Question 1

Etta has been using corticosteroids for severe hay fever asthma for the last few years, and is now experiencing some eye problems. Her physician told her that she was only in the early stages of glaucoma, which could be treated to ensure her vision for the rest of her life. What is the correct code for the ICD-9 codes for Etta's condition?
A)365.31, 365.71
B)365.32, 365.71
C)365.31, 365.72
D)365.9, 365.71

Accepted Answer

The correct code for the ICD-9 codes for Etta's condition are: 365.31 and 365.71. ICD-9 coding guidelines state that for types of glaucoma, categorized to subcategories 365.1 to 365.6, an additional code from category 365.7 should be assigned to indicate the stage of glaucoma. In Etta's case, her primary glaucoma diagnosis is 365.31 (Corticosteroid-Induced Glaucoma, Glaucomatous Stage), and her physician has indicated that it is in the early stage, so the correct secondary diagnosis is 365.71.

Question 2

HOSPITAL CHARGE SHEET PATIENT: Carson, Cason
AGE: 10
DATE OF ADMISSION: 01/02/2014
DIAGNOSIS: Coccidiomycosis Meningitis
DATE OF DISCHARGE: 01/08/2014
The patient was admitted on 01/02/2014 complaining of a severe headache and hyperpyrexia. An lumbar puncture determined on 01/02/2014 that the patient was suffering from coccidiomycosis meningitis. The patient was administered antibiotics and admitted to the hospital for observation and management of the condition. The patient's condition improved slowly with a regression on 01/05/2014, at which time the antibiotics were changed. After the change in medication, the patient's condition rapidly improved and by 01/07/2014, the patient no longer developed a fever or headache when not on pain medications. On 01/08/2012, the physician spent 20 minutes managing patient discharge, with instructions to continue antibiotics and pain medications, as needed.
What E&M service codes would be reported for this service?
A)99222 (X2), 99232 (X3), 99231 (X3), 99238 (X2)
B)99232 (X7)
C)99222, 99232, 99231 (X6)
D)99222, 99232 (X3), 99231 (X2), 99238

Accepted Answer

The E&M service codes that would be reported for this service are: 99222 (Initial Hospital Care Admission). This code only needs to be reported once per admission. The next code would be 99232 (X3) (Hospital Stay). This code is used to report daily visits by the hospital physician. In this case, the hospital stay would be reported as three units to represent the three days (an extended amount of time) that the physician spent caring for the patient. The next code would be 99231 (Inpatient Stay). This code would be reported as two units to represent the last two days before discharge, at a less complicated level of care, in response to an improved patient condition. The last code would be 99238 (Discharge). This code would be used to report the time it took to discharge the patient, which in this case, took less than 30 minutes.

Question 3

What is the correct code for the plastic repair of cleft lip with nasal deformity when utilizing an Abbe-Estlander cross-lip pedicle flap?
A)40527
B)40761
C)42200
D)40700

Accepted Answer

The correct code for the plastic repair of cleft lip with nasal deformity when utilizing an Abbe-Estlander cross-lip pedicle flap is 40527 (Excision of Lip; Full Thickness, Reconstruction with Cross-Lip Flap (Abbe-Estlander)). In parenthesis under code 40761 for plastic repair of cleft lip/nasal deformity, it notes that if using the Abbe-Estlander type repair, use the 40527 code. Code 42200 is only used for the repair of a cleft palate.

Question 4

Mastoiditis is inflammation of the middle ear, a condition that can occur when a chronic ear infection goes untreated. If a cholesteatoma develops as a result of a chronic ear infection, the surgeon may elect to remove the inflamed area. This procedure is referred to as which of the following:
A)Cochlear Implantation
B)Ossicular Surgery
C)Mastoidectomy
D)Retrobulbar Injection

Accepted Answer

This procedure is referred to as a mastoidectomy. A mastoidectomy is the removal of the mastoid bone. This procedure may also be performed to make room for a cochlear implant, which is inserted during a cochlear implantation procedure. Ossicular surgeries are performed to repair the ossicular chain or to correct defects in the oval or round windows in the inner ear. A retrobulbar injection in administered to the back of the eyeball or the retrobulbar area.

