Medical Coding (ICD 9 coding)

1) This full-term female infant was born in this hospital by vaginal delivery. Her mother has been an alcoholic for many years and would not stop drinking during her pregnancy. The baby was born with fetal alcohol syndrome and was placed in the NICU.
Assign the ICD-9-CM Diagnosis Codes for this encounter.
Principal Dx:
Secondary Dx:
2) This 59 year old patient has Type I diabetes mellitus. He has atherosclerosis and gangrene of the extremities due to the diabetes.
Assign the ICD-9-CM Diagnosis Codes for this encounter.
Principal Dx:
Secondary Dx:
3) A patient was seen in the ED with severe abdominal cramping, nausea and vomiting, and diarrhea. She states she ate turkey salad several hours before these symptoms developed. The patient has had the symptoms for about 20 hours. Lab tests show severe dehydration. She is admitted for IV hydration therapy. The physician documents the diagnoses as: Dehydration, salmonella gastroenteritis, abdominal cramping, nausea, vomiting and diarrhea.
Assign the ICD-9-CM Diagnosis Codes for this encounter.
Principal Dx:
Secondary Dx:
4) A patient with mitral regurgitation was placed on cardiopulmonary bypass and underwent a minimally invasive mitral valve repair via a small thoracotomy using a heart port device.
Assign the ICD-9-CM Diagnosis for this encounter:
Principal Dx:
Assign the Procedure Codes for this encounter:
Principal Procedure:
Secondary Procedure:
5) A patient is diagnosed with Diabetes Mellitus Type II with loss of protective sensation (LOPS).
Assign the ICD-9-CM Diagnosis Codes for this encounter.
Principal Dx:
Secondary Dx:
6) Congestive heart failure being treated with medication may be coded on an inpatient record even though it is not documented as being decompensated during the current episodes of care.
( )True
( )False
7) V codes may never be coded as a principal diagnosis.
( )True
( )False
8) An exception to the rule regarding the coding of symptoms when the underlying cause is known applies to patients presenting with an acute CVA in which associated speech and swallowing difficulties have not resolved by the time of discharge.
( )True
( )False
9) A diagnosis of malnutrition may be coded based upon a dietary consult performed by a Registered Dietician.
( )True
( )False
10) Suicidal attempt or ideation may be coded based on documentation by the LCSW if it is not noted by the physician.
( )True
( )False
11) The physician must state that an overdose of valium taken with alcohol is a poisoning situation in order for the coder to assign a poisoning code.
( )True
( )False
12) It is appropriate to review non-physician documentation in order to assign the appropriate stage for a skin ulcer.
( )True
( )False
13) There are no V codes which are considered to be CCs.
( )True
( )False
14) A history of CAD is documented in the history and physical examination. There is no conflicting documentation regarding this condition elsewhere in the record. It is appropriate for the coder to assign a code for the CAD as a chronic condition.
( )True
( )False
15) A nonspecific code cannot be assigned when the etiology is known and a more specific code is available.
( )True
( )False
16) A patient is admitted with intractable nausea and vomiting, diarrhea and dehydration. The final progress note documents “acute viral gastroenteritis”. Because the patient received aggressive treatment to control the nausea and vomiting, code 787.01 should be assigned in addition to 008.8.
( )True
( )False
17) Official coding guidelines indicate that it is permissible to code on the basis of laboratory reports.
( )True
( )False
18) The final discharge note on a short-stay inpatient record documents a diagnosis of probable UTI. It is appropriate to code 599.0 on this case.
( )True
( )False
19) Chronic conditions are reportable on inpatient records.
( )True
( )False
20) All debridements performed by a physician may be considered excisional due to the skill level required.
( )True
( )False

1) A patient is admitted and treated as an inpatient with symptoms of shortness of breath and greenish sputum. Following diagnostic workup, the provider documents, cryptogenic organizing pneumonia. What is the appropriate ICD-9-CM diagnosis code for this condition?
( )486
( )518.89
( )516.36
( )516.8
2) A patient is being treated for an infection due to a dialysis catheter. Without further information being provided, which of the following could be the correct ICD-9-CM diagnosis code assignment for this encounter?
