Deck 25: Complications of Surgical and Medical Care

Question 1

Complications affect only certain body systems.

Answer 1

False

Question 2

A patient is admitted with a urinary tract infection (UTI) resulting from E.coli.The patient has an indwelling Foley catheter following recent radical prostatectomy for cancer.The coder queries the physician regarding the relationship of the UTI and the Foley,and the physician documents that the UTI is caused by the Foley.The patient is morbidly obese with type II diabetes,controlled with insulin.

A)N39.0,B96.29,E66.01,E10.9,Z79.4,Z85.46,Y84.6
B)T83.51xA,N39.0,E66.9,E10.9,Z89.4,Z85.46,Y84.6
C)T83.51xA,N39.0,B96.20,E66.01,E11.9,Z85.46,Y84.6
D)B96.23,T83.51xA,N39.0,E66.01,E11.9,Z79.4,Z85.46,Y84.6

Answer 2

C

Question 3

Patient had an outpatient ERCP for extraction of a common bile duct stone.The patient developed acute abdominal pain and was admitted to rule out post ERCP pancreatitis.Impression: Post ERCP pancreatitis.

A)K91.89,K80.50,K85.9,Y83.8,0FC98ZZ
B)K86.1,K80.51,K91.89,Y83.9,0FC98ZZ
C)K85.1,K80.60,Y84.9,0F998ZZ
D)K85.9,K80.61,Y84.8,0F798ZZ

Answer 3

A

Question 4

Patient had an outpatient surgical procedure this morning and was discharged in stable condition.Patient returns because of inability to void.A Foley catheter is inserted.Diagnosis: Postoperative urinary retention.

A)R33.8,R33.9,Y84.9,0T9B80Z
B)N99.89,R33.9,Y83.9,Y83.9,0T9B70Z
C)N99.0,R33.9,Y84.9,0T9B80Z
D)R33.8,R33.9,Y83.9,0T9B70Z

Question 5

Patient presents with pseudoaneurysm right femoral artery due to recent cardiac cath.

A)I72.4,Y84.0
B)I72.8,Y84.2
C)I97.89,Y84.8
D)I97.89,I72.4,Y84.0

Question 6

The patient had a cerebrovascular accident embolic in nature and was documented by the surgeon as being due to the surgical procedure.The patient initially had been admitted for treatment of coronary artery arteriosclerosis with CABG.The patient is taken to the OR for an open three-vessel aorta to coronary artery using greater saphenous vein.The left greater saphenous vein was harvested via percutaneous approach.Cardiopulmonary bypass is performed during the surgery.

A)I97.820,I25.10,I63.40,Y84.2,021109W,06BS0ZZ
B)I25.10,I97.820,Y83.9,02110AW,06BS3ZZ
C)I25.10,I97.820,I63.40,Y83.2,021209W,06BQ3ZZ,5A1221Z
D)I63.40,I25.10,I97.820,Y83.8,021209W,06BQ3ZZ,5A1221Z

Question 7

Codes under subcategory T86 are used ____.

A)only for complications of transplanted organs
B)only for rejection of transplanted organs
C)for both complications and rejection of transplanted organs
D)for none of the above reasons

Question 8

Patient is admitted for treatment of primary liver cancer.Patient had a liver transplant 2 years ago.Patient has a past medical history of hypertension and COPD and is a former alcoholic,now in remission.Patient has been sober for 10 years.

A)T86.49,C80.2,C22.8,F10.20,Y83.0
B)T86.49,C80.2,C22.9,I10,J44.1,F10.20,Y83.0
C)C80.2,T86.49,C22.9,J44.1,F10.21,Y83.0
D)T86.49,C80.2,C22.8,I10,J44.9,F10.21,Y83.0

Question 9

A patient had a kidney transplant 2 years ago but developed ESRD again due to transplant failure.The patient has been on dialysis for the past year.The patient is now complaining of SOB and edema and is admitted for fluid overload and hemodialysis.Dialysis is performed multiple times during this stay.

A)E87.70,T86.12,N18.6,Z99.2,Y83.0,5A1D60Z
B)N18.6,Z99.2,Z94.0,E87.70,3E1M39Z
C)N18.6,T86.12,Z99.2,Y83.0,5A1D60Z
D)E87.70,Z99.2,N18.6,Z94.0,5A1D60Z

Question 10

There is a time limit for complications to occur.

Question 11

Patient with decreased visual acuity due to corneal graft rejection.Admitted for cadaver keratoplasty (external) of the left eye.

A)T86.840,Y83.0,H54.7,08R9XKZ
B)T85.318A,Y83.0,H54.7,08R93KZ
C)T86.840,Y83.0,H54.7,08R83KZ
D)T86.841,Y83.0,H54.7,08R8XKZ

Question 12

Patient was hospitalized 1 month prior to this admission.During that admit,she was diagnosed with COPD and placed on a ventilator;her sputum was positive for Pseudomonas aeruginosa.She is admitted today with another case of pneumonia.

A)J98.851,J18.9,J44.9
B)J18.9,J44.9
C)J95.851,486,B96.5
D)J44.9,J18.9,J95.851,B96.5

Question 13

The term dehiscence means ____.

