Deck 22: Fundamental Coding Guidelines

Question 1

The diagnostic statement "goiter, nodular nontoxic" would be coded as an unspecified nontoxic goiter, ICD-10 CM code E04.9, because the diagnosis does not describe the condition as diffuse, uninodular, multinodular, or other specified nontoxic goiter. This is an example of which abbreviation used in ICD?

A) CCI
B) NOS
C) MUE
D) NEC

Answer 1

NOS

Question 2

A 67-year-old female patient with stage 5 chronic kidney disease presents today for ongoing dialysis. Choose the appropriate ICD-10-CM codes:

A) I13.0, Z49.32, N18.9
B) N18.6, Z99.2
C) N18.5, Z99.2
D) I12.9, Z49.31, N18.9

Answer 2

N18.6, Z99.2

Question 3

A patient returns to the physician's office with flulike symptoms during the postoperative period for an appendectomy performed 1 month ago. Which modifier would need to be appended to today's office visit?

A) ?58
B) ?55
C) ?24
D) ?25

Answer 3

?24

Question 4

Many conditions and diseases have "sequelae (late effects)," such as a CVA. How much time must elapse between the incident and the acute symptoms for a residual condition to be coded as a sequela (late effect)?

A) More than 48 hours
B) No set time
C) 6 months
D) None of these

Question 5

Four people were seen in the ED. Which one will receive a diagnosis of poisoning?
Patient A: digitalis toxicity
Patient B: allergic reaction to contrast dye used for a CT exam
Patient C: syncope after taking antihistamine with alcohol
Patient D: reaction between two properly administered prescription drugs

A) Patient D
B) Patient C
C) Patient B
D) Patient A

Question 6

A patient returns to the physician's office with flulike symptoms during the postoperative period for an appendectomy performed 1 month ago. Which modifier would need to be appended to today's office visit?

A) ?58
B) ?55
C) ?25
D) ?24

Question 7

The flow of a practice's revenue, which begins when charges for services, procedures, or supplies are incurred and continues until those charges are paid in full or adjusted off the account is known as the:

A) Revenue cycle
B) Claim process
C) Adjudication
D) Reimbursement cycle

Question 8

CPT code range 90281-99607 is located in which section of the CPT manual?

A) Radiology
B) Medicine
C) Anesthesia
D) Evaluation and Management

Question 9

Identify the true statement concerning signs and symptoms:

A) If the sign or symptom is inherent to or commonly a part of the definitive diagnosis, the sign or symptom is coded in addition to the definitive diagnosis.
B) Codes for signs and symptoms must be used instead of codes for a diagnosis when a definitive diagnosis has been documented.
C) A symptom is something that can be measured, such as a blood pressure reading.
D) Codes for both signs and symptoms must be used instead of codes for a diagnosis when a definitive diagnosis has not been documented; if the sign or symptom is inherent to or commonly a part of the definitive diagnosis, the sign or symptom is not coded in addition to the definitive diagnosis.

Question 10

The patient is admitted for severe anemia due to chemotherapy treatments for metastatic bone cancer. The primary site is the prostate. What are the correct ICD-10-CM codes?

A) C79.51, D64.81
B) D64.81, C79.51, T45.1X5A
C) D64.81, C79.51
D) C41.9, D64.81

Question 11

The patient has type 2 diabetes mellitus that is controlled with insulin and complicated by proliferative retinopathy, gangrene, and ketonuria. Identify the correct ICD-10-CM codes:

A) E11.52, E11.3599, R82.4, Z79.4
B) A41.9, R65.20, E11.8
C) E11.3599, E11.641, I96, R82.4
D) E08.10, E08.51, Z79.4, M90.80

Question 12

When a condition is produced as a manifestation of another condition or a complication of a treatment, disease, or condition, more than one code is needed to clearly define the condition, injury, or disease. This is noted by which instructional note or notes in the ICD manual?

