Professional review guide for the RHIA and RHIT Examination 2011 Edition

210 terms by rcherryhomes 

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ICD-9-CM Coding

A patient is admitted with a left ankle fracture. The patient also has AIDS with Kaposi's sarcoma of the skin. He had a closed reduction with internal fixation of the ankle fracture.
A. 042, 176.0, 824.8, 79.16
B. 824.8, 176.0, V08, 79.16
C. 176.1, 824.8, V08, 79.16
D. 824.8, 042, 176.0, 79.16

D

A patient was admitted with Septicemia due to methicillin-resistant Staphylococcus aureus. The patient also was admitted with septic shock and decubitus ulcer of the sacrum. She had a central line inserted and infusion of drotrecogin alfa.

A. 038.19, 785.59, 707.02, 38.91
B. 038.12, 707.03, 995.92, 785.52, 707.20, 38.93, 00.11
C. 707.00, 038.11, 785.59, 38.93, 00.11
D. 038.11, 785.59, 995.92, 38.93

B

A patient was diagnosed with nephropathy due to tuberculosis (confirmed histologically) of the kidney. He had a right nephrectomy performed.

A. 016.05, 583.81, 55.51
B. 583.81, 016.06, 55.52
C. 016.02, 583.81, 55.51
D. 016.02, 583.81, 55.52

A

A patient is admitted with fever and severe headache. The diagnostic workup revealed viral meningitis. She also has asthma with acute exacerbation and hypertension, both of which are treated.

A. 047.9, 780.60, 784.0, 493.90, 401.9
B. 047.8, 493.92, 401.1
C. 047.9, 493.92, 401.9
D. 780.60, 784.0, 047.9, 493.90, 401.9

C

Nurse Jones suffers a needlestick and presents for HIV testing. She sees her physician for the test results and counseling.

A. V72.60, 795.71
B. 795.71, V65.8
C. V08, V72.60, V65.44
D. V73.89, V65.44, V01.79

D

A patient presents with right arm paralysis due to poliomyelitis that the patient suffered from as a child.

A. 045.11, 342.81
B. 138, 344.41
C. 344.40, 138
D. 138, 344.41

C

A patient is admitted for chemotherapy for treatment of breast cancer with liver metastasis. She had a mastectomy 4 months ago. Chemotherapy is given today.

B. 174.9, 197.7, 99.25
D. V58.11, 174.9, V45.71, 197.7, 99.25
A. 197.7, V10.3, 99.25
C. V58.11, V10.3, 197.7, 99.25

D

A patient with a history of malignant neoplasm of the lung is admitted with seizures. The workup revealed metastasis of the lung cancer to the brain.

A. 780.39, V10.11, 198.3
B. 162.9, V10.11, 198.3, 780.39
C. 198.3, 780.39, V10.11
D. 198.3, 780.39, 162.9

C

A patient is admitted to the hospital for treatment of dehydration following chemotherapy as treatment for ovarian cancer.

A. 276.51, 183.0
B. 183.0, 276.51, 99.25
C. 276.50, 183.0, 99.25
D. 183.0, 276.51

A

A patient has malignant melanoma of the skin of the back. She undergoes a radical excision of the melanoma with full-thickness skin graft.

A. 173.5, 86.4, 86.63
B. 172.5, 86.4, 86.63
C. 173.5, 86.3, 86.63
D. 172.5, 86.3, 86.63

B

A patient is admitted with abdominal pain. The needle biopsy of the liver reveals secondary malignancy of the liver. The patient has an exploratory laparotomy to determine the primary site. The primary site is unknown at the time of discharge.

A. 197.7, 199.1, 54.11, 50.12
B. 197.7, 789.00, 54.11, 50.11
C. 197.7, 199.1, 54.11, 50.11
D. 197.7, 199.1, 789.00, 54.11, 50.12

C

A patient with a history of cancer of the colon and status postcolostomy is admitted for closure of the colostomy. The patient is also being treated for chronic obstructive pulmonary disease and diastolic heart failure. He has a takedown of the colostomy.

A. 153.2, 496, 428.30, 46.52
B. V55.3, 496, V10.05, 428.30, 46.52
C. V55.3, 496, V10.05, 428.0, 46.52, 45.79
D. V10.05, 492.8, 428.30, 46.52

B

A female, 68 years old, was admitted with type II diabetes mellitus with a diabetic ulcer of the left heel. The patient was taken to the operating room for excisional debridement of the ulcer.

A. 250.80, 707.14, 86.22
B. 707.14, 250.80, 86.22
C. 250.81, 707.13, 86.22
D. 250.82, 707.14, 86.28

A

A 67-year-old man is admitted with acute dehydration secondary to nausea and vomiting that is due to acute gastroenteritis. He is treated for dehydration. An esophagogastroduodenoscopy is performed.

A. 558.9, 787.01, 276.51, 45.13
B. 558.9, 787.01, 276.51, 45.16
C. 276.51, 787.01, 558.9, 45.13
D. 276.51, 558.9, 45.13

D

A patient was found at home in a hypoglycemic coma. This patient had never been diagnosed as being diabetic.

A. 250.30
B. 251.0
C. 251.1
D. 251.2

B

A patient is admitted with aplastic anemia secondary to chemotherapy administered for multiple myeloma.

A. 284.89, 203.00, E933.1
B. 203.00, 284.81, E933.1
C. 284.9, 203.00, E933.1
D. 203.01, 284.89, E933.1

A

A male patient is admitted with gastrointestinal hemorrhage resulting in acute blood loss anemia. A colonoscopy and esophagogastroduodenoscopy fail to reveal the source of the bleed.
A. 285.9, 578.1, 45.13, 45.23
C. 578.9, 285.1, 45.13, 45.23
B. 578.1, 285.1, 45.13, 45.23
D. 578.9, 280.0, 45.13, 45.23

C

A patient is admitted with severe malnutrition. The physician performs a percutaneous endoscopic gastrostomy.

A. 263.9, 43.11
B. 261, 43.11
C. 261, 43.19
D. 263.8, 43.11

B

A patient is admitted with thrombocytopenia and purpura. A splenectomy is performed.

A. 287.49, 41.5
D. 287.30, 41.5
B. 287.8, 41.5
C. 287.9, 41.42

D

A patient is admitted with sickle cell anemia with crisis.

A. 282.61
B. 282.62
C. 282.63
D. 282.69

B

A patient is admitted with sickle cell pain crisis.

A. 282.62
B. 282.60
C. 282.5
D. 282.42

A Pain is a symptom that is integral to
the sickle cell crisis and therefore is
not coded.

A patient is admitted with Cooley's anemia. =

A. 282.41
B. 282.0
C. 282.49
D. 282.42

C

A patient is admitted with anemia due to end-stage renal disease. The patient is treated for anemia.

A. 285.8
B. 285.21, 585.6
C. 285.22, 585.6
D. 285.9

B

A patient is admitted with pernicious anemia.

