Chapter 3: Test Questions I Missed

Question 1

The terms malignant, benign, in situ, and uncertain behavior are all terms used when coding what?

Answer 1

Neoplasms

Question 2

What month does the new ICD-10-CM code book take effect each year?

Answer 2

October

Question 3

What does ICD-10-CM guideline I.B.1 state to use when locating and assigning a diagnosis code?

Answer 3

ICD-10-CM Alphabetic Index and Tabular List

Question 4

What section of the ICD-10-CM guidelines contains instructions on how to code for a patient receiving diagnostic services only in an outpatient setting?

Answer 4

Section IV

Question 5

Who are the parties responsible for providing the ICD-10-CM guidelines?

Answer 5

NCHS and CMS

Question 6

What is the ICD-10-CM code for cough?

Answer 6

R05.9 Rationale: Look in the ICD-10-CM Alphabetic Index for Cough. Without further description you are directed to R05.9. Verify code selection in the Tabular List.

Question 7

A 6-year-old patient is seen in the office for acute otitis media, coded as H66.90. This is an example of what ICD-10-CM convention?

Answer 7

NOS Rationale: H66.90 is Not Otherwise Specified. ICD-10-CM guideline I.A.9.b codes titled unspecified are for use when the information in the medical record is insufficient to assign a more specific code. The inclusion terms under H66.9 include NOS in the description.

Question 8

Which diagnosis code(s) should be reported for chronic gonococcal salpingitis?

Answer 8

A54.24 Rationale: Look in the ICD-10-CM Alphabetic Index for Salpingitis/gonococcal (acute) (chronic) A54.24. Look for A54.24 in the Tabular List. You only need to report one code for this diagnosis. Under code N70 there is an Excludes1 for gonococcal infection (A54.24). An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note.

Question 9

According to the Tabular List in the ICD-10-CM code book, category code H80 Otosclerosis, includes what other disorder?

Answer 9

Otospongiosis Rationale: Look for code H80 in the Tabular List of the ICD-10-CM code book. In the includes box is a note that appears under the three-character category code to further define or give examples of what is accepted in that category.

Question 10

What is the ICD-10-CM code for nausea?

Answer 10

R11.0 Rationale: Look in the ICD-10-CM Alphabetic Index for Nausea. You are directed to R11.0. There is no mention of vomiting. Verify code selection in the Tabular List.

Question 11

What is the ICD-10-CM code for strep throat?

Answer 11

J02.0 Rationale: Look in the ICD-10-CM Alphabetic Index for Streptococcus, streptococcal and you are directed to see also condition. Look in the Alphabetic Index for Sore/throat/streptococcal (ulcerative) J02.0. Verify code selection in the Tabular List.

Question 12

The diagnosis caudal cervical inflammatory spondylopathy is assigned ICD-10-CM code M46.82 and is an example of what ICD-10-CM coding convention?

Answer 12

NEC Rationale: The abbreviation NEC (not elsewhere classifiable) is used in the ICD-10-CM Alphabetic Index to indicate there is no separate code for the condition, even though the statement may be very specific. In the Tabular List, these conditions may include words such as other. In the Alphabetic Index look for Spondylopathy/inflammatory/specified type NEC/cervical region.

Question 13

When coding for an ambulatory surgical procedure, how is the diagnosis determined?

Answer 13

Rationale: For ambulatory surgery, if the postoperative diagnosis is known to be different from the preoperative diagnosis at the time the diagnosis is confirmed, select the postoperative diagnosis for coding because it is the most definitive. Refer to ICD-10-CM guideline IV.N.

Question 14

What is the ICD-10-CM code for hives?

Answer 14

L50.9 Rationale: Look in the ICD-10-CM Alphabetic Index for Hives and you are directed to see Urticaria. Urticaria directs you to L50.9. Verify code selection in the Tabular List.

