Question 1

Patient suffered dizziness as a result of taking prescribed Phenobarbital. Patient took medication with beer.

Accepted Answer

The patient is experiencing dizziness as a result of taking Phenobarbital, so code 967.0 (Drug-induced headache, not elsewhere classified) is appropriate. Additionally, the patient took the medication with alcohol (beer), so code 980.0 (Toxic effect of alcohol, unspecified) is also appropriate. Code 780.4 (Dizziness and giddiness) describes the patient’s presenting symptom, and codes E851 (Accidental poisoning by barbiturates, sequela) and E860.0 (Alcohol dependence, uncomplicated) describe the underlying causes of the patient’s symptoms.

Question 2

Fracture of the medial malleolus due to fall down steps. Fracture treated with closed reduction.

Accepted Answer

- 824.0 is the correct code for fracture of medial malleolus
- E880.9 is for the external cause (fall down steps)
- 79.06 is the correct code for closed reduction of fracture of lower leg.

Question 3

The patent is being admitted for a preoperative EKG on an outpatient basis. He is scheduled to have an elective cholecystectomy tomorrow for chronic cholecystitis and cholelithiasis. EKG reveals atrial flutter.

Accepted Answer

The patient requires the codes for preoperative evaluation (V72.81) and atrial flutter (427.32). Chronic cholecystitis and cholelithiasis are already included in the planned procedure code (51.23).

Question 4

Patient was admitted from the nursing home in acute respiratory failure that was due to congestive heart failure. Chest x-ray also showed pulmonary edema. Patient was intubated and placed on mechanical ventilation and expired the day after admission.

Accepted Answer

The answer of Patient was admitted from the nursing home...

Question 5

Third-degree burn to thigh and second-degree burn to foot. Patient was burned by hot liquid.

Accepted Answer

The correct codes are 945.36 for third-degree burn of the thigh, 945.22 for second-degree burn of the foot, and E924.0 for burns caused by hot liquid.

Question 6

Closed head injury, patient was a passenger in a motor vehicle involved in a head-on collision with another motor vehicle.

Accepted Answer

The correct codes are 959.01 for closed head injury and E812.1 for a passenger in a motor vehicle involved in a head-on collision.

Question 7

Patient was admitted with third-degree burn of upper back which involved 20% of his body surface. There was an explosion and fire at his home.

Accepted Answer

- 942.34: Third degree burns of back involving 20-29% of body surface, which is the correct code for the patient's burn.
- 948.22: Encounter for care and management of burn of 3rd degree of back, also correct for the patient's visit.
- E890.3: The external cause code for the patient's injury, which accurately describes an explosion and fire at home.

Question 8

Pain in hip due to displaced hip prosthesis. Patient is admitted and undergoes revision of hip prosthesis.

Accepted Answer

The correct ICD-9-CM code for a mechanical complication of an internal orthopedic device, implant, or graft is 996.49. The procedure code for the revision of a hip prosthesis is 81.53.

Question 9

Female, 76 years old, admitted with tachycardia due to theophylline toxicity.

Accepted Answer

The answer of Female, 76 years old, admitted with tachycardia...

Question 10

Elderly man was admitted through the emergency department for severe urinary retention. Upon study, it was determined that his hypertension was uncontrolled (215/108). Prior medical records show admission 8 weeks ago for the same problem. As per conditions on previous admission, his BPH is complicated by acute cystitis. He is noncompliant with medications. Medication for the hypertension was immediately started and his hypertension was quickly brought under control. Urinary retention was relieved by placement of a Foley

Accepted Answer

The answer of Elderly man was admitted through the emergency...

Question 11

Screening examination for lung cancer

Accepted Answer

V76.0 is the correct code for a screening examination for lung cancer. V72.82 is for pre-operative examination, 162.9 is for malignant neoplasm of bronchus, and V72.5 is for normal exam results.