A. 280.9
B. 280.8
C. 281.1
D. 281.0

D

A patient is admitted with mild mental retardation due to an old viral encephalitis.

A. 319, 049.8
B. 317, 326
C. 317, 047.8
D. 317, 139.0

D

A patient is admitted with anxiety with depression.

A. 300.11, 311
B. 300.4
C. 309.28
D. 300.00, 311

B

A patient is admitted with delirium tremens with alcohol dependence.

A. 291.0, 303.90
B. 303.91, 291.0
C. 291.3, 303.90
D. 291.0, 303.00

A

A patient is admitted with latent schizophrenia, chronic with acute exacerbation.

A. 295.52
B. 295.55
C. 295.54
D. 295.53

C

A patient with chronic paranoia due to continuous cocaine dependence is admitted. Drug rehabilitation is provided.

A. 301.0, 305.61, 94.63
B. 297.1, 304.21, 94.64
C. 297.1, 305.61, 94.64
D. 297.1, 304.21, 94.63

B

A patient is diagnosed with psychogenic paroxysmal tachycardia.

A. 427.2, 316
B. 306.2, 427.1
C. 427.1, 306.2
D. 316, 427.2

D

A 5-year-old female is admitted to ambulatory surgery with chronic otitis media. She has bilateral myringotomy with insertion of tubes.

A. 381.20, 20.01
B. 381.3, 20.01
C. 382.9, 20.01, 20.01
D. 381.89, 20.01

C

A patient is a type II diabetic with a diabetic cataract. He has phacoemulsification of the cataract with synchronous insertion of the lens.

A. 250.51, 366.42, 13.59, 13.71
B. 250.50, 366.41, 13.41, 13.71
C. 250.52, 366.41, 13.41, 13.71
D. 366.41, 250.50, 13.41, 13.71

B

A patient has epilepsy and paraplegia as residuals of a head injury he suffered 5 years ago.

A. 345.90, 344.1, 907.0
B. 345.91, 344.1, 907.0
C. 959.01, 345.90, 344.1
D. 345.81, 344.2, 907.0

A

A patient is diagnosed with Alzheimer's disease with dementia.

A. 331.0, 294.8
B. 294.8
C. 331.0, 294.10
D. 331.0

C

A patient is admitted with meningitis sarcoidosis.

A. 321.2, 136.1
C. 136.1, 321.2
B. 135, 321.4
D. 321.4, 135

B

A patient with carpal tunnel syndrome is admitted for arthroscopic release of the carpal tunnel.

A. 354.0, 04.43
B. 354.1, 80.23
C. 354.1, 04.43, 80.23
D. 354.0, 04.43, 80.23

D

A patient is admitted with acute cerebral infarction with left hemiparesis. The hemiparesis resolved by discharge.

A. 342.90
B. 434.91
C. 436, 342.90
D. 434.91, 342.90

D Effective October 1, 2010 the Official
ICD-9-CM Coding Guidelines state,
"Additional codes should be
assigned for any neurologic deficits
associated with the acute CVA,
regardless of whether or not the
neurologic deficit resolves prior to
discharge."

A patient is admitted with multiple problems. He has hypertensive kidney disease, congestive heart failure, and acute systolic heart failure.

A. 593.9, 401.9, 482.0, 428.21
B. 404.11, 428.0, 428.21
C. 403.90, 428.0, 428.21
D. 404.91

C

A patient is admitted with acute inferior wall myocardial infarction with unstable angina. He also has coronary artery disease and atrial fibrillation.

A. 410.41, 411.1, 414.01, 427.31
B. 410.41, 414.00, 411.1, 427.31
C. 410.40, 414.00, 427.31
D. 410.41, 414.00, 427.31

D

A patient with a diagnosis of aortic valve stenosis and mitral valve regurgitation is admitted for aortic valve replacement. The patient is also under treatment for congestive heart failure. He undergoes the placement of an aortic valve prosthesis with cardiopulmonary bypass.

D. 424.1, 424.0, 428.0, 35.21, 39.61
C. 396.2, 428.0, 35.22, 39.61
B. 424.1, 424.0, 428.0, 35.22
A. 396.2, 398.91, 35.22, 39.61

A

A patient with atherosclerotic peripheral vascular disease of the lower leg with claudication is admitted for angioplasty of the lower leg artery.

A. 440.20, 39.50
B. 440.21, 39.50
C. 444.22, 38.08
D. 443.9, 39.50

B

A patient presents to the outpatient department for a chest x-ray. The physician's order lists the following reasons for the chest x-ray: fever and cough, rule out pneumonia. The radiologist reports that the chest x-ray is positive for pneumonia.

A. 486
B. 486, 780.61, 786.2, V72.5
C. 780.61, 786.2
D. V72.5, 780.60, 786.2

A

A patient has aspiration pneumonia with pneumonia due to Staphylococcus aureus. The patient also has emphysema.

A. 507.0, 482.9, 496
B. 507.0, 482.41, 496
C. 507.0, 491.21
D. 507.0, 482.41, 492.8

D

A patient is admitted with acute respiratory failure due to congestive heart failure. The patient is placed on the ventilator for 3 days following insertion of the endotracheal tube.

A. 518.81, 428.0, 96.71, 96.04
B. 518.81, 428.0, 96.72, 96.04
C. 428.0, 518.81, 96.71, 96.04
D. 428.0, 518.83, 96.72, 96.04

A

A child has hypertrophic tonsillitis and is admitted for bilateral tonsillectomy and adenoidectomy.

A. 463, 28.3, 28.3
B. 474.00, 28.3
C. 474.02, 28.3, 28.3
D. 463, 28.3

B

A patient is admitted with chronic obstructive pulmonary disease with an exacerbation of acute bronchitis.

A. 491.22
B. 496, 466.0
C. 466.0, 496
D. 491.22, 466.0

A

A patient is admitted with extrinsic asthma with status asthmaticus.

A. 493.11
B. 493.90
C. 493.01
D. 493.81

C

A patient is experiencing exacerbation of myasthenia gravis resulting in acute respiratory failure. The patient required mechanical ventilation for 10 hours, following endotracheal intubation.

A. 358.00, 518.81, 96.71, 96.04
B. 518.81, 358.01, 96.71, 96.04
C. 358.00, 581.89, 96.71, 96.05
D. 518.82, 358.00, 96.72, 96.04

B

A patient is admitted to the hospital for repair of a ventral hernia. The surgery is canceled after the chest x-ray revealed lower lobe pneumonia. The patient is placed on antibiotics to treat the pneumonia.

A. 553.20, 486, V64.1
B. 486, 553.20, V64.3
C. 486, 553.20
D. 553.20, 486

A

A patient is admitted with gastric ulcer with hemorrhage resulting in acute blood-loss anemia. An esophagogastroduodenoscopy is performed.

A. 531.20, 285.1, 45.13
B. 285.1, 531.20, 45.13
C. 531.40, 280.0, 45.14
D. 531.40, 285.1, 45.13

D

A patient has diverticulitis of the large bowel with abscess. The physician performs a right hemicolectomy with colostomy.