Question 5

There are many types of urinary tract infections. Which of the following diagnosis codes represents an infection of just the urethra?
A)597.80
B)595.0
C)590.80
D)590.10

Accepted Answer

The code 597.80 (Urethritis, Unspecified) represents an infection of just the urethra. Code 595.0 is for cystitis, which is an infection of the bladder. Codes 590.80 and 590.10 are used for unspecified pyelitis or pyelonephritis and acute pyelitis, which are infections of the kidneys.

Question 6

Jaime is a 9-year-old obese boy. Jaime's pediatrician suspects that he may have hypertension due to his weight, but has not come to a conclusive diagnosis yet. So far, he has had two elevated blood pressure readings, but has not been diagnosed with hypertension. Jaime saw his pediatrician today for a blood pressure reading, which was elevated. What is the correct diagnosis code for Jaime's office visit?
A)401.9
B)401.0
C)405.9
D)796.2

Accepted Answer

The correct diagnosis code for Jaime's office visit is 796.2. According to the ICD-9 manual, the code 796.2 (Elevated Blood Pressure Reading Without Diagnosis of Hypertension) should be used for an incidental elevated high blood pressure reading, or in any case where there is a high blood pressure reading without a diagnosis of hypertension. Although Jaime's blood pressure reading today was high, he has not been officially diagnosed with hypertension, therefore the correct diagnosis is 796.2.

Question 7

The procedure known as blepharoplasty is performed to:
A)Correct the muscle misalignment caused by strabismus
B)Correct vision loss due to glaucoma
C)Plastic repair a droopy eyelid
D)Repair the lens of the eye caused by cataracts

Accepted Answer

The procedure known as blepharoplasty is performed to plastic repair a droopy eyelid. The prefix "blephar/o" means "eyelid," and as such, a "blepharoplasty" would be performed to repair the skin of the eyelid. A blepharoplasty is commonly performed to correct a droopy eyelid, a condition also known as ptosis. Codes for blepharoplasty can be found in both the Eye and Ocular Adnexa subsection as well as the Integumentary subsection of the surgery Chapter in the CPT manual.

Question 8

In the electrical conduction system of the heart, the sinoatrial node is located in the right atrium near the superior vena cava. It serves as the normal pacemaker of the heart. There is another node, which is located in the right atrium on the septal wall. This node slows the impulses of the heart so that the atria can fill with blood before it contracts. What is the name of this node?
A)Sinoatrial Node
B)Bundle of His
C)Purkinje Fibers
D)Atrioventricular Node

Accepted Answer

The atrioventricular node is located in the right atrium on the septal wall. This node slows the impulses of the heart so that the atria can fill with blood before it contracts. The bundle of his is a group of muscle fibers in the center of the heart on the septum. The bundle of his receives electrical impulses that branch off to the right and left. The Purkinje fibers lie across the surface of the ventricles and give the final signal for the ventricles to contract.

Question 9

Brown, a dermatologist, opened and drained multiple complicated acne pustules and comedones on a 19-year-old patient with severe acne. For one of the more complicated acne pustules, Dr. Brown incised, drained, and marsupialized the acne cyst by suturing the right and left sides, leaving the cyst open for drainage. What is the correct code for the procedure?
A)10060
B)10061, 10040
C)10040
D)10061

Accepted Answer

The correct code for the procedure is 10040 (Acne Surgery). This is the only code necessary, as it includes the opening of acne comedones, cysts, and pustules. It also includes the marsupialization of the acne cysts. Codes: 10060 and 10061 are used for the incision and drainage of unspecified abscesses or cysts, rather than acne cysts.

