Exam 5: General Coding Guidelines for Diagnosis

When you assign separate codes that are used to identify acute and chronic conditions,the acute code is sequenced first.

Principal diagnosis is defined in the Uniform Hospital Discharge Data Set (UHDDS)as that condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care.

When a coder notices on a laboratory test result that a patient's sodium is below normal,it is acceptable to code hyponatremia.

A(n)__________ code is a single code used to classify two diagnoses,a diagnosis with an associated secondary process,or a diagnosis with an associated complication.

A patient is admitted to the hospital with Crohn's disease,hypertension,and rheumatoid arthritis for bowel resection.In the OR before incision,the patient develops tachycardia,and the procedure is canceled.What is the principal diagnosis?

When the patient is admitted for a complication due to a surgical procedure,the complication is the principal diagnosis.

What is the diagnosis code(s)for memory deficit due to previous cerebral infarction?

What are the diagnosis code(s)for acute and chronic pancreatitis?

If the principal diagnosis was abdominal pain due to acute appendicitis,the abdominal pain would be coded as a secondary diagnosis.

A(n)____ is a residual effect (condition produced)after the acute phase of an illness or injury has terminated.

Conditions that are routinely associated with a disease or condition should not be coded as additional diagnoses unless instructed by the classification or unless they affect the patient's condition or treatment given.

What is the diagnosis code(s)for acute and chronic renal failure?

A patient who is a known diabetic is admitted for treatment of an ulcer of the left great toe.What is the principal diagnosis?

What is the diagnosis code(s)for acute and chronic bronchitis?

What is the diagnosis code(s)for acute and chronic respiratory failure?

List one reason when it is NOT acceptable to code a symptom code from Chapter 18.

What is the diagnosis code(s)for thoracolumbar scoliosis (neuromuscular)due to past history of poliomyelitis?

If a diagnosis is documented as possible at the time of discharge from an inpatient stay,code the condition as if it exists.

In the inpatient setting,it is not acceptable to code diagnoses that have not yet been confirmed and are questionable or suspected.

If a patient is admitted for a complication due to a surgical procedure,the reason for the surgical procedure is the principal diagnosis.