Question

QUESTION 25

1. A patient with end-stage renal disease and hypertension presents to outpatient dialysis for a regularly scheduled session. How should the medical necessity of this encounter be coded?

   	A.	I12.0, N18.6
   	B.	I12.9, N18.6
   	C.	N18.6, I10
   	D.	I12.9, N18.9

10 points   

QUESTION 26

1. A patient recently discharged after a 5-day stay for AMI returns to the emergency room 2 days after discharge. The patient is dyspneic, diaphoretic, and complaining of severe chest tightness. He says that he's afraid he's having another heart attack.

   After labs, an EKG, and evaluation by the ER attending physician, it is determined that this patient requires admission for further treatment.

   The ER attending notes describes the diagnosis as "subsequent STEMI AMI on top of previous non-ST elevation AMI."

   How should the coder capture this diagnosis?

   	A.	I25.2
   	B.	I21.29
   	C.	I24.1
   	D.	I22.9

10 points   

QUESTION 27

1. Code Z09 is used for follow-up encounters after completed treatment for a condition (other than malignant neoplasia). Of the following, which patient's scenario warrants the use of Z09?

   	A.	The patient with strep throat which has not responded to antibiotic treatments. The patient states that he has complied with the medication regimen but is feeling worse.
   	B.	The patient who presents without symptoms for a colonoscopy (at age 50) to screen for colon cancer. This patient has no symptoms and was referred by her primary care physician.
   	C.	A patient previously treated with antibiotics for severe bronchitis, but who returns at the physician's request for surveillance and check-up. The patient expresses no complaints or symptoms.
   	D.	A patient with a prior history of asymptomatic HIV who has returned for routine bloodwork and refill of anti-retroviral medications.

10 points   

QUESTION 28

1. An independent, Licensed Clinical Social Worker (LCSW) provides outpatient psychotherapy for patient's suffering from PTSD. During these sessions, she works to attempt alleviation of the patient's emotional disturbances, change maladaptive behaviors, encourage patients, and similar types of services. Which CPT code would the LCSW report for her professional services if she furnished an hour-long session with one of her patients?

   	A.	90837
   	B.	99404
   	C.	90791
   	D.	90882

10 points   

QUESTION 29

1. CPT codes group into which of the following for hospital outpatient payment?

   	A.	RUG
   	B.	RVU
   	C.	APC
   	D.	MS-DRG

10 points   

QUESTION 30

1. If renal failure is described as both acute and chronic, which one is sequenced first in accordance with ICD-10-CM guidelines?

   	A.	Either one. The nature of the encounter determines which would be listed first.
   	B.	Whichever is listed first on the physician's record
   	C.	Chronic kidney failure
   	D.	Acute kidney failure

10 points   

Answer 1

25.

(A) I 12.0, N18.6

I 12.0 for coded hypertensive chronic kidney disease with stage 5 chronic disease.

N18.6 coded for end stage renal disease.

26.

(D) I 22.9

I 25.2 Coded for old myocardial infraction.

I 21.29 coded for ST elevation MI involve other site.

I 22.9 coded for subsequent STelevation MI unspecific site.

27.

(C)

Code Z09 used for those patients who returns after the antibiotics are completed.Encoutered for follow up examination after completed treatment other than malignant neoplasms.

28. (C) 90791

This depends on the insurance and the plan. Typically medicare and medicald plans allow 90791 once per client per provider per year.

29. (c) APC

The hospital outpatient prospective payment system in place today clasify all hospital outpatient services into ambulatory classification. (APC)

30.(D) Acute kidney disease

If the same condition is described as both acute and chronic and separate subenties exist in the alphabetic index at the same indentation level code both and sequence the acute kidney disease come first in ICD-10-CM guidelines.