Deck 5: ICD-9-CM Medical Coding

Question 1

The first forms of medical diagnostic coding date back to:

A)12th-century Rome.
B)17th-century England.
C)18th-century America.
D)19th-century France.

Answer 1

17th-century England.

Question 2

ICD-9-CM codes submitted on insurance claim forms are used to:

A)record a patient's office visits or inpatient days.
B)report specific procedures and services.
C)determine medical necessity for covered procedures and services.
D)report patient demographic information.

Answer 2

determine medical necessity for covered procedures and services.

Question 3

ICD information was used by the World Health Organization (WHO) for all of the following purposes EXCEPT to:

A)assist in tracking mortality.
B)track morbidity.
C)make statistical assessments of international health and disease trends.
D)ensure that providers were being paid appropriately.

Answer 3

ensure that providers were being paid appropriately.

Question 4

As of 1948, the International Classification of Causes of Death name was changed to:

A)International Classification of Deaths.
B)International Listing of Causes of Death.
C)International Causes of Diseases.
D)International Classification of Diseases.

Question 5

What indicator appears with certain codes to indicate that they are either new codes or something is different about them?

A)The letter "N"
B)Parentheses
C)Brackets
D)Symbols

Question 6

Updates to Volumes 1 and 2 of the ICD-9-CM may include:

A)addition of new codes.
B)deletion of old codes.
C)revisions to descriptors.
D)all of the above.

Question 7

ICD-9-CM coding serves which of the following purposes?

A)It provides data for statistical analysis.
B)It translates written terminology into a universal, common language.
C)It establishes medical necessity.
D)All of the above.

Question 8

A coder's first step in the reimbursement process is:

A)registering the patient.
B)reading and understanding the physician's documentation.
C)filling out a claim form.
D)calling the insurance carrier.

Question 9

As part of the Medicare Catastrophic Coverage Act of 1988, providers were required to:

A)bill government or private insurance carriers within 90 days of the date of service.
B)include written descriptions of illnesses or injuries along with codes.
C)bill all insurance carriers using a standardized form.
D)use ICD-9-CM codes when billing government or private insurance carriers.

Question 10

The London Bills of Mortality were introduced to:

A)identify the towns with the highest death rates.
B)report officially how many people were affected by the plague each year.
C)identify the mortality rate of children.
D)warn about plague epidemics by reporting deaths and causes of death.

Question 11

In 1948 the International Classification of Causes of Death (ICD) came under the direction of the:

A)British government.
B)U.S. Department of Health and Human Services.
C)World Health Organization (WHO).
D)National Council of Diagnostic Coding.

Question 12

Volume 1 of the ICD-9-CM is known as the:

A)Alphabetic Index of Diseases.
B)Tabular/Numerical List of Diseases.
C)Tabular/Numerical Index of Diseases.
D)Alphabetic List of Procedures.

Question 13

Revisions to Volume 3 are made by the:

A)Centers for Medicare and Medicaid Services.
B)Centers for Disease Control and Prevention.
C)World Health Organization (WHO).
D)National Center for Health Statistics.

Question 14

Volume 3 of the ICD-9-CM is known as the:

A)Alphabetic Index of Diseases.
B)Tabular/Numerical List of Diseases.
C)Alphabetic List of Procedures.
D)Tabular and Alphabetic Index of Procedures.

Question 15

The clinical modification of the ICD-9 allowed the data to be used for all of the following EXCEPT:

A)compiling and comparing healthcare data and classifying morbidity data.
B)assisting in planning healthcare delivery systems.
C)communicating with patients about their conditions.
D)conducting epidemiological and clinical research.

Question 16

The clinical modification of the ICD-9 was developed by the:

A)World Health Organization (WHO).
B)National Center for Health Statistics.
C)U.S. Department of Health and Human Services.
D)Centers for Medicare and Medicaid Services.

Question 17

The cause or origin of a disease is its:

A)morphology.
B)past history.
C)etiology.
D)pathology.

Question 18

Diagnostic coding changes for Volumes 1 and 2 of ICD-9-CM take effect:

A)annually on January 1.
B)annually on July 1.
C)annually on October 1.
D)as needed.

Question 19

Volume 2 of the ICD-9-CM is known as the:

A)Alphabetic Index of Diseases.
B)Tabular/Numerical List of Diseases.
C)Tabular/Numerical Index of Diseases.
D)Alphabetic List of Procedures.

Question 20

In addition to the reimbursement process, ICD-9-CM codes are used by outside agencies to:

A)forecast healthcare needs.
B)conduct studies of disease trends.
C)review costs and evaluate facilities.
D)all of the above.

