CCA Exam Prep 2 | Fall 2023/2024
Which of the following organizations is responsible for updating the procedure
classification of ICD-10-PCS? Answer - Centers for Medicare and Medicaid Services
(CMS) is responsible for updating ICD-10-PCS
Coding accuracy is anticipated to improve due to which ICD-10-CM enhancement?
Answer - Expanding codes to capture more detail in several sections such as injury,
diabetes, and postoperative complications
Which character in an ICD-10-CM diagnosis code provides information regarding
encounter of care? Answer - Seventh character provides information about encounter of
care, such as intial encounter, subsequent encounter, or sequelae
What does the fourth character of an ICD-10-CM diagnosis code capture? Answer -
Fourth character capture etiology, fifth capture anatomic site, and sixth capture severity
ICD-10-CM codes must be a minimum of how many characters Answer - At least three
characters with a decimal point used after the 3rd character
To which of the following do notes appearing under a 3-character code apply? Answer -
When a note appears under a 3-character code, it applies to all codes within that
category
Which volume of ICD-10-CM contains the Tabular and Alphabetic Index of procedures?
Answer - None since the development of ICD-10-PCS
Identify the correct diagnosis code for lipoma of the face: Answer - Lipoma, face =
D17.0
Identify the correct diagnosis code(s) for adenoma of left adrenal cortex with Conn's
syndrome: Answer - Adenoma, adrenal (cortex) = D35.02
Syndrome, Conn = E26.01
Which of the following is a standard terminology used to code medical procedures and
services? Answer - CPT is a comprehensive descriptive listing of terms an codes for
reporting diagnostic and therapeutic procedures and medical services.
Identify the appropriate ICD-10-CM diagnosis code for right cerebral contusion with 15
minute loss of consciousness, initial encounter for care: Answer - Contusion, cerebral -
see Contusion, brain. Add 6th character "1" for loss of consciousness of 30 minutes for
less, 7th character for initial encounter = S06.311A
,If a patient has en excision of a malignant lesion of the skin, the CPT code is
determined by the body area from which the excision occurs and which of the following?
Answer - Diameter of the lesion as well as the most narrow margins required to
adequately excise the lesion described in the operative report
According to CPT, a repair of a laceration that includes retention sutures would be
considered what type of closure? Answer - Complex closures include the repair of
wounds requiring more that layered closure, namely, scar revision, debridement,
extensive undermining, stents, or retention sutures.
Patient is admitted with spotting, had been treated two weeks previously for miscarriage
with sepsis. Sepsis resolved, she is afebrile at this time, treated with an aspiration D&C,
and POC are found. Which of the following should be the PD? Answer - Miscarriage:
Retained POC following an abortion (Subsequent admissions for retained POC
following any type of abortion are assigned the appropriate code from category O03
[spont. abn.] or O07.4 [failed attempted term. of pg. w/o comp.] and Z33.2 [encounter
for elect. term of pg]. This advice is appropriate even when the patient was discharged
prev. with discharge diagnosis of complete ab.
An 80-year-old female is admitted with fever, lethargy, hypotension, tachycardia,
oliguria, elevated WBC, and more than 100K organisms of E. coli per cc of urine.
Attending physician documents "urosepsis". How should coder proceed to code?
Answer - Since urosepsis is nonspecific and not codable in ICD-10-CM, it cannot be
considered synonymous with sepsis, and therefore the physician should be queried.
65yo patient with history of lung cancer is admitted to healthcare facility with ataxia,
syncope, and a fractured arm as a result from falling. Pt undergoes closed reduction of
fracture in the ED and undergoes complete workup for metastatic carcinoma of the
brain. Pt is found to have metastatic carcinoma of the lung to brain and undergoes
radiation therapy to brain. Which of the following would be the PD in this case? Answer
- If a tx is directed at the malignancy, designate the malignancy as the PD with the only
exception to this guideline being if the pt admission or encounter is solely for the
administration of chemo, immunotherapy, or radiation, then assign the appropriate Z51.-
code as the first-listed or PD an the diagnosis or problem for which the service is being
performed as a secondary diagnosis.
Pt was admitted for abdominal pain with diarrhea and was diagnosed with infectious
gastroenteritis. Pt also has angina and COPD. Which of the following would be the
correct coding and sequencing for this case? Answer - Infectious gastroenteritis; COPD;
angina
Pt admitted with hx of prostate cancer and with mental confusion. Pt completed
radiation therapy for prostatic carcinoma 3 years ago and is status post a radical
resection of the prostate. CT scan of brain during current admission reveals metastasis.
Which of the following is the correct coding and sequencing for the current hospital
stay? Answer - Metastatic carcinoma of the brain; history of carcinoma of the prostate
, According to UHDDS, which of the following is the definition of "other diagnoses"?
