Question 1

Which is an example of a pathologic fracture?

Accepted Answer

A pathologic fracture occurs when a bone breaks in an area weakened by some other disease, such as cancer, osteoporosis, or infection. In this case, option C, a compression fracture of vertebrae due to metastatic carcinoma, is an example of a pathologic fracture because the bone's integrity is compromised by the cancer, not just by an external force or trauma.

Question 2

Identify the true statement concerning signs and symptoms:

Accepted Answer

When a definitive diagnosis has not been documented, codes for signs and symptoms are used. However, if the sign or symptom is inherent to or commonly associated with the definitive diagnosis, it is not coded in addition to the diagnosis. This approach avoids redundancy and focuses on the primary health issue.

Question 3

A patient who is suffering from osteosarcoma located above the right knee begins chemotherapy treatment at today's encounter. Select the appropriate ICD-10-CM codes to be reported for this encounter:

Accepted Answer

The correct ICD-10-CM codes for a patient beginning chemotherapy treatment for osteosarcoma located above the right knee are Z51.11 (Encounter for antineoplastic chemotherapy) and C40.21 (Malignant neoplasm of long bones of right leg), indicating the purpose of the visit (chemotherapy) and the specific location and side of the cancer.

Question 4

When a condition is produced as a manifestation of another condition or a complication of a treatment, disease, or condition, more than one code is needed to clearly define the condition, injury, or disease. This is noted by which instructional note or notes in the ICD manual?

Accepted Answer

The instructional notes "code first" and "use additional code" in the ICD manual indicate situations where more than one code is needed to fully describe a condition. "Code first" instructs the coder to first code the underlying condition, while "use additional code" indicates that an additional code should be used to provide more detail about the manifestation or complication.

Question 5

The patient is admitted to the ER for excessive weight loss and dehydration. The patient has a history of HIV-2 and has been taking nucleoside reverse transcriptase (RT) inhibitors. Assign the appropriate ICD-10-CM codes:

Accepted Answer

B20 indicates HIV disease, R63.4 is for abnormal weight loss, and E86.0 is for dehydration. T37.5X5A is for adverse effects of antiviral drugs, which includes nucleoside reverse transcriptase inhibitors.

Question 6

The patient has type 2 diabetes mellitus that is controlled with insulin and complicated by proliferative retinopathy, gangrene, and ketonuria. Identify the correct ICD-10-CM codes:

Accepted Answer

The correct ICD-10-CM codes for a patient with type 2 diabetes mellitus that is controlled with insulin and complicated by proliferative retinopathy, gangrene, and ketonuria are E11.52 (Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene), E11.3599 (Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye), R82.4 (Ketonuria), and Z79.4 (Long term (current) use of insulin).

Question 7

A patient returns to the physician's office with flulike symptoms during the postoperative period for an appendectomy performed 1 month ago. Which modifier would need to be appended to today's office visit?

Accepted Answer

Modifier -24 is used to indicate a service performed during the postoperative period that is unrelated to the original procedure. Since the patient is returning with flulike symptoms, which are unrelated to the appendectomy, modifier -24 is appropriate.

Question 8

The diagnostic statement "goiter, nodular nontoxic" would be coded as an unspecified nontoxic goiter, ICD-10 CM code E04.9, because the diagnosis does not describe the condition as diffuse, uninodular, multinodular, or other specified nontoxic goiter. This is an example of which abbreviation used in ICD?

Accepted Answer

NOS stands for "Not Otherwise Specified" and is used in ICD coding when a diagnosis is not specified as part of a more detailed category. In this case, because the goiter is described as nodular nontoxic without further specification, it is coded as unspecified nontoxic goiter, E04.9, under the NOS category.

Question 9

The language that is built on medical terminology, anatomy, and pathophysiology and describes services, procedures, and the medical necessity of those services and procedures is referred to as:

Accepted Answer

Provider language is built on medical terminology, anatomy, and pathophysiology to describe services, procedures, and the medical necessity of those services and procedures. It is used by healthcare providers to communicate patient care and treatment information.