Question 21

When using Volume 2 for coding narrowing of the vertebral artery with cerebral infarction, the main term a coder would look up is:

A)narrowing.
B)vertebral.
C)artery.
D)infarction.

Question 22

Volume 3 of the ICD-9-CM is used by:

A)physicians to code diagnoses and symptoms.
B)physicians to code procedures.
C)hospitals to code diagnoses and symptoms.
D)hospitals to code procedures.

Question 23

All of the following are true of supplementary terms in an ICD-9-CM entry EXCEPT that they:

A)are essential to the selection of the correct code.
B)aid the coder in finding the correct term.
C)can be in parentheses.
D)can be in brackets.

Question 24

Using a 3-digit category code only when no 4-digit codes exist and a 4-digit subcategory code only when no 5-digit subclassification code exists is coding to the highest level of:

A)authority.
B)reimbursement.
C)specificity.
D)certainty.

Question 25

When using Volume 2 for coding a pregnancy test with a positive result, the main term a coder would look up is:

A)pregnancy.
B)test.
C)positive.
D)result.

Question 26

Instructional notes are used in Volume 1 to:

A)define terms.
B)provide coding instructions.
C)provide fifth-digit information.
D)all of the above.

Question 27

An example of an eponym is:

A)Hodgkin's disease.
B)cardiovascular disease.
C)rheumatoid arthritis.
D)chronic disease.

Question 28

Tables found in Volume 2 (Alphabetic Index) include all of the following EXCEPT:

A)diabetes table.
B)tables of drugs and chemicals.
C)hypertension table.
D)neoplasm table.

Question 29

Subterms in an ICD-9-CM entry may show:

A)the cause or origin of the disease.
B)another name for the disease.
C)a better description of the disease.
D)treatments of the disease.

Question 30

Appendices in Volume 1 (Tabular List of Diseases and Injuries) include all of the following EXCEPT:

A)morphology of neoplasms.
B)symptoms, signs, and ill-defined conditions.
C)classification of industrial accidents according to agency.
D)list of three-digit categories.

Question 31

In Volume 2, the acronym NEC (not elsewhere classified) is used to indicate that:

A)a condition hasn't been researched enough to be included in the classifications.
B)the coder must choose between two similar codes.
C)a specified form of the condition is classified differently.
D)this is the first year a condition has been included in the classifications.

Question 32

The first step in locating the accurate and most-specific code is to:

A)determine the reason for the encounter.
B)locate the term in the alphabetic index in Volume 2.
C)locate the term in the tabular list in Volume 1.
D)determine the services that were provided.

Question 33

When coding acute serous otitis media using Volume 2, the main term a coder would look up is:

A)acute.
B)serous.
C)otitis.
D)media.

Question 34

Key coding guidelines that apply to ICD-9-CM coding include:

A)coding to the lowest level of specificity.
B)coding to the highest level of certainty and specificity.
C)coding the primary diagnosis after the current coexisting conditions.
D)downcoding to avoid any question of abuse.

Question 35

Which of the following is true of carryover lines (turnover lines)?

A)They are used if the main term or subterm is too long to fit on one line.
B)They are used to show the cause of the disease (etiology).
C)They are used to identify the body site of the condition.
D)They list another name for the condition or disease.

Question 36

Volume 1 should be referred to by a coder:

A)after the correct main term and code have been located in Volume 2.
B)before using Volume 2 to find the written description of a condition.
C)only if the correct main term and code cannot be found in Volume 2.
D)after the correct main term and code have been located in Volume 3.

Question 37

The chapters in Volume 1 (Tabular List of Diseases and Injuries) are grouped by:

A)frequency of disease occurrence.
B)treatment options for condition.
C)complexity of condition.
D)body system affected by condition.

Question 38

If the physician cannot determine the diagnosis at the time of the encounter, the coder should:

A)wait until a definite diagnosis is made.
B)ask the physician to guess at a possible diagnosis.
C)code the symptoms, signs, or reason for the encounter.
D)code any preexisting or coexisting conditions.

Question 39

To report external causes of injury and poisoning, a coder should use:

A)V codes.
B)E codes.
C)numeric codes only.
D)a written explanation.

Question 40

Square brackets are used in Volume 1 to enclose:

A)antonyms and synonyms.
B)synonyms, alternate wording, or explanatory text.
C)eponyms and other proper names.
D)homonyms, alternate wording, or explanatory text.

Question 41

E codes are used to provide data for injury research and evaluation of injury-prevention strategies.

Question 42

Coding burns is based on:

A)the location of the burn.
B)the degree of severity of the burn.
C)the percentage of the total body burned.
D)all of the above.

