Part A: Multiple-Choice Questions 1. A patient is admitted to undergo chemotherapy for cancer of the sigmoid colon that was previously treated with resection. Which code is sequenced first? A. 153.3 C. V58.11 B. 153.9 D. V10 2. A patient was admitted to the hospital for chest pain due to tachycardia. While in the hospital, the patient was also treated for type 1 diabetes. Upon further review, the coder noted that the documentation and EKG didn’t provide further evidence of the type of tachycardia or underlying cardiac condition(s). What should the coder report as the principal diagnosis? A. Chest pain B. Tachycardia, NOS C. Insulin-dependent diabetes mellitus D. Cardiac disease, NOS Lesson 1 ICD-9-CM Hospital Inpatient Coding When you feel confident that you have mastered the material in Lesson 1, submit this exam to your instructor for grading following the instructions at the end of the exam. You must type all of the answers to the questions and save them in a word-processing document. Include your name, address, and student number on the top of the first page of your answers. Use the exam number 40920800. Be certain to indicate the proper question number before each of your answers. Questions 1–25: Select the one best answer to each question. EXAMINATION NUMBER 40920800 Examination, Lesson 184 3. Dr. Smith recorded the following diagnoses on the patient’s discharge sheet: gastrointestinal bleeding due to acute gastritis and angiodysplasia. The principal diagnosis is coded as A. GI bleeding. B. acute gastritis. C. angiodysplasia. D. either acute gastritis or angiodysplasia. 4. A patient was admitted with extreme fatigue and lethargy. Upon discharge, the physician documents the following diagnosis: fatigue due to either depression or hypothyroidism. Which of the following are correct codes and sequencing for the scenario? A. 780.79, 311, 244.9 C. 249.9, 311 B. 311, 249.9, 789.79 D. 789.79 5. Of the following, which code would take precedence over the other? A. 072.0 over 033.0 C. 486 over 480 B. 595.0 over 131.09 D. 112.2 over 599.0 6. Upon discharge, the physician documents the following on the patient’s discharge sheet: ?HIV infection. As the inpatient coder, your next step should be to A. code the HIV infection as if it exists (according to UHDDS guidelines) and report it as the principal diagnosis. B. review the UHDDS guidelines for assigning possible HIV infection codes versus AIDS codes. C. query the physician and request that the statement be amended with a positive (or negative) confirmation of the HIV infection. D. wait to code the patient’s record until a positive finding on the serology report confirms the HIV diagnosis. 7. For which of the following scenarios would it be appropriate to query the physician for more information before coding and/or sequencing? A. A patient was admitted with severe abdominal pain. At discharge, the physician documents the following diagnosis: abdominal pain due to either hiatal hernia or diverticula. B. A patient was admitted with congestive heart failure (treated with IV furosemide) and unstable angina (treated with nitrates). C. A patient has low potassium levels noted on the laboratory report (treated with orally administered potassium). D. A patient is admitted with dysuria with no cause found. Examination, Lesson 1 85 8. Which of the following statements is true? A. A patient has diabetes and an ulcer. Code the ulcer as diabetic. B. A pregnant patient has diabetes. Code diabetes as complicating the pregnancy. C. A patient has diabetes and cardiomyopathy. Code the cardiomyopathy as a diabetic complication. D. A patient has diabetes and cataracts. Code diabetic cataracts. 9. A patient was admitted for metastatic carcinoma from the breast to several lymph node sites. Two years ago she had a double mastectomy. Which of the following is the correct code assignment for this case? A. 196.8, V10.3 C. 196.8, 174.9, 85.42 B. 174.9, 196.8 D. 196.8, 174.9, V10.3 10. One of the secondary diagnoses listed on the patient’s discharge sheet is seizures. As a coder, your next step is probably A. coding seizures to 780.39. B. coding seizures to 345. C. not reporting the code because it’s a symptom. D. querying the physician for more information/clarification. 11. A patient was discharged with the diagnosis of acute bronchitis with chronic obstructive asthma. Which of the following is the correct coding and sequencing (if applicable) for this patient? A. 493.21 C. 466.0, 493.21 B. 493.21, 496 D. 493.91 12. Code 780.2 can be listed as principal diagnosis in which of the following cases? A. For an outpatient encounter when the cause has been determined B. For an inpatient encounter when the cause hasn’t been determined C. When it’s listed with a contrasting diagnosis D. It can never be listed as principal diagnosis. 13. Which of the following codes should not be listed as principal diagnosis? A. 784.7 C. E812.0 B. V30.00 D. 307.81 14. Choose the correct code and sequencing for the following scenario: Reduction of right humerus fracture with cast. A. 79.00 C. 79.00, 93.53 B. 79.01 D. 79.01, 93.53 Examination, Lesson 186 15. Read the following excerpt from medical record documentation and determine the correct code(s) for coding. The physician writes the following information: “…noted burn on the arm skin with redness. Patient complained of tenderness to the touch.” A. 943.01 C. 943.21 B. 943.10 D. 943.30 16. A patient was admitted in a coma from intentionally ingesting an entire bottle of sedatives. Which of the following is the correct coding and sequencing assignment? A. 780.01, 967.8 C. 967.8, E950.2 B. 780.01, 967.8, E950.2 D. 967.8, 780.01, E950.2 17. Which of the following situations would allow the assigning of a V code for a principal diagnosis? A. Mother admitted for birth of infant, no complications B. Patient admitted for dialysis C. Patient admitted for metastatic breast cancer with a history of ovarian cancer D. Patient admitted for poisoning with a history of alcoholism 18. A patient was admitted for nausea and vomiting due to gastroenteritis. Which of the following is the correct code reporting and sequencing? A. 787.01, 787.02, 558.9 C. 558.9, 787.01 B. 787.02, 787.03, 558.9 D. 558.9 19. A physician lists positive findings on a purified protein derivative (PPD) test as a secondary diagnosis on the patient’s discharge sheet. How should this listing be coded? A. 795.51 B. 010.95 C. 011.05 D. This listing shouldn’t be coded. 20. A physician lists urosepsis as a secondary diagnosis on a patient’s discharge sheet. How would you code this diagnosis? A. Code it to 790.7. C. Code it to 599.0. B. Code it to 038.9. D. Code 599.0, 038.9. 21. A patient is admitted for metastatic adenocarcinoma of the sacrum from the prostate. A prostatectomy was performed 11 months ago. Which of the following should be reported as the principal diagnosis for this patient? A. V10 C. 198.5 B. 185 D. 170.6 Examination, Lesson 1 87 22. A patient was discharged with a diagnosis of diabetes with nephropathy and chronic renal failure. How many codes would be reported for this patient? A. One B. Two C. Three D. Need more information on the type of diabetes 23. If the physician describes the patient as presently in a manic phase, but has experienced depression in the past, this condition may be coded as A. 296.4X C. 296.6X B. 296.5X D. Need more information 24. Codes 331.9, 332.0, are conditions affecting the _______ system. A. central nervous C. gastrointestinal B. peripheral nervous D. cardiovascular 25. A patient was admitted with an acute exacerbation of chronic obstructive bronchitis and found to be in respiratory failure. Which of the following is the correct coding and sequencing for this case? A. 518.81, 491.21 C. 518.81, 496 B. 491.21, 518.81 D. 493.91, 496, 518.81

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