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E and V codes
The supplementary classifications in ICD-9-CM are the:
and
Which of the following terms, when used in a code descriptor in the "Tabular List of Diseases and Injuries," should be interpreted as "and/or" by the coder?
the condition established after study to
occasion the admission of the patient to the hospital.
The UHDDS definition of Principal Diagnosis is
dizziness, sweating, extensive bruising
The patient is seen in her family physician's office for complaints of dizziness, sweating, and extensive bruising. The physician documents her impression as "rule out diabetes mellitus" and orders appropriate testing. How will this encounter be coded?
excludes
Correct
The basic message of which of the following instructional notes, found in the "Tabular List of Diseases and Injuries," is "code this condition elsewhere."
Answer
Selected Answer: b.
excludes
coded
The discharged inpatient diagnostic statement (Discharge Summary) reads "rule out diabetes mellitus." Diabetes mellitus should be
nonessential modifiers
Parentheses enclose terms throughout ICD-9-CM that are included in the code but need not be stated in documentation as they do not affect code assignment in any way. These terms which serve as reassurance that the correct code has been selected are referred to as
Circumstance of admission
Which of the following will always govern the selection of the principal diagnosis for inpatient admission?
Use the combination code only
When one (1) code describes two (2) concurrent conditions, you are required to:
manifestation code
A code title in the "Tabular List of Diseases and Injuries" that is listed in an italicized bold font is a:
786.50, 733.6, 536.8
A patient is admitted with chest pain. The patient has a history of prior gastroesophageal reflux, but
he indicates this pain is different. The patient had been lifting weights earlier in the day. A coronary etiology is worked up but found to be negative. The patient was given antacids and pain medication to ease the symptoms. The physician lists the diagnosis "chest pain due to costochondritis vs. indigestion." 536.8 Indigestion
733.6 Costochondritis
786.50 Chest pain, unspecified
when the coder lacks sufficient information to assign a more specific code
Codes that contain the abbreviation "NOS" in their description are to be used:
Codes that contain the abbreviation "NOS" in their description are to be used:
infarction
The following diagnostic statement was documented by the physician: "acute anterior wall myocardial infarction." Which of the following is the main term that will need to be referenced in the "Alphabetic Index to Diseases and Injuries" to locate the appropriate diagnosis code
should be reported
Conditions that are not an integral part of a diagnosed disease process
essential modifiers
These modifiers, known as subterms in the "Alphabetic Index to Diseases and Injuries," are also referred to as which of the following?
that ICD-9-CM does not provide a specific
code for the patient's condition
Codes that include the abbreviation NEC, which itself can be found in both the Alphabetic Index and the Tabular List, indicates
the cause of the residual condition
The coding of late effects normally requires two (2) codes: one (1) for the residual condition, and one (1) for
017.80
Tuberculous esophagitis
461.0
Acute and chronic maxillary sinusitis
211.4
Adenomatous rectal polyp
088.81, 711.85
Pelvic arthritis due to Lyme disease
483.1
Pneumonia due to chlamydia
V and E Codes
The supplementary classifications in ICD-9-CM are
significant procedure
According to the UHDDS, a procedure that is surgical in nature, carries a procedural or anesthetic risk, or requires specialized training, is defined as a
hospital inpatient
ICD-9-CM procedure codes are required to be reported in which of the following settings?
the extensive definitive procedure and the open biopsy
When an open biopsy is followed by a more extensive definitive procedure, the coder reports
Drugs, medicinal agents, and biological substances causing adverse effects in therapeutic use
E codes are mandatory for adverse reactions due to
shunt
Which of the following is used to surgically divert fluids from one part of the body to another part of the body?
Never used as the principal diagnosis.
E codes are
code also
Which instructional note is used to indicate that an additional code should be assigned if the referenced procedure is performed
family history
E codes are used to report additional information in cases of all except
principal
The procedure performed for definitive treatment is referred to as what type of procedure
V30.00 Single liveborn; born in hospital, delivered without mention of cesarean delivery
Which of the following can only be sequenced as the principal/first-listed diagnosis?
excision
When only a lesion of an organ is removed, what main term should the coder reference in the Volume 3 alphabetic index?
The E codes Tabular List is located immediately after the Table of Drugs and Chemicals
which of the following statements about E codes is FALSE
Either V58.0 or V58.11
A patient is admitted to the hospital to receive radiation therapy and chemotherapy for esophageal cancer. What is the appropriate principal diagnosis?
Different V codes exist for family history of diseases and personal history of diseases
Which of the following statements about V codes is TRUE
V code
When an individual is well but seeking health care services for a particular reason, which type of code must be reported as the principal/first-listed diagnosis?
E885.9
slipped on sidewalk
V04.81
What code would be reported as the first-listed diagnosis when a patient presents to her physician's office for a flu shot
63.71
Select the procedure code for vasectomy with ligation of the vas deferens.
V76.0
What code would be reported when a patient presents to the hospital x-ray department for an outpatient screening examination for lung cancer?
E893.0, E849.0
Patient's clothes caught on fire in kitchen fire at home.