Question 43

Major categories of E codes include all of the following EXCEPT:

A)assaults or purposely inflicted injury.
B)late effects of accidents or self-injury.
C)accidental falls.
D)history of past medical conditions.

Question 44

It is acceptable to code encounters for "probable" or "suspected" conditions on a UB-04 claim form to indicate a patient's admitting diagnosis.

Question 45

Hypertension is classified in the hypertension table as:

A)benign or malignant.
B)malignant or unspecified.
C)malignant or unknown.
D)benign, malignant, or unspecified.

Question 46

The Rule of Nines is used in coding to:

A)estimate the degree of a burn.
B)estimate the body surface area involved in a burn.
C)identify the chemical used in an accident that resulted in burns.
D)determine the location of a burn.

Question 47

In coding surgical procedures, the coder should use the postoperative diagnosis only if it differs from the preoperative diagnosis.

Question 48

If a patient presents with no complaints of illness or injury, the coder should:

A)use a V code.
B)bill the patient for the standard office visit fee.
C)use an E code.
D)use the code of any preexisting condition.

Question 49

A condition that remains after a patient's acute illness or injury is called a(n):

A)complication.
B)late effect.
C)manifestation.
D)adverse effect.

Question 50

An E code would be used to report that a healthy person has become an organ donor.

Question 51

In coding late (residual) effects, the coder should:

A)code only the cause of the late effect.
B)code only the late effect.
C)code first the cause followed by the code for the late effect.
D)code first the late effect followed by the code for its cause.

Question 52

When the physician determines the patient's main reason for the encounter, this information is referred to as the:

A)primary diagnosis.
B)principal diagnosis.
C)admitting diagnosis.
D)chief complaint.

Question 53

The treatment provided for a particular condition is known as its manifestation.

Question 54

The primary diagnosis is the main reason for the visit or encounter.

Question 55

Malignant neoplasms are classified as:

A)primary, secondary, or carcinoma in situ.
B)primary, secondary, or third-level.
C)carcinoma in situ or noncarcinoma in situ.
D)primary or secondary only.

Question 56

Type I diabetes mellitus indicates that the:

A)patient is insulin-dependent.
B)patient is not insulin-dependent.
C)diabetes is uncontrolled.
D)diabetes occurred during pregnancy.

Question 57

0The term encounter refers to any occurrence of patient care, regardless of the setting in which it is provided.

Question 58

In billing for inpatient services, two diagnosis codes are used. The final diagnosis after the patient has been admitted and an examination or tests have been performed is known as the:

A)rule-out diagnosis.
B)secondary diagnosis.
C)principal diagnosis.
D)primary diagnosis.

Question 59

A medical office specialist should always code to the highest level of specificity.

Question 60

If a patient comes in for chemotherapy, the medical office specialist should code the cancer as primary and the V code for the encounter as secondary.

Question 61

A complication code is usually the secondary code on the claim form since it is NOT the primary reason for the encounter.

Question 62

A code that describes conditions that frequently occur together is called a(n) __________ code.

Question 63

A fifth digit is always required for coding diabetes.

Question 64

The physician or any qualified healthcare practitioner who is legally accountable for establishing the patient's diagnosis is called the __________ .

Question 65

In Volume 2, a(n) __________ is a term indented beneath a main term that provides greater specificity about the diagnosis.

Question 66

When coding for accidents, an E code is used in the primary position, followed by the resulting condition.

Question 67

High blood pressure is considered a disease and should be coded from the hypertension table.

Question 68

Diagnostic coding using the ICD-9-CM became mandatory for __________ claims as a result of the Medicare Catastrophic Coverage Act of 1988.

Question 69

The Tabular/Numerical List of Diseases is contained in Volume __________ .

Question 70

For multiple injuries, always sequence the least-severe injury first.

Question 71

Tumor cells that are undergoing malignant changes but do NOT extend beyond the point of origin are called __________ ITALIC_in situ_ITALIC

Question 72

A symptom is an objective (measurable) indication that can be evaluated by the physician.

Question 73

A patient admitted to a hospital is given two diagnoses; the diagnosis that indicates the reason the patient needs hospital care is the __________ diagnosis.

Question 74

When coding neoplasms, the fifth digit of a morphology code indicates the behavior of the neoplasm.

Question 75

A poisoning is reported using one, two, or three codes.

Question 76

Benign neoplasms are tumor cells that have the property of metastasis.

Question 77

Internal and external injuries are always coded the same.

Question 78

Volume 2 of the ICD-9-CM is the __________ of Diseases.

Question 79

The medical term that describes the condition for which a patient is receiving care is located in the physician's __________ statement in the medical record.

Question 80

Hypertension is defined in adults as 140/90 mm Hg on three separate readings recorded several weeks apart.