Chapter 4 Test Flashcards
What is the ICD-10-CM code for asthma?
(A) J45.909.
(B) J45.99.
(C) J45.90.
(D) J45.
(A) J45.909.
In the ICD-10-CM Alphabetic Index, look for Asthma, asthmatic (bronchial) (catarrh) (spasmodic). You are referred to J45.909. Verify in the Tabular List.
The patient’s dense breast tissue made the screening mammogram unreadable, and she is here today for a breast ultrasound. Her mother and aunt both have a history of breast cancer. What ICD-10-CM codes are reported for breast ultrasound?
(A) Z12.39, R92.2, Z80.3.
(B) Z12.39, R92.2, Z85.3.
(C) N63.0, Z80.3.
(D) N63.0, R92.2, Z85.3.
(A) Z12.39, R92.2, Z80.3.
Code the special screening as a reason for the encounter, along with a code to report the patient’s breast density, which provides medical necessity for a more extensive test. Dense breast tissue occurs in many premenopausal women and can interfere with reading a mammogram and may mask abnormalities in the image. From the ICD-10-CM Alphabetic Index look for Screening/neoplasm (malignant) (of)/breast refers you to Z12.39. Next look for Dense/breast, refers you to R92.2. Finally look for History/family(of)/malignant neoplasm (of)/breast, refers you to Z80.3. Verify codes in the Tabular List.
A 5 year-old receives 5 percent third degree burns on his right hand and also sustained 10 percent second degree burns on his upper right leg after pulling a pot of boiling water from off the stove onto him. Total body surface area that was burned was 15 percent. What are the correct codes for this encounter?
(A) T23.301, T24.211, T31, X12.
(B) T23.301A, T24.211A, T31.10, X12.XXA.
(C) T23.301A, T24.211A, T31.10.
(D) T23.301D, T24211D, T31.10, X12.XXA.
(B) T23.301A, T24.211A, T31.10, X12.XXA.
According to ICD-10-CM guidelines guidelines section I.C.19.d.1: Sequence first the code that reflects the highest degree of burn when more than one burn is present. In this case the third degree burns on the hand is reported first. From the ICD-10-CM Alphabetic Index, look for Burn/hand(s)/right/third degree. You are referred to T23.301 which needs an additional character. Reviewing the beginning of the Tabular List for this category shows that A as the 7th character indicates the initial encounter. Next, look for Burn/thigh/right/second degree. You are referred to T24.211 which also needs a 7th character A.
ICD-10-CM guidelines section I.C.19.d.6 indicates assigning a code from category T31 to identify the percentage of total body surface involved in a burn (all degrees). The question documents that the total body surface area burned was 15 percent guiding you to subcategory T31.1. In the Alphabetic Index, look for Burns/extent (percentage of body surface)/10-19 percent/with 0-9 percent third degree burns T31.10. Additionally, the 5th character is assigned to identify the percentage of body surface involved in third degree burns. The question documents that the patient had 5 percent third degree burns guiding you to report the 5th character 0. The complete code is T31.10.
The External cause code is reported for how the patient was burned. In the Alphabetic Index for External Causes look for Burn, burned, burning/hot/water (tap). You are to see Contact with hot, tap water. Looking at Contact (accidental)/hot/water/boiling, you are referred to subcategory X12 which needs a 7th character A, therefore you will need to add placeholders X. The final code is X12.XXXA.
A 30-year-old female suffers from menstrual migraines. She is in the ED because the medication has not relieved the migraine. What ICD-10-CM code is reported?
(A) G43.829.
(B) G43.839.
(C) G43.919.
(D) G43.909.
(B) G43.839.
From the Alphabetic Index look for Migraine/menstrual. The index refers you to G43.829. In the Tabular List, there is a not under the category G43 that states “Note: the following terms are to be considered equivalent to intractable: pharmacoresistant (pharmacologically resistant), treatment resistant, refractory (medically) and poorly controlled.” Therefore, since the migraine is not responding to medication, it is considered intractable. Further reference in the Tabular List shows the correct code to be G43.839.
Mrs. Baker was given Clonidine for her hypertension. She is only supposed to take one tablet in the morning. She mistakenly took tow tablets and is now feeling dizzy and nauseated. She is told by her primary care physician to go to the ED and he will meet her there. What ICD-10-CM code(s) is/are reported?