Question 15

In the ICD-10-CM Alphabetic Index next to Hypertension, what do the terms in parentheses indicate?

Answer 15

Supplementary words that can be present or absent with the diagnosis hypertension and does not affect the code to which it is assigned. Rationale: ICD-10-CM guideline I.A.7 states parentheses are used to enclose supplementary words that may be present or absent in the statement of disease or procedure, without affecting the code number to which it assigned.

Question 16

A 20-year-old comes into the emergency department (ED) with symptoms of a severe headache, vomiting, stiff neck, and fever. The ED physician suspects meningitis and performs a lumbar puncture. The ED physician reviews the results and the patient is admitted in the hospital for meningitis which is suspected to be bacterial. Which ICD-10-CM code(s) is/are reported by the ED physician?

Answer 16

G03.9 Rationale: The symptoms for this scenario (headache, vomiting, stiff neck, and fever) are associated with meningitis (definitive diagnosis). ICD-10-CM guideline I.B.4 states signs and symptoms that are associated routinely with a disease process should not be assigned as additional codes. Per ICD-10-CM guidelines IV.D and II.H do not code a diagnosis documented as probable, suspected, questionable, rule out, or working diagnosis. Look in the Alphabetic Index for Meningitis G03.9. Verify code selection in the Tabular List.

Question 17

A 30-year-old female patient was seen in the ED with complaints of diarrhea for the past four days. She was also complaining of lower abdominal pain. After examination, the patient was diagnosed with viral gastroenteritis. She was instructed to drink plenty of fluids and to begin eating solids only after the diarrhea has subsided. What diagnosis code(s) would be reported for this encounter?

Answer 17

A08.4 Rationale: Lower abdominal pain and diarrhea are symptoms of the viral gastroenteritis. See ICD-10-CM guideline I.B.5. Look in the ICD-10-CM Alphabetic Index for Gastroenteritis/viral NEC which directs the coder to A08.4. Code selection is confirmed in the Tabular List.

Question 18

A 22-year-old is in an outpatient facility for an inguinal hernia repair. Just before surgery, the surgeon discovers the patient is positive for Methicillin-resistant Staphylococcus aureus (MRSA) and the surgery is canceled. Which ICD-10-CM code(s) should be reported for the outpatient service?

Answer 18

K40.90, A49.02, Z53.09
Rationale: ICD-10-CM guidelines for outpatient services IV.A.1 states to report the reason for surgery as the first listed diagnosis even if the surgery is canceled due to a contraindication. Look in the ICD-10-CM Alphabetic Index for Hernia/inguinal referring you to code K40.90. Next, look for MRSA (Methicillin resistant Staphylococcus aureus)/infection referring you to code A49.02. Lastly, look for Canceled procedure (surgical)/because of/contraindication referring you to code Z53.09. Verify code selection in the Tabular List.

Question 19

What diagnosis codes should be reported for a patient with polyneuropathy as a result of vitamin B deficiency?

Answer 19

E53.9, G63
Rationale: In the ICD-10-CM Alphabetic Index look for Polyneuropathy/in (due to) deficiency (of)/B (-complex) vitamins guiding you to codes E53.9 [ G63]. Code G63 is a manifestation code. In the Tabular List the description is Polyneuropathy in other diseases classified elsewhere. There is an instructional note stating to code first underlying disease such as nutritional deficiency (E40-E64). Verify code selection in the Tabular List.

Question 20

A 50-year-old female presents to her provider with symptoms of insomnia and upset stomach. The provider suspects she is premenopausal. She is diagnosed with impending menopause. What diagnosis code(s) should be reported?

Answer 20

G47.00, K30
Rationale: ICD-10-CM guideline I.B.11 states to reference the ICD-10-CM Alphabetic Index to determine if the condition has a subentry for impending or threatened and reference main term entries for Impending and Threatened. If the subterms are listed, assign the given code. If the subterms are not listed, code the existing underlying condition(s) and not the condition described as impending or threatened. Look in the Alphabetic Index for Impending. There is not a subterm for menopause; therefore, the symptoms are coded. Look for Insomnia (organic) which directs the coder to G47.00. Next, look for Upset/stomach which directs the coder to K30. Verify code selection in the Tabular List.

