Deck 26: Complications of Surgical and Medical Care

Question 1

Patient was admitted for an open TAH (removal of uterus and cervix) due to symptomatic fibroids. The physician documented in the operative report that a complication had occurred in which the bladder was accidentally lacerated during the procedure and was repaired with suture.

A)D25.9, N99.72, 0UT97ZZ, 0UTC0ZZ, 0TQB0ZZ
B)D25.9, N99.71, 0UT90ZZ, 0UTC0ZZ, 0TQB0ZZ
C)D25.9, N99.72, 0UT90ZZ, 0TQB7ZZ
D)D25.9, N99.71, 0UT97ZZ, 0TQB7ZZ

Answer 1

B

Question 2

Patient was admitted with an abscess caused by Streptococcus of abdominal surgical wound, initial encounter. Cultures were positive for Streptococcus spp. The abscess of the skin was incised and drained.

A)T81.4, A49.1, Y84.9, 0H97X0Z
B)T81.4, L02.211, B95.5, Y84.9, 0H97Z0Z
C)T81.4xxA, L02.211, B95.5, Y83.9, 0H97XZZ
D)T81.4xxA, A49.1, Y83.9, 0H97XZZ

Answer 2

C

Question 3

Patient had an outpatient surgical procedure this morning and was discharged in stable condition. Patient returns because of inability to void. A Foley catheter is inserted.Diagnosis: Postoperative urinary retention

A)R33.8, R33.9, Y84.9, 0T9B80Z
B)N99.89, R33.9, Y83.9, 0T9B70Z
C)N99.0, R33.9, Y84.9, 0T9B80Z
D)R33.8, R33.9, Y83.9, 0T9B70Z

Answer 3

B

Question 4

During a posterior lumbar fusion at L4 to L5 for spinal stenosis, the surgeon accidentally nicks the dura. The fusion was performed via an open posterior approach with fusion of the posterior column using morselized allograft. Patient has a history of asthma for which he takes meds prn.

A)G97.41, M4.07, Y83.8, Y92.234, 0SG00K1
B)M48.06, G97.41, J45.909, Y83.2, Y92.234, 0SG00K1
C)G97.41, J45.998, Y83.8, Y92.234, 0SG0071
D)M48.06, G97.41, J45.998, Y83.2, 0SG0071

Question 5

Patient had an outpatient ERCP for extraction of a common bile duct stone. The patient developed acute abdominal pain and was admitted to rule out post ERCP pancreatitis.Impression: Post-ERCP pancreatitis

A)K91.89, K80.50, K85.90, Y83.8, 0FC98ZZ
B)K86.1, K80.51, K91.89, Y83.9, 0FC98ZZ
C)K85.10, K80.60, Y84.9, 0F998ZZ
D)K85.90, K80.61, Y84.8, 0F798ZZ

Question 6

A patient had a kidney transplant 2 years ago but developed ESRD again because of transplant failure. The patient has been on dialysis for the past year. The patient is now complaining of SOB and edema and is admitted for fluid overload and hemodialysis. Dialysis is performed multiple times during this stay.

A)E87.70, T86.12, N18.6, Z99.2, Y83.0, 5A1D60Z
B)N18.6, Z99.2, Z94.0, E87.70, 3E1M39Z
C)N18.6, T86.12, Z99.2, Y83.0, 5A1D60Z
D)E87.70, Z99.2, N18.6, Z94.0, 5A1D60Z

Question 7

Patient with a history of a kidney transplant comes to the ER with gastroenteritis. His history is positive for CKD, stage 2, and hypertension.

A)T86.10, I12.9, Z94.0
B)K52.9, I10, N18.2, Z94.0
C)T86.10, I10, N18.2
D)K52.9, I12.9, N18.2, Z94.0

Question 8

To aspirate means to ____.

A)breathe in a foreign substance
B)eat
C)drink
D)sleep

Question 9

Patient is admitted for treatment of primary liver cancer. Patient had a liver transplant 2 years ago. Patient has a past medical history of hypertension and COPD and is a former alcoholic, now in remission. Patient has been sober for 10 years.