Question 12

Patient admitted for observation for head injury following a fall. Patient also suffered a minor laceration to the forehead. Head injury was ruled out.

Accepted Answer

The correct coding for this scenario includes V71.4 for observation for a suspected condition not found (head injury ruled out), 873.42 for the minor laceration to the forehead, and E888.9 for the fall.

Question 13

Post-operative hemorrhage resulting in acute blood-loss anemia

Accepted Answer

The code for post-operative hemorrhage is 998.11 and the code for acute blood-loss anemia is 285.1. Therefore, the correct combination is C, which includes both codes. Code 997.72 is for surgical complications, not specifically hemorrhage, and code 999.1 is for other/unspecified complications of medical care, which is not the primary issue in this scenario. Code 998.11 is the only code that specifically addresses the hemorrhage, which is the primary issue in this scenario.

Question 14

A female patient was admitted with uncontrolled type II diabetes. Patient also had an abscessed diabetic ulcer of the foot that was treated with incision and drainage. Culture and sensitivity of abscess shows growth of Staphylococcus aureus, methicillin resistant. Patient was started on the appropriate antibiotic. Patient is on oral as well as injectional insulin for control of diabetes.

Accepted Answer

The answer of A female patient was admitted with uncontrolled...

Question 15

Urinary retention requiring insertion of Foley catheter

Accepted Answer

Urinary retention requiring insertion of Foley catheter is coded as 788.20 (Urinary retention, not elsewhere classified) and 57.94 (Insertion of indwelling urinary catheter).

Question 16

Laceration of left wrist with injury to radial nerve as a result of an accident with embedded glass. Wrist laceration repaired with sutures.

Accepted Answer

- 881.12 for laceration of left wrist with damage to nerves, which includes injury to radial nerve 
- 955.3 for injury due to embedded glass 
- E920.8 for the place of occurrence (in this case, it could be "accident involving glass" or something similar) 
- 86.59 for closure of the wrist laceration with sutures.

Question 17

A 32-year-old female known to be HIV positive was admitted with lesions of the anterior trunk. Excisional biopsies of the skin lesions were positive for Kaposi's sarcoma. Further examination revealed thrush.

Accepted Answer

The patient is HIV positive and has skin lesions that are positive for Kaposi's sarcoma, which is commonly seen in HIV patients. Furthermore, the patient has thrush, which is also common in HIV patients. Therefore, the correct code choices would be for HIV (042), Kaposi's sarcoma (176.0), thrush (112.0), and HIV-related skin disorders (86.11). Option A includes herpes (686.00) which is not mentioned in the scenario. Option C includes abnormal Papanicolaou smear of cervix (795.71) and option D includes genital warts (528.9), which are not relevant to the scenario.

Question 18

Admission for colostomy takedown. Takedown performed.

Accepted Answer

The correct coding for a colostomy takedown is V55.3, which indicates the attention to an artificial opening of the digestive system, specifically a colostomy, and 46.52, which is the procedure code for the takedown of a colostomy.

Question 19

Gunshot wound to abdomen with moderate laceration of liver. Patient was assaulted with a pistol.

Accepted Answer

The correct ICD-10-CM codes for a gunshot wound to the abdomen with moderate laceration of the liver due to an assault with a pistol are:

864.13 - Injury to liver, without mention of open wound into cavity (moderate laceration)
E965.0 - Assault by handgun, initial encounter (assault with a pistol)

Option A is incorrect because it indicates an unspecified injury to the liver without specifying the severity of the laceration. 
Option B is incorrect because it indicates an unspecified injury to the liver, whereas the question specifically states that the liver laceration is moderate. 
Option C is incorrect because it indicates an unspecified injury to the liver without specifying the severity of the laceration, and also specifies an intent to injure with unspecified means.

Question 20

Patient admitted with fever due to bacteremia.

Accepted Answer

The answer of Patient admitted with fever due to bacteremia.
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Exam 1: Registered Health Information Administrator