HIV disease (042); pneumonia (486)
A patient is seen with symptoms of fatigue, fever, and a persistent and productive cough. Testing reveals HIV-positive status and documented HIV-related pneumonia. Appropriate medications are prescribed for the pneumonia and the HIV infection. The proper sequencing and coding will be
The diabetes
In the diagnostic statement "diabetic foot ulcer," what condition should be assigned as the principal diagnosis
Septicemia, SIRS, septic shock
A patient is seen with septic shock from generalized septicemia. The correct coding and sequencing would be
Increases glucose metabolism
Which of the following is an effect of insulin
Fractured femur, HIV infection, lymphadenopathy
The patient is admitted through the Emergency Room with a comminuted fracture of the left femur. He had slipped in the bathtub at home. The patient is HIV positive and is exhibiting AIDS-related lymphadenopathy. The correct sequencing of these diagnoses is:
It involves abnormal glucose tolerance test findings/results in pregnant women without previous history of diabetes
Which of the following is true of gestational diabetes
organ dysfunction
he term "severe sepsis" is used to indicate sepsis with:
Diabetic peripheral vascular and/or neurological complications
Diabetic foot ulcers may result from:
trauma
When acute respiratory failure and acute renal failure are documented as being due to SIRS following trauma, which of the following codes will be listed as the principal diagnosis
540.9 Acute Appendicitis
A patient with known AIDS is admitted to the hospital as an inpatient with acute appendicitis and undergoes an open appendectomy. Her AIDS is under treatment and is asymptomatic at the present time. The appropriate principal diagnosis in this case would be:
retinopathy
A vision related pathology that can frequently be caused by diabetes is:
Urinary tract infection
In the diagnostic statement "E. coli urosepsis," which of the following will be sequenced as the principal diagnosis?
An additional code describing the diabetes mellitus should be assigned
A pregnant patient was admitted to the hospital with uncontrolled diabetes mellitus. She is a Type I diabetic and was brought under control and subsequently discharged. The following code was assigned:
648.03 Other current condition in the mother classifiable elsewhere but complicating pregnancy, childbirth, or the puerperium, diabetes mellitus, antepartum condition

Which of the following describe why the coding is in error?
bactremia
Physician documentation of a laboratory finding of bacteria in the blood will result in the reporting of which of the following conditions
Hyperglycemia
A 35-year-old patient is seen at his doctor's office with a previous lab test positive for hyperglycemia. The physician documents a diagnosis of "suspected diabetes mellitus." The correct diagnosis code(s) for the encounter will report
250.40, 581.81, 250.70, 443.81, V58.67
patient encounter for a patient with diabetic intercapillary glomerulosclerosis and peripheral angiopathy. For the past month the patient has been on daily insulin injections.
038.12, 995.92, 785.52, 707.03, 707.21; 38.93
Septicemia due to methicillin resistant staphylococcus aureus. Patient also had on admission septic shock and a stage 1 decubitus ulcer of the sacrum. Patient had a centrally placed venous line inserted, which will be used for drug infusion
042, 176.0, 571.8; 86.11
An HIV positive patient was admitted with skin lesions on the chest and back. Biopsies were taken, and the pathologic diagnosis was Kaposi's sarcoma. Hepatosplenomegaly was also noted on physical examination.
250.81, 707.14; 86.22
68 year old female was admitted with Type I diabetes mellitus with a diabetic ulcer of the left heel. Patient was taken to the operating room for excisional debridement of the ulcer.
042, 294.10
A patient is admitted with a diagnosis of dementia related to advanced HIV disease. What is the correct code assignment?
250.61, 357.2
A patient is admitted with a diagnosis of dementia related to advanced HIV disease. What is the correct code assignment?
250.61, 357.2
An elderly patient is seen by his physician for his diabetic polyneuropathy. He brought the log of his sugar readings for the past month. The log was reviewed with him and showed him to be in good control. The patient has been a type I diabetic for six years
has spread
When documentation states that a neoplasm has metastasized, the physician is saying that the neoplasm
describing the kind of neoplasm and its behavior.
Morphology (M) codes are used for
an admission for antineoplastic chemotherapy V code, the leukemia diagnosis code, and a procedure code for chemotherapy administration will be assigned, with the admission for antineoplastic chemotherapy V code sequenced as the principal diagnosis.
Richard is admitted for a round of adjunct cancer treatment consisting of chemotherapy for leukemia. The chemotherapy is administered
breast
Given the following diagnosis "Carcinoma of lung and axillary lymph nodes, metastatic from breast," what is the primary neoplasm site(s)?
be sequenced first, followed by the code for the neoplasm.
When a patient is admitted to the hospital solely for the purpose of treating a complication of a neoplasm, such as dehydration or anemia, the ICD-9-CM diagnosis code for the complication will:
In situ
A pathological diagnosis of transitional cell carcinoma of the cervix is made. The diagnosis will be classified in ICD-9-CM as a neoplasm of the cervix. Which of the following is the appropriate behavior classification of a transitional cell carcinoma?