A. 562.10, 45.74, 46.03
B. 562.11, 45.73, 46.10
C. 562.11, 569.5, 45.73, 46.10
D. 562.11, 569.5, 45.74, 46.11

C

A patient is admitted with acute and chronic cholecystitis with cholelithiasis. A laparoscopic cholecystectomy was attempted, and then it was converted to an open procedure.

A. 574.00, 574.10, V64.41, 51.22
B. 574.00, 574.10, 51.22, 51.23
C. 574.00, 51.22, 51.23
D. 574.00, V64.41, 51.22

A

A patient is admitted with bleeding esophageal varices with alcoholic liver cirrhosis and portal hypertension. The patient is alcohol dependent. An esophagogastroduodenoscopy is performed for control of the hemorrhage.

A. 456.20, 571.2, 303.90, 42.33
B. 571.2, 456.20, 303.90, 280.0, 42.33
C. 572.3, 571.2, 303.90, 456.20, 42.33
D. 303.90, 456.20, 303.90, 42.33

C

A patient is admitted for workup for melena. The laboratory results reveal chronic blood loss anemia. The colonoscopy with biopsy reveals Crohn's disease of the descending colon.

A. 578.1, 555.1, 45.25, 45.43
B. 555.1, 45.25
C. 555.1, 578.1, 45.25
D. 555.1, 578.1, 45.25, 45.23

B The physician should be asked if the
blood loss should be added as a
discharge diagnosis.

A patient is admitted with acute urinary tract infection due to E. coli.

A. 599.0, 041.4
B. 599.0
C. 041.4, 599.0
D. 590.2, 041.4

A

A patient presents with complaints of gross hematuria. The diagnosis is benign prostatic hypertrophy and the patient undergoes a transurethral prostatectomy.

A. 600.01, 60.21
B. 600.00, 60.29
C. 600.00, 599.71, 60.29
D. 600.00, 599.71, 60.21

C

A male patient presents to the ED with acute renal failure. He is also being treated for hypertension.

A. 410.00, 586
B. 401.9, 584.9
C. 585.9, 401.1
D. 584.9, 401.9

D

A patient is admitted with hemorrhagic cystitis. A cystoscopy with biopsy of the bladder is performed.

A. 595.9, 57.33
B. 595.9, 041.4, 57.32
C. 595.82, 57.33
D. 596.7, 57.33

A

A patient is admitted with chronic kidney disease due to hypertension and type I diabetes mellitus.

A. 250.41, 403.90, 585.9
B. 250.40, 403.10, 585.1
C. 403.90, 250.41, 585.9, V58.67
D. 403.10, 250.41, 585.2

C

A patient has end-stage kidney disease, which resulted from malignant hypertension.

A. 403.01, 585.6
B. 585.9, 401.0
C. 403.00
D. 401.0, 585.9

A

A woman has a vaginal delivery of a full-term liveborn infant. She undergoes an episiotomy with repair and post delivery elective tubal ligation.

A. 650, V25.2, V27.0, 73.6, 66.32
B. 648.91, V27.0, 73.6, 66.32
C. 650, V27.0, 66.32
D. 650, V27.0

A

A woman has an incomplete spontaneous abortion complicated by excessive hemorrhage. The physician performs a dilation and curettage.

A. 634.12, 69.09
B. 634.12, 285.1, 69.09
C. 634.11, 69.02
D. 634.91, 69.02

C

A patient has obstructed labor due to breech presentation. A single liveborn infant was delivered via Cesarean section.

A. 660.81, 74.1
B. 660.01, 652.21, V27.0, 74.99
C. 660.01, V27.0, 74.1
D. 660.81, 652.21, 74.99

B

A woman was admitted for delivery of a single newborn at 43 weeks' gestation. It was a manually assisted delivery.

A. 650, V27.0, 73.59
B. 645.20, V27.0, 73.59
C. 644.21, V27.0, 73.59
D. 645.21, V27.0, 73.59

D

A female who is 26 weeks' pregnant is treated for a fractured distal radius and ulna. A closed reduction of the fracture is performed.

A. 813.44, 79.02
B. 648.93, 813.44, 79.02
C. 813.44, V22.2, 79.02
D. V22.2, 813.44, 79.02

B

A patient is diagnosed with a tubal pregnancy. She undergoes a unilateral salpingectomy for removal of the tubal pregnancy.

A. 633.20, 66.63
B. 633.11, 66.62
C. 633.00, 66.61
D. 633.10, 66.62

D

A patient is admitted with an abscess with cellulitis of the abdominal wall. The culture is positive for Staphylococcus aureus.

A. 682.8, 041.11
B. 682.2, 041.11
C. 682.2, 707.8
D. 682.2

B

A patient had a cholecystectomy six days ago and is now coming back with evidence of staphylococcal cellulitis at the site of operative incision.

A. 958.3, 682.2, 041.19
B. 998.51, 682.8, 041.11
C. 958.3, 682.8, 041.11
D. 998.59, 682.2, 041.10

D

A patient has chronic ulcers of the calf and the back. Both ulcers are excisionally debrided and the ulcer on the back has a split-thickness skin graft.

A. 707.12, 707.8, 86.22, 86.22, 86.69
B. 707.12, 707.8, 86.22
C. 707.8, 86.22, 86.69
D. 707.8, 86.22, 86.22, 86.69

A

A patient presents with dermatitis due to prescription topical antibiotic cream used as directed by physician.

A. 692.4
B. 692.3, E930.9
C. 692.3
D. 692.3, E930.1

B

A patient developed a boil on the left side of the face. An incision and drainage was performed.

A. 680.0, 86.04
B. 680.0, 86.09
C. 680.8, 86.11
D. 680.0, 86.04, 86.11

A

A patient has an abscessed pilonidal cyst. An excision of the cyst was performed.

A. 685.1, 86.04
B. 686.09, 86.04
C. 685.0, 86.21
D. 686.01, 86.22

C

A patient has a pathological fracture of the femur due to metastatic bone cancer. He has a history of lung cancer.

A. 198.5, 733.14, V10.11
B. 733.14, 198.5, V10.11
C. 733.19, 198.5, V10.11
D. 821.00, 162.9

B

A 69-year-old man has a herniated lumbar intervertebral disc with paresthesia. A lumbar laminectomy with diskectomy is performed.

A. 722.11, 80.51, 03.09
B. 839.20, 80.51
C. 722.10, 80.59, 03.09
D. 722.10, 80.51

D

A patient developed pyogenic arthritis of the hip due to Group A Streptococcus. An arthrocentesis was done.

A. 716.95, 041.01, 81.91
B. 715.95, 041.01, 81.92
C. 711.05, 041.01, 81.91
D. 711.05, 81.91

C

A patient is admitted with a bunion of the left foot and a hammertoe of the right foot. Keller procedure and hammer toe repair was performed.

