Medical Coding ICD-10
1. This 60-year-old patient was admitted with emphysematous nodules. A thoracoscopic wedge resection was performed in the left lung to remove the lung nodules. A resection was done in the upper and lower lobes. Which of the following answers is correct? (Points : 2)
J98.4, 32666, 32667
J43.9, 32666
J98.4, 32505
J43.9, 32666, 32667
Question 2. 2. A neonatal patient is brought to the operating room for repair of complete transposition of the great arteries under cardiopulmonary bypass. The infant is in critical condition and may not survive. Assign the correct diagnosis codes and CPT codes to report the administration of anesthesia, including physical status, Level I and II modifiers, and qualifying conditions for this procedure. (Points : 2)
Q20.3, 00562–AA–23, 99100
Q20.1, 00561–AD–P5, 99140
Q20.3, 00561–AA–P5
Q20.3, 00563–AA–P5, 99100, 99140
Question 3. 3. A 69-year-old patient was hit by a car, causing intra-thoracic trauma and hemorrhage. The patient was taken directly from the Emergency Department to the operative suite where the chest was opened and hemorrhage was controlled, but the patient’s heart stopped. Open heart massage was performed but the patient expired before the patient could be admitted. Assign the appropriate CPT code(s) and any required modifier(s) to report this service. (Points : 2)
32110-CA
32110, 32160
32160-CA
32110-CA, 32160-CA
Question 4. 4. A non-Medicare patient with carcinoma of the oral cavity and lower lip is receiving daily intramuscular injections of the interferon alfa-2a (3 million units) in the outpatient cancer center. Which of the following will be reported for this service? The payer does accept HCPCS Level II codes for drugs. (Points : 2)
Z51.12, I49.8, 96401, J9213
C14.8, 96372, J9213
C06.9, C00.2, 96372
Z51.12, 96549
Question 5. 5. An elderly patient has an abscess formation around a pacemaker pocket on his chest wall that requires that the device be removed and the pocket reformed in another location. Which of the following code sets is appropriate for this outpatient surgical service? (Points : 2)
T82.7XXA, L02.219, 33222
L02.219, 33222
T82.7XXA, 33223
T82.857A, L02.219, 33999
Question 6. 6. Assign the appropriate ICD-10-CM diagnosis code for aspiration pneumonia due to inhalation of food. (Points : 2)
J15.9
J69.0
J18.9
J69.1
Question 7. 7. A hospital-based pediatric clinic is treating a newborn with talipes equinovarus by manipulation and short leg casting. Which of the following code sets is reported for a visit where the condition is evaluated with a -problem-focused history and examination and parents’ questions are answered, followed by foot and ankle manipulation and replacement of the plaster cast? (Points : 2)
Q66.6, 29450
M21.549, 29405
Q66.0, 29405
...
Medical Coding ICD-101. This 60-year-old patient was admitted .docx
1. Medical Coding ICD-10
1. This 60-year-old patient was admitted with emphysematous
nodules. A thoracoscopic wedge resection was performed in the
left lung to remove the lung nodules. A resection was done in
the upper and lower lobes. Which of the following answers is
correct? (Points : 2)
J98.4, 32666, 32667
J43.9, 32666
J98.4, 32505
J43.9, 32666, 32667
Question 2. 2. A neonatal patient is brought to the operating
room for repair of complete transposition of the great arteries
under cardiopulmonary bypass. The infant is in critical
condition and may not survive. Assign the correct diagnosis
codes and CPT codes to report the administration of anesthesia,
including physical status, Level I and II modifiers, and
qualifying conditions for this procedure. (Points : 2)
Q20.3, 00562–AA–23, 99100
Q20.1, 00561–AD–P5, 99140
Q20.3, 00561–AA–P5
Q20.3, 00563–AA–P5, 99100, 99140
Question 3. 3. A 69-year-old patient was hit by a car, causing
intra-thoracic trauma and hemorrhage. The patient was taken
directly from the Emergency Department to the operative suite
where the chest was opened and hemorrhage was controlled, but
the patient’s heart stopped. Open heart massage was performed
but the patient expired before the patient could be admitted.