A) Code first
B) Use additional code
C) Both code first and use additional code
D) Excludes

Question 13

CPT code range 90281-99607 is located in which section of the CPT manual?

A) Radiology
B) Evaluation and Management
C) Anesthesia
D) Medicine

Question 14

Identify the true statement concerning signs and symptoms:

A) A symptom is something that can be measured, such as a blood pressure reading.
B) Codes for both signs and symptoms must be used instead of codes for a diagnosis when a definitive diagnosis has not been documented; if the sign or symptom is inherent to or commonly a part of the definitive diagnosis, the sign or symptom is not coded in addition to the definitive diagnosis.
C) If the sign or symptom is inherent to or commonly a part of the definitive diagnosis, the sign or symptom is coded in addition to the definitive diagnosis.
D) Codes for signs and symptoms must be used instead of codes for a diagnosis when a definitive diagnosis has been documented.

Question 15

A nonhealing burn should be coded as which type of burn?

A) Late effect
B) Acute burn
C) Chronic burn
D) Severe burn

Question 16

When a condition is produced as a manifestation of another condition or a complication of a treatment, disease, or condition, more than one code is needed to clearly define the condition, injury, or disease. This is noted by which instructional note or notes in the ICD manual?

A) Both code first and use additional code
B) Excludes
C) Code first
D) Use additional code

Question 17

Many conditions and diseases have "sequelae (late effects)," such as a CVA. How much time must elapse between the incident and the acute symptoms for a residual condition to be coded as a sequela (late effect)?

A) 6 months
B) No set time
C) More than 48 hours
D) None of these

Question 18

What is a two-digit modifier used for in CPT coding?

A) Add-on codes
B) Code changes
C) Conscious sedation
D) Alteration of a procedure or service

Question 19

Which of the following are true statements concerning acute and chronic conditions and their coding guidelines?

A) Acute and chronic conditions may be coded separately, with one code for the acute condition and another for the chronic condition.
B) If the subterms for acute and chronic are connected by a with statement, ICD has provided a combination code to indicate both conditions.
C) All of these statements are true.
D) Acute and chronic conditions may be coded as a combination code that identifies both the chronic and acute forms of the condition in one code.

Question 20

The patient is admitted for severe anemia due to chemotherapy treatments for metastatic bone cancer. The primary site is the prostate. What are the correct ICD-10-CM codes?

A) C79.51, D64.81
B) D64.81, C79.51, T45.1X5A
C) D64.81, C79.51
D) C41.9, D64.81

Question 21

A patient is diagnosed with sickle cell crisis and acute chest syndrome with respiratory failure. Select the correct ICD codes:

A) D57.219, J99
B) D57.01, J96.90
C) D57.1, J96.00
D) D57.1, J99, J96.00

Question 22

A physician performed a simple mastectomy on both the left and right breasts-19303 mastectomy, simple, complete. Assign the appropriate modifier to be added to 19303 to indicate that both breasts were removed in the same operative session:

A) ?51
B) ?50
C) ?76
D) ?57

Question 23

A nonhealing burn should be coded as which type of burn?

A) Late effect
B) Acute burn
C) Chronic burn
D) Severe burn

Question 24

An elderly patient was admitted with malnutrition. He had suffered a stroke 2 years previously that left him with dysphagia. He was treated for the malnutrition with hyperalimentation. He was also diagnosed with hypokalemia. What are the correct codes?

A) E46, R13.10
B) E46, I69.391
C) E43, I69.391
D) E46, E87.6, I69.391, R13.10

Question 25

Where in the CPT manual will a coder locate all the instructions necessary to properly code a procedure?