A. 727.1, 735.4, 77.59, 77.56
B. 727.1, 735.8, 77.52, 77.59
C. 727.2, 735.4, 77.52, 77.58
D. 727.1, 735.3, 77.56, 77.59

A

A patient developed a malunion of the humeral fracture. The original injury occurred 1 year ago. Open reduction with internal fixation was performed.

A. 812.20, 79.39
B. 733.82, 905.2, 79.31
C. 733.81, 905.2, 79.31
D. 733.94, 905.2, 79.32

C

A patient has recurrent internal derangement of the left knee. A diagnostic arthroscopy of the knee is performed.

A. 715.96, 80.26
B. 718.36, 80.26
C. 836.2, 80.26
D. 718.36, 80.6

B

A liveborn infant is born in hospital with a cleft palate and cleft lip.

A. 749.00, 749.10
B. 749.20
C. V30.00, 749.20
D. V30.00, 749.00, 749.10

C

A newborn is born in the hospital with tetralogy of Fallot.

A. 745.8
B. V30.01, 746.09
C. 745.2
D. V30.00, 745.2

D

A newborn infant is transferred to Manasota Hospital for treatment of an esophageal atresia.
What is the code for Manasota Hospital?

A. V30.00
B. 750.3
C. V30.00, 750.3
D. 750.3, V30.00

. B Newborn V-code is not assigned by the
receiving facility when a newborn is
transferred.

A patient presents with cervical spina bifida with hydrocephalus.

A. 741.02
B. 741.93
C. 741.01
D. 741.91

C

An infant is seen with clubfoot, which is corrected by the Evans operation.

A. 754.70, 83.84
B. 754.71, 83.84
C. 736.71, 83.84
D. 736.79, 83.84

A

A full-term infant, born in hospital is diagnosed with polycystic kidneys.

A. 753.12
B. V30.00, 753.12
C. V30.00
D. 753.12, V30.00

B

A full-term newborn is born in hospital to a mother who is addicted to cocaine; however, the infant tested negative.

A. V30.00, 760.75
B. 779.5 V29.8
C. V30.00, 779.5
D. V30.00, V29.8

D

A preterm infant is born via Cesarean section and has severe birth asphyxia.

A. V30.01, 765.10, 768.5
B. 765.10, 768.5, V30.01
C. 768.5, 765.10
D. 768.5

C

A preterm infant born in the hospital has neonatal jaundice. Phototherapy is done to treat the jaundice.

A. V30.00, 774.2, 99.83
B. 774.2, 99.83
C. V30.00, 99.83
D. V30.00, 774.2

A

A one-week-old infant is admitted to the hospital with a diagnosis of urinary tract infection contracted prior to birth. The urine culture is positive for E. coli.

A. V30.00, 599.0
B. 599.0, 041.4
C. V30.00, 599.0, 041.4
D. 771.82, 041.4

D

An infant has hypoglycemia with diabetic mother.

A. 251.2
B. 775.1
C. 775.0
D. 251.1

C

A full-term infant is born in the hospital. The birth is complicated by cord compression, which affected the newborn.

A. V30.00, 762.5
B. V30.00
C. 762.5
D. 762.6, V30.00

A

A patient is admitted with abdominal pain. The discharge diagnosis is listed as abdominal pain due to gastroenteritis or diverticulosis.

A. 789.00
B. 562.10, 558.9
C. 789.00, 558.9, 562.10
D. 558.9, 562.10, 789.00

C

A patient has a lung mass. A diagnostic bronchoscopy is performed.

A. 518.89, 33.23
C. 793.1, 33.27
B. 786.6, 33.23
D. 786.6, 33.27

B

A woman has a pap smear that detected cervical high-risk human papillomavirus (HPV). The DNA test was positive.

A. 795.05
B. 795.09
C. 795.04
D. 795.02

A

A patient presents to the emergency department with ascites. A paracentesis was done.

A. 789.30, 54.91
B. 789.51, 54.91
C. 789.59, 54.91
D. 782.3, 54.91

C

A patient is admitted with fever due to bacteremia.

A. 780.61, 790.7
B. 038.9
C. 780.61
D. 790.7, 780.61

D

A patient has urinary retention requiring the insertion of a Foley catheter.

D. 788.29, 57.93
C. 788.20, 57.94
B. 788.20, 57.93
A. 788.21, 57.94

C

A patient has a fracture of the medial malleolus due to a fall down some steps. The fracture was treated with a closed reduction procedure.

A. 824.1, E880.9, 79.05
B. 824.0, E880.9, 79.06
C. 824.0, 79.09
D. 824.1, E880.1, 79.05

B

A patient experienced a closed head injury. He was a passenger in a motor vehicle involved in a head-on collision with another motor vehicle.

A. 959.01, E812.1
B. 959.09, E812.2
C. 959.01, E813.1
D. 959.09, E813.1

A

A man appears with a gunshot wound to the abdomen. There is a moderate laceration of the liver. The patient stated that he was assaulted with a pistol.

A. 864.00, E965.1
B. 864.10, E965.0
C. 864.13, E965.1
D. 864.13, E965.0

D

A patient was admitted with third-degree burns to his upper back, which involved 20% of his body surface. There was an explosion and fire at his home.

A. 942.25, 948.22, E890.2
B. 942.44, 948.21, E895
C. 942.34, 948.22, E890.3
D. 942.24, 949.3, E897

C

A woman experienced third-degree burns to her thigh and second-degree burns to her foot. She stated that the burns were from hot liquid.

A. 945.36, 945.22, E924.0
B. 945.22, 945.36, E924.0
C. 945.22, E924.0
D. 945.29, 945.39, E924.0

A

A patient presents with a laceration of left wrist with injury to the radial nerve as a result of an accident, with embedded glass. The wrist laceration was repaired with sutures.

A. 881.02, 86.59
B. 881.12, E920.8, 86.59
C. 955.3, E920.8, 86.59
D. 881.12, 955.3, E920.8, 86.59

D

A 76-year-old female is admitted with tachycardia due to theophylline toxicity.

A. 785.0, E942.1
B. 995.20, E942.1
C. 785.0, E944.1
D. 995.20, E944.1

C

A patient suffered dizziness as a result of taking prescribed Phenobarbital. The patient took his medication with beer.

A. 780.4, 980.0, E860.0
B. 967.0, 980.0, 780.4, E851, E860.0
C. 967.0, 708.4, E851
D. 780.4, E851, E860.0

B

A patient is experiencing pain in the hip due to a displaced hip prosthesis. The patient is admitted and undergoes a revision of the hip prosthesis.

A. 996.49, 81.53
B. 996.77, 81.53
C. 719.45, 81.53
D. 996.49, 719.45, 81.53

A

A patient has postoperative hemorrhage resulting in acute blood-loss anemia.

A. 997.72, 285.1
B. 999.1, 285.1
C. 998.11, 285.1
D. 998.11

C

A patient is admitted for colostomy takedown. The takedown procedure is performed.

A. V44.3, 46.52
B. 569.60, 46.52
C. 997.4, 46.52
D. V55.3, 46.52

D

The patent is being admitted for a preoperative EKG on an outpatient basis. He is scheduled to have an elective cholecystectomy tomorrow for chronic cholecystitis and cholelithiasis. The EKG reveals atrial flutter.

