Deck 24: Injuries and Certain Other Consequences of External Cases and External Causes of Morbidity

Question 1

A patient is admitted with a closed head injury with concussion with LOC for less than 30 minutes at the scene. The patient is intoxicated (alcohol) and fell down the steps at home (a single-family home). The patient also sustained an open wound of the lip and an abrasion of the forehead.

A)S06.0x1D, S01.501D, F10.129, W10.9xxD, Y92.019
B)S06.0x1A, S01.501A, W10.9xxA, Y92.019
C)S06.0x1A, S01.501A, F10.129, W10.9xxA, Y92.019
D)S01.501A, S06.0x1A, F10.129, W10.9xxA, Y92.019

Answer 1

C

Question 2

Patient was seen with an abrasion with laceration of the left knee, initial encounter. Assign only the injury code.

A)S81.011D
B)S81.011A
C)S81.012D
D)S81.012A

Answer 2

D

Question 3

All of the following are true of external cause codes EXCEPT they capture____.

A)the cause
B)the intent
C)how to screen patients
D)the place where the event occurred

Answer 3

C

Question 4

A patient suffered a blowout fracture 1 week ago and is being seen by an orthopedic consultant and is scheduled to have surgery in 2 days. Assign only the injury code.

A)S02.3xxA
B)S02.3xxD
C)S02.3xxG
D)S02.3xxK

Question 5

All of the following are symptoms of fat embolism syndrome EXCEPT ____.

A)tachycardia
B)elevated temperature
C)decreased temperature
D)hypoxemia

Question 6

The displacement of the bones that form a joint is called ____.

A)fracture
B)sprain
C)dislocation
D)strain

Question 7

The patient is a 2-year-old child who was admitted after falling down four steps and hitting his head on concrete. The accident occurred at the patient's house. There was about 5 minutes' LOC with continued lethargy per paramedics. CT of the head and neck revealed no abnormality. The patient is on oral antibiotics for pneumonia and AOM, and these were continued during the hospital stay. He will follow up with pediatrician.Final Diagnosis: Closed head injury due to fall

A)S06.9x0A, J18.9, H66.90, W10.9xxA, Y92.019
B)S06.9x1D, J18.9, H66.90, W10.9xxD, Y92.019
C)S06.9x1A, J18.9, H66.90, W10.9xxA, Y92.019
D)S06.9x1A, J18.8, H66.90, W10.9xxA

Question 8

The patient was admitted for observation for internal injury after an accident at work. The patient, who does construction work, fell into a pit but was quickly rescued by coworkers. CT scan and x-rays were taken to evaluate for internal injury. No respiratory issues were noted. On the following morning, the patient had no complaints and was discharged to home.Discharge Diagnosis: Contusion on forehead

A)Z04.1, S00.83xA, W17.4xxA, Y92.69, Y99.1
B)Z04.2, S00.83xA, W17.2xxA, Y92.69, Y99.0
C)Z04.3, S00.83xS, W17.0xxA, Y92.69, Y99.0
D)S00.83xA, W17.2xxA, Y92.69, Y99.8

Question 9

When the surgeon makes an incision at the fracture site to reduce or manipulate the fracture into anatomic position, this is called ____ of a fracture.

A)open reduction
B)closed reduction
C)suture
D)Dermabond

Question 10

The patient (civilian) has chronic posttraumatic stress syndrome after a terrorist attack.

A)F43.12, Y38.9x2S
B)F43.11, Y38.9x2A
C)F43.10, Y38.9x2S
D)Z86.59, Y38.9x2A

Question 11

External cause codes identify ____.

A)the activity at the time of the event
B)the cause of an injury
C)the intent or place of occurrence
D)all of the above

Question 12

The patient is a 12-year-old female who was involved in a motor vehicle collision (MVC). She was a restrained passenger in a back seat of a car that was rear-ended by a car at a stoplight downtown. Initial exam in the ER indicated that she was hemodynamically stable but was complaining of left arm and right leg pain. X-rays revealed a nondisplaced tibial diaphyseal fracture and a nondisplaced proximal humerus fracture. Orthopedic consult was obtained, and a sling was applied to the arm, and a cast was applied to the leg. The patient was discharged and will receive physical therapy as an outpatient.Final Diagnoses: Nondisplaced humerus fracture, left
Fracture of tibial diaphysis, right

A)S42.295A, S82.201A, V43.62xA, Y92.414, 2W3QX2Z, 2W3BXYZ
B)S42.302A, S82.201A, V49.50xA, Y92.414, 2W3LX2Z, 2W38X1Z
C)S42.294A, S82.201A, V43.62xA, Y92.410, 2W3LXZ, 2W38XYZ
D)S82.202A, S42.294A, V43.62xA, Y92.410, 2W3QX1Z, 2W3BX2Z

Question 13

A ____ is a stretch and/or tear of a ligament.