(A) R42, R11.0, T46.5X1A.
(B) T46.5X1A, R42, R11.0.
(C) T46.5X5A, R42, R11.0.
(D) T46.5X1A.
(B) T46.5X1A, R42, R11.0.
ICD-10-CM Coding Guideline I.C.19.e.5.b indicates when coding a poisoning or reaction to the improper use of a medication (e.g., wrong dose, wrong substance, wrong route of administration), first assign the appropriate code from categories T36-T50. The poisoning codes have an associated intent as the 5th or 6th character (accidental, intentional self-harm, assault and undetermined). Use additional codes for all manifestations of poisonings.
This is a poisoning because Mrs. Baker took the wrong dose of the medication. In the ICD-10-CM Alphabetic Index of the Table of Drugs and Chemicals, look for Clonidine/Poisoning, Accidental (unintentional) (column). You are referred to T46.6X1 which will need a 7th character A since this is the initial encounter. Next, we list the manifestation codes. From the Alphabetic Index look for Dizziness and you are referred to code R42. Next, look for Nausea (without vomiting). You are referred to code R11.0. Verify all codes in the Tabular List.
A 66-year-old fractured her scaphoid bone in her right wrist 3 months ago. She now presents with a nonunion of the scaphoid bone. What is the appropriate ICD-10-CM code?
(A) S62.001P.
(B) S62.001G.
(C) S62.001S.
(D) S62.001K.
(D) S62.001K.
According to ICD-10-CM Guidelines Section I.C.19.c.1., Care of complications of fractures such as malunion and nonunion, should be reported with the appropriate 7th character for subsequent care with nonunion (K, M, N) or subsequent care with malunion (P, Q, R). From the ICD-10-CM Alphabetic Index look for Fracture/traumatic/scaphoid (hand) which says to see also Fracture/carpal/navicular, which in turn indexes to S62.00. Looking for S62.00 in the Tabular List gives us a 6th character 1 for the right wrist. Reviewing the 7th character information box at the beginning of the category, you will see that the 7th character K is used for non-union. The final code is S62.001K.
What is the ICD-10-CM code for essential HTN?
(A) I15.9.
(B) I10.
(C) I11.9.
(D) I15.
(B) I10.
HTN is the medical abbreviation for hypertension. In the ICD-10-CM Alphabetic Index, look for Hypertension, hypersensitive (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic). The code next to Hypertension is I10. In the Tabular List locate I10 and validate that it is the correct code for essential hypertension.
A patient who is HIV positive has been showing purplish nodules on the skin on different areas of the body. He is diagnosed with having Kaposi’s sarcoma which is a manifestation of having AIDS. What ICD-10-CM code(s) is/are reported?
(A) B20, C46.0
(B) C46.0, Z21.
(C) Z21.
(D) B20, C46.0, Z21.
(A) B20, C46.0.
According to ICD-10-CM Guidelines Section I.C.1.a.2.d: Z21, Asymptomatic human immunodeficiency virus (HIV) infection, is to be applied when the patient without any documentation of symptoms is listed as being HIV positive, known HIV, HIV test positive, or similar terminology. Do NOT use this code if the term AIDS is used or if the patient is treated for any HIV-related illness or is described as having any condition(s) resulting from his/her HIV positive status; use B20 in these cases. In the question the patient is showing a condition Kaposi’s sarcoma resulting from his HIV positive status, in which now code B20 AIDS will now be assigned.
From the ICD-10-CM Alphabetic Index look for AIDS (related complex). You are referred to B20. There is a note in the Tabular List to use additional code(s) to identify all manifestations of HIV infection. Next, look for Kaposi’s/sarcoma/skin (multiple site). You are referred to C46.0. The scenario documented that this type of cancer was found on the skin of the patient. Verify in the Tabular List.
A patient is brought to the ED with seizures. After the ED physician examines the patient and reviews the lab work, he determines the seizures are due to alcohol abuse. Patient does not have a history of having seizures. What ICD-10-CM code(s) is/are reported?
(A) R56.9, F10.288.
(B) G40.909.