A. 574.10
B. V72.81, 51.23
C. V72.81, 574.10, 427.32
D. 427.32

C

The patient presents for a screening examination for lung cancer.

A. V72.82
B. 162.9
C. V72.5
D. V76.0

D

A patient is admitted for observation for a head injury following a fall. The patient also suffered a minor laceration to the forehead. Head injury was ruled out.

A. V71.4, 873.42, E888.9
B. 873.42, E888.9
C. 959.01, 873.42, E888.9
D. V71.4, E888.9

A

An elderly man was admitted through the emergency department for severe urinary retention. Upon study, it was determined that his hypertension was uncontrolled (215/108). Prior medical records show admission 8 weeks ago for the same problem. As per conditions on previous admission, his BPH is complicated by acute cystitis. He is noncompliant with medications. Medication for the hypertension was immediately started and his hypertension was quickly brought under control. Urinary retention was relieved by placement of a Foley catheter.
Transurethral resection of the prostate was done.

401.0 Essential hypertension, malignant
401.9 Essential hypertension, unspecified benign or malignant
595.0 Acute cystitis
595.9 Cystitis, unspecified
600.00 Hypertrophy, (benign) of prostate without urinary obstruction and other lower urinary tract symptoms (LUTS)
600.01 Hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (LUTS)
600.3 Cyst of prostate
788.20 Retention of urine, unspecified
V15.81 Personal history of noncompliance with medical treatment
57.92 Dilation of bladder neck
57.94 Insertion of indwelling urinary catheter
60.29 Other transurethral prostatectomy
60.61 Local excision of lesion of prostate

A. 600.01, 595.0, 788.20, 401.9, V15.81, 57.94, 60.29
B. 600.3, 595.0, 401.0, V15.81, 57.92, 60.61
C. 600.00, 595.9, 788.20, 401.9, V15.81, 57.94, 60.61
D. 600.3, 595.0, 788.20, 401.0, V15.81, 57.94, 60.61

A

A 32-year-old female known to be HIV positive was admitted with lesions of the anterior trunk. Excisional biopsies of the skin lesions were positive for Kaposi's sarcoma. Further examination revealed thrush.
042 Human Immunodeficiency Virus (HIV) Disease
112.0 Candidiasis of mouth
176.0 Kaposi's sarcoma of skin
528.9 Other and unspecified diseases of the oral soft tissues
686.00 Pyoderma, unspecified
795.71 Nonspecific serological evidence of Human Immunodeficiency Virus (HIV)
86.11 Closed biopsy of skin and subcutaneous tissue
86.22 Excisional debridement of wound, infection, or burn

A. 042, 686.00, 112.0, 86.22
B. 042, 176.0, 112.0, 86.11
C. 795.71, 176.0, 528.9, 86.11
D. 795.71, 686.00, 528.9, 86.22

B

A female patient was admitted with uncontrolled type II diabetes. She also had an abscessed diabetic ulcer of the foot that was treated with incision and drainage. The culture and sensitivity of the abscess shows growth of Staphylococcus aureus, methicillin resistant. The patient was started on the appropriate antibiotic. The patient is on oral as well as injectional insulin for control of her diabetes.
041.11 Bacterial infection in conditions classified elsewhere and of unspecified site, methicillin susceptible staphylococcus aureus (MSSA)
041.19 Bacterial infection in conditions classified elsewhere and of unspecified site, other staphylococcus
250.82 Diabetes mellitus with other specified manifestation, type II or unspecified type, uncontrolled
250.83 Diabetes mellitus with other specified manifestation, type I (juvenile type), uncontrolled
682.7 Other cellulitis and abscess of foot, except toes
682.8 Other cellulitis and abscess of other specified sites
707.00 Chronic ulcer of skin, pressure ulcer, unspecified site
707.15 Ulcer of lower limbs, except pressure ulcer, of other part of foot (toes)
707.8 Chronic ulcer of other specified sites
V09.0 Infection with microorganisms resistant to penicillins
86.01 Aspiration of skin and subcutaneous tissue
86.04 Other incision with drainage of skin and subcutaneous tissue

A. 250.83, 682.8, V09.0, 86.04
B. 682.7, 682.8, 707.15, 041.19, 86.01
C. 682.8, 041.19, 250.82, 707.00, 86.04,
D. 250.82, 682.7, 707.15, 041.11, V09.0, 86.04

D

A patient was admitted from the nursing home in acute respiratory failure that was due to congestive heart failure. Chest x-ray also showed pulmonary edema. Patient was intubated and placed on mechanical ventilation and expired the day after admission.
428.0 Congestive heart failure, unspecified
428.1 Left heart failure
428.20 Systolic heart failure, unspecified as to acute, chronic, or acute on chronic
518.4 Acute edema of lung, unspecified
518.81 Acute respiratory failure
518.84 Acute and chronic respiratory failure
96.71 Continuous invasive mechanical ventilation for less than 96 consecutive hours
96.04 Insertion of endotracheal tube
A. 428.1, 518.84, 518.4, 96.71, 96.04
B. 428.20, 428.0, 518.81, 518.4, 96.71, 96.04
C. 518.81, 428.0, 96.71, 96.04
D. 428.0, 518.4, 96.04, 96.71

C

The patient has hypertensive heart disease and nephrosclerosis with end stage renal disease. The patient had placement of arteriovenous fistula in his left wrist to prepare for the hemodialysis.
Dialysis was also performed on this admission.
404.92 Hypertensive heart and chronic kidney disease, unspecified as malignant or benign, without heart failure and with chronic kidney disease Stage V or end stage renal
disease
404.93 Hypertensive heart and chronic kidney disease unspecified as malignant or benign, with heart failure and chronic kidney disease Stage V or end stage renal disease
585.6 End stage renal disease
585.9 Chronic kidney disease, unspecified
V56.0 Encounter for extracorporeal dialysis
39.27 Arteriovenostomy for renal dialysis
38.95 Venous catheterization for renal dialysis
39.95 Hemodialysis
54.98 Peritoneal dialysis

A. 404.93, 585.9, 54.98, 39.27
B. 404.92, 585.6, 39.95, 39.27
C. 404.93, 585.6, 39.95, 39.27
D. 404.92, 585.9, 38.95, 39.27

B

The patient has had abnormal heavy uterine bleeding and abdominal pain. There was bright red blood in the vagina and the right adnexa was enlarged. The woman was admitted. In surgery, a laparoscopy revealed a right follicular ovarian cyst. A laparoscopic ovarian cystectomy was performed. Following surgery, she was transfused two units of packed red blood cells for acute blood-loss anemia.
280.0 Iron deficiency anemia secondary to blood loss (chronic)
285.1 Acute posthemorrhagic anemia
620.0 Follicular cyst of ovary
65.25 Other laparoscopic local excision or destruction of ovary
65.39 Other unilateral oophorectomy

