ICD-10-CM Coding Practice: Questions and Answers | Exams Nursing

MEDICAL CODING STUFF QUESTIONS &

ANSWERS CORRECT!!

A patient is admitted to the hospital for repair of an open fracture, type 1, of the head of

the left femur. The patient has been previously diagnosed with symptomatic HIV.

Applying the coding concept from ICD-10-CM guideline I.C.1.a.2.b, what ICD-10-CM

code(s) is/are reported for the admission? - ANSWERSAnswer: D. S72.052B, B20

Rationale: ICD-10-CM guideline I.C.1.a.2.b. states, "If a patient with HIV disease is

admitted for an unrelated condition (such as a traumatic injury), the code for the

unrelated condition (e.g., the nature of the injury code) should be the principal

diagnosis. Other diagnoses would be B20 followed by additional diagnosis codes for all

reported HIV-related conditions." The open fracture of the head of the femur (S72.052B)

is reported first as the reason for the visit because it is unrelated to HIV. To locate the

diagnosis, look in the ICD-10-CM Alphabetic Index for Fracture, traumatic/femur,

femoral/upper end/head referring you to subcategory code S72.05-. In the Tabular List,

6th character 2 indicates the left femur. 7th character B indicates the initial encounter for

a type 1 open fracture. HIV is symptomatic so it is reported secondarily with B20.

A 22-year-old female is admitted to ICU for acute renal (kidney) failure due to sepsis

(causal organism unknown). Applying the coding concept from ICD-10-CM guideline

I.C.1.d.1.b, what ICD-10-CM codes are reported (in the correct sequenci -

ANSWERSAnswer: A. A41.9, R65.20, N17.9

Rationale: ICD-10-CM guideline I.C.1.d.1.b indicates: The coding of severe sepsis

requires a minimum of two codes. First, a code for the underlying systemic infection,

followed by a code from subcategory R65.2, Severe sepsis. If the causal organism is

not documented, assign code A41.9, Sepsis, unspecified organism, for the infection.

Additional codes(s) for the associated acute organ dysfunction are also required (if

present). The first code to report is sepsis; look for the main term Sepsis in the ICD-10-

CM Alphabetic Index referring you to code A41.9. Next, look for Sepsis/with organ

dysfunction (acute) (multiple) referring you to code R65.20. For the last code, look for

Failure/renal/acute referring you to code N17.9. In the Tabular List, you will find an

instructional note under subcategory R65.2 indicating what codes should be reported

first and what codes should be reported as additional codes.

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MEDICAL CODING STUFF QUESTIONS &

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A patient is admitted to the hospital for repair of an open fracture, type 1, of the head of the left femur. The patient has been previously diagnosed with symptomatic HIV. Applying the coding concept from ICD-10-CM guideline I.C.1.a.2.b, what ICD-10-CM code(s) is/are reported for the admission? - ANSWERSAnswer: D. S72.052B, B Rationale: ICD-10-CM guideline I.C.1.a.2.b. states, "If a patient with HIV disease is admitted for an unrelated condition (such as a traumatic injury), the code for the unrelated condition (e.g., the nature of the injury code) should be the principal diagnosis. Other diagnoses would be B20 followed by additional diagnosis codes for all reported HIV-related conditions." The open fracture of the head of the femur (S72.052B) is reported first as the reason for the visit because it is unrelated to HIV. To locate the diagnosis, look in the ICD-10-CM Alphabetic Index for Fracture, traumatic/femur, femoral/upper end/head referring you to subcategory code S72.05-. In the Tabular List, 6th character 2 indicates the left femur. 7th character B indicates the initial encounter for a type 1 open fracture. HIV is symptomatic so it is reported secondarily with B20. A 22-year-old female is admitted to ICU for acute renal (kidney) failure due to sepsis (causal organism unknown). Applying the coding concept from ICD-10-CM guideline I.C.1.d.1.b, what ICD-10-CM codes are reported (in the correct sequenci - ANSWERSAnswer: A. A41.9, R65.20, N17. Rationale: ICD-10-CM guideline I.C.1.d.1.b indicates: The coding of severe sepsis requires a minimum of two codes. First, a code for the underlying systemic infection, followed by a code from subcategory R65.2, Severe sepsis. If the causal organism is not documented, assign code A41.9, Sepsis, unspecified organism, for the infection. Additional codes(s) for the associated acute organ dysfunction are also required (if present). The first code to report is sepsis; look for the main term Sepsis in the ICD-10- CM Alphabetic Index referring you to code A41.9. Next, look for Sepsis/with organ dysfunction (acute) (multiple) referring you to code R65.20. For the last code, look for Failure/renal/acute referring you to code N17.9. In the Tabular List, you will find an instructional note under subcategory R65.2 indicating what codes should be reported first and what codes should be reported as additional codes.