A)dislocation
B)subluxation
C)sprain
D)strain

Question 14

A patient is admitted with a parietal bone fracture and fracture of the left fifth rib. Assign only the injury code.

A)S02.0xxA, S22.31xA
B)S02.0xxA, S22.32xA
C)S22.32xA, S02.0xxA
D)S22.31xA, S02.0xxA

Question 15

Which of the following is NOT an external cause code guideline?

A)Assign the appropriate external cause code for each encounter for which the injury or condition is being treated.
B)Use a full range of external cause codes to completely describe the injury.
C)External cause code is always the principal diagnosis.
D)Assign as many external cause codes as necessary.

Question 16

Which of the following is NOT a common site for a laceration?

A)Above the eyebrows
B)Scalp
C)Stomach
D)Knees
E)Face

Question 17

The patient was the driver in an ATV rollover. The patient was intoxicated at the time of the accident and was not wearing a helmet. There was no LOC. CT of the head revealed a small subdural hemorrhage. The patient was observed closely for any change in mental status, and neurology was consulted. There was no need for operative intervention at this time. The patient was stable and was given instructions for follow-up.

A)S06.300A, F10.129, V86.59xA
B)S06.5x0D, F10.129, V86.53xD
C)S06.5x0S, F10.129, V86.59xS
D)S06.5x0A, F10.129, V86.59xA

Question 18

A ____ is an injury to a muscle or a tendon.

A)dislocation
B)subluxation
C)sprain
D)strain

Question 19

Which of the following would NOT be an upper limb fracture?

A)A fracture to the shoulder
B)A fracture to the femur
C)A fracture to the clavicle
D)A fracture to the upper humerus

Question 20

A ____ fracture is a common fracture in adults in which the lower end of the radius is fractured and the wrist and hand are displaced backward.

A)hangman's
B)Colles
C)subluxation
D)Moore

Question 21

An injury to the brain that results from a significant blow to the head is called a(n) ____________________.

Question 22

In ICD-10-CM, if a fracture is not specified, it is coded to nondisplaced.

Question 23

A(n) ____________________ fracture causes injury to the surrounding tissues.

Question 24

The patient sustained a contusion and severe sprain of left ankle after falling into a hole while hiking in the mountains while on vacation.

A)S93.401D, W17.2xxD, Y92.828
B)S93.401A, W17.2xxD, Y92.828, Y93.01, Y99.8
C)S93.402D, W17.2xxD, Y92.828, Y93.01, Y99.8
D)S93.402A, W17.2xxA, Y92.828, Y93.01, Y99.8

Question 25

An open fracture occurs when the bone is broken but the skin remains intact.

Question 26

ICD-10-CM guidelines state that if the intent of an injury is unknown or unspecified, code the intent as accidental.

Question 27

A break in a bone is called a(n) ____________________.

Question 28

Laceration on nose due to being hit on nose by surfboard while vacationing at the beach. Laceration of the skin was repaired.

A)S01.21xD, W21.89xA, Y92.832, Y93.18, 0HQ1XZZ
B)S01.21xA, W21.89xA, Y92.832, Y93.18, Y99.8, 0HQ1XZZ
C)S01.22xA, W21.89xA, Y92.832, Y99.8, 0HQ1XZZ
D)S01.22xD, W21.89xA, 0HQ1XZZ

Question 29

Small piece of grass from mowing lawn at a single-family house stuck on right cornea. Grass was removed. Assign injury and procedure codes only.

A)T15.01xD, 08C8XZZ
B)T15.01xA, 08C8XZZ
C)T15.02xA, 08C9XZZ
D)T15.02XD, 08C9XZZ

Question 30

A(n) ____________________ is a partial or completed dislocation.

Question 31

When coding injuries, assign separate codes for each injury unless a combination code is provided.

Question 32

When the primary injury is to the blood vessels or nerves, that injury should be sequenced first.

Question 33

In ICD-10-CM, complications of a fracture such as malunion or nonunion are reported with a seventh character for subsequent care with nonunion or malunion.

Question 34

When a patient is unable to respond to people or to other stimuli, he or she is considered to have ____________________.

Question 35

In ICD-10-CM, if a fracture is not specified, it is coded to displaced.

Question 36

In ICD-10-CM, there are more Instructional notes for the coder to also code any associated injuries.

Question 37

Spinal cord injuries tend to occur where the spine is most flexible.