A)T86.49, C80.2, C22.8, F10.20, Y83.0
B)T86.49, C80.2, C22.9, I10, J44.1, F10.20, Y83.0
C)C80.2, T86.49, C22.9, J44.1, F10.21, Y83.0
D)T86.49, C80.2, C22.8, I10, J44.9, F10.21, Y83.0

Question 10

Codes under subcategory T86 are used ____.

A)only for complications of transplanted organs
B)only for rejection of transplanted organs
C)for both complications and rejection of transplanted organs
D)for none of the above reasons

Question 11

A patient had a partial pancreatectomy for chronic pancreatitis and has now developed postpancreatectomy diabetes mellitus along with diabetic nephrosis.

A)E09.69, E89.1, E13.21
B)E08.21, E89.1, Z90.410, Y83.6
C)E89.1, E13.21, Z90.411, Y83.6
D)E89.1, E08.21, E13.21

Question 12

Patient presents with pseudoaneurysm right femoral artery due to recent cardiac cath at another facility.

A)I72.4, Y84.0
B)I72.8, Y84.2
C)I97.89, Y84.8
D)I97.89, I72.4, Y84.0

Question 13

Patient with decreased visual acuity due to corneal graft rejection. Patient was admitted for cadaver keratoplasty (external) of the left eye with removal of the previous corneal graft.

A)T86.840, Y83.0, H54.7, 08R9XKZ
B)T85.318A, Y83.0, H54.7, 08R93KZ
C)T86.840, Y83.0, H54.7, 08R83KZ
D)T86.841, Y83.0, H54.7, 08R8XKZ

Question 14

There is a time limit for complications to occur.

Question 15

The patient had an embolic cerebrovascular accident and was documented by the surgeon as being a postoperative complication. The patient initially had been admitted for treatment of coronary artery arteriosclerosis with CABG. The patient is taken to the OR for an open three-vessel aorta to coronary artery using greater saphenous vein. The left greater saphenous vein was harvested via percutaneous endoscopic approach. Cardiopulmonary bypass is performed during the surgery.

A)I97.820, I25.10, I63.40, Y84.2, 021109W, 06BS4ZZ
B)I25.10, I97.820, Y83.9, 02110AW, 06BS3ZZ
C)I25.10, I97.820, I63.40, Y83.2, 021209W, 06BQ4ZZ, 5A1221Z
D)I63.40, I25.10, I97.820, Y83.8, 021209W, 06BQ3ZZ, 5A1221Z

Question 16

Leakage of peritoneal dialysis catheter. Patient is on dialysis for end-stage renal disease. Peritoneal catheter was removed (percutaneous removal of infusion device from peritoneal cavity). Patient has a history of hypertension and type 2 diabetes with associated neuropathy.

A)I12.0, N18.6, T85.631D, I12.0, E11.40, Z99.2, Y84.1, 0WPGX0Z
B)T85.631A, I12.0, E11.22, N18.6, E11.40, Z99.2, Y84.1, 0WPG33Z
C)T82.43A, I11.2, E11.40, Z99.2, Y84.1, 0WPG33Z
D)T82.43xA, I12.0, E11.40, Z99.2, Y84.1, 0WPGX0Z

Question 17

The term dehiscence means ____.

A)breathing in a foreign object
B)opening a surgical wound
C)caused by medical treatment
D)small amount of urine

Question 18

A patient is admitted with a urinary tract infection (UTI) resulting from E. coli. The patient has an indwelling Foley catheter after recent radical prostatectomy for prostate cancer. The coder queries the physician regarding the relationship of the UTI and the Foley catheter, and the physician documents that the UTI is caused by the Foley catheter. The patient is morbidly obese with type 2 diabetes, controlled with insulin. The patient is still under active treatment for the cancer.