A patient is admitted to the hospital with pneumonia. Testing indicates the patient's pneumonia is due to Staphylococcus aureus and is methicillin resistant (MRSA). Applying the coding concept from ICD-10-CM guideline I.C.1.e.1.a, what ICD-10-CM code(s) are reported? - ANSWERSAnswer: B. J15. Rationale: Look in the ICD-10-CM Alphabetic Index for Pneumonia/in (due to)/staphylococcus/aureus/methicillin resistant (MRSA) J15.212. According to ICD-10- CM guideline 1.C.1.e.1.(a), when a combination code exists for MRSA and the infection, only the combination code should be reported. Pneumonia due to Methicillin-resistant Staphylococcus aureus is reported with J15.212. A 32-year-old female had a mastectomy for breast cancer. The mastectomy completely removed the breast cancer with no further treatment. On a follow-up visit to her oncologist, it is determined the cancer has metastasized to the right lung. The patient is now undergoing a lung resection for the lung cancer. Applying the coding concept from ICD-10-CM guidelines I.C.2.b. and I.C.2.d., what ICD-10-CM codes are reported for the lung resection? - ANSWERSAnswer: D. C78.01, Z85. Rationale: According to ICD-10-CM guidelines 1.C.2.d., when a primary malignancy has been previously excised and there is no evidence of any existing primary malignancy, a code from category Z85.-, Personal history of malignant neoplasm should be used. Any mention of metastasis to another site is coded as a secondary malignant neoplasm to that site and the secondary site may be the first-listed with the Z85- code used as a secondary code. For the metastasized lung cancer, look in the Table of Neoplasms for lung and use the code from the Malignant Secondary column (C78.0-). In the Tabular List, C78.01 is selected for the right lung. For the history of breast cancer, look in the ICD-10-CM Alphabetic Index for History/personal (of)/malignant neoplasm (of)/breast Z85.3. The correct codes and sequencing are C78.01 and Z85.3. A 45-year-old female with ovarian cancer visits her oncologist to receive an injection of Procrit. The Procrit has been prescribed to her for treatment of her anemia resulting from antineoplastic chemotherapy treatment. Applying the coding concept from ICD-10- CM guideline I.C.2.c.2., what ICD-10-CM codes should be reported? - ANSWERSAnswer: A. D64.81, C56.9, T45.1X5A Rationale: According to ICD-10-CM guidelines 1.C.2.c.2., because the treatment is directed at the anemia associated with chemotherapy, and the treatment is only for the anemia, the anemia should be sequenced first, followed by the appropriate codes for the neoplasm and the adverse effect (T45.1X5). Look in the ICD-10-CM Alphabetic Index for Anemia/due to (in) (with)/antineoplastic chemotherapy (D64.81). According to guideline 1.C.2.c.2. the malignancy is reported secondarily followed by code T45.1X5. Look in the ICD-10-CM Table of Neoplasms for ovary and report the code from the Malignant Primary column (C56.-). In the Tabular List, C56.9 is reported because the laterality is not stated. Next, to locate T45.1X5, look in the Table of Drugs and Chemicals for Antineoplastic NEC and selecting the code from the Adverse effect column (T45.1X5). In the Tabular List, T45.1X5 requires a 7th character extender. A is selected because this is considered active treatment.

