Final Exam Test with Bonus
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San Jacinto Community College *
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Course
2335
Subject
Medicine
Date
Dec 6, 2023
Type
docx
Pages
6
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1.The first three characters of an ICD-10-CM code represent the ___________. C Category
2.How many characters are in each ICD-10-PCS code? C Seven
3.The third character of the ICD-10-PCS coding system defines the ___________.
C. Root
Operation
4. In order to code a valid combination of values for characters four through seven
on an ICD-10-PCS code, the coder must:
B. Stay on one row of a table
5. An external approach is used when procedures:
C. Are performed directly on the skin or mucous membrane
6. Choose the correct code assignment for the following scenario (diagnostic and
procedural): 65-year-old with Viral carditis. A right and left diagnostic cardiac
catheterization was performed.
C. B33.20, 4A023N8
7. Choose the correct code assignment for the following scenario: 47-year-old
admitted with a high fever, elevated white count and general malaise. After work-up
it was determined that she had sepsis due to enterococcus. She was started on an
antibiotic regimen and her condition improved and she was discharged on day 4.
A. A41.81
8. Choose the correct code assignment for the following scenario: 12-year-old male
with carcinoma of his right descended testicle. A right orchiectomy was completed.
Include both diagnosis and procedure codes.
B. C62.11, 0VT90ZZ
9. Choose the correct code assignment for the following scenario: 36-year-old
female with carcinoma of her left breast nipple. An excision of the left breast nipple
was performed. Include both diagnosis and procedure codes.
B. C50.012, 0HBX0ZZ
10. Choose the correct code assignment for the following scenario: 44-year-old male
with dyspnea and swelling on the left side of his neck was seen today in Dr. Smith’s
office. Dr. Smith suspected cancer and requests that the patient have a CT scan of
the neck. The patient will have a CT scan completed on Thursday and will follow-up
with Dr. Smith in 1 week.
D. R06.00, R22.1
11.
When a biopsy is conducted, it is captured by the seventh character of ___ in PCS.
D. X, Diagnostic
12.
Choose the correct code assignment for the following scenario: 33-year-old seen
for anemia. A diagnostic EGD was performed and it was determined that the anemia
is due to blood loss from a chronic gastric ulcer.
C. D50.0, K25.4, 0DJ08ZZ
13. Choose the correct code assignment for the following scenario: 27-year-old
admitted with dyshematopoietic anemia who has a transfusion via a peripheral vein
of nonautologous packed red blood cells.
B. D64.4, 30233N1
14. Choose the correct code assignment for the following scenario: Procedure –
Lymph node open biopsy by excision, left axilla.
A. 07B60ZX
15. Choose the correct code assignment for the following scenario: The patient is a
45-year-old patient admitted for treatment of her anemia, neutropenia and
thrombocytopenia (all three POA).
D. D61.818
16. Choose the correct code assignment for the following scenario: 24-year-old with
an adenomatous goiter of her thyroid with thyrotoxicosis has an open
thyroidectomy completed without any complications.
D. E05.20, 0GTK0ZZ
17. Choose the correct code assignment for the following scenario: Morbidly obese
39-year-old female with Pickwickian Syndrome is admitted for a gastric banding. An
extraluminal laparoscopic gastric banding was completed without any problems.
B. E66.2, 0DV64CZ
18. Choose the correct code assignment for the following scenario: Procedure:
Partial left lobectomy, thyroid gland, open.
D. 0GBG0ZZ
19.
The procedures performed on organs in the endocrine system appear in the ICD-10-PCS code book
in tables that start with the Character 1 Value 0 – Medical and Surgical. Which of the following correctly
represents the Character 2 Value for procedures performed on organs in the endocrine system?
C. Value G – Endocrine System
20.
Choose the correct code assignment for the following scenario: Procedure:
Patient admitted for treatment of severe dehydration with gastroenteritis. The focus
of the treatment today is the dehydration.
C. E86.0, K52.9
21. Choose the correct code assignment for the following scenario: 45-year-old male
with angina pectoris who was found to have coronary arteriosclerosis in the native
coronary vessels. A percutaneous right and left heart catheterization was performed
without any complications.
C. I25.119, 4A023N8
22. Choose the correct code assignment for the following scenario: 46-year old
admitted to the ICU after suffering a ruptured berry aneurysm with subarachnoid
hemorrhage today and was brought in via life flight. Patient now suffers from ataxia
and aphasia. A craniotomy with evacuation of the subarachnoid hemorrhage is
completed.
C. I60.7, R47.01, R27.0, 00C50ZZ23.
Choose the correct code assignment for the following scenario: Thrombosis of left
subclavian vein.
C. I82.B12
24. Choose the correct code assignment for the following scenario: Combined acute-
on-chronic systolic with diastolic heart failure with end stage heart failure.
D. I50.43, I50.84
25. Choose the correct code assignment for the following scenario: A patient was
admitted with angina. Diagnostic cardiac catheterizations determined that the
angina was due to coronary arteriosclerosis of the native vessels.
A. I25.119
26. Choose the correct code assignment for the following scenario: Hypertensive
cardiorenal disease with stage 3 chronic kidney disease.
B. I13.0, N18.3
A. I13.10, N18.3
27. Choose the correct code assignment for the following scenario: 27-year-old
admitted with acute respiratory distress syndrome (ARDS.) Patient was placed on
continuous positive airway pressure for less than 24 hours.
A. J80, 5A09357
28.
When acute respiratory failure is present with another respiratory condition,
how is the acute respiratory failure code sequenced with the other respiratory
diagnoses?