A) Unlisted procedures
B) Appendix A
C) Index
D) Guidelines and parenthetical notes

Question 26

A 32-year-old female was diagnosed with premature menopause that is symptomatic of ovarian failure and is experiencing headaches, flushing, and night sweats. Select the correct ICD-10-CM code(s):

A) E28.310
B) E28.39
C) N18.6, Z99.2
D) E23.0, N95.8

Question 27

Four people were seen in the ED. Which one will receive a diagnosis of poisoning?
Patient A: digitalis toxicity
Patient B: allergic reaction to contrast dye used for a CT exam
Patient C: syncope after taking antihistamine with alcohol
Patient D: reaction between two properly administered prescription drugs

A) Patient D
B) Patient B
C) Patient A
D) Patient C

Question 28

Which is an example of a pathologic fracture?

A) Greenstick fracture due to fall from bed
B) Vertebral fracture with cord injury due to automobile accident
C) Compression fracture of vertebrae due to metastatic carcinoma
D) Compression fracture after sustaining injury to head

Question 29

The language that is built on medical terminology, anatomy, and pathophysiology and describes services, procedures, and the medical necessity of those services and procedures is referred to as:

A) Compliance language
B) Billing language
C) Payer language
D) Provider language

Question 30

A physician performed a simple mastectomy on both the left and right breasts-19303 mastectomy, simple, complete. Assign the appropriate modifier to be added to 19303 to indicate that both breasts were removed in the same operative session:

A) ?57
B) ?51
C) ?50
D) ?76

Question 31

An elderly patient was admitted with malnutrition. He had suffered a stroke 2 years previously that left him with dysphagia. He was treated for the malnutrition with hyperalimentation. He was also diagnosed with hypokalemia. What are the correct codes?

A) E46, I69.391
B) E46, E87.6, I69.391, R13.10
C) E46, R13.10
D) E43, I69.391

Question 32

A patient who is suffering from osteosarcoma located above the right knee begins chemotherapy treatment at today's encounter. Select the appropriate ICD-10-CM codes to be reported for this encounter:

A) C40.21, Z51.11
B) Z51.11, C40.21
C) Z51.11, C40.20
D) C49.20, Z51.0

Question 33

A 67-year-old female patient with stage 5 chronic kidney disease presents today for ongoing dialysis. Choose the appropriate ICD-10-CM codes:

A) I13.0, Z49.32, N18.9
B) N18.5, Z99.2
C) N18.6, Z99.2
D) I12.9, Z49.31, N18.9

Question 34

The flow of a practice's revenue, which begins when charges for services, procedures, or supplies are incurred and continues until those charges are paid in full or adjusted off the account is known as the:

A) Revenue cycle
B) Reimbursement cycle
C) Adjudication
D) Claim process

Question 35

Which of the following are true statements concerning acute and chronic conditions and their coding guidelines?

A) Acute and chronic conditions may be coded as a combination code that identifies both the chronic and acute forms of the condition in one code.
B) Acute and chronic conditions may be coded separately, with one code for the acute condition and another for the chronic condition.
C) All of these statements are true.
D) If the subterms for acute and chronic are connected by a with statement, ICD has provided a combination code to indicate both conditions.

Question 36

A patient is diagnosed with sickle cell crisis and acute chest syndrome with respiratory failure. Select the correct ICD codes:

A) D57.1, J99, J96.00
B) D57.01, J96.90
C) D57.219, J99
D) D57.1, J96.00

Question 37

Why is it necessary for a medical coder to use a current edition of the AMA CPT manual?

A) Reimbursement will be more.
B) Reimbursement will be less.
C) This is the law.
D) This ensures accurate coding.

Question 38

The patient is in the intensive care unit with fluid overload with acute renal failure. He has type 2 DM and sepsis. The patient is sedated and on a ventilator because of respiratory failure. Code the diagnoses only:

A) R65.20, A41.9, N17.9, J96.00, E11.8
B) A41.9, R65.20, N17.9, J96.00, E11.8
C) R65.20, A41.9, N17.9, J96.00
D) A41.9, R65.20, E11.8

Question 39

The language that is built on medical terminology, anatomy, and pathophysiology and describes services, procedures, and the medical necessity of those services and procedures is referred to as:

A) Provider language
B) Billing language
C) Compliance language
D) Payer language

Question 40

The patient is in the intensive care unit with fluid overload with acute renal failure. He has type 2 DM and sepsis. The patient is sedated and on a ventilator because of respiratory failure. Code the diagnoses only:

A) R65.20, A41.9, N17.9, J96.00
B) A41.9, R65.20, N17.9, J96.00, E11.8
C) R65.20, A41.9, N17.9, J96.00, E11.8
D) A41.9, R65.20, E11.8

Question 41

Where in the CPT manual will a coder locate all the instructions necessary to properly code a procedure?

