Question 1

Patient admitted with carotid artery disease and acute cerebral infarction with left hemiparesis, dysphagia, and aphasia. Dysphagia and aphasia have resolved by discharge, but residual hemiparesis remains.

Accepted Answer

The correct codes are 433.11 for carotid artery disease with cerebral infarction and 342.90 for unspecified hemiparesis. Dysphagia and aphasia resolved by discharge, so they are not coded.

Question 2

Patient admitted to the hospital for repair of ventral hernia. Surgery is canceled after chest x-ray revealed lower lobe pneumonia. Patient is placed on antibiotics to treat the pneumonia.

Accepted Answer

The correct answer is A because the patient was admitted for repair of ventral hernia (553.20), but the surgery was canceled after a chest x-ray revealed lower lobe pneumonia (486). The patient was placed on antibiotics to treat the pneumonia (V64.1).

Question 3

Acute respiratory failure due to congestive heart failure. Patient is placed on the ventilator for 3 days following insertion of endotracheal tube.

Accepted Answer

The correct coding sequence is 518.81 for acute respiratory failure, 428.0 for congestive heart failure, 96.71 for continuous invasive mechanical ventilation for less than 96 consecutive hours, and 96.04 for insertion of endotracheal tube.

Question 4

Patient with a diagnosis of aortic valve stenosis and mitral valve regurgitation is admitted for aortic valve replacement. Patient is also under treatment for congestive heart failure. Patient undergoes placement of aortic valve prosthesis with cardiopulmonary bypass.

Accepted Answer

The answer of Patient with a diagnosis of aortic valve...

Question 5

Diverticulitis large bowel with abscess; right hemicolectomy with colostomy performed

Accepted Answer

- 562.11 for diverticulitis with abscess
- 569.5 for unspecified disorder of intestine (useful to provide additional information about the area of the intestine affected)
- 45.73 for open approach to right hemicolectomy
- 46.10 for colostomy creation

Question 6

Aspiration pneumonia with pneumonia due to Staphylococcus aureus. Patient also has emphysema.

Accepted Answer

The answer of Aspiration pneumonia with pneumonia due to Staphylococcus...

Question 7

Atherosclerotic peripheral vascular disease of the lower leg with claudication. Angioplasty of the lower leg artery performed.

Accepted Answer

Atherosclerotic peripheral vascular disease of the lower leg with claudication is classified as 440.21, and angioplasty of the lower leg artery is classified as 39.50.

Question 8

Carpal tunnel syndrome; arthroscopic release of carpal tunnel.

Accepted Answer

The answer of Carpal tunnel syndrome; arthroscopic release of carpal...

Question 9

Meningitis sarcoidosis

Accepted Answer

The answer of Meningitis sarcoidosis
...

Question 10

Patient presents to the outpatient department for a chest x-ray. Physician order lists the following reasons for the chest x-ray: fever and cough, rule out pneumonia. Radiologist reports the chest x-ray is positive for pneumonia.

Accepted Answer

The correct ICD-9-CM code for pneumonia is 486. The other codes listed are for symptoms or unrelated conditions.

Question 11

Acute inferior wall myocardial infarction with unstable angina. Patient also has coronary artery disease and atrial fibrillation.

Accepted Answer

The answer of Acute inferior wall myocardial infarction with unstable...

Question 12

Bleeding esophageal varices with alcoholic liver cirrhosis and portal hypertension. Patient is alcohol dependent. Esophagogastroduodenoscopy for control of hemorrhage.

Accepted Answer

The answer of Bleeding esophageal varices with alcoholic liver cirrhosis...

Question 13

Acute and chronic cholecystitis with cholelithia'sis. Laparoscopic cholecystectomy attempted and converted to open.

Accepted Answer

The correct codes are 574.00 for acute cholecystitis with cholelithiasis, 574.10 for chronic cholecystitis with cholelithiasis, V64.41 for laparoscopic procedure converted to open, and 51.22 for cholecystectomy.

Question 14

Hypertrophic tonsillitis; bilateral tonsillectomy and adenoidectomy

Accepted Answer

The answer of Hypertrophic tonsillitis; bilateral tonsillectomy and adenoidectomy
...

Question 15

Chronic obstructive pulmonary disease with an exacerbation of acute bronchitis

Accepted Answer

The answer of Chronic obstructive pulmonary disease with an exacerbation...

Question 16

Patient is admitted for workup for melena. Laboratory results reveal chronic blood loss anemia. Colonoscopy with biopsy reveals Crohn's disease of the descending colon.

Accepted Answer

The answer of Patient is admitted for workup for melena....

Question 17

Exacerbation of myasthenia gravis resulting in acute respiratory failure. Patient required mechanical ventilation for 10 hours, following endotracheal intubation.

Accepted Answer

- 518.81 (Acute respiratory failure) is the main reason for hospitalization in this case, as it resulted from the exacerbation of myasthenia gravis. 
- 358.01 (Myasthenia gravis with exacerbation) can also be coded as a secondary diagnosis to provide more details about the condition. 
- 96.71 (Continuous invasive mechanical ventilation for less than 96 consecutive hours) is the procedure code for the mechanical ventilation required by the patient for 10 hours. 
- 96.04 (Tracheal intubation) is the procedure code for the endotracheal intubation that was performed.

Question 18

Hypertensive kidney disease, congestive heart failure, and acute systolic heart failure

Accepted Answer

- Hypertensive kidney disease is coded as 403.90, which is an unspecified code for hypertensive chronic kidney disease. 
- Congestive heart failure is coded as 428.0, which is the code for congestive heart failure, unspecified. 
- Acute systolic heart failure is coded as 428.21, which is the code for acute systolic heart failure. 
Therefore, the combination of 403.90, 428.0, and 428.21 is the best choice to accurately represent the mentioned conditions.

Question 19

Gastric ulcer with hemorrhage resulting in acute blood-loss amnia Esophagogastroduodenoscopy performed.

Accepted Answer

The answer of Gastric ulcer with hemorrhage resulting in acute...

Question 20

Extrinsic asthma with status asthmaticus

Accepted Answer

The answer of Extrinsic asthma with status asthmaticus
...

Exam 1: Registered Health Information Administrator