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Acute respiratory failure may be assigned as the principal diagnosis when it meets
the definition of principal diagnosis in the absence of chapter-specific coding
guidelines (such as obstetrics and poisoning) that provide sequencing direction and
take precedence.
29. Choose the correct code assignment for the following scenario: 27-year-old
female presents to labor and delivery today in active labor. She is at 40 weeks
gestation with her first baby. She has an uncomplicated assisted spontaneous
delivery of a healthy single liveborn female infant weighing 7 lbs. 10 oz. and 20
inches long.
B. O80, Z37.0, Z3A.40, 10E0XZZ
30. Choose the correct code assignment for the following scenario: 37-year-old
female presents today for an elective abortion at 9 weeks because of chromosomal
abnormality of her fetus. An abortion was induced by dilation and curettage.
C. Z33.2, O35.1XX0, 10A07ZZ
31. Choose the correct code assignment for the following scenario: Baby Boy Jones
was delivered via cesarean delivery today due to large baby status. He was post-
term at 41 weeks and weighed 4550 grams. A circumcision using a Plasti-bell was
completed on day 2 and baby was discharged with mother to home.
A. Z38.01, P08.0, P08.21, 0VTTXZZ
32.
When is a code from category Z38, Liveborn infants according to place of birth and type of delivery,
assigned as the principal diagnosis?
A.
At the hospital at the time of birth only, when born in the hospital or outside the hospital
33.
Dr. Gilbert sees a 14-old-male with adolescent idiopathic thoracic scoliosis. Surgery for
spinal fusion was cancelled after the patient was diagnosed with mononucleosis. On today’s
visit the patient is started on prednisone for severe sore throat and difficulty swallowing. The
patient was accompanied by his parents who have health insurance through the mother’s
employment at the State Department of Treasury.
Who is the first party in this healthcare reimbursement scenario?
b. parents
34.
Dr. Gilbert sees a 14-old-male with adolescent idiopathic thoracic scoliosis. Surgery for
spinal fusion was cancelled after the patient was diagnosed with mononucleosis. On today’s
visit the patient is started on prednisone for severe sore throat and difficulty swallowing. The
patient was accompanied by his parents who have health insurance through the mother’s
employment at the State Department of Treasury.
Who is the second party in this healthcare reimbursement scenario?
c. Dr. Gilbert
35.
In the healthcare sector, what is the term for
a group of individual entities, such as
individual persons, employers, or associations, whose healthcare costs are combined for
evaluating financial history and estimating future costs?
b. Risk pool
36.
What is the term for the set fee that a policyholder or certificate holder must periodically pay a
health insurance plan in return for healthcare coverage?
c. Premium
37.
Wes is enrolled in Medicare Part A. He had his first hospital encounter this March. He was admitted
for congestive heart failure and stayed three days? Which of the following will Wes need to pay?
d. Deductible and copayment amount
38.
Medicare part C is a ___________ option known as Medicare Advantage.
a. Managed care
39.
Dr. McGee is a primary care physician. Several of Dr. McGee’s patients are insured by Super Payer.
Super Payer reimburses Dr. McGee for each service she provides during a clinic visit. Which
reimbursement methodology does Super Payer use to reimburse Dr. McGee?
a. Fee schedule
40.
CMS uses which reimbursement methodology for inpatient psychiatric facility services payment
system because a specific payment rate is established for each day of the admission?
b. Per diem
41.
The pathologist’s office submitted a $54 bill for a laboratory test. In its payment notice (remittance
advice), the healthcare plan lists its payment for the laboratory test as $28. What does the amount of
$54 represent?
b. billed charges
42.
In which government publication are the details about the various PPS introduced, commented on,
and finalized?
a. federal registar
43.
The MS-DRG payment includes reimbursement for all of the following inpatient services
except
:
a. Physician hospital visit
44.
Reimbursement for minor ancillary services associated with a significant procedure are combined
into a single payment for the procedure. This is the definition of _________.
a. Packaging
45.
The methodology used for critical care services, imaging, and mental health services that results in
composite APCs is ______________.
b. Bundling
46.
Under the OPPS, outpatient services that are similar both clinically and in use of resources are
assigned to separate groups called ____.
b. APCs
47.
Which element of the relative value unit accounts for the physician effort (mental effort and
judgement, technical skill, physical effort, and psychological stress)?
a. Physician work
48.
What does the designation of participating physician mean?
c. Physician participates in Medicare
49.
Rebecca is a coder at Community Hospital. She is coding same-day outpatient surgeries for the
hospital. Which code set does she use to report procedure codes?
CPT and HCPCS Level II
50.
Which of the following adjudication outcomes results in the facility being required to appeal the
payer decision?
DENY
QUESTION 51
1.
BONUS (worth 10 points)
A 30 year old female has been treated for Crohn's disese of the small intestine since 18 years of
age. She has had several exacerbations of the disease over the past years. At this time the
patient comes to the emergency department in extreme pain. A small bowel x-ray shows a small
bowel obstruction. The patient was admiited to the hospital. Later the obstruction was found to be
the result of mural thickening. The patient is take to surgery and a partial resection of the terminal
ileum is performed to release the obstruction. An end-to-end anastamosis is performed to close
the small intestine. The patient was also noted to have flat, firm, hot, and red painful small lumps
on the shins of both legs. Consultation with the wound care physician determined the ulcers to be
erythema nodosum, a known complication of Crohn's disease. The wound care physician
prescribed oral and topical medications.
Assign the appropriate Principal and secondary diagnoses and any procedures. (Hint, 2 CM, 1
PCS). Separate each code with a comma. This question may require manual grading.
K50.012, L52, 0DBB0ZZ
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