Ch 5: Pretest

Question 1

T/F: Codes that describe symptoms and signs, as opposed to diagnoses, are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider.

Answer 1

True

Question 2

What is a sequela?

Answer 2

The residual effect (condition produced) after the acute phase of an illness or injury has terminated

Question 3

T/F: In the inpatient setting, it is acceptable to code diagnoses that have not yet been confirmed but are questionable or suspected at the time of discharge.

Answer 3

True

Question 4

T/F: If a condition is documented as both acute and chronic and there are separate codes at the same indentation level, the chronic condition is sequenced first.

Answer 4

False

Question 5

T/F: Principal diagnosis is the condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care.

Answer 5

True

Question 6

T/F: According to the guidelines, it is acceptable to assign codes for BMI based on the documentation of a clinician such as a dietitian.

Answer 6

True

Question 7

T/F: If a condition has been documented as impending and actually occurs, it is acceptable to code the confirmed diagnosis.

Answer 7

True

Question 8

T/F: Conditions that are routinely associated with a disease should be coded as additional diagnosis.

Answer 8

False

Question 9

History codes may be used as secondary codes if the historical condition or family history ______.

Answer 9

has an impact on current care or influences treatment

Question 10

T/F: When coding encounters for rehabilitation, the coder should first sequence the code for the underlying condition.

Answer 10

True