Assign the appropriate CPT code(s) and any required
modifier(s) to report this service. (Points : 2)
2. 32110-CA
32110, 32160
32160-CA
32110-CA, 32160-CA
Question 4. 4. A non-Medicare patient with carcinoma of the
oral cavity and lower lip is receiving daily intramuscular
injections of the interferon alfa-2a (3 million units) in the
outpatient cancer center. Which of the following will be
reported for this service? The payer does accept HCPCS Level
II codes for drugs. (Points : 2)
Z51.12, I49.8, 96401, J9213
C14.8, 96372, J9213
C06.9, C00.2, 96372
Z51.12, 96549
Question 5. 5. An elderly patient has an abscess formation
around a pacemaker pocket on his chest wall that requires that
the device be removed and the pocket reformed in another
location. Which of the following code sets is appropriate for
this outpatient surgical service? (Points : 2)
T82.7XXA, L02.219, 33222
L02.219, 33222
T82.7XXA, 33223
T82.857A, L02.219, 33999
Question 6. 6. Assign the appropriate ICD-10-CM diagnosis
code for aspiration pneumonia due to inhalation of food. (Points
: 2)
J15.9
J69.0
J18.9
3. J69.1
Question 7. 7. A hospital-based pediatric clinic is treating a
newborn with talipes equinovarus by manipulation and short leg
casting. Which of the following code sets is reported for a visit
where the condition is evaluated with a -problem-focused
history and examination and parents’ questions are answered,
followed by foot and ankle manipulation and replacement of the
plaster cast? (Points : 2)
Q66.6, 29450
M21.549, 29405
Q66.0, 29405
Q66.0, 99212–25, 29450
Question 8. 8. A 32-year old female has recently had surgery for
melanoma of the right lower leg, Clark level IV> She had no
other signs of metastasis or adenopathy. Under general
anesthesia, a sentinel node biopsy of the deep axillary nodes
was performed with a gamma counter probe. An injection of
isosulfan blue dye was performed and the nodes followed
carefully to the single-bright-blue node. This node was excised
and sent for frozen section, which proved to be negative for
melanoma. Before the procedure, the radiologist performed a
lymphoscintigraphy. Which of the following code sets would
the surgeon report. (Points : 2)
C44.691, 38525
C4A.71, 38525, 38792
C4A.71, 38525, 38792–51, 78195
C43.9, 38525, 38790–51
Question 9. 9. What code(s) is/are assigned for a patient
4. receiving home care after a kidney transplant? (Points : 2)
Z48.29
Z48.298, Z94.0
N18.6
Z94.0
Question 10. 10. What would be the appropriate ICD-10-CM
code for lumbar stenosis? (Points : 2)
M48.00
M48.06
M48.07
M48.26
Question 11. 11. Dr. Smith sent a patient to observation care at
the local hospital following his visit to the nursing facility. The
patient was admitted for observation to rule out stoke due to a
change in mental status. The next morning, Dr. Smith left town,
and his partner, Dr., Johnson, admitted the patient to inpatient
care because of sudden worsening symptoms. The patient
expired later the same day. Assuming documentation guidelines
were met, how would E/M services for these two physician be
coded? (Points : 5)
Dr. Smith: 99315; 99219; Dr. Johnson: 99236
Dr. Smith: 99219; Dr. Johnson: 99217, 99236
Dr. Smith: 99219; Dr. Johnson: 99236
Dr. Smith: 99315; 99222; Dr. Johnson: 99238
Question 12. 12. The following documentation is from the
health record of a 3-year-old child.
Parents bring their 3-year-old boy, who was born with
hydrocephalus, to the pediatric neurology clinic at Unive3rsity
Hospital to have the child evaluated by the pediatric neurologist
5. and have his VP shunt lengthened to accommodate a growth
spurt. Their pediatrician requested a consultation to evaluate
the shunt and replace the peritoneal catheter if needed.
Outpatient surgery had been previously scheduled tentatively
pending this evaluation for the afternoon.
The catheter used in the shunt was removed and replaced in the
outpatient surgery suite following a follow-up consultation,
which included a detailed interim history, a detailed
examination, and medical decision making of moderate
complexity. Findings documented in the consultation include
“Assessment: Shunt valve malfunction requiring replacement”.
The VP shunt valve was replaced along with a new peritoneal
catheter in a longer length.
Which of the following code sets will be reported for this
service? (Points : 5)
Z45.41, 62230
T8503XA, Q03.9, 62230
Q03.9, Z45.41, 62225
Q03.9, 62230
Question 13. 13.
