Question 1

Which of the following is coded as an adverse effect in ICD-9-CM?

Accepted Answer

An adverse effect in ICD-9-CM refers to an unintended, harmful reaction to a drug or substance. Tinnitus due to an allergic reaction after the administration of eardrops fits this definition, as it is a harmful reaction to a medication.

Question 2

Which of the following is classified as a poisoning in ICD-9-CM?

Accepted Answer

Syncope due to Contac pills and a three martini lunch is classified as a poisoning in ICD-9-CM because it involves the harmful effects of a drug (Contac pills) and alcohol, which is considered a toxic combination.

Question 3

Jane Moore was admitted to the ambulatory care unit of the hospital for a planned cholecystectomy for cholelithiasis. Shortly before surgery, Jane developed tachycardia, and the surgery was canceled. After a thorough workup for the tachycardia, Jane was discharged. This outpatient admission should be coded in the following sequence:

Accepted Answer

The primary diagnosis should be cholelithiasis since that was the reason for the planned surgery. The V code for canceled surgery should be listed second since the surgery was not performed due to the tachycardia. Tachycardia should be listed as an additional diagnosis.

Question 4

Code 402, Hypertensive Heart Disease, would appropriately be used in which of the following situations?

Accepted Answer

Choice C specifically mentions both hypertensive cardiovascular disease and congestive heart failure, which fits the criteria for assigning code 402 for Hypertensive Heart Disease. The other options either do not mention both conditions or do not provide enough information to support the use of this code.

Question 5

A patient is admitted is alcohol withdrawal suffering from delirium tremens. The patient is a chronic alcoholic and cocaine addict. Which of the following is the principal diagnosis?

Accepted Answer

Delirium tremens is the principal diagnosis as it is a severe and potentially life-threatening manifestation of alcohol withdrawal commonly seen in chronic alcoholics. The patient's cocaine addiction is a comorbidity that may exacerbate the symptoms of delirium tremens but is not the principal diagnosis. Chronic alcoholism and alcohol withdrawal are related to the principal diagnosis but do not specifically encompass the severe manifestation of delirium tremens.

Question 6

A patient is admitted to your hospital 6 weeks post myocardial infarction with severe chest pains. Which is the correct code?

Accepted Answer

The patient is presenting with severe chest pains 6 weeks after a myocardial infarction, indicating a possible new or recurrent episode of acute MI. Code 410.1x (depending on documentation of whether it is an initial or subsequent episode) is the most appropriate code for acute MI. The other options (414.8, 412, 413.0) do not match the clinical presentation of the patient.

Question 7

A 75-year-old female was admitted for repair of a hiatal hernia which was performed on the first day of admission. While recovering, the patient fell out of her bed and sustained a fractured femur which was surgically reduced. Further complications included severe angina for which a cardiac catheterization and PTCA were performed. The principal procedure is

Accepted Answer

The herniorrhaphy (repair of the hiatal hernia) was the reason for admission and the initial procedure performed. While there were complications and additional procedures performed, the herniorrhaphy remains the principal procedure.

Question 8

A nomenclature of codes and medical terms and that provides standard terminology for reporting physicians' services for third-party reimbursement is

Accepted Answer

Current Procedural Terminology (CPT) is the nomenclature of codes and medical terms that provides standard terminology for reporting physicians' services for third-party reimbursement. CPT codes are maintained by the American Medical Association (AMA) and are used by healthcare professionals, payers, and accreditation organizations to describe medical procedures and services. CMIT, SNOP, and DSM are other nomenclatures or classification systems used in healthcare, but they do not specifically pertain to reporting physicians' services for reimbursement purposes.

Question 9

The most widely discussed and debated unique patient identifier is the

Accepted Answer

The use of the patient's Social Security number as a unique patient identifier has been a controversial topic for years due to concerns about privacy and security breaches. However, it is still the most widely discussed and debated option as it would provide a unique identifier that is already familiar to most patients and healthcare providers in the United States.

Question 10

The Level II (national) codes of the HCPCS coding system are maintained by the

Accepted Answer

The Level II codes of the HCPCS coding system are maintained by the Centers for Medicare and Medicaid Services (CMS). The Level II codes are used primarily for durable medical equipment, prosthetics, orthotics, and supplies. The American Medical Association is responsible for maintaining the Level I codes of the HCPCS coding system, also known as Current Procedural Terminology (CPT) codes. The CPT Editorial Panel is responsible for reviewing and updating the Level I codes. The local fiscal intermediary is a Medicare contractor responsible for processing and paying Medicare claims.

Question 11

The Level I (CPT) codes of the HCPCS coding system are maintained by the

Accepted Answer

The Level I (CPT) codes of the HCPCS coding system are maintained by the American Medical Association (AMA).

Question 12

The nursing staff would most likely use which of the following to facilitate aggregation of data for comparison at local, regional, national, and international levels?

Accepted Answer

The answer of The nursing staff would most likely use...

Question 13

A patient with leukemia is admitted for chemotherapy 5 weeks after experiencing an acute myocardial infarction. How will the MI be coded?

Accepted Answer

The answer of A patient with leukemia is admitted for...

Question 14

A service provide by a physician whose opinion or advice regarding evaluation and/or management of a specific problem is requested by another physician is referred to as

Accepted Answer

A consultation is a service provided by a physician at the request of another physician to provide an opinion or advice regarding the evaluation and management of a specific problem. A referral is the process of sending a patient to another provider or specialist for further evaluation or treatment. Risk factor intervention refers to actions taken to reduce a patient's chance of developing a particular disease or health condition. Concurrent care is when a patient receives care from multiple providers at the same time for the same or different conditions.

Question 15

In ICD-9-CM, when an exploratory laparotomy is performed followed by a therapeutic procedure, the coder lists

Accepted Answer

The answer of In ICD-9-CM, when an exploratory laparotomy is...

Question 16

A patient is admitted with pneumonia. Cultures are requested to determine the infecting organism. Which of the following, if present, would alert the coder to ask the physician whether or not this should be coded as gram-negative pneumonia?

Accepted Answer

Pseudomonas is a gram-negative bacteria, while Clostridium, Staphylococcus, and Listeria are gram-positive. Therefore, the presence of Pseudomonas would suggest the need to clarify whether the pneumonia is gram-negative.

Question 17

A physician excises a 3.1-cm malignant lesion of the scalp that requires full-thickness graft from the thigh to the scalp. In CPT, which of the following procedures should be coded?

Accepted Answer

Code for both the excision of the malignant lesion and the full-thickness skin graft to the scalp. The excision and skin graft from the thigh are included in the full-thickness skin graft to the scalp code. Option A only codes for the skin graft and option C adds an additional excision code that is not necessary. Option D is incorrect because code 15000 is for surgical preparation of the recipient site only and does not include the actual graft procedure.

Question 18

The Central Officer on ICD-9-CM, which publishes Coding Clinic, is maintained by the

Accepted Answer

The Central Officer on ICD-9-CM is maintained by the American Hospital Association, and they publish Coding Clinic. This publication provides official coding advice and guidance for using ICD-9-CM and other coding systems. The National Center for Health Statistics is responsible for maintaining and updating the ICD-9-CM and other vital statistics classifications. The Centers for Medicare and Medicaid Services provides guidance on coverage policies and reimbursement for healthcare services. The American Health Information Management Association is a professional organization for health information management professionals but is not directly involved in maintaining the ICD-9-CM or publishing Coding Clinic.

Question 19

A cancer program is surveyed for approval by the

Accepted Answer

The Commission on Cancer of the American College of Surgeons is responsible for accrediting cancer programs in the United States. They establish standards for cancer care and evaluate cancer programs to ensure they meet these standards. The American Cancer Society and State Department of Health may offer support and resources for cancer programs, but do not have the authority to approve them. The Joint Commission on Accreditation of Health care Organizations evaluates a range of healthcare organizations, but does not specialize in cancer programs.

Question 20

Susan Dawn is status post mastectomy (6 weeks) due to carcinoma of the breast. She is admitted to the outpatient clinic for chemotherapy. What is the correct sequencing of the codes?

Accepted Answer

The correct sequencing is to first code for the reason for the encounter, which is chemotherapy (V58.11), followed by the current condition being treated, which is the malignant neoplasm of the breast (174.9).

Exam 1: Registered Health Information Administrator