Deck 5: Inpatient Coding

Question 1

For inpatient coding, the use of "rule out" may be utilized as long as the diagnosis has not been ruled out prior to discharge.

Answer 1

True

Question 2

Chronic diagnosis should always be assigned for inpatient claims.

Answer 2

False

Question 3

The admitting diagnosis is always utilized as the principal diagnosis as well.

Answer 3

False

Question 4

When contrasting diagnoses are listed as either/or, only one diagnosis should be listed.

Question 5

Dehydration would always be considered as a complication or comorbidity (CC).

Question 6

Colonoscopies would be located in the 55-59 ICD-9 Procedure Code Categories.

Question 7

Fracture care diagnostic codes should only be utilized for encounters for initial treatment in ICD-9-CM coding

Question 8

ICD-9-CM "V" codes should be utilized for follow-up or aftercare management when the initial treatment for the injury or disease has been completed.

Question 9

When a patient presents with a cough and is diagnosed with acute bronchitis, both conditions should be coded.

Question 10

Shortness of breath should be coded in conjunction with congestive heart failure (CHF).

Question 11

For the purposes of inpatient coding, "chest pain, rule out MI" would be coded as:

A) chest pain.
B) chest pain and MI.
C) MI.
D) any of the above.

Question 12

For inpatient coding purposes, the diagnosis "chest pain, ruled out chest pain" should be coded as:

A) CAD.
B) MI.
C) Chest Pain.
D) None of the above.

Question 13

When a physician requests testing to determine HIV status, the following ICD-9-CM diagnostic codes should be assigned:

A) V73.89
B) V08.
C) V73.89 and V08.
D) 042.

Question 14

When a patient presents for chemotherapy for metastatic pancreatic cancer from the colon, the primary diagnosis would be:

A) Encounter for Chemotherapy.
B) Secondary Neoplasm Pancreas.
C) Colon Cancer.
D) Neoplasm, Site Unknown.

Question 15

What diagnosis would neoplasm of the lung be assigned?

A) Neoplasm, lung, uncertain behavior
B) Neoplasm, primary, malignant, lung
C) Neoplasm, primary, benign, lung
D) Neoplasm, lung, unspecified behavior

Question 16

Type II diabetes would be assigned the ICD-9-CM diagnostic codes:

A) 250.00.
B) 250.01.
C) 250.02.
D) 250.0.

Question 17

The diagnosis of acute abdominal pain would be assigned the ICD-9-CM diagnostic codes:

A) 789.00.
B) 338.29.
C) 338.19.
D) 338.19, 789.00.

Question 18

Chronic obstructive pulmonary disease (COPD) with chronic asthma would be assigned the ICD-9-CM diagnostic codes:

A) 493.90, 496.
B) 493.20.
C) 496.
D) 493.92, 496.

Question 19

When a procedure is performed bilaterally, and the ICD-9-CM procedure code description is not specified as bilateral:

A) assign the ICD-9-CM procedure code once.
B) assign the ICD-9-CM procedure code twice.
C) assign the ICD-9-CM procedure code with modifier 50.
D) assign the ICD-9-CM procedure code with modifiers RT/LT.

Question 20

Which ICD-9-CM diagnostic codes and procedures are assigned when a laparoscopic procedure is converted to an open procedure?

A) Laparoscopic and Open Procedure
B) Open Procedure Only
C) Open Procedure and V64.41
D) Laparoscopic Procedure and V64.41

Question 21

The old diagnosis-related group (DRG) reimbursement system was replaced in 2008 with the __________ system?

Question 22

A "POA" diagnosis is defined by CMS as present at the time the ____________ ____________ order occurs.

Question 23

When a condition exists based on clinical documentation but the physician has not documented, it would be appropriate for the coder to generate __________?

Question 24

Determine the admitting ICD-9-CM diagnosis in the following scenario:
​
Patient presented to the emergency room (ER) with complaints of nausea and vomiting. CT abdomen and pelvis indicates multiple calculi located in the right ureter. Patient admitted for pain management and possible cystoscopy with removal of stone.

