Guidelines And Rules

Question 1

Acute and chronic

Answer 1

If the Same condition is described as both acute and chronic and separate sub entries exist in the alphabetic index, code both and sequence acute first

Question 2

Code all documented conditions that coexist and require or effect patient care or management

Answer 2

Not conditions that no longer exist - history codes can be used if historical or family condition effects care

Question 3

Chronic diseases

Answer 3

Can be coded and reported as many times as the patient receives treatment or care

Question 4

Procedure not carried out for removal of right ovarian cyst due to urinalysis tract infection

Answer 4

Code sequence: n83201, j069, z5309
Guidelines state that reason for surgery first listed, then acute, then zcode.

Question 5

Sepsis

Answer 5

Underlying organism coded first, then sesis or sepsis with organ dysfunction, last type of organ dysfunction. example: A419, R6520, N179

Question 6

Adverse effect from chemo example

Answer 6

Acute condition, cancer code, external cause. Example: D6481, C569, T451x5A

Question 7

Anemia associated with neoplasm

Answer 7

Malignant first, then anemia
Example: C61, D630

Question 8

Neurotransmitter for pain

Answer 8

Assign pain code first, site of pain second. Example: G8921, M545

Question 9

Meneirs disease

Answer 9

H8101 search coding index

Question 10

When is a problem caused by diabetes not sequenced after the diabetes code?

Answer 10

When the patients pump malfunctions

Question 11

Code for pink eye/mucus discharge coming from eye

Answer 11

H10011: conjunctivitis, acute, mucopurulent

Question 12

Excised malignancy

Answer 12

When malignancy has been completely excised and no trace left behind, use as code even in a case of metastasis. In this example to the lung.
Example: C7801, Z853

Question 13

Acute bronchitis in COPD patient

Answer 13

COPD with acute bronchitis, then additional code for infection
J440, J209

Question 14

Pt dense breast tissue made mammogram unreadable. Encounter for breast ultrasound, family Hx of breast cancer

Answer 14

Z1239, R929, Z803
Special screening reason for encounter, report breast density for med necessity, and then family hx

Question 15

Pt has sciatica die to herniated disc between L5 and S1

Answer 15

M1517
L5 and S1 refer to fifth lumbar disc and first sacral disc in vertebra. Look for herniated disk in lumbosacral region with sciatica (Combo code)

Question 16

NCCI files contain CCM (correct coding modifier) in files. What does 0 mean?

Answer 16

A CCM is not allowed and will not bypass edits

Question 17

Cat 3 codes are

Answer 17

New and emerging procedures

Question 18

CMS global period status for endoscopies

Answer 18

000 for minor procedures or endos

Question 19

Modifier for when commercial insurance company requires consult from second physician

Answer 19

32 mandated services