Answer - Receives clinical eval or therapeutic tx or diagnostic procedures to extends the
LOS or increases nursing care and monitoring
Pt is admitted with abdominal pain and physician documents the discharge dx as
pancreatitis vs. noncalculus cholecystitis. Both dx are equally treated. The correct
coding/sequencing for this case would be: Answer - Sequence either pancreatitis or
noncalculus cholecystitis as PD
7yo pt admitted to ED for tx for shortness of breath and given epinephrine and nebulizer
tx. Shortness of breath and wheezing are unabated following tx. What diagnosis should
be suspected? Answer - Asthma with status asthmaticus since pt failed to respond to
therapy during attack. This is a life-threatening condition that requires emergency care
and likely hospitalization.
Pt is seen in ED for chest pain. After eval, it is suspected that pt may have
gastroesophageal reflux disease (GERD). Final dx was "rule out chest pain vs. GERD".
The correct ICD-10-CM is: Answer - Physician has uncertainty about GERD, so rather
than code a condition that potentially does not exist, it is best to code to the highest
degree of certainty which is the sign/symptom the pt exhibits = Chest pain, unspecified
R07.9
Skin lesion was removed from pt's cheek in doctor's office and is documented as "skin
lesion" in health record. Before billing, pathology report returns with dx of basal cell
carcinoma. Which of the following action should the coding professional do for claim
submission? Answer - Code basal cell carcinoma since diagnostic tests interpreted by
physician and final report is available and this is a outpatient encounter. However, this is
different from inpatient rules regarding abnormal findings on test results.
Epidural given during labor and subsequently it was determined that pt would require C-
section for cephalopelvic disproportion due to obstructed labor. Assign correct ICD-10-
CM dx and CPT anesthesia codes without modifiers: Answer - Cephalopelvic = O65.4;
two codes req for anesthesia: planned vaginal delivery = 01967 and add'l code
describing anesthesia for c-section following planned vaginal delivery converted to
cesarean = 01968 (instructional note guides coder to use 01968 with 01967)
Which of the following purpose and use goals does NOT apply to ICD-10-PCS? Answer
- Improved collection of data about nursing care
Which of the following is NOT a way that ICD-10-CM improves coding accuracy?
Answer - Increases cross-referencing
To help clarify terms that currently have overlapping meaning, ICD-10-PCS has defined
root operations. What is an example of the root operation of "Excision"? Answer - Partial
nephrectomy: a portion of the body part is cut out or off, without replacement
Which of the following organizations is responsible for updating the procedure
classification of ICD-10-PCS? Answer - Centers for Medicare and Medicaid Services
(CMS) is responsible for updating ICD-10-PCS
Coding accuracy is anticipated to improve due to which ICD-10-CM enhancement?
Answer - Expanding codes to capture more detail in several sections such as injury,
diabetes, and postoperative complications
Which character in an ICD-10-CM diagnosis code provides information regarding
encounter of care? Answer - Seventh character provides information about encounter of
care, such as intial encounter, subsequent encounter, or sequelae
What does the fourth character of an ICD-10-CM diagnosis code capture? Answer -
Fourth character capture etiology, fifth capture anatomic site, and sixth capture severity
ICD-10-CM codes must be a minimum of how many characters Answer - At least three
characters with a decimal point used after the 3rd character
To which of the following do notes appearing under a 3-character code apply? Answer -
When a note appears under a 3-character code, it applies to all codes within that
category
Which volume of ICD-10-CM contains the Tabular and Alphabetic Index of procedures?
Answer - None since the development of ICD-10-PCS
Identify the correct diagnosis code for lipoma of the face: Answer - Lipoma, face =
D17.0
Identify the correct diagnosis code(s) for adenoma of left adrenal cortex with Conn's
syndrome: Answer - Adenoma, adrenal (cortex) = D35.02
Syndrome, Conn = E26.01
Which of the following is a standard terminology used to code medical procedures and
services? Answer - CPT is a comprehensive descriptive listing of terms an codes for
reporting diagnostic and therapeutic procedures and medical services.
Identify the appropriate ICD-10-CM diagnosis code for right cerebral contusion with 15
minute loss of consciousness, initial encounter for care: Answer - Contusion, cerebral -
see Contusion, brain. Add 6th character "1" for loss of consciousness of 30 minutes for
less, 7th character for initial encounter = S06.311A
,If a patient has en excision of a malignant lesion of the skin, the CPT code is
determined by the body area from which the excision occurs and which of the following?
Answer - Diameter of the lesion as well as the most narrow margins required to
adequately excise the lesion described in the operative report
According to CPT, a repair of a laceration that includes retention sutures would be
considered what type of closure? Answer - Complex closures include the repair of
wounds requiring more that layered closure, namely, scar revision, debridement,
extensive undermining, stents, or retention sutures.