A) Index
B) Unlisted procedures
C) Appendix A
D) Guidelines and parenthetical notes

Question 42

Which is an example of a pathologic fracture?

A) Greenstick fracture due to fall from bed
B) Vertebral fracture with cord injury due to automobile accident
C) Compression fracture of vertebrae due to metastatic carcinoma
D) Compression fracture after sustaining injury to head

Question 43

A 32-year-old female was diagnosed with premature menopause that is symptomatic of ovarian failure and is experiencing headaches, flushing, and night sweats. Select the correct ICD-10-CM code(s):

A) E28.310
B) N18.6, Z99.2
C) E23.0, N95.8
D) E28.39

Question 44

What is a two-digit modifier used for in CPT coding?

A) Code changes
B) Alteration of a procedure or service
C) Conscious sedation
D) Add-on codes

Question 45

The patient is admitted to the ER for excessive weight loss and dehydration. The patient has a history of HIV-2 and has been taking nucleoside reverse transcriptase (RT) inhibitors. Assign the appropriate ICD-10-CM codes:

A) N18.2
B) Z21, R63.4, E86.0
C) I12.9, Z49.31, N18.2
D) B20, T37.5X5A, R63.4, E86.0

Question 46

The diagnostic statement "goiter, nodular nontoxic" would be coded as an unspecified nontoxic goiter, ICD-10 CM code E04.9, because the diagnosis does not describe the condition as diffuse, uninodular, multinodular, or other specified nontoxic goiter. This is an example of which abbreviation used in ICD?

A) MUE
B) NOS
C) CCI
D) NEC

Question 47

Why is it necessary for a medical coder to use a current edition of the AMA CPT manual?

A) Reimbursement will be more.
B) Reimbursement will be less.
C) This ensures accurate coding.
D) This is the law.

Question 48

The patient is admitted to the ER for excessive weight loss and dehydration. The patient has a history of HIV-2 and has been taking nucleoside reverse transcriptase (RT) inhibitors. Assign the appropriate ICD-10-CM codes:

A) Z21, R63.4, E86.0
B) B20, T37.5X5A, R63.4, E86.0
C) N18.2
D) I12.9, Z49.31, N18.2

Question 49

Why is it necessary for a medical coder to use a current edition of the AMA CPT manual?

A) Reimbursement will be less.
B) Reimbursement will be more.
C) This is the law.
D) This ensures accurate coding.

Question 50

The patient is in the intensive care unit with fluid overload with acute renal failure. He has type 2 DM and sepsis. The patient is sedated and on a ventilator because of respiratory failure. Code the diagnoses only:

A) R65.20, A41.9, N17.9, J96.00, E11.8
B) A41.9, R65.20, N17.9, J96.00, E11.8
C) R65.20, A41.9, N17.9, J96.00
D) A41.9, R65.20, E11.8

Question 51

CPT code range 90281-99607 is located in which section of the CPT manual?

A) Medicine
B) Anesthesia
C) Radiology
D) Evaluation and Management

Question 52

A patient who is suffering from osteosarcoma located above the right knee begins chemotherapy treatment at today's encounter. Select the appropriate ICD-10-CM codes to be reported for this encounter:

A) Z51.11, C40.21
B) Z51.11, C40.20
C) C49.20, Z51.0
D) C40.21, Z51.11

Question 53

The patient is admitted for severe anemia due to chemotherapy treatments for metastatic bone cancer. The primary site is the prostate. What are the correct ICD-10-CM codes?