Question 38

When air or gas bubbles get into the bloodstream, it is called a(n) ___________________.

Question 39

A(n) ____________________ is a break in a bone that occurs because of underlying disorders that weaken the bone, including malignancy, benign bone tumors, metabolic disorders, infection, and osteoporosis.

Question 40

A closed fracture occurs when the bone exits and is visible through the skin or when a deep wound exposes the bone through the skin.

Question 41

Where are foreign bodies most likely to enter?

Question 42

Match each definition to one of the following items.
a.Crush injury
b.Fissured fracture
c.Comminuted fracture
d.Greenstick fracture
e.External skeletal fixation
f.Contusion
A form of fracture treatment that involves inserting percutaneous pins proximal and distal to the fracture

Question 43

Match each definition to one of the following items.
a.Crush injury
b.Fissured fracture
c.Comminuted fracture
d.Greenstick fracture
e.External skeletal fixation
f.Contusion
A fracture that is broken, splintered, or crushed into pieces

Question 44

What does TBI stand for?

Question 45

Match each definition to one of the following items.
a.Crush injury
b.Fissured fracture
c.Comminuted fracture
d.Greenstick fracture
e.External skeletal fixation
f.Contusion
An incomplete fracture that does not split the bone

Question 46

Match each definition to one of the following items.
a.Z94.6
b.Z89.211
c.Z89.432
d.Z87.820
e.Z91.81
Organ or tissue replaced by transplant-bone

Question 47

Match each definition to one of the following items.
a.Crush injury
b.Fissured fracture
c.Comminuted fracture
d.Greenstick fracture
e.External skeletal fixation
f.Contusion
When the bone is somewhat bent and partially broken; usually occurs in children

Question 48

Match each definition to one of the following items.
a.Z94.6
b.Z89.211
c.Z89.432
d.Z87.820
e.Z91.81
Upper limb amputation status-below elbow

Question 49

Match each definition to one of the following items.
a.Crush injury
b.Fissured fracture
c.Comminuted fracture
d.Greenstick fracture
e.External skeletal fixation
f.Contusion
The body part is subjected to a high degree of force or pressure, usually after being squeezed between two heavy or immobile objects

Question 50

Match each definition to one of the following items.
a.Z94.6
b.Z89.211
c.Z89.432
d.Z87.820
e.Z91.81
Lower limb amputation status-foot

Question 51

When air or gas bubbles get into the bloodstream, what is one thing that can happen?

Question 52

Match each definition to one of the following items.
a.Z94.6
b.Z89.211
c.Z89.432
d.Z87.820
e.Z91.81
History of falling

Question 53

Anaphylactic shock due to ingestion of milk: __________

Question 54

Name some diagnostic tools used to diagnose injuries.

Question 55

Where is the best place to look for the petechial rash that forms from fat embolism syndrome?

Question 56

Fat embolism syndrome usually is present within _____ to _____ hours after the injury.

Question 57

C5 spinal cord injury with complete lesion, initial encounter: __________

Question 58

Match each definition to one of the following items.
a.Crush injury
b.Fissured fracture
c.Comminuted fracture
d.Greenstick fracture
e.External skeletal fixation
f.Contusion
Any mechanical injury that results in hemorrhage beneath unbroken skin

Question 59

Match each definition to one of the following items.
a.Z94.6
b.Z89.211
c.Z89.432
d.Z87.820
e.Z91.81
Personal history of TBI

Question 60

What are external cause codes? ____________________

Question 61

A patient is admitted with a laceration of the forehead due to a collision with another player during a professional soccer game. On further exam, it feels as though there may be a foreign body, so the patient is taken to the OR for exploration, where the laceration was extended and a foreign body was removed from the subcutaneous tissue. The laceration of the skin was sutured. The pathology report determines the foreign body to be a tooth.

Question 62

Sprained left ankle, initial encounter: __________

Question 63

Fifteen mosquito bites on right lower leg, initial encounter: __________

Question 64

Injury to spleen with massive parenchymal disruption (major laceration) and a total splenectomy (open) was performed, initial encounter: __________

Question 65

Open-fracture fifth metatarsal on the right, initial encounter: __________

Question 66

Fractured coccyx, initial encounter: __________

Question 67

Patient fractured left tibia 2 weeks ago and is seen as an outpatient for cast change: __________

Question 68

Open dislocation (open wound), right acromioclavicular joint, initial encounter: __________

Question 69

A 7-year-old child is admitted to the hospital with fractured shaft of the right humerus after falling out of a tree. The patient is taken to the OR for ORIF. __________

Question 70

Fractured both wrists; left distal radius and ulna, right distal ulnar fracture, initial encounter: __________