Quiz Offers Coding Practice


Quiz Offers Coding Practice

CCS Prep!

Quiz Offers Coding Practice

DEBBIE DAY OLIVER

ADVANCE Columnist

As we approach the end of the CCS Prep! segments, and as the certified coding specialist (CCS) and CCS physician based (CCS-P) exams draw closer, we decided to devote this segment to an ICD-9-CM review using numerous competency based questions from throughout the nomenclature. For those of you who will be sitting for the certification exams, remember, the first portion of the test is competency-based, multiple choice questions. The following is a good review for that first portion of the exam.

To truly test yourself, use the parameters that will be used for the exam: allow yourself 9 minutes (estimate one minute per question) and do not use your coding books. Have fun!

  1. A newborn (born 10 days ago) was transferred to Children’s Medical Center for specialized treatment of a pneumothorax, which developed two days following birth. The pneumothorax has not responded to the typical treatment regime. The principal diagnosis for the second admission should be:
    1. V300.00 (single liveborn, born in hospital)
    2. 770.2 (other respiratory conditions of fetus and newborn, interstitial emphysema and related conditions, pneumothorax)
    3. 512.8 (pneumothorax, other spontaneous pneumothorax)
  2. A patient is admitted with stable angina. Combined right and left heart cath demonstrate Arteriosclerotic heart disease. Using the information provided below, the principal diagnosis should be:

    414.00 Other forms of chronic ischemic heart disease, coronary atherosclerosis of unspecified type of vessel

    413.0 Angina pectoris, angina decubitus

    413.9 Angina pectoris, other and unspecified angina pectoris

    1. 414.00
    2. 413.9
    3. 413.0
  3. A patient is readmitted to an acute facility for insertion of a Hickman cat; first course of chemotherapy administered for fibrosarcoma of the spleen. Using the information abstracted from ICD-9-CM, sequence the codes correctly:

    159.1 Malignant neoplasm of other and ill-defined sites within the digestive organs and peritoneum, spleen, NEC

    V58.1 Encounter for other and unspecified procedures and aftercare chemotherapy

    1. 159.1, V58.1
    2. V58.1, 159.1
    3. V58.1
  4. An 88-year-old type I diabetic with hypoglycemic shock (accidentally tripled Insulin dosage.) Using the codes referenced from ICD-9-CM, assign all applicable codes:

    250.01 Diabetes mellitus, diabetes mellitus without mention of complication, type I (insulin dependent type) (IDDM) (juvenile type), not stated as uncontrolled

    250.03 Diabetes mellitus, diabetes mellitus without mention of complication, type I (insulin dependent type) (IDDM) (juvenile type), uncontrolled

    250.81 Diabetes mellitus, diabetes mellitus with other specified manifestations including: diabetic hypoglycemia, hypoglycemic shock

    251.0 Other disorders of pancreatic internal secretion, hypoglycemic coma

    962.3 Poisoning by hormones and synthetic substitutes, insulins and antidiabetic agents

    E858.0 Accidental poisonings by other drugs, hormones and synthetic substitutes

    1. 250.01, 251.0, 962.3
    2. 962.3, 250.81, E858.0
    3. 250.81, 251.0, 962.3
  5. When coding anemia in a patient with a malignant neoplasm, indicate which of the following statements are true:
    1. if the patient is admitted for the management of the anemia, code the anemia first and the neoplasm second
    2. if the patient is admitted for management of anemia associated with chemotherapy and the treatment is limited to the anemia, code the anemia first, followed by the neoplasm
    3. if the patient is admitted for the management of anemia associated with radiotherapy and the treatment is limited to the anemia, code the anemia first and the neoplasm second
    4. all of the above
    5. none of the above
  6. A 30-year-old-female was discharged from an acute facility with the diagnosis: pregnancy delivered, methadone dependence due to drug history (prior cocaine abuse.) Using the information provided below, assign the correct codes for the admission:

    304.01 Drug dependence, opioid type dependence (includes metha-done) continuous

    304.21 Drug dependence, cocaine dependence, continuous

    304.00 Drug dependence, opioid type dependence (includes metha-done) unspecified

    304.20 Drug dependence, cocaine dependence, unspecified

    648.31 Other current condition in the mother classified elsewhere but complicating pregnancy, childbirth or the puerperium, delivered with or without antepartum condition

    1. 648.31, 304.01, 304.21
    2. 648.31, 304.01
    3. 648.31, 304.00, 304.20
  7. Complete the following statement. When coding a cataract for a diabetic patient, the coder should always …
    1. assume the cataract is a manifestation of the diabetes and code as a diabetic cataract
    2. assume the cataract and the diabetes are not necessarily related
    3. never assume

* About the author: Deborah Day-Oliver is the president of Health Data Concepts and author of the Clinical Coding Compendium. ADVANCE presents CCS Prep! for eight months preceding the CCS exam. Discussion of coding practices within this column is for educational purposes. Health Data Concepts has made every effort to assure the accuracy of the contents herein. Official coding guidelines are maintained by the Central Office on ICD-9-CM of the American Hospital Association. For more information, contact Health Data Concepts, P.O. Box 915, Bethel, ME 04217, voice: (207) 824-3550, fax: (207) 824-4918 or e-mail HDConcepts@aol.com.

Answers:

  1. b.) 770.2
  2. a.) 414.00
  3. b.) V58.1, 159.1
  4. b.) 962.3, 250.81, E858.0
  5. d.) all of the above
  6. b.) 648.31, 304.01
  7. c.) never assume

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