Patient is admitted with spotting, had been treated two weeks previously for miscarriage
with sepsis. Sepsis resolved, she is afebrile at this time, treated with an aspiration D&C,
and POC are found. Which of the following should be the PD? Answer - Miscarriage:
Retained POC following an abortion (Subsequent admissions for retained POC
following any type of abortion are assigned the appropriate code from category O03
[spont. abn.] or O07.4 [failed attempted term. of pg. w/o comp.] and Z33.2 [encounter
for elect. term of pg]. This advice is appropriate even when the patient was discharged
prev. with discharge diagnosis of complete ab.
An 80-year-old female is admitted with fever, lethargy, hypotension, tachycardia,
oliguria, elevated WBC, and more than 100K organisms of E. coli per cc of urine.
Attending physician documents "urosepsis". How should coder proceed to code?
Answer - Since urosepsis is nonspecific and not codable in ICD-10-CM, it cannot be
considered synonymous with sepsis, and therefore the physician should be queried.
65yo patient with history of lung cancer is admitted to healthcare facility with ataxia,
syncope, and a fractured arm as a result from falling. Pt undergoes closed reduction of
fracture in the ED and undergoes complete workup for metastatic carcinoma of the
brain. Pt is found to have metastatic carcinoma of the lung to brain and undergoes
radiation therapy to brain. Which of the following would be the PD in this case? Answer
- If a tx is directed at the malignancy, designate the malignancy as the PD with the only
exception to this guideline being if the pt admission or encounter is solely for the
administration of chemo, immunotherapy, or radiation, then assign the appropriate Z51.-
code as the first-listed or PD an the diagnosis or problem for which the service is being
performed as a secondary diagnosis.
Pt was admitted for abdominal pain with diarrhea and was diagnosed with infectious
gastroenteritis. Pt also has angina and COPD. Which of the following would be the
correct coding and sequencing for this case? Answer - Infectious gastroenteritis; COPD;
angina
Pt admitted with hx of prostate cancer and with mental confusion. Pt completed
radiation therapy for prostatic carcinoma 3 years ago and is status post a radical
resection of the prostate. CT scan of brain during current admission reveals metastasis.
Which of the following is the correct coding and sequencing for the current hospital
stay? Answer - Metastatic carcinoma of the brain; history of carcinoma of the prostate
, According to UHDDS, which of the following is the definition of "other diagnoses"?
Answer - Receives clinical eval or therapeutic tx or diagnostic procedures to extends the
LOS or increases nursing care and monitoring
Pt is admitted with abdominal pain and physician documents the discharge dx as
pancreatitis vs. noncalculus cholecystitis. Both dx are equally treated. The correct
coding/sequencing for this case would be: Answer - Sequence either pancreatitis or
noncalculus cholecystitis as PD
7yo pt admitted to ED for tx for shortness of breath and given epinephrine and nebulizer
tx. Shortness of breath and wheezing are unabated following tx. What diagnosis should
be suspected? Answer - Asthma with status asthmaticus since pt failed to respond to
therapy during attack. This is a life-threatening condition that requires emergency care
and likely hospitalization.
Pt is seen in ED for chest pain. After eval, it is suspected that pt may have
gastroesophageal reflux disease (GERD). Final dx was "rule out chest pain vs. GERD".
The correct ICD-10-CM is: Answer - Physician has uncertainty about GERD, so rather
than code a condition that potentially does not exist, it is best to code to the highest
degree of certainty which is the sign/symptom the pt exhibits = Chest pain, unspecified
R07.9
Skin lesion was removed from pt's cheek in doctor's office and is documented as "skin
lesion" in health record. Before billing, pathology report returns with dx of basal cell
carcinoma. Which of the following action should the coding professional do for claim
submission? Answer - Code basal cell carcinoma since diagnostic tests interpreted by
physician and final report is available and this is a outpatient encounter. However, this is
different from inpatient rules regarding abnormal findings on test results.
Epidural given during labor and subsequently it was determined that pt would require C-
section for cephalopelvic disproportion due to obstructed labor. Assign correct ICD-10-
CM dx and CPT anesthesia codes without modifiers: Answer - Cephalopelvic = O65.4;
two codes req for anesthesia: planned vaginal delivery = 01967 and add'l code
describing anesthesia for c-section following planned vaginal delivery converted to
cesarean = 01968 (instructional note guides coder to use 01968 with 01967)
Which of the following purpose and use goals does NOT apply to ICD-10-PCS? Answer
- Improved collection of data about nursing care
Which of the following is NOT a way that ICD-10-CM improves coding accuracy?
Answer - Increases cross-referencing
To help clarify terms that currently have overlapping meaning, ICD-10-PCS has defined
root operations. What is an example of the root operation of "Excision"? Answer - Partial
nephrectomy: a portion of the body part is cut out or off, without replacement
