Question 1

Bleeding prolapsed internal hemorrhoids and chronic constipation. Patient is admitted for

Accepted Answer

The answer of Bleeding prolapsed internal hemorrhoids and chronic constipation....

Question 2

Bilateral sensorineural conductive hearing loss

Accepted Answer

The answer of Bilateral sensorineural conductive hearing loss 
...

Question 3

Crystal has been vomiting for 24 hours with complaint of right lower quadrant pain. Examination is suspicious for acute appendicitis. Crystal is taken to surgery and laparoscopic appendectomy is carried out. Pathological diagnosis is consistent with acute appendicitis.

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Question 4

Patient is treated for congestive heart failure with pleural effusion. A therapeutic

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Question 5

Dale is admitted with emphysematous nodules. He undergoes, without complication, a wedge resection of the right upper lobe. Dale developed atelectasis post-operatively that required monitoring with portable chest x-rays and extended his length of stay.

Accepted Answer

Emphysematous nodules are classified to ICD-10-CM code J43.9. Dale’s post-operative complication, atelectasis is coded to J98.11, while the wedge resection of the right upper lobe is coded to 0B515ZZ (ICD-10-PCS). There is no code for monitoring with portable chest x-rays. 
A) Code 518.89 is used to report other diseases of the respiratory system, code 997.3 is used to report complication of surgical and medical care that is not elsewhere classified and code 32.3 is used to report pharyngitis. There is no code to report Dale’s medical conditions.
B) Code 518.89 is used to report other diseases of the respiratory system, code 997.3 is used to report complication of surgical and medical care that is not elsewhere classified, code 518.0 is used to report pulmonary collapse and code 32.29 is used to report other forms of pneumonia. There is no code to report emphysematous nodules.
C) Code 492.8 is used to report other emphysema and chronic obstructive pulmonary disease, code 997.3 is used to report complication of surgical and medical care that is not elsewhere classified, code 518.0 is used to report pulmonary collapse and code 32.29 is used to report other forms of pneumonia. These codes correctly report Dale’s medical conditions and complication.
D) Code 518.89 is used to report other diseases of the respiratory system, code 518.0 is used to report pulmonary collapse and code 32.29 is used to report other forms of pneumonia. There is no code to report emphysematous nodules or the post-operative complication of atelectasis.

Question 6

Frank has been diagnosed with sick sinus syndrome and is being admitted for dual chamber pacemaker and leads insertion. Frank also has type II diabetes on oral medication as well as insulin regimen. Surgery is carried out without complication.

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The answer of Frank has been diagnosed with sick sinus...

Question 7

Diabetic macular or retinal edema

Accepted Answer

Diabetic macular or retinal edema is coded using the combination of codes for diabetes (250.50), macular edema (362.07), and retinopathy (362.01). Choice A includes an incorrect code for retinopathy (262.02), while choice B includes an incorrect code for macular edema (362.02) and choice D includes an incorrect code for diabetes (362.05). Therefore, choice C is the best option that includes all three correct codes.

Question 8

Jennifer presents to the emergency department with severe chest pain and shortness of breath. Chest x-ray revealed a spontaneous pneumothorax. Jennifer also has acute bronchitis. The emergency department physician inserts a chest tube and Jennifer is admitted.

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Question 9

Mary presents to the emergency department with complaints of chest pain. Myocardial infarction is ruled out, however gastrointestinal studies indicate Mary is suffering from gastroesophageal reflux disease (GERD). Mary is given medication to relieve her symptoms and instructed to follow up with her physician.

Accepted Answer

The diagnosis given in the scenario is gastroesophageal reflux disease (GERD), which falls under ICD-10 code 530.81. No other diagnosis is mentioned, so there is no need to include additional codes.

Question 10

Accepted Answer

There are two values present in the answer choices: 486 and 491.21. The number in the middle of the string of characters, "88" in this case, suggests that this is a decimal number. Of the two values present, 491.21 has an additional digit after the decimal point, which makes it a more precise measurement. Therefore, the best choice is B, which includes both values.