Neoplasm-related pain
A 72-year-old female patient is admitted to the hospital with excruciating lower back pain. She has breast cancer with metastasis to the bone, specifically the lumbar vertebrae. She was treated with rest and analgesics, then discharged on day two to follow up with her oncologist.
When the primary malignancy has been removed or irradiated and there is currently no adjunct treatment being given to the patient.
When would it be appropriate to report a code from category V10, "Personal History of Malignant Neoplasm," on a patient's chart
Metastatic adenocarcinoma of the lung
A 65-year-old female was admitted to the hospital with shortness of breath and diagnosed with metastatic adenocarcinoma of the lung, with the primary site listed as the breast. The patient previously had a lumpectomy (removal of the breast tumor) performed three years ago. Following surgery she received a round of chemotherapy, after which she had been given a clean bill of health. What would you sequence as the principal diagnosis?
widely metastatic.
The diagnostic phrase "disseminated cancer" is to be interpreted by the coder as
Either V58.0 or V58.11
A patient is admitted to the hospital to receive radiation therapy (V58.0) and chemotherapy (V58.11) for esophageal carcinoma (150.5). What is the appropriate principal diagnosis
Malignant neoplasm of the colon (153.2)
A patient who had cancer of the descending colon, which was removed one year ago, returns for a follow-up visit. Colonoscopy revealed a recurrence of cancer. Which of the following would be reported?
small cell lung carcinoma
A patient is admitted with shortness of breath and hemoptysis. A chest x-ray was inconclusive, revealing patchy infiltrates in the left lung. On the third day of hospitalization, a bronchoscopy with biopsy was performed which revealed a small cell carcinoma of the left upper lobe of the lung, which was determined to be the cause of the SOB and hemoptysis. A secondary metastatic lesion in the brain was subsequently detected following CT scan. The principal diagnosis is the:
b.
Malignant but not yet invasive or metastatic
If a neoplasm is classified in the pathology report as "in situ," which of the following describes the behavior of the neoplasm?
b.
malignant
Which of the following ICD-9-CM neoplasm behavior classifications is reported for tumor cells that have the property for invasion of or attachment to adjacent structures, for spread to distant sites, for relentless growth, and for a lethal effect?
c.
Two (2) aortocoronary grafts and one (1) mammary-coronary graft
During a coronary artery bypass surgery, the patient underwent the following saphenous vein bypass grafts: from the aorta to the left anterior descending (LAD) branch of the left main coronary artery (LMCA), and from the aorta to the posterior descending branch of the LMCA. The patient also had repositioning of the internal mammary artery to the right coronary artery.
b.
A code from subcategory 403.9 (Hypertensive Chronic Kidney Disease) is assigned, with an additional code reported to identify the stage of chronic kidney disease
When the diagnostic statement lists hypertension and chronic kidney disease, which of the following coding guidelines applies?
b.
Acute MI with a fifth digit of 1 (initial episode of care)
A patient with no previous history of cardiovascular disease is admitted to St. Elegius Hospital with a diagnosis of acute anteroseptal myocardial infarction, and is transferred seventy-two hours later to Chicago Sun Hospital for specialized care and further workup. Which of the following best describes the appropriate coding for the patient's stay at St. Elegius?
b.
Acute myocardial infarction with a 5th digit of "1" - (initial episode of care)
Referring to the same patient in question #2, which of the following best describes the appropriate coding for the inpatient encounter at Chicago Sun Specialty Hospital?
d.
accelerated
Which of the following descriptors of hypertension will require the coder to classify the hypertension as malignant?
c.
Cerebral thrombosis; hemiplegia, aphasia
A patient was admitted to the hospital with hemiplegia and aphasia. The patient was diagnosed as having suffered a cerebral thrombosis, which has resolved along with all neurological deficits.
b.
Myocardial infarction only
An elderly patient is admitted to the hospital with unstable anginal symptoms and undergoes cardiovascular workup. A myocardial infarction is diagnosed. Which of the following should be coded?
b.
aortic valve insufficiency and tricuspid valve stenosis
Which of the following cardiac valve conditions would not be reported as rheumatic heart disease unless the attending physician diagnoses them as such?
b.
MI with 5th digit "2" - subsequent episode of care
A patient with CLL (chronic lymphocytic leukemia) is admitted for chemotherapy five (5) weeks after experiencing a heart attack. How will the MI be coded?
c.
unspecified
If documentation on the final diagnostic statement reads "uncontrolled hypertension." which nature of hypertension will be reported?
4
You have been hired as a coder at an acute care facility that specializes in cardiac procedures, and the very first chart you will code is a Percutaneous Transluminal Coronary Angioplasty (PTCA) with stent placement. Confidently, you begin to code the chart because you know that this type of procedure will require, at a minimum, how many codes?
b.
renal disease
Coding professional must always assume a cause-and-effect relationship between hypertension and which of the following conditions?
a.
Diastolic blood pressure is the pressure on the arterial walls during heart muscle contraction
Which of the following statements about circulatory disorders is FALSE?
a.
the CHF only
When Ed was discharged from the hospital, his physician listed his diagnoses as left heart failure and congestive heart failure (CHF) with acute pulmonary edema. You are coding Ed's record and you will report: