Question 1

What is the main term in "infantile eczema"?

Accepted Answer

The answer of What is the main term in "infantile...

Question 2

What is the main purpose of the Alphabetic Index in ICD-10-PCS?

Accepted Answer

To locate

Question 3

Match the following with the correct term or definition.
-The reason,in the patient's own words,for coming to the hospital

Accepted Answer

A) Tabular List 
B) See also 
C) Subterms 
D) Discharge summary 
E) Coding Clinic
F)ER
G)Differential diagnosis
H)Chief complaint
I)The first basic step in coding the principal diagnosis
J)Nonessential modifiers 
A) Tabular List 
B) See also 
C) Subterms 
D) Discharge summary 
E) Coding Clinic
F)ER
G)Differential diagnosis
H)Chief complaint
I)The first basic step in coding the principal diagnosis
J)Nonessential modifiers

Question 4

What is the subterm in "esophageal reflux"?

Accepted Answer

The answer of What is the subterm in "esophageal reflux"?...

Question 5

Match the following with the correct term or definition.
-Have no effect on the main term

Accepted Answer

A) Tabular List 
B) See also 
C) Subterms 
D) Discharge summary 
E) Coding Clinic
F)ER
G)Differential diagnosis
H)Chief complaint
I)The first basic step in coding the principal diagnosis
J)Nonessential modifiers 
A) Tabular List 
B) See also 
C) Subterms 
D) Discharge summary 
E) Coding Clinic
F)ER
G)Differential diagnosis
H)Chief complaint
I)The first basic step in coding the principal diagnosis
J)Nonessential modifiers

Question 6

When evaluating an ER record,a coder should look for the ____.

Accepted Answer

A) diagnosis 
B) chief complaint 
C) probable diagnosis 
D) differential diagnosis 
A) diagnosis 
B) chief complaint 
C) probable diagnosis 
D) differential diagnosis

Question 7

What is the main term in "rheumatoid arthritis"?

Accepted Answer

The answer of What is the main term in "rheumatoid...

Question 8

The first step in coding the principal diagnosis is to ____.

Accepted Answer

A) identify the diagnosis and the principal procedure 
B) identify main term(s) in the Alphabetic Index 
C) review the medical record 
D) review any subterms under the main term in the Index 
A) identify the diagnosis and the principal procedure 
B) identify main term(s) in the Alphabetic Index 
C) review the medical record 
D) review any subterms under the main term in the Index

Question 9

What is the main term in "esophageal reflux"?

Accepted Answer

The answer of What is the main term in "esophageal...

Question 10

Match the following with the correct term or definition.
-Provides advice on how to correctly code specific diagnoses

Accepted Answer

A) Tabular List 
B) See also 
C) Subterms 
D) Discharge summary 
E) Coding Clinic
F)ER
G)Differential diagnosis
H)Chief complaint
I)The first basic step in coding the principal diagnosis
J)Nonessential modifiers 
A) Tabular List 
B) See also 
C) Subterms 
D) Discharge summary 
E) Coding Clinic
F)ER
G)Differential diagnosis
H)Chief complaint
I)The first basic step in coding the principal diagnosis
J)Nonessential modifiers

Question 11

The main term is ____.

Accepted Answer

A) always identified in italics 
B) a review of the patient's hospital course 
C) a term identifying disease conditions or injuries 
D) a word found in parentheses that enclose explanatory information that does NOT affect the code 
A) always identified in italics 
B) a review of the patient's hospital course 
C) a term identifying disease conditions or injuries 
D) a word found in parentheses that enclose explanatory information that does NOT affect the code

Question 12

Exceptions to the general rule that main terms usually identify disease conditions are Z codes.

Accepted Answer

A) True 
 B)False

Question 13

What is the main term in "aspiration pneumonia"?

Accepted Answer

The answer of What is the main term in "aspiration...

Question 14

In the discharge summary,a physician lists the __________ that were evaluated and treated and any procedures that were performed.

Accepted Answer

The answer of In the discharge summary,a physician lists the...

Question 15

The coder should rely solely on the discharge summary to capture all of the diagnoses and procedures that were treated and performed.

Accepted Answer

A) True 
 B)False

Question 16

Which of the following is a basic step in coding?

Accepted Answer

A) Review the medical record 
B) Identify main term(s) in the Alphabetic Index 
C) Assign codes to the highest level of specificity by verifying in the Tabular 
D) All of the options are correct 
A) Review the medical record 
B) Identify main term(s) in the Alphabetic Index 
C) Assign codes to the highest level of specificity by verifying in the Tabular 
D) All of the options are correct

Question 17

Match the following with the correct term or definition.
-Emergency Room

Accepted Answer

A) Tabular List 
B) See also 
C) Subterms 
D) Discharge summary 
E) Coding Clinic
F)ER
G)Differential diagnosis
H)Chief complaint
I)The first basic step in coding the principal diagnosis
J)Nonessential modifiers 
A) Tabular List 
B) See also 
C) Subterms 
D) Discharge summary 
E) Coding Clinic
F)ER
G)Differential diagnosis
H)Chief complaint
I)The first basic step in coding the principal diagnosis
J)Nonessential modifiers

Question 18

When assigning a procedure code in ICD-10-PCS,the coder must first start with the Alphabetic Index.

Accepted Answer

A) True 
 B)False

Question 19

A coder must always remember that,once a term is located in the Alphabetic Index,the code must be verified in the Tabular List.

Accepted Answer

A) True 
 B)False

Exam 4: Basic Steps of Coding

What is the main term in "infantile eczema"?

What is the main purpose of the Alphabetic Index in ICD-10-PCS?

Match the following with the correct term or definition. -The reason,in the patient's own words,for coming to the hospital

What is the subterm in "esophageal reflux"?

Match the following with the correct term or definition. -Have no effect on the main term

When evaluating an ER record,a coder should look for the ____.

What is the main term in "rheumatoid arthritis"?

The first step in coding the principal diagnosis is to ____.

What is the main term in "esophageal reflux"?

Match the following with the correct term or definition. -Provides advice on how to correctly code specific diagnoses

The main term is ____.

Exceptions to the general rule that main terms usually identify disease conditions are Z codes.

What is the main term in "aspiration pneumonia"?

In the discharge summary,a physician lists the __________ that were evaluated and treated and any procedures that were performed.

The coder should rely solely on the discharge summary to capture all of the diagnoses and procedures that were treated and performed.

Which of the following is a basic step in coding?

Match the following with the correct term or definition. -Emergency Room

When assigning a procedure code in ICD-10-PCS,the coder must first start with the Alphabetic Index.

A coder must always remember that,once a term is located in the Alphabetic Index,the code must be verified in the Tabular List.

The Rationale for and History of Coding

The Health Record As the Foundation of Coding

ICD-10-Cm Format and Conventions

General Coding Guidelines for Diagnosis

General Coding Guidelines for Medical and Surgical Procedures

General Coding Guidelines for Other Medical- and Surgical-Related Procedures and Ancillary Procedures

Symptoms, Signs, and Abnormal Clinical and Laboratory Findings Not Elsewhere Classified, and Z Codes

Certain Infectious and Parasitic Diseases

Neoplasms

Diseases of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism

Endocrine, Nutritional, and Metabolic Diseases

Mental, Behavioral, and Neuro developmental Disorders

Diseases of the Nervous System,Diseases of the Eye and Adnexa,and Diseases of the Ear and Mastoid Process

Diseases of the Circulatory System

Diseases of the Respiratory System

Diseases of the Digestive System

Diseases of the Skin and Subcutaneous Tissue

Diseases of the Musculoskeletal System and Connective Tissue

Diseases of the Genitourinary System

Pregnancy, Childbirth, and the Puerperium

Certain Conditions Originating in the Perinatal Period and Congenital Malformations, deformations, and Chromosomal Abnormalities

Injuries and Certain Other Consequences of External Cases and External Causes of Morbidity

Burns, adverse Effects, and Poisonings

Complications of Surgical and Medical Care

Reimbursement Methodologies

Out patient Coding

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