Question 25

Determine the appropriate principal ICD-9-CM diagnosis in the following scenario:

Patient presents with abdominal pain and nausea. Previously diagnosed with a urinary tract infection. Patient is admitted for IV antibiotic therapy. Further workup of CT abdomen and pelvis reveals acute pyelonephritis.

Question 26

Assign the appropriate ICD-9-CM diagnoses for the following outpatient scenario:
​
Patient presents with abdominal pain, duration of 7 days, increasing in severity. Patient awoke this morning with temperature of 104.1 $^\circ$ F along with nausea and chills. Workup in emergency department (ED) was negative for appendicitis and gallbladder disease. Will prescribe pain meds and work up further as an outpatient for the possibility of gastritis.

Question 27

Assign the appropriate ICD-9-CM diagnosis codes for the outpatient setting.
Patient presents with a 4-day history of right, lower quadrant abdominal pain. An abdominal and pelvic CT with contrast is ordered to rule out an ectopic pregnancy.

Question 28

Assign ICD-9-CM diagnosis codes for the following inpatient scenario. (You will need to assign an admitting diagnosis, a principal diagnosis, and a secondary diagnosis(es).)
​
57-year-old female presents with nausea and vomiting, which started last evening after the ingestion of tuna salad sandwich. She presented suspecting she had food poisoning. Patient was dehydrated, so she was rehydrated with fluids and given pain meds. She was admitted with gastroenteritis, probably viral.

Question 29

A significant procedure is defined by which four characteristics?

Question 30

A tympanoplasty would be found in what category of ICD-9-CM procedure codes?

Question 31

ICD-10
"Z"
codes should be utilized for follow-up or aftercare management when the initial treatment for the injury or disease has been completed?.

Question 32

ICD-10
Colonoscopies would be located in the 0CD category for ICD-10 PCS codes?.

Question 33

ICD-10
Fracture care codes should only be utilized for encounters for initial treatment?.

Question 34

ICD-10
When a physician requests testing to determine HIV status, the following ICD-10-CM diagnostic codes should be assigned:

A) Z11.4
B) signs and symptoms and Z71.7
C) R75
D) Z21

Question 35

ICD-10
Type II diabetes would be assigned what ICD-10-CM codes:

A) E11.9
B) E10.9
C) E10.52
D) E13.9

Question 36

ICD-10
The diagnosis for acute abdominal pain would be assigned the ICD-10-CM codes:

A) R10.9
B) R10.821
C) R10.83
D) R10.84

Question 37

ICD-10
COPD with chronic asthma would be assigned what ICD-10-CM codes:

A) J44.0
B) J44.9
C) J67.9
D) J47.9

Question 38

ICD-10
When a procedure is performed bilaterally and the ICD-10 PCS procedure code description is NOT specified as bilateral,

A) assign the ICD-10 PCS code twice.
B) assign the ICD-10 PCS code once.
C) assign the ICD-10 PCS code with modifier 50.
D) assign the ICD-10 PCS code with modifiers RT/LT.

Question 39

ICD-10
What ICD-10 PCS codes are assigned when a laparoscopic procedure is converted to an open procedure

A) Both the laparoscopic and open procedure
B) Laparoscopic procedure with modifier 74
C) Only the open procedure
D) Laparoscopic procedure only

Question 40

ICD-10
Determine the admitting diagnosis for the following scenario:
Patient presented to the ER with complaints of nausea and vomiting. CT abdomen and pelvis indicates multiple calculi located in the right ureter. Patient admitted for pain management and possible cystoscopy with removal of stone

Question 41

ICD-10
Determine the principal diagnosis in the following scenario:
Patient presents with abdominal pain and nausea. Previously diagnosed with a urinary tract infection. Patient is admitted for IV antibiotic therapy. Further workup of CT abdomen and pelvis reveals acute pyelonephritis.