A) D64.81, C79.51, T45.1X5A
B) C41.9, D64.81
C) C79.51, D64.81
D) D64.81, C79.51

Question 54

What is a two-digit modifier used for in CPT coding?

A) Code changes
B) Add-on codes
C) Alteration of a procedure or service
D) Conscious sedation

Question 55

The diagnostic statement "goiter, nodular nontoxic" would be coded as an unspecified nontoxic goiter, ICD-10 CM code E04.9, because the diagnosis does not describe the condition as diffuse, uninodular, multinodular, or other specified nontoxic goiter. This is an example of which abbreviation used in ICD?

A) CCI
B) NEC
C) MUE
D) NOS

Question 56

A patient is diagnosed with sickle cell crisis and acute chest syndrome with respiratory failure. Select the correct ICD codes:

A) D57.01, J96.90
B) D57.1, J99, J96.00
C) D57.219, J99
D) D57.1, J96.00

Question 57

An elderly patient was admitted with malnutrition. He had suffered a stroke 2 years previously that left him with dysphagia. He was treated for the malnutrition with hyperalimentation. He was also diagnosed with hypokalemia. What are the correct codes?

A) E46, I69.391
B) E46, E87.6, I69.391, R13.10
C) E46, R13.10
D) E43, I69.391

Question 58

The patient has type 2 diabetes mellitus that is controlled with insulin and complicated by proliferative retinopathy, gangrene, and ketonuria. Identify the correct ICD-10-CM codes:

A) A41.9, R65.20, E11.8
B) E11.52, E11.3599, R82.4, Z79.4
C) E11.3599, E11.641, I96, R82.4
D) E08.10, E08.51, Z79.4, M90.80

Question 59

Four people were seen in the ED. Which one will receive a diagnosis of poisoning?
Patient A: digitalis toxicity
Patient B: allergic reaction to contrast dye used for a CT exam
Patient C: syncope after taking antihistamine with alcohol
Patient D: reaction between two properly administered prescription drugs

A) Patient C
B) Patient D
C) Patient B
D) Patient A

Question 60

Many conditions and diseases have "sequelae (late effects)," such as a CVA. How much time must elapse between the incident and the acute symptoms for a residual condition to be coded as a sequela (late effect)?

A) 6 months
B) More than 48 hours
C) No set time
D) None of these

Question 61

The patient is admitted to the ER for excessive weight loss and dehydration. The patient has a history of HIV-2 and has been taking nucleoside reverse transcriptase (RT) inhibitors. Assign the appropriate ICD-10-CM codes:

A) B20, T37.5X5A, R63.4, E86.0
B) N18.2
C) I12.9, Z49.31, N18.2
D) Z21, R63.4, E86.0

Question 62

A physician performed a simple mastectomy on both the left and right breasts-19303 mastectomy, simple, complete. Assign the appropriate modifier to be added to 19303 to indicate that both breasts were removed in the same operative session:

A) ?50
B) ?57
C) ?51
D) ?76

Question 63

Which of the following are true statements concerning acute and chronic conditions and their coding guidelines?

A) Acute and chronic conditions may be coded separately, with one code for the acute condition and another for the chronic condition.
B) Acute and chronic conditions may be coded as a combination code that identifies both the chronic and acute forms of the condition in one code.
C) If the subterms for acute and chronic are connected by a with statement, ICD has provided a combination code to indicate both conditions.
D) All of these statements are true.

Question 64

Which is an example of a pathologic fracture?

A) Greenstick fracture due to fall from bed
B) Compression fracture after sustaining injury to head
C) Compression fracture of vertebrae due to metastatic carcinoma
D) Vertebral fracture with cord injury due to automobile accident

Question 65

When a condition is produced as a manifestation of another condition or a complication of a treatment, disease, or condition, more than one code is needed to clearly define the condition, injury, or disease. This is noted by which instructional note or notes in the ICD manual?