Question 11

Mark has a long history of epilepsy. He is brought to the emergency department and is admitted with intractable epileptic seizures. Mark's epilepsy is the result of a head injury he suffered several years ago.

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Question 12

Grace has been having abdominal pain for several weeks and has been vomiting blood for 2 days. Her physician performs an esophagogastroduodenoscopy and biopsies a lesion in the duodenum. The pathology report indicates Grace has acute and chronic gastritis.

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Question 13

Agnes is admitted with cough, fever, and dysphagia. Chest x-ray shows infiltrates in both lower lobes. Sputum culture is positive for Staph aureus. Swallow study indicates that Agnes aspirates. Physician documents aspiration pneumonia and Staph aureus pneumonia. As a coder, you would assign codes for the following and with correct sequencing order.

Accepted Answer

Code for both aspiration pneumonia and Staph aureus pneumonia, with the aspiration pneumonia listed first due to sequencing guidelines. Dysphagia is not coded separately as it is an expected complication of aspiration pneumonia. Therefore, the correct order is aspiration pneumonia, Staph aureus pneumonia, and dysphagia.

Question 14

Ronald is admitted for stenosis of his tracheostomy. He is a quadriplegic, C1-C4 secondary to spinal cord injury suffered in a diving accident. He has chronic respiratory failure and is maintained on mechanical ventilation. He undergoes revision of his tracheostomy.

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The answer of Ronald is admitted for stenosis of his...

Question 15

Jeff was in a car accident when he was 25 years old and suffered a spinal cord injury. As a result, he is a paraplegic and has neurogenic bladder. Jeff also has chronic ulcers of the buttocks. He is being seen for evaluation of his paraplegia.

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Question 16

Madeline is diagnosed with bilateral carotid stenosis. She is being admitted for a bilateral endarterectomy. Madeline is also treated for Parkinson's disease and glaucoma.

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The answer of Madeline is diagnosed with bilateral carotid stenosis....

Question 17

Acute and chronic maxillary sinusitis. Maxillary sinusectomy performed.

Accepted Answer

The correct code for acute maxillary sinusitis is 461.0 and for chronic maxillary sinusitis is 473.0. The sinusectomy procedure performed is not specified as endoscopic or Caldwell-Luc, so we cannot assign a more specific code. Therefore, we should assign both sinusitis codes and the procedure code for an unspecified sinusectomy: 461.0, 473.0, 22.62.

Question 18

Josephine has developed senile cataracts in both eyes. She is admitted for right extracapsular cataract extraction with synchronous lens insertion.

Accepted Answer

ICD-10-CM code for right senile cataract with IOL placement is 366.9. The additional procedure code for extracapsular cataract extraction is 13.59 and for synchronous lens insertion is 13.71. Therefore, the correct choice is B: 366.9, 13.59, 13.71. Choice A is incorrect because there is no code with decimals in ICD-10-CM. Choice C is incorrect because it only includes two of the necessary procedure codes.

Question 19

Patient presents to the emergency room complaining of a severe headache. Work-up revealed a ruptured berry aneurysm.

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Question 20

Joseph has had cough, fever, and painful respirations for 2 days. He also has congestive heart failure and COPD. Joseph presents to the emergency department with severe shortness of breath, using accessory muscles to assist with breathing. Upon examination, Joseph is diagnosed with acute respiratory failure, congestive heart failure, pneumonia, and exacerbation of COPD. Joseph is intubated and placed on mechanical ventilation. He is weaned from the ventilator on the third day of admission. Two days later, he again goes into respiratory failure, requiring reintubation and placement on the ventilator. Fortunately, he is able to breath on his own the following day, so was extubated.

Accepted Answer

The answer of Joseph has had cough, fever, and painful...

Exam 1: Registered Health Information Administrator