Chapter 4 Practical Flashcards
A patient was seen for a left ear infection. The provider diagnosed the patient with Swimmer’s Ear in the left ear. The biller received a denial from XYZ Insurance Company stating H60.33 is an invalid diagnosis code. Why is this an invalid code?
(A) H60.33 represents an additional character; the code should be H60.332.
(B) H60.33 is not an invalid diagnosis code.
(C) H60.33 requires an additional character; the code should be H60.339.
(D) H60.33 requires an additional character; the code should be H60.332.
(D) H60.33 requires an additional character; the code should be H60.332.
H60.33 is a subcategory code that requires an additional character to be complete. The ear affected is the left ear. Look in the ICD-10-CM Tabular List and find that H60.332 represents Swimmer’s Ear in the left ear.
A patient is seen for a cough, chest congestion, and a headache. The provider documents a URI. What ICD-10-CM coding is reported?
(A) J06.9.
(B) R05, R09.89, R51.9, J98.8.
(C) R05, R09.89, R51.9.
(D) J98.8.
(A) J06.9.
Signs and symptoms are not reported when a definitive diagnosis is given (ICD-10-CM guideline I.B.4). Look in the ICD-10-CM Alphabetic Index for Infection/respiratory (tract)/upper (acute) J06.9. Verify code selection in the Tabular Index.
What codes are reported for a patient that is being treated for ESRD and hypertension?
(A) I11.9, N18.9.
(B) I12.9, N18.6.
(C) I12.0, N18.5.
(D) I12.0, N18.6.
(D) I12.0, N18.6.
The ICD-10-CM guideline (I.C.a.2) indicates to assign codes for category I12 with code from category N18 as the relationship between hypertension and chronic kidney disease is presumed.
A patient complains if a severe sore throat, a fever, and headache. Based on the results of a rapid strep test the provider determines the patient has strep throat. What ICD-10-CM coding is reported?
(A) R07.0, R50.9, R51.9.
(B) J02.0.
(C) J02.0, R50.9, R51.9.
(D) J02.9, R50.9, R51.9.
(B) J02.0.
The ICD-10-CM guideline (I.B.18) states when a definitive diagnosis is documented by the provider, the signs and symptoms of the condition would not be reported separately. If the provider was waiting for the results of the lab work, the signs and symptoms would be reported.
What should a biller do if the ICD-10-CM instructions indicate “See” or “See Also”?
(A) Ignore this statement is only used by coders.
(B) Go to the main term referenced with the “see” note to locate the correct code.
(C) Only research the other codes if you do not know what this diagnosis is.
(D) Add all of the ICD-10-CM codes indicated to the claim.
(B) Go to the main term referenced with the “see” note to locate the correct code.
The “see” or “see also” indicates that another term should be referenced for correct code selection.
Which ICD-10-CM must be listed first on a claim?
(A) Z98.870.
(B) Z87.892.
(C) Z65.0.
(D) Z51.0.
(D) Z51.0.
The ICD-10-CM guideline (I.C.21.c.16) indicates that Z51.0 must be reported as the principal/first-listed diagnosis, except when there are multiple encounters on the same day and the medical records for the encounter are combined.
A patient presents for a lump in the lower inner quadrant of her right breast. The provider orders a mammogram. What is the correct ICD-10-CM code for the encounter?
(A) C50.919.
(B) Z12.39.
(C) Z12.31.
(D) N63.14.
(D) N63.14.
Without a confirmed diagnosis of a neoplasm, the office visit should be coded with the symptom that is being treated. Look in the ICD-10-CM Alphabetic Index for Lump/breast/lower inner quadrant. Verify in the Tabular List.
A 3 year-old is seen for ear infections in both of his ears. The provider’s assessment indicates that the infection is worse in the child’s right ear. What ICD-10-CM code(s) should be assigned?
(A) H66.90.
(B) H66.92, H66.91.
(C) H66.93.
(D) H66.91, H66.92.
(C) H66.93.
The infection is found in both ears, so the appropriate code would indicate bilateral. The documentation of the infection being worse in one ear versus the other would not warrant the coding of both codes.
A patient has a burn that the provider notates as non-healing. How should this be coded?
(A) Code as an infected burn.
(B) Code as a corrosion burn.
(C) Code as an acute burn.
(D) Code as a late effect burn.
(C) Code as an acute burn.
The ICD-10-CM guideline (I.C.19.d.3) indicates to code “non-healing burns as acute burns.”
A patient is seen in the emergency room for treatment of injuries that occurred from a fall during rock climbing. The patient has a large laceration of the forehead that requires stitches. The patient also suffered some small abrasions and bruises in the area. What code(s) should be selected?
(A) S01.90XA.
(B) S01.81XA.
(C) S01.82XA.
(D) S01.81XA, S00.81XA, S00.83XA.
(B) S01.81XA.
Per the ICD-10-CM guideline (I.C.19.b.1), superficial injuries such as abrasions or contusions are not coded when associated with more severe injuries of the same site.
