Question 1

In the ICD-9-CM classification system, a nonfunctioning pacemaker due to the disintegration of the electrodes (leads) would be coded as a(n)

Accepted Answer

The disintegration of electrodes (leads) in a pacemaker is considered a mechanical complication of an internal prosthetic device and would be coded as such in the ICD-9-CM classification system. Choices A, B, and D do not accurately describe this specific situation.

Question 2

Which code represents an HCPCS Level II National Code?

Accepted Answer

HCPCS Level II National Codes are alphanumeric codes that begin with a letter and are followed by four numbers. D0417 is an example of an HCPCS Level II National Code.

Question 3

When coding neoplasms, topography means

Accepted Answer

Topography refers to the site or location of the neoplasm in the body. It is used in conjunction with morphology (cell structure and form) to accurately code neoplasms according to the ICD-10-CM coding system. Variation from normal tissue and extent of spread of the disease are not related to topography.

Question 4

The method of calculating errors in a coding audit that allows for benchmarking with other hospitals, and permits the reviewer to track error by case type, is the

Accepted Answer

The answer of The method of calculating errors in a...

Question 5

In the ICD-9-CM classification system, an esophageal stricture due to a burn received in a house fire several years ago would be coded as a(n)

Accepted Answer

According to the ICD-9-CM classification system, a condition that is the residual effect after the acute phase of an illness or injury has ended is considered as a late effect. Therefore, an esophageal stricture due to a burn received in a house fire several years ago would be coded as a late effect.

Question 6

A radiologist is asked to review a patient's CT scan that was taken at another facility. The modifier -26 attached to the code indicates that the physician is billing for what component of the procedure?

Accepted Answer

The modifier -26 indicates that the physician is billing for the professional component of the procedure. This means that they are interpreting and providing a report of the images, but did not perform the actual scan.

Question 7

Dizziness and blurred vision following ingestion of prescribed Allegra and a glass of wine at dinner would be reported as a(n)

Accepted Answer

The answer of Dizziness and blurred vision following ingestion of...

Question 8

A list or collection of clinical words or phrases with their meanings is a

Accepted Answer

The answer of A list or collection of clinical words...

Question 9

The patient underwent bypass surgery for life-threatening coronary artery disease. With the aid of extracorporeal circulation, the right internal mammary artery was taken down to the left anterior descending artery and saphenous vein grafts were brought from the aorta to the diagonal, the right coronary artery, and the posterior descending artery. What is the correct ICD-9-CM coding for this procedure?

Accepted Answer

The procedure involved a single internal mammary artery bypass and aortocoronary bypass of three vessels using extracorporeal circulation. Therefore, the correct code is D: single internal mammary artery bypass; aortocoronary bypass of three vessels, extracorporeal circulation.

Question 10

The main difference between concurrent and retrospective coding is

Accepted Answer

Concurrent coding is done in real-time while the patient is still in the hospital, while retrospective coding is done after the patient has been discharged. This is the main difference between the two coding methods.

Question 11

A rare malignant tumor often associated with AIDS is

Accepted Answer

Kaposi's sarcoma is a rare malignant tumor that is often associated with AIDS. It presents as skin lesions that may spread to internal organs. It is caused by the herpesvirus HHV-8 and is more common in individuals with weakened immune systems, such as those with AIDS. Glioblastoma multiforme, pheochromocytoma, and melanoma are not specifically associated with AIDS.

Question 12

A patient was discharged from the acute care hospital with a final diagnosis of bronchial asthma. As the coder reviews the record, she notes that the patient was described as having prolonged and intractable wheezing, airway obstruction that was not relieved by bronchodilators and the lab values showed decreased respiratory function. The coder queried the physician to determine whether the code for ________ is appropriate to be added to the final diagnoses.

Accepted Answer

The patient's description indicates that they had prolonged and intractable wheezing, airway obstruction that was not relieved by bronchodilators, and decreased respiratory function. These are all indicative of status asthmaticus, which is a severe and life-threatening exacerbation of asthma. Thus, the appropriate code to add to the final diagnoses is status asthmaticus (J46).

Question 13

Blindness due to an allergic reaction to ampicillin administered 6 years ago would be reported as a(n)

Accepted Answer

The answer of Blindness due to an allergic reaction to...

Question 14

Tachycardia after taking a correct dosage of prescribed Lortab would be reported as a(n)

Accepted Answer

Tachycardia (rapid heart rate) after taking a correct dosage of prescribed Lortab would be classified as an adverse reaction to the drug. An adverse reaction is an unexpected or harmful reaction to a medication that occurs at therapeutic doses. A poisoning refers to an overdose or toxicity from a medication, which would not apply in this scenario since the correct dosage was taken. Late effects refer to long-term consequences of a previous poisoning or adverse reaction, which would not apply in this scenario since the tachycardia is occurring shortly after taking the medication.

Question 15

A patient is seen in the emergency room of an acute care hospital with tachycardia and hypotension. The patient had received an injection of tetanus toxoid (correct dosage) earlier at his primary care physician's office. Which of the following is the appropriate sequencing for this encounter?

Accepted Answer

The patient is experiencing a potential adverse reaction to the tetanus toxoid. The appropriate E code to use in this situation is a therapeutic use E code because the vaccine was given for prophylaxis. The symptoms of hypotension and tachycardia should also be reported. Option A is incorrect because accidental poisoning is not the appropriate code to use in this situation. Option B is incorrect because there is no information to suggest an adverse reaction could not be determined. Option D is incorrect because poisoning is not the appropriate code to use in this situation.

Question 16

Patient Jamey Smith has been seen at Oceanside Hospital three times prior to this current encounter. Unfortunately, because of clerical errors, Jamey's information was entered into the MPI incorrectly on the three previous admissions and consequently has three different medical record numbers. The unit numbering system is used at Oceanside Hospital. Jamey's previous entries into the MPI are as follows: 09/03/04 Jamey Smith MR# 10361 03/10/05 Jamey Smith Doe MR# 33998 07/23/06 Jamie Smith Doe MR# 36723 The next available number to be assigned at Oceanside Hospital is 41369. Duplicate entries in the MPI should be scrubbed and all of Jamey's medical records should be filed under medical record number

Accepted Answer

According to the question, Jamey Smith has three different medical record numbers due to clerical errors. The correct approach is to scrub duplicate entries and file all of Jamey's medical records under the correct medical record number. In this case, the correct medical record number is the first one assigned to Jamey, which is MR# 10361. Therefore, the best choice is option A.

Question 17

According to CPT, antepartum care includes all of the following EXCEPT

Accepted Answer

Antepartum care typically includes initial and subsequent history, physical examinations, and routine chemical urinalysis, but monthly visits up to 36 weeks are not specifically included in the CPT definition of antepartum care.

Question 18

A patient is undergoing hemodialysis for end-stage renal disease in the outpatient department of observation for several hours, at which time the patient is admitted to inpatient care for further workup. The cardiologist diagnoses the patient's problem as unstable angina. What is the principal diagnosis for the acute hospital stay?

Accepted Answer

The patient was admitted to the hospital for further workup and was diagnosed with unstable angina by the cardiologist. Therefore, the principal diagnosis for the acute hospital stay would be unstable angina. The fact that the patient was undergoing hemodialysis for end-stage renal disease and was in outpatient observation prior to admission may be considered comorbidities or contributing factors, but they are not the primary reason for the hospitalization. Heartburn is not mentioned as a diagnosis for the patient, and renal disease is not the principal reason for the hospitalization.

Question 19

The most common type of registry located in hospitals of all sizes and in every region of the country is the

Accepted Answer

The most common type of registry located in hospitals is the cancer registry, which collects and maintains data on cancer cases diagnosed and treated at the hospital. Trauma registries and birth defects registries are also commonly found in hospitals, but they are not as prevalent as cancer registries. AIDS registries may exist in some hospitals, but they are not as common as the other types of registries mentioned.

Question 20

The Cancer Committee at Wharton General Hospital want sto compare long-term survival rates for pancreatic cancer by evaluating medical versus surgical treatment of the cancer. The best source of this data is the

Accepted Answer

The best source of data for comparing long-term survival rates of pancreatic cancer is the cancer registry abstracts. This is because the cancer registry collects and maintains comprehensive data on cancer patients, including treatment methods and outcomes, making it the most reliable source for conducting such comparisons. The disease index, operation index, and master patient index may contain some relevant data, but they are not as comprehensive and specific to cancer patients as the cancer registry.

Exam 1: Registered Health Information Administrator