and then seven other
sites of metastasis. What is the coder's best action?
a. Code the primary site and all of the metastasis sites.
b. Code only the primary site and 5 of the secondary sites since there are only 6 spots on the
OASIS for diagnoses.
c. Use C80.0 for the disseminated cancer.
,d. Only code the primary site because coding the secondary sites is unnecessary. Correct
Answ_a. Code the primary site and all of the metastasis sites.
21. What is the best action when the physician documents diabetic ketoacidosis?
a. Query the provider as to type of diabetes.
b. Code type 2 diabetes with ketoacidosis since unspecified diabetes is coded as type 2
c. Do not code diabetic ketoacidosis because that would always be resolved
d. Code type 1 diabetes with ketoacidosis since ketoacidosis is rare in type 2 Correct
Answ_a. Query the provider as to type of diabetes
22. If the patient is admitted with sepsis and a related localized infection, the coder should:
a. Code the localized infection first because it caused the sepsis.
b. Code the underlying systemic infection (sepsis) first because the patient was admitted with
sepsis. Correct Answ_b. Code the underlying systemic infection (sepsis) first because the
patient was admitted with sepsis.
23. Adnexa refers to:
a. Anatomical parts associated with an organ
b. Optic nerve
,c. Abnormal ophthalmic conditions
d. None of the Above Correct Answ_a. Anatomical parts associated with an organ
24. The patient had surgery to excise a benign neoplasm of the brain. He will need no further
treatment to the tumor. The physician has ordered surgical wound care including dressing
changes. Appropriate codes include:
a. Z48.812, Z48.01, D33.2
b. Z48.3, Z48.01, D33.2
c. Z48.3, Z48.01, Z86.011
d. Z48.3, Z48.01, Z85.841 Correct Answ_c. Z48.3, Z48.01, Z86.011
25. Referral on a 27 year old male from MD office. Complaint of pain and stiffness to thoracic
spine. PMH: smokes current 1 pack/day; hyperlipidemia, CHF, obesity, ETOH dependence and
ankylosing spondylitis. Received steroid injections at MD visit and prescribed Cymbalta and
NSAIDS for pain management. How would this be coded?
a. M45.4, I50.9, F10.20, F17.210, E78.5, E66.09, Z72.0
b. M45.6, I50.30, F10.20, E66.02, E78.5, Z72.0
c. M45.5, I50.30, F10.20, Z72.0, E78.5, E66.09
, d. M45.4, I50.9, F10.20, F17.210, E78.5, E66.09 Correct Answ_d. M45.4, I50.9, F10.20,
F17.210, E78.5, E66.09
26. To find the code for use of supplemental oxygen, look under ________ in the alphabetical
index.
a. dependence, supplemental oxygen
b. oxygen, dependence on
c. status, supplemental oxygen
d. use of, oxygen, supplemental Correct Answ_a. dependence, supplemental oxygen
27. The patient has a large area that includes the right lower back, right buttock and right hip
covered with what the physician has classified as stage 2 pressure ulcers. The patient also has
CVA with right sided hemiparesis and is wheelchair bound. SN to perform wound care and
therapy to assist with mobility. How would this be coded?
a. L89.41, I69.351, Z99.3
b. L89.139, L89.319, L89.212
c. L89.132, L89.312, L89.212
d. L89.42, I69.351, Z99.3 Correct Answ_d. L89.42, I69.351, Z99.3
