AAPC CPB - CHAPTER 4: QUESTIONSWhich sections of ICD-10-CM does a biller use to code for a physician's office?

Child is brought in by her mother for a skin rash on her arms, legs, and midsection. Mother states the patient has been playing in a field across from the house. She is diagnosed with chigger bites. What ICD-10-CM code is reported (do not code the External Cause)? a. B88.0 b. B88.9 c. B88.8 d. S40.869A

a. B88.0 (In the ICD-10-CM Alphabetic Index look for chiggers (infestation) which leads to B88.0, Other ascariasis in the Tabular List. Ascariasis is defined as infestation with or disease caused by mites.)

Patient is in the observation room with an impending CVA. The test results come back with the patient having a CVA and is admitted to the hospital. What ICD-10-CM code is reported? a. I63.9 b. I67.9 c. I63.8 d. Z03.89

a. I63.9 (ICD-10-CM coding guideline I.B.11 indicates because the CVA did occur and is no longer impending, code the confirmed diagnosis. You will only report one code, the confirmed diagnosis CVA. CVA stands for Cerebrovascular accident. From the ICD-10-CM Alphabetic Index look for Accident/cerebrovascular (embolic) (ischemic) (thrombotic). This index refers you to I63.9 in the Tabular List.)

Which sections of ICD-10-CM does a biller use to code for a physician's office? a. ICD-10-CM Alphabetic Index and Tabular List b. Alphabetic Index only c. Tabular List only d. ICD-10-CM and ICD-10-PCS

a. ICD-10-CM Alphabetic Index and Tabular List

What is/are the correct code(s) for a patient with acute on chronic maxillary sinusitis? a. J01.00, J32.0 b. J01.00 c. J32.0, J01.00 d. J01.01

a. J01.00, J32.0 (There are instances when a patient will have both the acute form and the chronic form of a condition and there is not a combination code to report both the acute and the chronic condition. According to the ICD-10-CM guidelines, if separate subentries exist code both and sequence the acute code first. Look in the ICD-10-CM Alphabetic Index for Sinusitis/acute/maxillary J01.00. Look in the ICD-10-CM Alphabetic Index for Sinusitis (accessory) (chronic) (hyperplastic) (nasal) (nonpurulent) (purulent)/maxillary J32.0. Verify both codes in the Tabular List.)

What is the ICD-10-CM code for asthma? a. J45.909 b. J45.99 c. J45.90 d. J45

a. J45.909

Patient is seen for urinary symptoms that include nocturia, hesitancy, frequency, and a weak urinary stream. Exam reveals that the patient has an enlarged prostate. What ICD-10-CM code(s) is/are reported? a. N40.0 b. N40.1, R35.1, R39.11, R35.0, R39.12 c. N40.1 d. R35.1, R39.11, R35.0, R39.12

a. N40.0 (In the ICD-10-CM Alphabetic Index, look for Block/bundle branch/right which sends the user to I45.10, verify in the Tabular List.)

What is the ICD-10-CM code for a cough? a. R05 b. F45.8 c. R04.2 d. J41.0

a. R05

What is the ICD-10-CM code for the first encounter for a left wrist fracture from a fall? Code the injury only, not the External Cause (the fall). a. S62.102A b. S62.10 c. S62.109A d.S62.10XA

a. S62.102A (Rationale: Fractures can be traumatic (due to injury or accident) or pathological (due to disease). In the ICD-10-CM Alphabetic Index, look for Fracture, traumatic/wrist and you are referred to subcategory S62.10. Turn to subcategory S62.10 in the Tabular List. Most fractures require 6th and 7th characters. From the indented listings in the subcategory, you will see that the 6th character is for laterality; S62.102 specifies left wrist. For the 7th character, reference the list under the category heading S62. The notes under this heading indicate a fracture not indicated as open or closed should be coded as closed. Then it lists the appropriate 7th characters: A is for initial encounter for closed fracture. The correct code for this wrist fracture is S62.102A.)

Patient is being treated for a metastatic thoracic spinal cord cancer from the lung. What ICD-10-CM codes are reported? a. C34.90, C79.49 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 secondary neoplasm is designated as the principal diagnosis even though the primary malignancy is still present. In the ICD-10-CM Alphabetical 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.)

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 chronic kidney disease CKD (N18.1-N18.6). Looking for those codes in the Tabular List shows that Stage 3, without further specification, is coded as N18.30.)

A 32-year-old has been admitted to a 45-day program for rehabilitation. She has a daily barbiturate dependence with anxiety disorder. What ICD-10-CM code(s) is/are reported? a. F13.10, F41.9 b. F13.280 c. F41.9, F13.280 d. F13.980

b. F13.280 (The key word is dependence. There is documentation that she has a drug dependence to the barbiturates. In the Alphabetic Index look for Dependence/barbiturates(s) (compound) (drugs classifiable to T42) which refers you to see Dependence, drug, sedative. Look for Dependence/drug/sedative/with/anxiety disorder refers you to code F13.280. Verify the code in the Tabular List.)

A patient presents to the ophthalmologist for follow up of hypertensive retinopathy in both eyes. The retinopathy is due to the patient's malignant hypertension. What ICD-10-CM code(s) is/are reported? a. I10, H35.033 b. H35.033, I10 c. H35.033 d. I10

b. H35.033, I10 (From the ICD-10-CM Alphabetic Index look for Retinopathy/hypertensive. This refers you to H35.03-. Look for this code in the Tabular List; a 6th character is necessary, in this case, 3 indicates bilateral. The note under the subcategory states to code also any associated hypertension (I10.-). ICD-10-CM Guideline I.C.9.a.5 indicates for Hypertensive Retinopathy two codes are necessary. First assign code H35.033 and then code I10 to include the malignant hypertension. Verify both codes in the Tabular List.)

What are the correct codes for benign hypertensive heart disease and stage 3a chronic kidney disease? a. I10, I11.9, I12.9, N18.31 b. I13.10, N18.31 c. N18.31, I13.10 d. I13.0, N18.31

b. I13.10, N18.31 (Look in the ICD-10-CM Alphabetic Index for Hypertension, hypertensive/heart/with/kidney disease (chronic). There is a note to see Hypertension/cardiorenal. Look in the ICD-10-CM Alphabetic Index for Hypertension/cardiorenal/without heart failure/with stage 1 through 4 chronic kidney disease I13.10. Verify the code selection in the Tabular List. This is a combination code for hypertensive heart and chronic kidney disease, so I13.10 is used instead of reporting a code for each one. Code I31.10, Hypertensive heart and chronic kidney disease, without heart failure, with stage 1 through stage 4 chronic kidney, or unspecified chronic kidney disease, has a use additional note that states to code the stage of kidney disease as a secondary code. Look in the Alphabetic Index for Disease, diseased/kidney/chronic/stage 3a. Code N18.31 Chronic kidney disease, stage 3a is the correct code.)

A patient presents with symptoms of chest pain, nausea, and pain in the neck and arm. He is diagnosed with a STEMI (or ST Elevation) myocardial infarction of the anterior wall. What ICD-10-CM code(s) is/are reported? a. I21.29 b. I21.09 c. I21.09, R07.9, R11.0, M54.2, M79.629 d. I21.29, R07.89

b. I21.09 (A STEMI is an ST Elevated Myocardial Infarction. In the ICD-10-CM Alphabetic Index look for Infarct, infarction/myocardium myocardial/ST Elevation (STEMI)/anterior (anteroapical) (anteroseptal) (Q wave) (wall), which leads to I21.09. Chest pain, nausea, and pain in the neck and arm are symptoms of the MI and not separately reported. Verify code in the Tabular List.)

Patient is admitted with SOB (shortness of breath) and cough with production of sputum. He has a history of COPD (chronic obstructive pulmonary disease) and is taking Symbicort. Diagnosis: Exacerbation of COPD. What ICD-10-CM code is reported? a. J42 b. J44.1 c.J44.0 d. J44.9

b. J44.1 (Rationale: In the ICD-10-CM Alphabetic index look for Disease, diseased/pulmonary/chronic obstructive/with/exacerbation (acute) which leads to J44.1. Verify in the Tabular List. An exacerbation is different from an infection.)

A 5-year-old receives 5 percent third degree burns on his right hand and also sustained 10 percent second degree burns on his right upper 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 diagnosis codes for this encounter? a. T23.301, T24.211, T31, X12 b. T23.301A, T24.211A, T31.10, X12.XXXA c. T23.301A, T24.211A, T31.10 d. T23.301D, T24.211D, T31.10, X12.XXXA

b. T23.301A, T24.211A, T31.10, X12.XXXA (According to ICD-10-CM 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 code T31.1. In the Alphabetic Index, look for Burns/extent (percentage of body surface)/10-19 percent/with 0-9 percent thrid 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 fifth 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)/with/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.)

Mrs. Baker was given Clonidine for her hypertension. She is only supposed to take one tablet in the morning. She mistakenly took two 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 their 5th or 6th character (accidental, intentional self-harm, assault and undetermined.) Use additional code(s) 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 T46.5X1 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.)

How many chapters does ICD-10-CM contain? a. 17 b. 19 c. 22 d. 20

c. 22

In looking at the notes with this code, which statement is TRUE? K67 Disorders of the peritoneum in infectious diseases classified elsewhere Code first underlying disease, such as: congenital syphilis (A50.0) helminthiasis (B65.0-B83.9) Excludes1: peritonitis in chlamydia (A74.81) peritonitis in diphtheria (A36.89) peritonitis in gonococcal (A54.85) peritonitis in syphilis (late) (A52.74) peritonitis in tuberculosis (A18.31) a. Code K67 may be a first-listed code b. Code K67 may be coded with code A74.81 c. Code K67 may never be coded with codes A74.81, A36.89, A54.85, A52.74 and A18.31 d. Code K67 is a secondary code with codes A74.81, A36.89 or A52.74 being coded first

c. Code K67 may never be coded with codes A74.81, A36.89, A54.85, A52.74 and A18.31

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. ICD-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.)