( )996.69
( )999.31
( )Either 999.31 or 996.62
( )996.62
3) A 57 year old female is being treated for Stage II breast cancer and is undergoing neo-adjuvant chemotherapy prior to any surgical intervention or radiology treatment. The patient has completed the first two cycles of chemotherapy and is now undergoing Herceptin therapy over the course of the next nine months in order to complete a one-year course of treatment with Herceptin. The patient is being seen on this encounter for her second dose of Herceptin infusion. The correct ICD-9-CM codes for this encounter are:
( )V58.12, 174.9, 99.25
( )174.9, V58.69, 99.25
( )V58.11, 174.9, 99.25
( )174.9, V58.69, 99.28
4) An orthopedic surgeon performs a laminectomy with excision of the intervertbral disc of L4-5 after decompressing the spinal canal to gain access to the site. The correct ICD-9-CM procedure code(s) for this procedure is:
( )80.51
( )03.09, 80.51
( )03.09
( )03.01
5) Which of the following ICD-9-CM procedures is not considered inherently bilateral for coding purposes?
( )28.3
( )22.63
( )20.01
( )28.6
6) A patient with a long history of emphysema presents for bronchial valve insertion to repair the air leakage in multiple lobes due to long-term emphysema. The pulmonologist documents the endoscopic placement of bronchial valves in the left and right lower lobes. The correct ICD-9-CM procedure code(s) for this procedure is:
( )33.71, 33.71, 33.23
( )33.73, 33.23
( )33.73
( )33.73, 33.29
7) A patient was admitted for treatment of a right carotid artery aneurysm. The physician performing the procedure in the cardiac cath lab documented the placement of three bioactive coils in order to accomplish the endovascular occlusion of the aneurysm. The correct ICD-9-CM code(s) for this procedure is:
( )39.76
( )39.75
( )39.75, 39.75, 39.75
( )39.76, 39.76, 39.76
8) The correct ICD-9-CM procedure code for a paravertebral facet joint injection placed at L4 for chronic pain relief is:
( )03.92
( )04.81
( )03.91
( )81.92
9) A 59 year old female, status post prior mastectomy for breast cancer, was admitted for reconstructive surgery. The surgeon documents breast reconstruction with harvesting of fat graft material from the abdomen with transplantation to prior mastectomy site. The correct ICD-9-CM procedure code for this case is:
( )86.90, 86.87
( )85.55
( )85.55, 86.90
( )86.87
10) A patient is undergoing long-term antibiotic therapy but elects not to have a port placed. The physician orders the placement of a central venous catheter. Chart documentation indicates that the catheter was placed using fluoroscopic guidance. The correct ICD-9-CM procedure code for this case is:
( )38.93
( )38.97
( )86.07
( )38.99
11) A patient with a long-term history of uncontrolled atrial fibrillation is admitted for a Maze procedure. The surgeon documents a Maze Procedure under thoracoscopic approach not requiring bypass. The appropriate ICD-9-CM procedure code for this procedure is:
( )37.37
( )37.39
( )37.73, 39.61
( )37.33, 39.61
12) A patient with a history of severe asthma over the course of twenty years is admitted for ablation of the airway smooth muscle of the lung. The physician documents in the operative report ablation lung tissue via bronchial thermoplasty. The appropriate ICD-9-CM procedure code for this procedure is:
( )33.27
( )32.29
( )32.27
( )33.29
13) The physician lists the final diagnosis as GI bleeding due to acute ischemic colitis. What is the correct coding for this diagnosis?
( )555.9
( )557.0, 578.9
( )578.9
( )557.0
14) A patient was diagnosed with ventilator associated pneumonia due to Klebsiellapneumoniae. What is the correct code assignment?
( )999.9, 482.0
( )997.31, 486, 041.3
( )998.89, 482.89
( )997.31, 041.3
15) A 72 year old female patient was admitted with nausea and vomiting. The patient is 3 days status post her last episode of chemotherapy for Stage III breast cancer. The physician documents the final diagnosis as gastroenteritis due to chemotherapy. What is the correct code assignment?
( )174.9, 787.01, 558.9, E933.1
( )558.9, 787.01, V10.3, E933.1
( )558.9, E933.1, 174.9
( )555.9, E933.1

16) What is the correct diagnosis code assignment for a diagnosis of multi-lobar pneumonia?
( )486
( )481
( )482.39
( )485
17) A 75 year old female patient presented with an acute hemorrhagic cerebrovascular accident with accompanying right hemiplegia. The hemiplegia was totally resolved by the time of the patients discharge. The correct ICD-9-CM diagnosis (es) code assignment for this case is:
( )432.9
( )432.9, 342.90
( )436, 342.90
( )431, 342.90
18) This 45 year old male underwent colon resection for carcinoma of the transverse colon. The physician progress note on postop day #2 states anemia. H&H dropped significantly after surgery and a blood transfusion was ordered. How is the anemia coded?