Question 10

A physician performed a simple mastectomy on both the left and right breasts-19303 mastectomy, simple, complete. Assign the appropriate modifier to be added to 19303 to indicate that both breasts were removed in the same operative session:

Accepted Answer

Modifier -50 is used to indicate a bilateral procedure, which is appropriate when a procedure like a simple mastectomy is performed on both sides (left and right) during the same operative session.

Question 11

A 32-year-old female was diagnosed with premature menopause that is symptomatic of ovarian failure and is experiencing headaches, flushing, and night sweats. Select the correct ICD-10-CM code(s):

Accepted Answer

E28.310 is the correct ICD-10-CM code for primary ovarian failure, which is synonymous with premature menopause. This code specifically addresses the condition described.

Question 12

Why is it necessary for a medical coder to use a current edition of the AMA CPT manual?

Accepted Answer

Using the most current edition of the AMA CPT manual ensures accurate coding, which is crucial for correct billing and compliance with medical coding standards. Changes in codes, guidelines, and procedures are updated annually, making it necessary to use the latest version for accuracy.

Question 13

The patient is admitted for severe anemia due to chemotherapy treatments for metastatic bone cancer. The primary site is the prostate. What are the correct ICD-10-CM codes?

Accepted Answer

The correct ICD-10-CM codes are D64.81 for anemia due to antineoplastic chemotherapy, C79.51 for bone metastasis (since the primary site is the prostate, metastatic bone cancer indicates bone as a secondary site), and T45.1X5A for adverse effect of antineoplastic and immunosuppressive drugs during therapeutic use, initial encounter. This combination accurately reflects the patient's condition and the cause of the anemia.

Question 14

The flow of a practice's revenue, which begins when charges for services, procedures, or supplies are incurred and continues until those charges are paid in full or adjusted off the account is known as the:

Accepted Answer

The revenue cycle encompasses all the administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue, from the initial scheduling or encounter with a patient to the final payment or adjustment of the account.

Question 15

The patient is in the intensive care unit with fluid overload with acute renal failure. He has type 2 DM and sepsis. The patient is sedated and on a ventilator because of respiratory failure. Code the diagnoses only:

Accepted Answer

The correct answer is A because it includes all the relevant diagnoses: A41.9 (fluid overload), R65.20 (acute renal failure), N17.9 (type 2 diabetes mellitus), J96.00 (respiratory failure), and E11.8 (sepsis).

Question 16

Four people were seen in the ED. Which one will receive a diagnosis of poisoning?
Patient A: digitalis toxicity
Patient B: allergic reaction to contrast dye used for a CT exam
Patient C: syncope after taking antihistamine with alcohol
Patient D: reaction between two properly administered prescription drugs

Accepted Answer

The answer of Four people were seen in the ED....

Question 17

Many conditions and diseases have "sequelae (late effects)," such as a CVA. How much time must elapse between the incident and the acute symptoms for a residual condition to be coded as a sequela (late effect)?

Accepted Answer

There is no set time for a residual condition to be coded as a sequela (late effect) following an incident like a CVA. The determination depends on the individual case and the nature of the residual effects, rather than a fixed time period.

Question 18

Where in the CPT manual will a coder locate all the instructions necessary to properly code a procedure?

Accepted Answer

The Guidelines and parenthetical notes in the CPT manual provide all the necessary instructions for properly coding a procedure, including specific coding rules, exceptions, and clarifications.

Question 19

What is a two-digit modifier used for in CPT coding?

Accepted Answer

Two-digit modifiers in CPT coding are used to indicate that a procedure or service has been altered in some way without changing the definition of the original code.

Question 20

A 67-year-old female patient with stage 5 chronic kidney disease presents today for ongoing dialysis. Choose the appropriate ICD-10-CM codes:

Accepted Answer

N18.6 is the ICD-10-CM code for Chronic kidney disease, stage 5, and Z99.2 is for Dependence on renal dialysis. These codes accurately describe the patient's condition and treatment.

Quiz 22: Fundamental Coding Guidelines