A. 620.0, 285.1, 65.25
B. 620.0, 280.0, 65.39
C. 620.0, 285.1, 65.39
D. 620.0, 280.0, 65.25

A

Jane Doe is 6 weeks post mastectomy for carcinoma of the breast. She is admitted for chemotherapy. What is the correct sequencing of the codes?
A. V58.11 (chemotherapy), 174.9 (malignant neoplasm of the breast), V45.71 (acquired absence of breast)
B. V58.11 (chemotherapy), V10.3 (personal history of malignant neoplasm of breast), V45.71 (acquired absence of breast)
C. V67.00 (follow-up exam after surgery), V58.11 (chemotherapy)
D. V10.3 (personal history of malignant neoplasm of breast)

A

The patient was admitted due to increasingly severe pain in his right arm, shoulder, and neck for the past 6 weeks. MRI tests showed herniation of the C5-C6 disc. Patient underwent cervical laminotomy and diskectomy C5-C6 disc. The patient is currently being treated for COPD and CAD with a history of a PTCA.
414.00 Coronary atherosclerosis of unspecified type of vessel, native or graft
414.01 Coronary atherosclerosis of native coronary artery
492.8 Other emphysema
496 Chronic airway obstruction, not elsewhere classified
722.0 Displacement of cervical intervertebral disc without myelopathy
722.11 Displacement of thoracic intervertebral disc without myelopathy
V45.82 Percutaneous transluminal coronary angioplasty status
80.51 Excision of intervertebral disc
03.09 Other exploration and decompression of spinal canal

A. 722.0, 492.8, 414.01, V45.82, 80.51
B. 722.11, 496, 414.01, V45.82, 03.09, 80.51
C. 722.11, 492.8, 414.00, 03.09, 80.51
D. 722.0, 496, 414.01, V45.82, 80.51

D

A 75-year-old man is admitted with acute cerebral embolism with infarction. He had hemiplegia and dysphagia. Physical therapy was given for the hemiplegia. The hemiplegia was resolved at the time of discharge.
342.90 Hemiplegia, unspecified, affecting unspecified side
434.11 Cerebral embolism with cerebral infarction
787.20 Dysphagia, unspecified
V57.1 Other physical therapy
A. 434.11, 342.90, V57.1
B. 434.11, 342.90, 787.20
C. 434.11, 342.90
D. 434.11, 342.90, 787.20, V57.1

D Effective October 1, 2010, the Official
ICD-9-CM Coding Guidelines state,
"Additional codes should be assigned
for any neurologic deficits associated
with the acute CVA, regardless of
whether or not the neurologic deficit
resolves prior to discharge."

Patient is admitted to St. Mary's Hospital with hyperthermia, tachycardia, hypoxemia, and
altered mental status. Urinalysis is positive for E. coli and blood cultures are negative. Patient is
immediately started on broad-spectrum IV antibiotics. Physician documents urosepsis as the
final diagnosis. The coder should
A. report 599.0 (UTI) and 041.4 (E. coli).
B. report 038.42 (septicemia due to E. coli) and 995.91 (SIRS-sepsis).
C. report 038.42 (septicemia due to E. coli), 599.0 (UTI) and 995.91 (SIRS-sepsis).
D. confer with physician for reporting 038.9 (unspecified septicemia) based upon the clinical findings with 041.4 (E. coli) and 995.91 (SIRS-sepsis).

D

Six-year-old Alex attended a birthday party where hot dogs and potato salad were served for lunch. Several hours after returning home, Alex began vomiting and having severe diarrhea. Alex was admitted to the hospital for treatment of his vomiting and diarrhea and was diagnosed with Salmonella food poisoning. Alex was given IV fluids for dehydration. Alex also has asthma, so he was given respiratory treatments while in the hospital.
003.9 Salmonella infection, unspecified
005.9 Food poisoning, unspecified
276.51 Dehydration
493.90 Asthma, unspecified, unspecified as to with status asthmaticus or with acute exacerbation
787.03 Vomiting alone
787.91 Diarrhea

A. 003.9, 276.51, 493.90
B. 005.9, 003.9, 276.51, 493.90
C. 005.9, 276.51, 493.90
D. 005.9, 003.9, 267.51, 787.03, 787.91, 493.90

A

A patient is admitted to the hospital with listlessness, fever, and persistent cough. Workup reveals HIV infection with HIV-related pneumonia. The patient is treated for pneumonia.
042 Human Immunodeficiency Virus (HIV) disease
486 Pneumonia, organism unspecified
795.71 Nonspecific serologic evidence of Human Immunodeficiency Virus (HIV)
V08 Asymptomatic Human Immunodeficiency Virus (HIV) infection status

A. 486, 042
B. 042, 486
C. 486, 795.71
D. 486, V08

B

David was experiencing chronic fatigue and was experiencing flulike symptoms. Blood testing indicated that he had hepatitis C. A percutaneous liver biopsy was performed to determine the stage of the disease.
070.41 Acute viral hepatitis C with hepatic coma
070.51 Acute viral hepatitis C without mention of hepatic coma
487.1 Influenza with other respiratory manifestations
780.79 Other malaise and fatigue
50.11 Closed (percutaneous) (needle) biopsy of liver
50.12 Open biopsy of liver

A. 070.51, 487.1, 780.79, 50.12
B. 070.41, 50.11
C. 070.51, 487.1, 50.11
D. 070.51, 50.11

D Fatigue and flulike symptoms/signs
of hepatitis would not be coded.

A 40-year-old female suddenly develops a painful rash. A visit to her physician reveals she has shingles. She is experiencing a great amount of anxiety and stress, so her physician prescribes medication for the shingles and for the anxiety that occurred as a reaction to the stress.
053.8 Herpes zoster with unspecified complication
053.9 Herpes zoster without mention of complication
300.00 Anxiety state, unspecified
308.0 Predominant disturbance of emotions
308.3 Other acute reactions to stress

A. 053.9, 308.0
B. 053.9, 308.3, 300.00
C. 053.8, 300.00
D. 053.8, 308.0

A

James is admitted to the hospital for severe anemia that is a result of the chemotherapy treatments he is receiving for metastatic prostate cancer to bone. James receives blood transfusions and is discharged home.
185 Malignant neoplasm of prostate
198.5 Secondary malignant neoplasm, bone and bone marrow
285.22 Anemia in neoplastic disease
E933.1 Adverse effect of antineoplastic and immunosuppressive drugs

A. 185, 198.5, 285.22, E933.1
B. E933.1, 285.22
C. 285.22, E933.1
D. 285.22, 185, 198.5, E933.1

D

Mary had resection of the large bowel for carcinoma of the colon. She is admitted for further staging of her cancer and receives radiation therapy during this admission.
153.9 Malignant neoplasm of colon, unspecified
V10.05 Personal history of malignant neoplasm of large intestine
V58.0 Encounter for radiotherapy
V67.09 Follow-up examination following other surgery
92.29 Other radiotherapeutic procedure

A. 153.9, 92.29
B. V58.0, V10.05
C. V67.09, V58.0
D. V10.05, V58.0

A

Jackie has developed a lesion on her right shoulder. A biopsy was obtained and was positive for malignant melanoma. She is now admitted for radical excision of the melanoma lesion and full-thickness skin graft.
172.6 Malignant melanoma of skin, upper limb, including shoulder
173.5 Other malignant neoplasm of skin of trunk, except scrotum
173.6 Other malignant neoplasm of skin of upper limb, including shoulder
86.3 Other local excision or destruction of lesion or tissue of skin and subcutaneous tissue
86.4 Radical excision of skin lesion
86.63 Full thickness skin graft to other sites

A. 172.6, 86.4, 86.63
B. 173.5, 86.4, 86.63
C. 173.5, 86.3, 86.63
D. 172.6, 86.3, 86.63

A

Richard is admitted for chemotherapy for leukemia. Chemotherapy is administered. Given this information,
A. the leukemia code and a procedure code for the chemotherapy will be assigned.
B. an admission for chemotherapy code and a chemotherapy procedure code will be assigned.
C. an admission for chemotherapy code, a leukemia code, and a procedure code for the chemotherapy should be assigned and the principal diagnosis will be the admission for chemotherapy V code.
D. an admission for chemotherapy code, a leukemia code, and a procedure code for the chemotherapy should be assigned and the principal diagnosis will be the leukemia code.

C

Sophia has been diagnosed with metastatic carcinoma of lung, primary site breast. Simple mastectomy performed 2 years ago. What is the principal diagnosis?
A. Metastatic carcinoma of lung
B. Carcinoma of breast
C. History of carcinoma of breast
D. Status post mastectomy

A

Given the following diagnosis: "Carcinoma of axillary lymph nodes and lungs, metastatic from breast." What is the primary cancer site(s)?
A. Axillary lymph nodes
B. Lungs
C. Breast
D. Both A and B

C

When is it appropriate to use category V10, history of malignant neoplasm?
A. Primary malignancy recurred at original site and adjunct chemotherapy is directed at the site.
B. Primary malignancy has been eradicated and no adjunct treatment is being given at this time.
C. Primary malignancy eradicated and the patient is admitted for adjunct chemotherapy to primary site.
D. Primary malignancy is eradicated; adjunct treatment is refused by patient even though there is some remaining malignancy.

B

Ralph is a 96-year-old nursing home resident who is admitted for malnutrition. Ralph has suffered a previous stroke that has left him with dysphagia. Ralph is treated for malnutrition with hyperalimentation. Ralph was also found to have hypokalemia that was treated with IV potassium replacement. On the day prior to discharge, Ralph underwent a PEG tube insertion.

263.9 Unspecified protein-calorie malnutrition
276.8 Hypopotassemia (Hypokalemia)
438.82 Dysphagia, late effect of cerebrovascular disease
787.20 Dysphagia, unspecified
43.11 Percutaneous endoscopic gastrostomy (PEG) insertion
A. 438.82, 263.9, 787.20, 43.11
B. 787.20, 276.8, 43.11
C. 263.9, 276.8, 438.82, 43.11
D. 263.9, 787.20, 276.8, 43.11

C

Jessica has been diagnosed with hyperthyroidism due to toxic multinodular goiter with crisis. She also has hypertension and has a history of sick sinus syndrome with pacemaker insertion. Jessica has a partial thyroidectomy on this admission.

240.9 Goiter, unspecified
241.1 Nontoxic multinodular goiter
242.21 Toxic multinodular goiter with mention of thyrotoxic crisis or storm
401.0 Essential hypertension, malignant
401.9 Essential hypertension, unspecified benign or malignant
427.81 Sinoatrial node dysfunction
V45.01 Other postprocedural states, cardiac pacemaker
06.39 Other partial thyroidectomy
06.4 Complete thyroidectomy

A. 240.9, 401.0, 427.81, 06.4
B. 242.21, 401.9, 427.81, V45.01, 06.39
C. 240.9, 242.21, 401.9. V45.01, 06.4
D. 242.21, 401.9. V45.01, 06.39

D SSS would not be reported as a
current condition because the
pacemaker would have taken care
of this condition.

Laura is 7 years old and has acute bronchitis and cystic fibrosis. She is admitted to ambulatory surgery for bronchoscopy.
277.00 Cystic fibrosis without mention of meconium ileus
277.01 Cystic fibrosis with meconium ileus
466.0 Acute bronchitis
33.23 Other bronchoscopy
33.24 Closed (endoscopic) biopsy of bronchus
96.56 Other lavage of bronchus and trachea

A. 466.0, 277.00, 33.23
B. 466.0, 277.01, 33.24
C. 277.00, 96.56, 33.23
D. 277.00, 33.23, 33.24, 96.56

A

Estelle has had nausea and vomiting and is unable to eat. She develops dehydration and is subsequently admitted for rehydration with intravenous fluids.
276.51 Dehydration
787.01 Nausea with vomiting
787.02 Nausea alone
787.03 Vomiting alone
A. 276.51, 787.01
B. 276.51
C. 276.51, 787.02
D. 276.51, 787.02, 787.03

B

A patient is admitted for treatment of peripheral vascular disease, renal failure, and diabetes mellitus. The coder would
A. assign codes for PVD, renal failure, and diabetes.
B. assign codes for diabetes with peripheral vascular and renal manifestations.
C. query physician for causal relationship between the PVD, renal failure, and diabetes.
D. assign codes of diabetes with PVD and a code for renal failure.

C The coder cannot assume a causal
relationship between the diabetes
and conditions that are usually
related to the diabetes unless a
physician confirms this relationship.

Lucy is admitted because of diabetic coma. She is a type II diabetic with nephritic syndrome and gangrene of her toes, all due to her diabetes.
250.30 Diabetes mellitus with other coma, type II or unspecified type, not stated as uncontrolled
250.31 Diabetes mellitus with other coma, type I (juvenile type), not stated as uncontrolled
250.40 Diabetes mellitus with renal manifestations, type II or unspecified type, not stated as uncontrolled
250.41 Diabetes mellitus with renal manifestations, type I (juvenile type), not stated as uncontrolled
250.70 Diabetes mellitus with peripheral circulatory disorders, type II or unspecified type, not stated as uncontrolled
581.81 Nephrotic syndrome in diseases classified elsewhere (manifestation)
785.4 Gangrene