will be an instructional note (such as a code first note) with these manifestation codes that will indicate the proper sequencing order of the codes. Look in the ICD-10-CM Alphabetic Index for Anemia/in (due to) (with)/chronic kidney disease D63.1. See the Code first note instructing to report the CKD (N18-) code first. Look in the ICD-10-CM Alphabetic Index for Disease/kidney/chronic/stage 3 (moderate) N18.30. Verification in the Tabular List verifies correct sequencing as N18.30, D63. Name an example of when a problem caused by diabetes is NOT sequenced after the code for diabetes. Refer to ICD-10-CM guideline I.C.4.a.5.a. - ANSWERSAnswer: A. When a patient's insulin pump malfunctions Rationale: The ICD-10-CM Official Coding Guidelines, Section I.C.4.a.5.a states to use a code from category T85.6 as the primary diagnosis for an underdose of insulin, due to insulin pump malfunction. The second code would be T38.3x6-, for the underdosing of insulin, followed by the appropriate diabetes mellitus code based on documentation. A 12-year-old's diabetes mellitus is well controlled with oral antidiabetic medications. The patient has no complications. Applying the coding concept from ICD-10-CM guidelines I.C.4.a.1, I.C.4.a.2, and I.C.4.a.3, what ICD-10-CM code(s) is/are reported? - ANSWERSAnswer: A. E11.9, Z79. Rationale: According to ICD-10-CM Official Coding Guidelines, Section I.C.4.a.1, the age of the patient is not the determining factor in what type of diabetes is coded. In addition, Section I.C.4.a.2 says if the type of diabetes mellitus is not documented in the medical record the default type is type 2. To find the code, look in the ICD-10-CM Alphabetic Index for Diabetes, diabetic (mellitus) (sugar). The default code is E11.9. Verification in the Tabular List verifies code selection. ICD-10-CM guideline I.C.4.a. directs the coder to report Z79.84 to indicate the patient uses oral hypoglycemic or antidiabetic drugs. Look in the Alphabetic Index for Long-term (current) (prophylactic) drug therapy (use of)/oral/antidiabetic Z79.84. A type 2 diabetic patient with diabetic retinopathy visits his ophthalmologist for blurred vision. After performing a visual acuity test and a dilated eye exam, the provider states the patient has macular edema. Applying the coding concept from ICD-10-CM guideline I.C.4.a, what ICD-10-CM code is reported? - ANSWERSAnswer: A. E11. Rationale: According to ICD-10-CM Official Coding Guidelines, Section I.C.4.a the diabetes codes are combination codes that include the type of diabetes, the body system affected, and the complications affecting that body system. To locate the codes in the ICD-10-CM code book, look in the ICD-10-CM Alphabetic Index for Diabetes, diabetic/with/retinopathy/with macular edema E11.311. Verify code choice in the Tabular List. A patient with a four-year history of eating disorders is seen in the physician's office due to significant weight loss over the past three months. She went from 82 pounds down to 53 pounds due to restricting her food intake. She is diagnosed with anorexia nervosa. Select the diagnosis code(s). - ANSWERSAnswer: D. F50. Rationale: In the ICD-10-CM Alphabetic Index, look for Anorexia/nervosa/restricting type which directs you to code F50.01. The patient is losing weight due to restricting her

intake of food; this is considered restricting type. Weight loss is integral to the diagnosis of anorexia nervosa; therefore, no additional codes are assigned. Verify code selection in the Tabular List. A patient presents to her physician and tells him she drinks each night when she gets home from work. She asks her physician to recommend an alcohol treatment center because her life has become unmanageable and she wishes to quit drinking. The patient is diagnosed with uncomplicated alcohol dependence. Select the diagnosis code. - ANSWERSAnswer: B. F10. Rationale: The patient's diagnosis is uncomplicated alcohol dependence. In the ICD-10- CM Alphabetic Index, look for dependence/alcohol F10.20. Verify code selection in the Tabular List. 3.Answer: A. F90. Rationale: The patient is diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), predominately inattentive type. In the ICD-10-CM Alphabetic Index, look for Disorder (of)/attention deficit hyperactivity (adolescent) (adult) (child)/inattentive/ type F90.0. Verify code selection in the Tabular List. A mother brings her son into the doctor because he has been getting in trouble in school for his behavior. He is not paying attention or following the instructions. He is constantly losing his pencil and forgetting to bring in his homework. After evaluating the child, the provider diagnoses him with attention deficit hyperactivity disorder (ADHD), predominately inattentive type, and sends the patient for a consultation with a psychiatrist to see if medication can help. Select the diagnosis code. - ANSWERS

ICD-10-CM Coding Practice: Questions and Answers, Exams of Nursing

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MEDICAL CODING STUFF QUESTIONS &

ANSWERS CORRECT!!