A) Both code first and use additional code
B) Code first
C) Excludes
D) Use additional code

Question 66

A 67-year-old female patient with stage 5 chronic kidney disease presents today for ongoing dialysis. Choose the appropriate ICD-10-CM codes:

A) I12.9, Z49.31, N18.9
B) N18.6, Z99.2
C) N18.5, Z99.2
D) I13.0, Z49.32, N18.9

Question 67

Where in the CPT manual will a coder locate all the instructions necessary to properly code a procedure?

A) Appendix A
B) Unlisted procedures
C) Guidelines and parenthetical notes
D) Index

Question 68

A patient returns to the physician's office with flulike symptoms during the postoperative period for an appendectomy performed 1 month ago. Which modifier would need to be appended to today's office visit?

A) ?25
B) ?55
C) ?58
D) ?24

Question 69

A nonhealing burn should be coded as which type of burn?

A) Acute burn
B) Late effect
C) Chronic burn
D) Severe burn

Question 70

A 32-year-old female was diagnosed with premature menopause that is symptomatic of ovarian failure and is experiencing headaches, flushing, and night sweats. Select the correct ICD-10-CM code(s):

A) N18.6, Z99.2
B) E28.310
C) E28.39
D) E23.0, N95.8

Question 71

The flow of a practice's revenue, which begins when charges for services, procedures, or supplies are incurred and continues until those charges are paid in full or adjusted off the account is known as the:

A) Adjudication
B) Claim process
C) Revenue cycle
D) Reimbursement cycle

Question 72

Many conditions and diseases have "sequelae (late effects)," such as a CVA. How much time must elapse between the incident and the acute symptoms for a residual condition to be coded as a sequela (late effect)?

A) More than 48 hours
B) None of these
C) No set time
D) 6 months

Question 73

A 32-year-old female was diagnosed with premature menopause that is symptomatic of ovarian failure and is experiencing headaches, flushing, and night sweats. Select the correct ICD-10-CM code(s):

A) E28.310
B) E28.39
C) E23.0, N95.8
D) N18.6, Z99.2

Question 74

The patient is admitted to the ER for excessive weight loss and dehydration. The patient has a history of HIV-2 and has been taking nucleoside reverse transcriptase (RT) inhibitors. Assign the appropriate ICD-10-CM codes:

A) N18.2
B) B20, T37.5X5A, R63.4, E86.0
C) I12.9, Z49.31, N18.2
D) Z21, R63.4, E86.0

Question 75

A nonhealing burn should be coded as which type of burn?

A) Chronic burn
B) Acute burn
C) Late effect
D) Severe burn

Question 76

When a condition is produced as a manifestation of another condition or a complication of a treatment, disease, or condition, more than one code is needed to clearly define the condition, injury, or disease. This is noted by which instructional note or notes in the ICD manual?

A) Excludes
B) Code first
C) Use additional code
D) Both code first and use additional code

Question 77

Why is it necessary for a medical coder to use a current edition of the AMA CPT manual?

A) This ensures accurate coding.
B) Reimbursement will be less.
C) This is the law.
D) Reimbursement will be more.

Question 78

Where in the CPT manual will a coder locate all the instructions necessary to properly code a procedure?

A) Guidelines and parenthetical notes
B) Unlisted procedures
C) Index
D) Appendix A

Question 79

The language that is built on medical terminology, anatomy, and pathophysiology and describes services, procedures, and the medical necessity of those services and procedures is referred to as:

A) Provider language
B) Billing language
C) Payer language
D) Compliance language

Question 80

A patient who is suffering from osteosarcoma located above the right knee begins chemotherapy treatment at today's encounter. Select the appropriate ICD-10-CM codes to be reported for this encounter:

A) C40.21, Z51.11
B) Z51.11, C40.21
C) Z51.11, C40.20
D) C49.20, Z51.0