Question 21

A patient presents to the Emergency Department with nausea and vomiting, abdominal pain, and fever. The provider suspects appendicitis. The test results are pending. What ICD-10-CM code(s) is/are reported?

Answer 21

R11.2, R10.9, R50.9
Rationale: ICD-10-CM guideline 1.B.4 indicates codes that describe symptoms and signs, as opposed to diagnoses, are acceptable for reporting purposes when a provider has not established (confirmed) the diagnosis. Guideline II.H states not to code a diagnosis documented as probable, suspected, questionable, rule out, or working diagnosis. Nausea and vomiting have a combination code. ICD-10-CM guideline I.B.9 states that multiple coding should not be reported when a combination code clearly identifies all the elements documented in the diagnosis. Look in the Alphabetic Index for Nausea/with vomiting R11.2; Pain/abdominal R10.9; Fever (of unknown origin) R50.9. Verify code selection in the Tabular List.

Question 22

What diagnosis codes should be reported for fragilitas ossium, osteogenesis imperfecta and osteopsathyrosis?

Answer 22

Q78.0
Rationale: Look in the ICD-10-CM Alphabetic Index for Fragilitas/ossium Q78.0. Next look for Osteogenesis imperfect Q78.0. Look for Osteopsathyrosis Q78.0. The Tabular List includes all the conditions in the code Q78.0.

Question 23

The provider orders the following serum blood tests as part of a pre-employment physical exam: Complete Blood Count (CBC) automated and automated differential White Blood Count (WBC) count, Comprehensive Metabolic Panel (CMP), and a Thyroid Stimulating Hormone (TSH) assay, which are all part of the general health panel. A drug screen for multiple drug classes was also collected. What diagnosis code is reported?

Answer 23

Z02.1
Rationale: Look in the ICD-10-CM Alphabetic Index for Examination/medical/pre-employment which directs the coder to Z02.1. Verification in the Tabular List confirms code selection.

Question 24

What diagnosis code(s) is/are reported for behavioral disturbances in a patient with early onset Alzheimer’s?

Answer 24

G30.0, F02.81
Rationale: In the Alphabetic Index, look for Disease/Alzheimer’s/Early Onset/with behavioral disturbance guiding you to codes G30.0 [ F02.81]. A code in brackets is reported as an additional diagnosis. There is an instructional note in the Tabular List under category code G30 that states, use additional code to identify manifestation. You see dementia with behavioral disturbance listed as an additional code. When you go to code F02.81 in the Tabular List there is an instructional note under category F02 to code first Alzheimer’s (G30.-).

Question 25

A 10-month-old comes into the pediatrician’s office for a harsh, bark-like cough. She is diagnosed with croup. The mother also wants the pediatrician to look at a rash that has developed on her leg. The pediatrician prescribes over the counter medication of acetaminophen for the croup and hydrocortisone cream for the rash on the leg. She is to follow up in five days or return earlier if the conditions worsen. What ICD-10-CM code(s) should be reported for this visit?

Answer 25

J05.0, R21
Rationale: Signs and symptoms that are associated with a disease process should not be reported, refer to ICD-10-CM guideline I.B.5. ICD-10-CM code R05.9 is not reported because cough is a symptom of croup. Codes for signs and symptoms that are not routinely associated with a definitive diagnosis should be reported, according to ICD-10-CM guidelines 1.B.4 and I.B.5. The rash is reported because it is not related or associated with croup. Look for Croup in the ICD-10-CM Alphabetic Index referring you to code J05.0. Look for Rash in the Alphabetic Index referring you to code R21. Verify both codes in the Tabular List.