I50.23 Acute on chronic systolic (congestive) heart failurea.I10,
I50.9
b.I11.0
c.I50.23, I10
d.I11.0, I50.9
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Answer d Heart conditions are assigned a combination code when a causalrelationship is
stated (due to hypertension) or implied (hypertensive). Use an ad- ditional code to identify the
type of heart failure in those patients with heart failure (ICD-10-CM Official Guidelines for
Coding and Reporting 2016b, 41).
2. Assign the best answer to complete the following sentence.The CPT codesfor treatment
of fractures
a.Use the terminology "manipulation" rather than "reduction" of fractureb.Include
internal fixation in all codes
c.Do not include application of cast
d.Do not differentiate between open and closed treatment; CPT only specifiesthe site of the
fracture
Answer a Manipulation refers to the attempted reduction or restora-tion of a dislocated joint or
fracture (Smith 2015, 84)
3. In CPT, if a patient has two lacerations of the arm that are repaired withsimple
closures, the coder would assign
a.Two CPT codes expressing each laceration repairb.One
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CPT code for the largest laceration
c.One CPT code, adding the lengths of the lacerations together
d.One CPT code for the most complex closure
Answer c When multiple wounds are repaired with the same closure type (for example, simple),
lengths of the wounds inthe same classification and from all anatomical sites that are grouped
together intothe same code descriptor should be added together (Smith 2015, 67).
4. Patient admitted for laparoscopic repair of right diaphragmatic hernia. As-sign the
ICD-10-PCS procedure code for this surgery.
0BQR4ZZ Repair right diaphragm, percutaneous endoscopic approach0BQROZZ
Repair right diaphragm, open approach
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0BQS4ZZ Repair left diaphragm, percutaneous endoscopic approach0BQSOZZ
Repair left diaphragm, open approach
a.0BQR4ZZ
b.0BQR0ZZ
c.0BQS4ZZ
d.0BQS0ZZ
Answer a Surgery is the only treatment for diaphragmatic hernias.ICD-10-PCScode 0BQR4ZZ, is
used for laparoscopic repair of diaphragmatic hernia (Garvin 2015, 192, 284)
5. When trying to determine if documentation is present to substantiate statusasthmaticus,
the coder should review the record for what terms and phrases?a.Intractable pneumonia
b.Refractory asthma and severe, intractable wheezingc.Airway
obstruction relieved by bronchodilators
d.Limited but pronounced wheezing
Answer b Status asthmaticus is defined as continualwheezing in spite of therapy (Leon-Chisen
2013, 230).
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