Question 10

Alma is a 32-weeks pregnant, Type I diabetic, who was diagnosed at 10-years-old. She has taken insulin continuously since her diagnosis. So far, Alma' diabetes has not significantly affected her pregnancy, but Alma and her physicians have closely monitored her pregnancy and diabetes. What are the correct ICD-9 diagnosis codes for Alma's condition?
A)648.80, V58.67
B)648.00, 250.00
C)648.00, 250.01, V58.67
D)648.80, 250.01, V58.67

Accepted Answer

The correct diagnosis codes for Alma's condition are: 648.00, 250.01 and V58.67. According to ICD-9 coding guidelines, a pregnant woman with diabetes, like Alma, should be assigned the 648.00 (Diabetes Complicating Pregnancy Code). In addition, they should be assigned the appropriate diabetes code. Alma has Type I diabetes, so the correct code is 250.01. She is also on insulin so the appropriate code is also V58.67 (Long-Term Use of Insulin).

Question 11

The lymphatic system contains four organs:
A)Spleen, tonsils, bone marrow, and thymus
B)Spleen, Peyer's patches, and tonsils
C)Spleen, tonsils, Peyer's patches, and thymus
D)Tonsils, Peyer's patches, thymus, and bone marrow

Accepted Answer

the spleen, tonsils, Peyer's patches, and thymus gland. The spleen is a part of the hemic system, which creates and stores red blood cells. The tonsils are an initial line of defense against bacteria entering through the throat. Peyer's patches are located in the small intestine and help prevent bacteria from infecting the intestines. The thymus gland produces T-cells, which are used in the immune system and also aid in auto-immunity or keeping the body from attacking itself.

Question 12

When you are searching for a diagnosis code in the ICD-9 manual:
A)You must first locate the diagnosis code description in the index and then verify the correct code selection in the tabular list
B)You must locate the diagnosis code in the index and then assign the appropriate code
C)You must determine which procedure you will bill for first, and then find out which diagnosis codes match the procedure
D)You must first locate the diagnosis code description in the index and then verify the code in Volume III

Accepted Answer

When you are searching for a diagnosis code in the ICD-9 manual, you must first locate the diagnosis code description in the index and then verify the correct code selection in the tabular list. It is an incorrect coding practice to code directly from the index. Once you locate your code in the index, it is important to verify the code in the tabular list to make sure it is the correct code.

Question 13

After careful selection and testing of bone marrow donors, a potential candidate was found for a patient with severe leukemia. The physician collected a small sample of the potential donor's bone marrow via aspiration technique. This sample was then sent to pathology to determine whether or not it would be a match for the patient's bone marrow. What is the correct code for the procedure performed by the physician?
A)38221
B)38220
C)38230
D)38232

Accepted Answer

The correct code for the procedure performed by the physician is 38220 (Bone Marrow; Aspiration Only). This is the appropriate code because the physician was not harvesting the marrow from the donor. Harvesting codes, such as 38230 and 38232 are only used when the bone marrow is harvested in large amounts in order to transplant the marrow into the patient. In this case, the physician was only aspirating a small sample to test (to see if the donor and the patient were matches).

Question 14

Two weeks ago, James was walking in the mountains and scratched his leg with a large branch on the edge of the trail. Yesterday, he went to the pediatrician's office because his scratch was not healing and was getting worse. Today, he is being seen again by the pediatrician, who diagnosed James with MRSA cellulitis at the site of the wound on his leg. Which of the following represents the correct code(s) for today's visit?
A)682.6, 041.12
B)686.9, 041.11
C)958.3, 041.12
D)041.12

Accepted Answer

The codes: 682.6 and 041.12 represent the correct codes for today's visit. According to ICD-9 guidelines, you must select the appropriate code for the condition, which in this case is 682.6 (Cellulitis of Leg), along with the MRSA code 041.12. Code 958.2 is incorrect because it is not used when the injury is classified as cellulitis.

Quiz 1: Medical Coding

What is the correct code for the plastic repair of cleft lip with nasal deformity when utilizing an Abbe-Estlander cross-lip pedicle flap?

Mastoiditis is inflammation of the middle ear, a condition that can occur when a chronic ear infection goes untreated. If a cholesteatoma develops as a result of a chronic ear infection, the surgeon may elect to remove the inflamed area. This procedure is referred to as which of the following:

There are many types of urinary tract infections. Which of the following diagnosis codes represents an infection of just the urethra?

The procedure known as blepharoplasty is performed to:

The lymphatic system contains four organs:

When you are searching for a diagnosis code in the ICD-9 manual: