Coding Practice 6
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St. Petersburg College *
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2810
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Medicine
Date
Dec 6, 2023
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Coding Price 6
Chapter 1
1.82
Von Willebrand’s disease and hemophilia C are both types of _____.
a. Iron-deficiency anemia
b. Hereditary hemolytic anemia
c. Aplastic anemia
d. Coagulation defects
1.94
Christmas disease
ICD-10-CM Code(s): D67
1.100
Sarcoidosis of lung
ICD-10-CM Code(s): D86.0
1.104
Opioid dependence with withdrawal
ICD-10-CM Code(s): F11.23
1.116
Depression
ICD-10-CM Code(s): F32.A
1.120
Alcoholic paranoia
ICD-10-CM Code(s): F10.950
1.126
Contact blepharoconjuctivitis of both eyes
ICD-10-CM Code(s): G00.3
1.136
What is the correct code for sensorineural hearing loss of both ears?
a. H90.0
b. H90.3
c. H90.5
d. H90.6
1.142
Acute flaccid myelitis
ICD-10-CM Code(s): G04.82
1.144
Reflex sympathetic dystrophy, both arms
ICD-10-CM Code(s): G90.513
Chapter 6
6.8
This established patient comes to the physician’s office and after evaluation requires a glucose tolerance test. The physician drew the three specimens by venipuncture and performed the test at the office. List the correct CPT procedure code(s).
CPT Codes: 36415, 82951
6.16
A patient is admitted with an acute exacerbation of congestive heart failure due to hypertensive heart disease. This patient has chronic systolic heart failure. The patient responds positively to Lasix therapy. The patient also has chronic kidney disease stage V and is a type 1 diabetic. Assign the correct diagnostic codes.
ICD-10-CM Code(s): I13.2, I50.23, E10.22, N18.5
6.18
This 25-year-old female has been treated for Crohn’s disease of the small intestine since she was 18 years oof age. She has had several exacerbations but has been maintained on drug therapy. She is being seen now for extreme pain, which on x-ray shows small bowel obstruction. Patient is taken to surgery immediately. During the surgery, a partial excision of the terminal ileum is performed to release the obstruction. There is also a section of the jejunum that is very inflamed. This section is also resected. An end-to-end anastomosis is completed on all segments. The patient tolerates the procedure well. Which of the following is the correct ICD-10-CM and CPT code assignment?
a. K56.600, K50.012, 44120, 44121-51
b. K50.012, 44120, 44121-51
c. K50.012, 44120, 44121
d. K50.012, 44020
6.40
A 6-year-old child, an established patient, is seen in the pediatrician’s office for routine immunization. The physician speaks with the child’s father about national immunization recommendations, and the risks and benefits of vaccine provided, and gives follow-up instructions for possible side-effect treatment. The patient receives a DtaP immunization IM. Assign the appropriate ICD-
10-CM and CPT procedure code(s).
a. Z23, 90461, 90700
b. Z23, Z71.85, 99213, 90460, 90700
c. Z23, Z71.85, 90460, 90461, 90461, 90700
d. Z23, Z71.85, 90460
6.46
This 35-year-old male has had an eruption of molluscum contagiosum on the penis for several months. He finally sought medical attention. He was advised to have these lesions removed. He is here now for the procedure. The patient had extensive destruction of a penile molluscum contagiosum performed by cryosurgery and laser surgery. What are the correct codes?
ICD-10-CM and CPT Code(s): B08.1, 54065
Chapter 9
9.6
The following documentation is from the health record of a 66-year-old male patient.
Discharge Summary
Admission Date: 6/19/XX
Discharge Date: 6/28/XX
History of Present Illness: This patient is a 66-year-old male admitted on 6/19 because of unstable postinfarct angina. He underwent cardiac bypass surgery here 15 years ago. He did well until two years ago, when he developed angina and underwent angioplasty here. On 6/19, he was awakened by severe chest pain and was taken to a nearby community hospital where he was found to have a small anterior wall myocardial infarction with the CPK only slightly elevated. He had cardiac catheterization performed at that time. Because of this small infarction, he was referred here for consideration for further surgical intervention. He was discharged from the hospital on 6/16. On 6/19, as the patient was walking from the car to the office, he developed significant chest pain and was therefore admitted to rule out further infarction.
Documentation of recent cardiac catheterization showed that complete left heart catheterization, left ventricular cineangiography, and bypass visualization were performed. The left ventricle showed severe anterior hypokinesis, although it did still move. The left main coronary artery was narrowed by about 70 percent. The bypass to the circumflex looked good, but the bypass to the left anterior descending had a very severe stenosis in the body of the graft. There was a very large, marginal circumflex artery that had an orificial, 80 percent stenosis. He was thought not to be a candidate for angioplasty but bypass surgery instead.
Surgical Procedure: Using extracorporeal, the left internal mammary artery was anastomosed to the left anterior descending coronary artery, and a venous graft was placed from the aorta to the marginal circumflex. It was found that the old venous graft to the main circumflex was in excellent condition with very soft, pliable walls so that the vessel was left intact. There were no complications of this surgery. His postoperative course was singularly uncomplicated. He never had any arrhythmia problems; his wounds healed nicely. He had a tiny left pleural effusion that never needed to be tapped. He was walking about the ward participating in the cardiac rehab program at the time of discharge.
Discharge Instructions: Discharge medications will simply be aspirin grains 5 q.d., Tylenol with Codeine 1 or 2 p.r.n. for pain, Lopressor 50 mg a day, and Colace, as necessary. He was instructed to contact his private physician upon return home for resumption of his medical care. He is to call me here at the medical center if there are any questions or problems that he wishes to discuss.
Discharge Diagnosis: 1. Unstable angina (intermediate coronary syndrome)
2. Recent incomplete, anterior wall myocardial infarction
3. Coronary atherosclerosis, three vessel
4. Successful double-bypass surgery
What are the correct codes for this admission?
a.
I25.110, I25.700, I21.01, Z95.1, 33533, 33517, 33530
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b.
I25.110, I25.700, I21.01, Z95.1, 33510, 33533
c.
I25.10, I25.700, I22.0, Z95.1, 33530
d.
I25.110, I25.700, I25.2, Z95.1, 33518, 33530
9.16
The patient presents for a laparoscopic Nissen fundoplasty due to gastroesophageal reflux with esophagitis. He also has Barrett’s esophagus. These conditions have not been responding to conservative
treatment, and the patient wishes to undergo surgery at this time. The patient has also had many instances of treatment for chronic cholecystitis with cholelithiasis. It has been decided to pursue a laparoscopic cholecystectomy at the same time that the fundoplasty is done. Which of the following is the correct code assignment?
a. K21.9, K22.70, 47562, 43289-51
b. K21.00, K22.70, K80.10, 43327, 47600-52
c. K21.00, K22.10, K81.1, 43281
d. K21.00, K22.70, K80.10, 43280, 47562-51
9.26
The following documentation is from the health record a 56-year-old female.
Preventative Medicine Visit
This patient is a 56-year-old female who comes in today for a complete physical, which is covered by her private insurance company. Patient is known to me, although has not been in to see me since last year.
Past Medical History: 1. History of proctosigmoiditis, probably ischemic, treated 1/05
2. History of TAH-BSO for endometriosis
3. History of NVSD x2
4. History of correction of bunion and hammer toe, 2007
The only concern that she has is some problems with headaches in the frontal area in the morning. The headaches seem to be worse fairly consistently in the morning. She has also had some problems with hips aching, and her eyes occasionally have been a little blurry. Other than that, she has no other concerns on ROS. She has no jaw claudication, joint pains, etc.
Family History: Her mother died of CVA and colon cancer at age 76. Her father died of heart disease at age 80.
Social History: She has been married for 25 years. She has two children and is a homemaker. She does not smoke or drink. Her husband is a farmer.
Allergies: No known allergies
Medications: ASA, Premarin, Caltrate
ROS is otherwise entirely unremarkable.
Physical Exam: She appears to be in no acute distress
HEENT: Head is normocephalic. PERRLA: Fundi benign. THs are clear. Pharynx is negative. There is no temporal artery tenderness.
Neck: without adenopathy or thyromegaly
Lungs: Clear
Heart: Showed a normal S1, S2, with regular rate and rhythm and no murmur
Breasts: Without masses. Self breast examination was taught and encouraged on a monthly basis. Axillary is unremarkable.
Abdomen: Soft and nontender with no hepatosplenomegaly present.
Genitalia: External genitalia normal. Cervix was absent. Vaginal Pap smear was done. Bimanual exam revealed an absent uterus and nonpalpable ovaries. Rectal exm was normal.
Neurological: Exam intact
Psychiatric: Patient is alert and oriented to person, place, and time. No defects. Well groomed. No counseling is indicated.
Assessment: 1. Headaches, exact etiology not clear. I am going to check her sed rate. If that is normal, then will proceed with CT scan of the head.
2. Routine physical
I will write to her with the test results. If she does not hear from me in two weeks, she will give me a call. Otherwise, I will see her right after her head CT.
Assign the correct codes for this visit:
a.
Z00.01, Z01.149, Z12.72, Z90.710, Z80.0, R51.9, 99396, 99212-25
b.
Z00.01, R51.9, 99396, 99212
c.
Z01.419, Z12.72, Z90.710, Z80.0, R51.9, G0101, Q0091, 99212-25
d.
R51.9, Z00.01, Z01.419, Z12.72, Z90.710, Z80.0, 99213