If a patient has acute diastolic heart failure, what is the main term that is used in the ICD-10-CM Alphabetic Index? a. Heart b. Acute c. Failure d. Diastolic

c. Failure

Patient presents with difficulty speaking, facial droop, and she is unable to close her left eye. She has no other complaints. She is diagnosed with Bell's palsy. She is prescribed Corticosteroids. She will return in 3 days for follow-up. What ICD-10-CM code(s) is/are reported? a. G51.0, R29.810, R47.81 b. P11.3 c. G51.0 d. R29.810, R47.81

c. G51.0 (n the ICD-10-CM Alphabetic Index look for Bells/palsy, paralysis which leads to G51.0. Verify code in the Tabular List. Newborn palsy is P11.3. Signs and symptoms of facial droop and difficulty speaking are inherent to Bell's palsy and not separately reported.)

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.)

Patient is diagnosed with a pressure ulcer of the heel. What ICD-10-CM code is reported? a. L89.601 b. L89.6 c. L89.609 d. L89.600

c. L89.609 (In the ICD-10-CM Alphabetic Index look for Ulcer, ulcerating, ulceration, ulcerative/pressure/heel which leads to subcategory L89.6. Turn to this subcategory in the Tabular List. A 5th and 6th character are required to complete the code. Information is not given as to which side or what stage the ulcer is, therefore, code L89.609 is correct. Verify in the Tabular List.)

A claim was denied with diagnosis M19.9. What is the reason for the denial? a. This code cannot be a first listed diagnosis b. The code is correct c. The code requires a 5th character d. A second code is required

c. The code requires a 5th character (Category M19.9 requires a 5th character to be a complete code. Look in the Tabular List of the ICD-10-CM codebook and you will see an icon indicating a 5th character is required. The codes underneath the subcategory show the codes with the 5th character added.)

What general guideline is addressed in I.C.1.a.2.c.? a. Documentation unclear as to whether sepsis or severe sepsis is present on admission b. Other codes for MRSA c. Whether the patient is newly diagnosed d. Code only confirmed cases

c. Whether the patient is newly diagnosed

When a patient is admitted for chemotherapy for cancer what code is reported as the first listed diagnosis? a. C80.1 b. Z51.1 c. Z51.11 d. Z51.12

c. Z51.11 (CD-10-CM guideline I.C.2.e.2 states if a patient admission/encounter is solely for the administration of chemotherapy, assign code Z51.11 as the first-listed or principal diagnosis. From the Index, reference Chemotherapy (session) (for)/cancer Z51.11.Verify the code in the Tabular List.)

What is/are the correct code(s) for a patient with type 1 diabetic neuropathy? a. E11.40 b. E90.40 c. E10.9, G62.9 d. E10.40

d. E10.40

Patient has upper GI performed for epigastric abdominal pain, + occult blood, and weight loss over the past 2 months to rule out an ulcer. What ICD-10-CM code(s) is/are reported? a. K25.9 b. K25.9, R10.13, R19.5, R63.4 c. K25.4 d. R10.13, R19.5, R63.4

d. R10.13, R19.5, R63.4 (This example does not provide a definitive diagnosis, so signs and symptoms are reported. In the ICD-10-CM Alphabetic Index look for Pain/epigastric, epigastrum leading to R10.13. Look for Blood/occult in feces leads to R19.5. Look for Weight/loss (abnormal) (cause unknown) which leads to R63.4. Verify all codes in the Tabular List.)

What is the ICD-10-CM code for fever? a. R50.83 b. R50 c. P81.9 d. R50.9

d. R50.9

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

Which statement is TRUE regarding the ICD-10-CM codebook? a. Every code requires seven characters b. The External Cause of Injuries Index is the first index found in the ICD-10-CM codebook c. An ICD-10-CM code can be reported directly from the ICD-10-CM Alphabetic Index d. The abbreviation that indicates a provider has documented a specific diagnosis but there is not a code for that specificity is NEC

d. The abbreviation that indicates a provider has documented a specific diagnosis but there is not a code for that specificity is NEC

In looking at the following listing in the ICD-10-CM Alphabetic Index, what can you tell about the codes for curvature of the spine due to Charcot-Marie-Tooth disease? Curvaturespine (acquired) (angular) (idiopathic) (incorrect) (postural) --see Dorsopathy, deforming congenital Q67.5 due to or associated withCharcot-Marie-Tooth disease (see also subcategory M49.8) G60.0 a. Only one code is required G60.0 b. Two codes are required with code from subcategory M49.8 coded first c. Two codes are required and it does not matter which one is coded first d. Two codes may be required; double check the Tabular List to be sure both codes are accurate and determine which to code first.

d. Two codes may be required; double check the Tabular List to be sure both codes are accurate and determine which to code first.

A patient presents for removal of IUD. What code is used? a. Z30.433 b. Z30.432 c. Z30.431 d. Z30.8

d. Z30.8