A)N39.0, B96.29, E66.01, E10.9, Z79.4, Z85.46, Y84.6
B)T83.512A, N39.0, E66.9, E10.9, Z89.4, Z85.46, Y84.6
C)T83.511A, N39.0, B96.20, E66.01, E11.9, C61, Z79.4, Y84.6
D)B96.23, T83.511S, N39.0, E66.01, E11.9, Z79.4, C61, Y84.6

Question 19

Complications affect only certain body systems.

Question 20

Patient was hospitalized 1 month before this admission. During that admit, she was diagnosed with COPD and placed on a ventilator for 2 days. She is admitted today with pneumonia.

A)J98.851, J18.9, J44.9
B)J18.9, J44.9
C)J95.851, J18.9, B96.5
D)J44.9, J18.9, J95.851, B96.5

Question 21

Match each definition to one of the following items.
a.Malunion
b.Nonunion
c.Neuroma
d.Extravasation
e.Contracture
f.Necrosis
Occurs when bony healing is not achieved at the fracture site.

Question 22

Patient with acute osteomyelitis right femur due to infected right knee joint replacement, initial encounter: __________

Question 23

Codes for complications may be located in the chapter for specified body sites.

Question 24

Match each definition to one of the following items.
a.Malunion
b.Nonunion
c.Neuroma
d.Extravasation
e.Contracture
f.Necrosis
The decay of tissue

Question 25

When looking for a complication code in the Index, the coder should first look under the ____________________.

Question 26

If the documentation is unclear whether the diagnosis was the result of a procedure or condition, a physician query should be initiated.

Question 27

Leaking silicone breast implant, initial visit: __________

Question 28

Match each definition to one of the following items.
a.Malunion
b.Nonunion
c.Neuroma
d.Extravasation
e.Contracture
f.Necrosis
A growth made up of a bundle of nerve fibers

Question 29

Rejection of heart transplant confirmed by right percutaneous ventricular biopsy: __________

Question 30

Coding complications always imply that poor care has been delivered.

Question 31

Iatrogenic is a term used to signify that a condition is a result of treatment.

Question 32

Match each definition to one of the following items.
a.Malunion
b.Nonunion
c.Neuroma
d.Extravasation
e.Contracture
f.Necrosis
Leakage of infused substance into vasculature or subcutaneous tissue

Question 33

Code only complications that occur within 2 weeks of a transplant surgery.

Question 34

When no entry is found under the main term for the condition, the coder should refer to the main term ____________________.

Question 35

Match each definition to one of the following items.
a.Malunion
b.Nonunion
c.Neuroma
d.Extravasation
e.Contracture
f.Necrosis
Occurs when the fracture fragments have united but are not properly aligned.

Question 36

What are some examples of procedures resulting in complications that occur during medical care and not during surgery?

Question 37

Match each definition to one of the following items.
a.Malunion
b.Nonunion
c.Neuroma
d.Extravasation
e.Contracture
f.Necrosis
A tightening of muscle and skin that prevents normal movement

Question 38

Mechanical complications are related to ____________________ malfunctions.

Question 39

What does DVT stand for?

Question 40

Can code Z94.0 and a T86.1-code be used together?

Question 41

A patient comes to the hospital with acute appendicitis and is taken to the OR for an open appendectomy. During the course of the surgery, the liver is accidentally lacerated and repaired with sutures. The patient recovers without any ill effects. __________

Question 42

Patient with an intestine transplant with diverticulitis of the intestinal graft: __________

Question 43

Patient has left subclavian vein thrombosis due to PICC: __________

Question 44

NSTEMI following laparoscopic appendectomy for acute appendicitis. Physician documents that the NSTEMI was due to the procedure: __________

Question 45

Mechanical complication of gastrostomy: __________

Question 46

Pneumonitis due to organism growing in ventilation (air conditioning) system: __________

Question 47

Displacement of an insulin pump, initial encounter; patient has type 1 DM: __________

Question 48

A patient comes to the hospital with chronic cholecystitis, and a laparoscopic cholecystectomy is performed. The patient's bowel function was slow to return, and on day 3, the patient developed a postoperative obstruction that was slow to resolve. __________