A)breathing in a foreign object
B)opening a surgical wound
C)caused by medical treatment
D)small amount of urine

Question 14

Leakage of peritoneal dialysis catheter.Patient is on dialysis for end-stage renal disease.Peritoneal catheter was removed (percutaneous removal of infusion device from peritoneal cavity).Patient has a history of hypertension and type II diabetes with associated neuropathy.

A)I12.0,N18.6,T85.631,I12.0,E11.40,Z99.2,Y84.1,0WPGX0Z
B)T85.631A,I12.0,N18.6,E11.40,Z99.2,Y84.1,0WPG33Z
C)T82.43A,I11.2,E11.40,Z99.2,Y84.1,0WPG33Z
D)T82.43xA,I112.0,E11.40,Z99.2,Y84.1,0WPGX0Z

Question 15

Patient was admitted for TAH (removal of uterus and cervix) due to symptomatic fibroids.The physician documented in the operative report that a complication had occurred in which the bladder was accidentally lacerated during the procedure and was repaired with suture.

A)D25.9,N99.72,0UT97ZZ,0UTC0ZZ,0TQB0ZZ
B)D25.9,N99.71,0UT90ZZ,0UTC0ZZ,0TQB0ZZ
C)D25.9,N99.72,0UT90ZZ,0TQB7ZZ
D)D25.9,N99.71,0UT97ZZ,0TQB7ZZ

Question 16

Patient admitted with an abscess due to Streptococcus of abdominal surgical wound,initial encounter.Cultures were positive for Streptococcus.The abscess of the skin was incised and drained.

A)T81.4,A49.1,Y84.9,0H97X0Z
B)T81.4,L02.211,B95.5,Y84.9,0H97Z0Z
C)T81.4xxA,L02.211,B95.5,Y83.9,0H97XZZ
D)T81.4xxA,A49.1,Y83.9,0H97XZZ

Question 17

A patient had a pancreatectomy for chronic pancreatitis and has now developed postpancreatectomy diabetes mellitus along with diabetic nephrosis.

A)E09.69,E89.1,E13.21
B)E08.21,E89.1,Z90.410
C)E89.1,E13.21,Z90.410
D)E89.1,E08.21,E13.21

Question 18

Patient with a history of a kidney transplant comes to the ER with gastroenteritis.His history is positive for CKD,stage 2,and hypertension.

A)T86.10,I12.9,Z94.0
B)K52.9,I10,5N18.2,Z94.0
C)T86.10,I10,N18.2
D)K52.9,I12.9,N18.2,Z94.0

Question 19

During a posterior lumbar fusion at L4-L5 for spinal stenosis,the surgeon accidentally nicks the dura.The fusion was performed via an open posterior procedure on the posterior column using morselized allograft.Patient has a history of asthma for which he takes meds p.r.n.

A)G97.41,M4.07,Y83.8,Y92.234,0SG0071
B)M48.06,G97.41,J45.909,Y83.2,Y92.234,0SG0071
C)G97.41,J45.998,Y83.8,Y92.234,0SG0071
D)M48.06,G97.41,J45.998,Y83.2,0SG0071

Question 20

To aspirate means to ____.

A)breathe in a foreign substance
B)eat
C)drink
D)sleep

Question 21

Displacement of an insulin pump,initial encounter;patient has type 1 DM: __________

Question 22

Leaking silicone breast implant,initial visit: __________

Question 23

Code only complications that occur within 2 weeks of a transplant surgery.

Question 24

When looking for a complication code in the Index,the coder should first look under the ____________________.

Question 25

What does DVT stand for?

Question 26

Pneumonitis due to organism growing in ventilation (air conditioning) system: __________

Question 27

When no entry is found under the main term for the condition,the coder should refer to the main term ____________________.

Question 28

Codes for complications may be located in the chapter for specified body sites.

Question 29

NSTEMI following laparoscopic appendectomy for acute appendicitis.Physician documents that the NSTEMI was due to the procedure: __________

Question 30

Mechanical complications are related to ____________________ malfunctions.

Question 31

Patient with acute osteomyelitis right femur due to infected right knee joint replacement,initial encounter: __________

Question 32

Patient with an intestine transplant with diverticulitis of the intestinal graft: __________

Question 33

Mechanical complication of gastrostomy: __________

Question 34

Patient has subclavian vein thrombosis due to PICC: __________

Question 35

Rejection of heart transplant confirmed by left percutaneous ventricular biopsy: __________

Question 36

If the documentation is unclear whether the diagnosis was the result of a procedure or condition,a physician query should be initiated.

Question 37

How often are code Z94.0 and a T86.1- code used together?

Question 38

Coding complications always imply that poor care has been delivered.

Question 39

What are some examples of procedures resulting in complications that occur during medical care and not during surgery?

Question 40

Iatrogenic is a term used to signify that a condition is a result of treatment.

Question 41

A patient comes to the hospital with acute appendicitis and is taken to the OR for an open appendectomy.During the course of the surgery,the liver is accidentally lacerated and repaired.The patient recovers without any ill effects.__________

Question 42

A patient comes to the hospital with chronic cholecystitis,and a laparoscopic cholecystectomy is performed.The patient's bowel function was slow to return,and on day 3 the patient developed a post-operative ileus.__________