( )998.11, 285.1
( )998.11
( )285.9
( )285.1
19) A pulmonologist performed a diagnostic bronchoscopy with biopsy. The endoscope was introduced into the bronchus, and attachments were used to perforate the bronchial wall. Tissue was obtained and submitted to the pathologist, who identified it as lung parenchyma. What type of biopsy was performed?
( )Bronchial biopsy
( )Transbronchial lung biopsy
( )Bronchoalveolar lavage
( )Protected specimen brush biopsy
20) A patient with known AIDS is admitted to the hospital for treatment of Pneumocystis carinii pneumonia. Assign the principal diagnosis.
( )486
( )042
( )136.3
( )Any of these could be principal diagnosis
21) Manifestation codes:
( )All of these statements describe manifestation codes
( )Describe a condition that results from another, underlying condition
( )Are printed in italics in the Tabular List
( )Can never be reported first
22) A coding professional may assume a cause-and-effect relationship between hypertension and which of the following conditions?
( )Heart disease and chronic kidney disease
( )Heart disease
( )None of the above
( )Chronic kidney disease
23) When multiple burns are present, the first sequenced diagnosis is the:
( )All of the above
( )Burn that is treated surgically
( )Highest-degree burn
( )Burn that is closest to the head
24) A patient was admitted for replacement of a single-chamber pacemaker device because the battery was expected to fail within a short time. The device was replaced with a dual chamber rate-responsive pacemaker device and a ventricular lead was inserted. The pacemaker had been initially inserted for the treatment of sick sinus syndrome. The patient had a history of atrial fibrillation for which she was taking Digoxin. She developed accelerated hypertension while in the hospital which was treated with IV anti-hypertensive medication.
( )V53.31, 427.31, 401.0, 37.83, 37.71
( )V53.31, 427.31, 401.0, 37.87, 37.71
( )V53.31, 427.81, 427.31, 401.9, 38.87
( )V53.31, 427.81, 427.31, 37.87, 37.71
25) A newborn is transferred to a tertiary care hospital immediately after spontaneous vaginal delivery due to erythroblastosisfetalis due to ABO incompatibility for exchange transfusion and Level III NICU care.
( )V30.00, 773.1, 99.04
( )V30.00, 773.1, 99.01
( )773.1, 99.0
( )773.1, 99.01
26) 15 year old boy is admitted with an infected friction burn of the left thigh due to a rope burn while water skiing at a local lake. He is given IV antibiotics and discharged home after three days.
( )945.06, E838.4, E849.8
( )916.1, E838.4, E849.8
( )945.06, 948.00, E838.4, E849.8
( )692.71, E838.4, E849
27) A 28 year old male is admitted with acute appendicitis. He also has Kaposis sarcoma of the skin of the chest and is HIV positive. A laparoscopic appendectomy is performed and the pathology report indicates a perforated appendix. He also had thrush.
( )540.0, 042, 176.0, 112.0
( )540.0, 042, 176.8, 112.0
( )540.0, V08, 176.0, 112.0
( )540.0, V08, 176.8, 112.0
28) A patient with thyroid cancer is admitted for treatment by radioactive iodine. She is kept an extra day after insertion of the radioactive iodine because she lives alone.
( )V58.0, 193, 92.27
( )V58.12, 193, 92.27
( )193, 92.27
( )193, V60.3, 92.27
29) A 68 year old female is admitted with unstable angina. She is status post CABG and the physician orders IV nitroglycerin. The angina was relieved and the patient was sent home the next day.
( )414.01, 411.1, V45.81
( )411.1, 414.01, V45.81
( )414.00, 411.1, V45.81
( )414.00, 413.9, V45.81
30) The patient was diagnosed with right carotid artery stenosis and was admitted for the insertion of a carotid stent. The patient was taken to cardiac catheterization lab and two stents were inserted at the bifurcation of the right common carotid and the internal carotid arteries after angioplasty. No complications were noted.
( )39.50, 00.40, 00.46
( )00.40, 00.64, 00.44, 00.46
(x)00.61, 00.40, 00.63, 00.44, 00.46
( )00.40, 00.63, 39.50

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