Question 42

ICD-10
Assign the appropriate diagnoses for the following outpatient scenario:
Patient presents with abdominal pain, duration of 7 days, increasing in severity. Patient awoke this morning with temperature of 104.1 along with nausea and chills. Workup in ED was negative for appendicitis and gallbladder disease. Will prescribe pain meds and work up further as an outpatient for the possibility of gastritis.​

Question 43

ICD-10
Assign the appropriate ICD-10 diagnostic codes for the following setting:
Patient presents with a 4-day history of right, lower quadrant abdominal pain. An abdominal and pelvic CT with contrast is ordered that ruled out ectopic pregnancy.​

Question 44

ICD-10
Assign ICD-10 diagnostic codes for the following inpatient scenario. (You will need to assign an admitting diagnosis, a principal diagnosis, and a secondary diagnosis(es).)
​
57-year-old female presents with nausea and vomiting, which started last evening after ingestion of tuna salad sandwich. She presented suspecting she had food poisoning. Patient was dehydrated, so she was rehydrated with fluids and given pain meds. She was admitted with gastroenteritis, probably viral.​

Question 45

ICD-10
A tympanoplasty would be found in what category of ICD-10 PCS procedure codes

Question 46

ICD-9
Assign the appropriate ICD-9-CM diagnostic codes to the following scenario:
​
69 year old admitted to hospital due to altered mental status
​
Assessment/Plan:
Altered Mental Status
Dehydration
Multiple Myeloma
Hypertension
Type II Diabetes Mellitus​

Question 47

ICD-10
Assign the appropriate ICD-10-CM diagnostic codes to the following:
​
69 year old admitted for altered mental status
​
Assessment/Plan:
Altered mental status
Dehydration
Multiple myeloma
Hypertension
Type II Diabetes Mellitus​

Question 48

ICD-9
Assign the appropriate ICD-9-CM diagnostic codes to the following:
​
Patient initially treated with oral antibiotics but did not improve, therefore, admitted, treated with IV fluids and antibiotics. His dehydration improved, he became much more alert, and his white count improved
​
DISCHARGE DIAGNOSIS:
Pneumonia
Dehydration
Dementia
Chronic ITP
Peripheral Vascular Disease
AKA right leg
CHF​

Question 49

ICD-10
Assign the appropriate ICD-10-CM diagnostic codes for the following:
​
Patient treated with oral antibiotics, however, there was no improvement, and, he was admitted and treated with IV fluids and IV antibiotics. His dehydration improved, he became much more alert and his white count improved.
​
DISCHARGE DIAGNOSIS:
Pneumonia
Dehydration
Dementia
ITP
Peripheral Vascular Disease
AKA right leg
CHF​

Question 50

ICD-9-CM
Assign the appropriate ICD-9-CM diagnostic codes to the following:
​
82-year-old gentlemen who usually resides at a local nursing home, however, brought to hospital for significant respiratory symptoms over the past week. Chest x-ray was non-conclusive, however, patient was treated with IV antibiotics and IV hydration.
​
IMPRESSION:
Acute dyspnea, hypoxia
Dehydration
Chronic ITP
Chronic constipation
Peripheral vascular disease​

Question 51

ICD-10-CM
​
Assign the appropriate ICD-10-CM diagnostic codes for the following:
​
Patient usually resides at a local nursing home and was brought to ED for significant respiratory symptoms. Chest x-ray was not clear, but, patient was admitted for IV antibiotics and IV hydration.
​
IMPRESSION:
Acute dyspnea
Hypoxia
Dehydration
ITP
Chronic constipation
Peripheral vascular disease​

Question 52

ICD-9-CM
​
Assign ICD-9-CM diagnostic codes to the following:
​
62 year old admitted with chest discomfort. Electrocardiogram (EKG) shows atrial fibrillation , with no evidence of angina or myocardial infarction.
​
FINAL DIAGNOSIS:
Congestive heart failure with PND
Atrial fibrillation
Hypercholesterolemia
Chronic DJD knee, right
Coronary artery disease​

Question 53

ICD-10-CM
​
Assign the appropriate ICD-10 diagnostic codes to the following:
​
62 year old admitted with chest discomfort. EKG shows atrial fibrillation with no evidence of angina or myocardial infarction.
​
FINAL DIAGNOSIS:
Congestive heart failure
CAD
Atrial fibrillation
Hypercholesterolemia
Chronic DJD Knee, Right​