(C) R56.9, F10.188.
(D) G40.919.
(C) R56.9, F10.188.
Codes G40.909 and G40.919 are reported when documentation indicates the seizure is an epileptic seizure or that there is a history of recurring seizures. This was a seizure brought on by the intake of alcohol. From the ICD-10-CM Alphabetic Index look for Seizure(s) referring you to R56.9. Documentation states alcohol abuse. Look in the Alphabetic Index for Abuse/alcohol/with other specified disorder referring you to F10.188. The documentation does NOT state alcohol dependence so code F10.288 is incorrect. Verify both codes in the Tabular List.
Patient is being treated for a metastatic thoracic spinal cord cancer from the lung. What ICD-10-CM codes are reported?
(A) C34.90, C72.0.
(B) C79.49, C34.90.
(C) C72.0, C34.90.
(D) C34.90, C72.0.
(B) C79.49, C34.90
According to ICD-10-CM Guidelines Section I.C.2.b: when a patient is admitted because of primary neoplasm with metastasis and treatment is directed toward the secondary site only, the second neoplasm is designated as the principal diagnosis even though the primary malignancy is still present.
In the ICD-10-CM Alphabetic Index look for Cancer; it instructs you to see also Neoplasm, by site, malignant. Look for Neoplasm, neoplastic/spine, spinal/cord (cervical) (lumbar) (sacral) (thoracic)/Malignant Secondary (column) in the Table of Neoplasms, guiding you to code C79.49. Next look for Neoplasm neoplastic/lung/Malignant Primary (column) guiding you to subcategory C34.9. Reference the Tabular List for the appropriate 5th character, which is 0 since we do not know which lung is affected.
What is the ICD-10-CM code for a headache?
(A) G44.209.
(B) G44.89.
(C) G44.1.
(D) R51.9.
(D) R51.9.
In the ICD-10-CM Alphabetic Index, look for Headache. You are referred to R51.9. In the Tabular List locate code R51.9 and verify that it is the correct code for headache.
What is the ICD-10-CM code for DM?
(A) E09.9.
(B) E10.9.
(C) E11.9.
(D) Z71.3.
(C) E11.9.
DM is the medical abbreviation for diabetes mellitus. In the ICD-10-CM Alphabetic Index, look for Diabetes, diabetic (mellitus) (sugar). You are referred to E11.9. In the Tabular List locate code E11.9. IDC-10-CM Official Guideline Section I.C.4.a.2. states if the type of diabetes mellitus is not documented in the medical record the default is E11, Type 2 diabetes mellitus.
Patient presents with follow-up of Type 1 Diabetes with Stage 3 CKD. What code(s) is/are reported?
(A) E11.9, N18.30.
(B) E10.22, N18.30.
(C) E10.22.
(D) E11.22, N18.30.
(B) E10.22, N18.30.
In the ICD-10-CM Alphabetic Index, look for Diabetes, diabetic (mellitus) (sugar)/type 1/with/chronic kidney disease, which refers the user to E10.22. In the Tabular List locate code E10.22. The note states to use an additional code to identify the stage of the CKD (N18.1-N18.6). Looking for those codes in the Tabular List shows that Stage 3, without further specification, is coded N18.30.
What is the ICD-10-CM code for a sore throat?
(A) J02.8.
(B) J02.0.
(C) J02.9.
(D) J31.2.
(C) J02.9.
In the ICD-10-CM Alphabetic Index, look for Sore/Throat (acute). You are to see also Pharyngitis. Look for Pharyngitis (acute) (catarrhal) (gangrenous) (infective) (malignant) (membranous) (phlegmonous) (pseudomembranous) (simple) (subacute) (suppurative) (ulcerative) (viral) and you are referred to code J02.9. In the Tabular List locate code J02.9, Acute pharyngitis, unspecified. The inclusion terms below J02.9 list sore throat (acute) NOS.
A patient presents for removal of IUD. What code is used?
(A) Z30.433.
(B) Z30.432.
(C) Z30.431.
(D) Z30.8.
(B) Z30.432.
In the ICD-10-CM Alphabetic Index, look for Removal (from) (of)/device/contraceptive which leads to Z30.432 in the Tabular List.
