Question 1

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

Accepted Answer

The Guidelines and parenthetical notes in the CPT manual provide the necessary instructions for properly coding a procedure, including specific coding rules, exceptions, and clarifications.

Question 2

Which is an example of a pathologic fracture?

Accepted Answer

A pathologic fracture occurs when a bone breaks in an area weakened by some other disease, such as cancer, osteoporosis, or infection. In this case, option C, a compression fracture of vertebrae due to metastatic carcinoma, is an example of a pathologic fracture because the bone's integrity is compromised by the cancer, not just by an external force or trauma.

Question 3

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):

Accepted Answer

E28.310 is the correct ICD-10-CM code for primary ovarian failure, which is synonymous with premature menopause. This code accurately reflects the diagnosis given in the scenario.

Question 4

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

Accepted Answer

Two-digit modifiers in CPT coding are used to provide additional information or alter the description of a procedure or service to ensure accurate billing and coding. They indicate that a service or procedure has been altered in some specific way without changing the definition of the original code.

Question 5

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:

Accepted Answer

The correct ICD-10-CM codes for a patient admitted to the ER for excessive weight loss and dehydration, with a history of HIV-2 and taking nucleoside reverse transcriptase (RT) inhibitors, are B20 (HIV disease), T37.5X5A (Adverse effect of antiviral drugs, initial encounter), R63.4 (Abnormal weight loss), and E86.0 (Dehydration). B20 is used for HIV disease, R63.4 for the weight loss, E86.0 for dehydration, and T37.5X5A for the adverse effect of the medication.

Question 6

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?

Accepted Answer

NOS stands for "Not Otherwise Specified." It is used in ICD coding when the information available is not enough to code the condition to a more specific category. In this case, because the diagnosis "goiter, nodular nontoxic" does not specify the type of nontoxic goiter further, it is coded as unspecified nontoxic goiter, which is an example of using NOS.

Question 7

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

Accepted Answer

Using a current edition of the AMA CPT manual ensures accurate coding, which is crucial for proper billing and compliance with medical coding standards.

Question 8

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:

Accepted Answer

B20 represents HIV disease, which is appropriate given the patient's history of HIV-2. T37.5X5A is not correct as it relates to adverse effects of antivirals, which is not specified in the scenario. R63.4 (Abnormal weight loss) and E86.0 (Dehydration) are correct based on the patient's symptoms of excessive weight loss and dehydration.

Question 9

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

Accepted Answer

Using the most current edition of the AMA CPT manual ensures accurate coding, which is crucial for correct billing and compliance with medical coding standards. Changes, updates, and revisions in coding can significantly impact the accuracy of the codes used for procedures and services.

Question 10

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:

Accepted Answer

The correct coding sequence for the diagnoses given is A41.9 (Sepsis, unspecified organism), R65.20 (Severe sepsis without septic shock), N17.9 (Acute kidney failure, unspecified), J96.00 (Acute respiratory failure, unspecified whether with hypoxia or hypercapnia), and E11.8 (Type 2 diabetes mellitus with unspecified complications). This sequence covers all the conditions mentioned: sepsis, severe sepsis, acute renal failure, respiratory failure, and type 2 diabetes mellitus with complications. The order of the codes is based on the coding guidelines which prioritize the reason for the encounter/visit and the severity of the conditions.

Question 11

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

Accepted Answer

The CPT code range 90281-99607 is located in the Medicine section of the CPT manual. This section covers a wide range of procedures and services including vaccinations, therapies, and various diagnostic and therapeutic services not covered in other sections.

Question 12

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:

Accepted Answer

The answer of A patient who is suffering from osteosarcoma...

Question 13

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?

Accepted Answer

The answer of The patient is admitted for severe anemia...

Question 14

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

Accepted Answer

Two-digit modifiers in CPT coding are used to indicate that a procedure or service has been altered in some way without changing the definition of the original code.

Question 15

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?

Accepted Answer

NOS stands for "Not Otherwise Specified." It is used in ICD coding when the information in the medical record is insufficient to assign a more specific code. In this case, because the diagnosis does not specify the type of nontoxic goiter beyond "nodular," the unspecified code E04.9 is used, exemplifying the NOS designation.

Question 16

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

Accepted Answer

D57.01 is the ICD code for Sickle-cell anemia with acute chest syndrome, and J96.90 is for Respiratory failure, unspecified, which accurately reflects the patient's condition.

Question 17

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?

Accepted Answer

E46 represents malnutrition, E87.6 represents hypokalemia, I69.391 represents dysphagia following cerebral infarction, and R13.10 represents dysphagia, unspecified. All these codes accurately describe the patient's conditions and treatments.

Question 18

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:

Accepted Answer

B) E11.52, E11.3599, R82.4, Z79.4 is correct because it accurately represents type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene (E11.52), proliferative diabetic retinopathy without macular edema (E11.3599), ketonuria (R82.4), and long-term (current) use of insulin (Z79.4).

Question 19

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

Accepted Answer

The answer of Four people were seen in the ED....

Question 20

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)?

Accepted Answer

There is no set time for a condition to be coded as a sequela (late effect) after an incident like a CVA. The determination depends on the individual case and the nature of the residual effects, rather than a specific timeframe.

Quiz 22: Fundamental Coding Guidelines

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

Which is an example of a pathologic fracture?

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) :

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

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:

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

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:

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

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:

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

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:

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?

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

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

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?

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:

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) ?