Question 1

Patient was found at home in a hypoglycemic coma. This patient had never been diagnosed as being diabetic.

Accepted Answer

The patient's presentation suggests that they have diabetes. Code 251.0 is used to report the diagnosis of diabetes mellitus without mention of complication.

Question 2

Anemia due to end-stage renal disease, patient treated for anemia

Accepted Answer

The answer of Anemia due to end-stage renal disease, patient...

Question 3

Cooley's anemia

Accepted Answer

Cooley's anemia is classified as 282.49 in the ICD-10-CM.

Question 4

Severe malnutrition, percutaneous endoscopic gastrostomy

Accepted Answer

The ICD-9-CM code for severe malnutrition is 261, and the procedure code for percutaneous endoscopic gastrostomy is 43.11.

Question 5

Mild mental retardation due to old viral encephalitis

Accepted Answer

The answer of Mild mental retardation due to old viral...

Question 6

Anxiety with depression

Accepted Answer

The answer of Anxiety with depression
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Question 7

Sickle cell pain crisis

Accepted Answer

282.62 is the ICD-9-CM code for sickle cell pain crisis.

Question 8

Male patient admitted with gastrointestinal hemorrhage resulting in acute blood loss anemia. Colonoscopy and Esophagogastroduodenoscopy fail to reveal source of bleed.

Accepted Answer

- 578.9 (Unspecified Gastrointestinal Hemorrhage)
- 285.1 (Acute blood loss anemia)
- 45.13 (Esophagogastroduodenoscopy with biopsy)
- 45.23 (Colonoscopy with biopsy)

The patient's primary diagnosis is gastrointestinal hemorrhage (578.9), and the acute blood loss anemia (285.1) is a result of this. Both colonoscopy and Esophagogastroduodenoscopy fail to reveal the source of the bleed, so codes 45.13 and 45.23 (endoscopic biopsies) are also appropriate.

Question 9

Delirium tremens with alcohol dependence

Accepted Answer

Delirium tremens is coded to 291.0, and alcohol dependence is coded to 303.90.

Question 10

Epilepsy and paraplegia as residuals of a head injury suffered 5 years ago

Accepted Answer

Epilepsy is coded to 345.91, paraplegia is coded to 344.1, and head injury is coded to 907.0.

Question 11

Chronic paranoia due to continuous cocaine dependence. Drug rehabilitation 'provided.

Accepted Answer

- 297.1: This code represents delusional disorder, which is characterized by non-bizarre delusions (i.e. beliefs that are not true but are plausible) and otherwise normal behavior. Chronic paranoia would fit under this diagnosis.
- 304.21: This code represents cocaine dependence. The description specifically mentions "continuous cocaine dependence", indicating that the patient has a significant problem with this substance.
- 94.64: This code represents rehabilitation services. The patient is receiving treatment for their drug dependence, which would include therapy for their chronic paranoia as well. 
Therefore, option B is the best fit for this scenario.

Question 12

Patient is a type II diabetic with a diabetic cataract. Patient has phacoemulsification of the cataract with synchronous insertion of lens.

Accepted Answer

- 250.50 for type II diabetes without mention of complication
- 366.41 for diabetic cataract
- 13.41 for phacoemulsification of cataract
- 13.71 for synchronous insertion of lens.

Question 13

Psychogenic paroxysmal tachycardia

Accepted Answer

The ICD-9 code 316 refers to "Psychogenic disorders," and 427.2 refers to "Paroxysmal tachycardia."

Question 14

Latent schizophrenia, chronic with acute exacerbation

Accepted Answer

The answer of Latent schizophrenia, chronic with acute exacerbation
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Question 15

A 5-year-old female is admitted to ambulatory surgery with chronic otitis media. Patient has bilateral myringotomy with insertion of tubes.

Accepted Answer

The correct ICD-9-CM code for chronic otitis media is 382.9. The procedure code for myringotomy with insertion of tubes is 20.01, and since the procedure is bilateral, the code 20.01 is listed twice.

Question 16

Thrombocytopenia, purpura; splenectomy

Accepted Answer

Thrombocytopenia is assigned code 287.30, which is the default code for unspecified thrombocytopenia. Purpura is assigned code 287.4, and splenectomy is assigned code 41.5. The combination of these codes is best represented by option D. Code 287.8 (other specified hemorrhagic conditions) and 287.9 (unspecified hemorrhagic conditions) are not specific enough to capture the diagnosis of thrombocytopenia and purpura. Code 41.42 (open and other total splenectomy) is not appropriate because the procedure mentioned in the scenario is splenectomy without specifying whether it is total or partial.

Question 17

Aplastic anemia secondary to chemotherapy administered for multiple myeloma.

Accepted Answer

Aplastic anemia is coded to 284.89. Multiple myeloma is coded to 203.00. Chemotherapy is coded to E933.1.

Question 18

Alzheimer's disease with dementia

Accepted Answer

The answer of Alzheimer's disease with dementia
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Question 19

Sickle cell anemia with crisis

Accepted Answer

Sickle cell anemia with crisis is coded as 282.62. The crisis indicates an acute exacerbation or worsening of the condition. Codes 282.61 and 282.63 are for sickle cell anemia without crisis and sickle cell trait, respectively. Code 282.69 is for other specified hemoglobinopathies, and would not be appropriate for sickle cell anemia with crisis.

Question 20

Pernicious anemia

Accepted Answer

Pernicious anemia is coded as 281.0, which is a specific code for vitamin B12 deficiency due to intrinsic factor deficiency. Codes 280.8 and 281.1 are more general codes for anemia, while code 280.9 is for unspecified iron deficiency anemia.

Exam 1: Registered Health Information Administrator