This 21-month old male presents to the Emergency Department
with nausea and vomiting since 10 pm last night, at least 8
times, which is nonbloody but bilious. Temp of 39.8 since last
night. He has a history of Tetralogy of Fallot, s/p repair 2
months ago. He has known immunodeficiency, laryngomalacia,
and a gastrostomy tube. After examination, working
differential diagnoses are acute gastroenteritis, bacteremia, or
possible septicemia. Symptoms similar to episode about 1
month ago that was determined to be bacteremia with G-tube
site infection. The patient is treated with Zofran 2 mg IV,
followed by Ceftriaxone 600 mg IV. The patient is discharged
after resolution of vomiting and fever. Diagnosis listed as acute
6. gastroenteritis.
Assign the correct ICD-10-CM codes for the facility services
provided today.
(Points : 5)
D84.9, K52.9, Q31.5, Z87.74, Z93.1
D84.9, K52.9, Q31.5, Z98.89, Z93.1
D84.9, K52.9, Q33.5, Z84.74, Z98.89, Z93.1
D84.9, K52.9, Q31.5, Z84.74, Z98.89
Question 14. 14. A 48-year-old man came in to the emergency
department complaining of vomiting material resembling coffee
grounds several times within the past hour. He has abdominal
pain and has been unable to eat for the past 24 hours. He is
dizzy and lightheaded. Two stools today have been black and
tarry. While in the emergency department, he vomited bright-
red blood and some material resembling coffee grounds. A
nasogastric tube was inserted by the ED physician and attached
to suction. An abdominal exam showed a fluid wave consistent
with ascites. CBC and clotting studies were drawn. A detailed
history and physical exam with high-complexity medical
decision making were documented. A GI consultant was called
and the patient was taken to the Endoscopy for further
evaluation of upper GI bleeding. Diagnosis: Hematemesis, rule
out esophageal varices; blood loss anemia, acute; ascites.
Which of the follow is the correct diagnosis and CPT procedure
assignment for the independent ED physician? (Points : 5)
K92.0, D62, R18.8, 99285, 43752
K92.0, R10.9, R42, 99284-25, 91105
R18.0, K92.0, D50.0, 99284, 43752
K92.0, D62, R18.8, 99284-25, 43752
7. Question 15. 15. The following documentation is from the
health record of a 39-year-old female patient.
This 39-year-old female was diagnosed with breast cancer 2
years ago. At that time she had a mastectomy performed, with
no evidence of metastases to the lymph nodes. About 8 months
ago, metastases were found in her liver. The patient was given
chemotherapy. She has been losing weight and developing
increased fatigue. Patient was referred to hospice care program,
with a life expectancy of 4 to 6 months. Progressive weight
loss due to loss of appetite led to cachexia and program of home
intravenous hyperalimentation. Progressive, unrelenting
abdominal pain led to chronic use of analgesics. Patient is
awake, alert, and desires to spend more time with family.
Progressive weakness and dropping hemoglobin led to the
decision to transfuse the patient every 2 weeks with 2 units of
packed cells. Patient is stable and more comfortable on this
regimen.
What are the correct diagnosis codes assigned in this case?
(Points : 5)
D63.0, D64.81, C78.7, Z85.3, T45.1X5
D64.9, C78.7, Z85.3, T45.1X5
D63.0, C78.7, Z85.3, T45.1X5
D64.9, C78.7, Z85.3
Question 16. 16. The patient is a four-year-old male with acute
lymphocytic leukemia who has had a fever for the last 24
hours. It has been nine days since his last chemotherapy, which
8. was his first. A comprehensive history is documented. On
examination, the skin over his Hickman site is extremely red
and starting to break down. No other abnormal findings are
noted in the comprehensive exam. Labs show that the patient is
not neuropenic. The physician lists the diagnoses as : ALL not
in remission, infected Hickman. The patient is given 770 mg of
Ceptz over 10 minutes through a new peripheral IV site and
admitted for continued treatment. Medical decision making is
moderate.
What code set is reported for the services of the emergency
physician? (Points : 5)
C91.00, T827XXA, R50.9, 99284-25, 96374
T80218A, Y83.8, 99284
C91.00, T8579XA, R50.81, 99285
C91.00, T80219A, 99285-25, 96374
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