A. 250.30, 250.40, 581.81, 250.70, 785.4
B. 250.31, 581.81, 785.4
C. 250.30, 250.40, 581.81
D. 250.30, 250.41, 785.4

A

George is a type II diabetic who is admitted in a coma with blood glucose of 876. He is diagnosed with diabetic ketoacidosis. George also has a diabetic cataract.
250.10 Diabetes mellitus with ketoacidosis, type II or unspecified type, not stated as
uncontrolled
250.11 Diabetes mellitus with ketoacidosis, type I (juvenile type), not stated as uncontrolled
250.30 Diabetes mellitus with other coma, type II or unspecified type, not stated as
uncontrolled
250.31 Diabetes mellitus with other coma, type I (juvenile type), not stated as uncontrolled
250.32 Diabetes mellitus with other coma, type II or unspecified type, uncontrolled
250.50 Diabetes mellitus with ophthalmic manifestations, type II or unspecified type, not
stated as uncontrolled
250.51 Diabetes mellitus with ophthalmic manifestations, type I (juvenile type), not stated as
uncontrolled
250.52 Diabetes mellitus with ophthalmic manifestations, type II or unspecified type, uncontrolled
366.41 Diabetic cataract (manifestation)
366.9 Unspecified cataract

A. 250.11, 250.31, 366.9
B. 250.10, 250.30, 250.50, 366.9
C. 250.32, 250.52, 366.41
D. 250.31, 250.51, 366.41

C Diabetic ketoacidosis by definition
is uncontrolled

Spencer has hypercholesterolemia and is treated with medication.
272.0 Pure hypercholesterolemia
272.1 Pure hyperglyceridemia
272.3 Hyperchylomicronemia
272.8 Other disorders of lipoid metabolism

A. 272.0
B. 272.1
C. 272.3
D. 272.8

A

Edward is diagnosed with syndrome of inappropriate antidiuretic hormone with resultant electrolyte imbalance.
253.6 Other disorders of neurophyophysis (syndrome of inappropriate secretion of antidiuretic hormone—ADH)
272.9 Unspecified disorder of lipoid metabolism
276.50 Volume depletion, unspecified
276.8 Hypopotassemia (hypokalemia)
276.9 Electrolyte and fluid disorders, not elsewhere classified

A. 276.50
B. 276.9, 272.9
C. 253.6, 276.9
D. 253.6. 276.8

C

Ruth is admitted for an axillary lymph node biopsy to determine the cause of her chronic lymphadenitis. She is on medication for gout and atrial fibrillation.
274.9 Gout, unspecified
289.1 Chronic lymphadenitis
289.2 Nonspecific mesenteric lymphadenitis
427.31 Atrial fibrillation
40.11 Biopsy of lymphatic structure
40.23 Excision of axillary lymph node
40.51 Radical excision of axillary lymph nodes

A. 289.1, 274.9, 427.31, 40.11
B. 274.9, 289.2, 427.31, 40.11
C. 289.1, 427.31, 40.23
D. 289.1, 427.31, 274.9, 40.51

A

Elizabeth has a history of von Willebrand's disease and frequently requires transfusions for chronic blood loss anemia associated with her condition. She presents to the outpatient department for routine blood transfusion.
280.0 Iron deficiency anemia secondary to blood loss (chronic)
280.1 Iron deficiency anemia secondary to inadequate dietary iron intake
285.1 Acute posthemorrhagic anemia
286.4 Von Willebrand's disease
286.7 Acquired coagulation factor deficiency

A. 285.1, 286.4
B. 286.7, 286.4
C. 286.4, 280.1
D. 280.0, 286.4

D

Steven, a 7 year old, is seen in the emergency department with severe joint pain. Following workup, it is discovered that he is having a severe crisis due to sickle cell anemia.
282.61 Sickle cell disease (Hb-SS disease without crisis)
282.62 Sickle cell disease (Hb-SS disease with crisis)
282.63 Sickle cell/Hb-C disease without crisis
282.69 Other sickle cell disease with crisis

A. 282.61
B. 282.62
C. 282.63
D. 282.69

B

Angela has just undergone orthopedic surgery. Documentation indicates that she lost 700 cc of blood during surgery. Her hemoglobin and hematocrit are monitored following surgery.
Subsequently she is transfused. The physician documents anemia as a secondary diagnosis. The coder would
A. query the physician to clarify the type of anemia as acute blood loss.
B. assign a code for unspecified anemia.
C. assign a code for acute blood loss anemia.
D. not assign a code for anemia.

A

Liza has been diagnosed with anemia. She is being admitted for a bone marrow aspiration to determine the specific type of anemia. The pathology report indicates that she has iron- deficiency anemia.
280.0 Iron deficiency anemia secondary to blood loss (chronic)
280.8 Other specified iron deficiency anemias
280.9 Iron deficiency anemia, unspecified
41.31 Biopsy of bone marrow
41.38 Other diagnostic procedures on bone marrow
41.91 Aspiration of bone marrow from donor for transplant

A. 280.0, 41.38
B. 280.9, 41.31
C. 280.9, 41.91
D. 280.8, 41.38

B

Peggy has thymic dysplasia with immunodeficiency.
254.0 Persistent hyperplasia of thymus
254.8 Other specified diseases of thymus gland
254.9 Unspecified disease of thymus gland
279.2 Combined immunity deficiency (thymic aplasia or dysplasia with immunodeficiency)
279.3 Unspecified immunity deficiency

A. 279.3, 254.8
B. 254.0
C. 279.2
D. 279.2, 254.9

C

Aaron has suffered a hypoglycemic reaction due to alcohol intoxication. Hypoglycemia is treated.
250.80 Diabetes mellitus with other specified manifestations, type II or unspecified type, not stated as uncontrolled
251.2 Hypoglycemia, unspecified
303.90 Other and unspecified alcohol dependence, unspecified
305.00 Alcohol abuse, unspecified
995.29 Unspecified adverse effect of other drug, medicinal, and biological substance

A. 251.2, 305.00
B. 251.2, 303.90
C. 995.29, 303.90
D. 250.80, 305.00

A

Joe is being admitted for treatment of chronic alcoholism. As a result of Joe's drinking he also has chronic alcoholic gastritis for which he receives medication. Joe is scheduled to spend 30 days in the inpatient rehab unit of Sunshine Hospital.
303.01 Acute alcoholic intoxication, continuous
303.90 Other and unspecified alcohol dependence, unspecified
303.91 Other and unspecified alcohol dependence, continuous
535.00 Acute gastritis without mention of hemorrhage
535.30 Alcoholic gastritis without mention of hemorrhage
535.31 Alcoholic gastritis with hemorrhage
94.61 Alcohol rehabilitation
94.62 Alcohol detoxification
94.63 Alcohol rehabilitation and detoxification
A. 303.01, 535.00, 94.63
C. 303.90, 535.30, 94.61
B. 303.91, 535.00, 94.63
D. 303.01, 303.90, 535.30, 94.63

C The term "continuous" refers to daily intake of large amounts of
alcohol, or regular heavy drinking
on weekends or days off. The coder
should not assume to use the fifth
digit "1" unless documented as
continuous.

Sheila has paranoid alcoholic psychosis with chronic alcoholism, continuous. She is admitted for treatment of her psychosis.
291.5 Alcohol induced psychotic disorder with delusions
303.91 Other and unspecified alcohol dependence, continuous
V57.89 Other specified rehabilitation procedure
A. 291.5, 303.91
C. V57.89, 303.91
B. 303.91, 291.5
D. 291.5, 303.91, V57.89

A

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