, Solution manual for Understanding Current
Procedural Terminology and HCPCS Coding Systems
2024 Edition, 11th Edition Mary Jo Bowie
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel
sheet if it exists.
4- We have all what you need, we make
update at every time. There are many new
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
Solution and Answer Guide
PEER CODING AUDIT ACTIVITIES (2024)
TABLE OF CONTENTS
Activities ...................................................................................................................................................... 2
Activity 1: Infectious and Parasitic Diseases (A00–B99) ......................................................................... 2
Activity 2: Neoplasms (C00–D49) ........................................................................................................... 4
Activity 3: Coding Practice for Diseases of Blood and Blood-Forming Organs (D50–D89)................... 5
Activity 4: Coding Practice for Endocrine, Nutritional, and Metabolic Diseases (E00–E89) .................. 5
Activity 5: Coding Practice for Mental, Behavioral, and Neurodevelopmental Diseases (F01–F99) ...... 6
Activity 6: Coding Practice for Diseases of the Nervous System (G00–G99) ........................................ 7
Activity 7: Coding Practice for Disorders of the Sensory Organs (Eye and Adnexa (H00–H59)/ Ear and
Mastoid Process (H60–H95) ..................................................................................................................... 8
Activity 8: Coding Practice for Diseases of the Circulatory System (I00–I99) ........................................ 9
Activity 9: Coding Practice for Diseases of the Respiratory System (J00–J99) ..................................... 10
Activity 10: Coding Practice for Diseases of the Digestive System (K00–K95).................................... 12
Activity 11: Coding Practice for Diseases of the Skin and Subcutaneous Tissue (L00–L99) ................ 13
Activity 12: Coding Practice for Diseases of the Musculoskeletal System and Connective Tissue (M00–
M99)........................................................................................................................................................ 14
Activity 13: Coding Practice for Diseases of the Genitourinary System (N00–N99) ............................ 15
Activity 14: Coding Practice for Pregnancy, Childbirth, and the Puerperium (O00–O9A)] .................. 16
Activity 15: Coding Practice for Certain Conditions Originating in the Perinatal Period(P00–P96) ..... 18
Activity 16: Coding Practice for Congenital Malformations, Deformations, and Chromosomal
Abnormalities (Q00–Q99) ...................................................................................................................... 19
Activity 17: Coding Practice for Symptoms, Signs, and Abnormal Clinical laboratory Findings (R00–
R99) ........................................................................................................................................................ 19
Activity 18: Coding Practice for Injury and Poisoning (S00–T88) ........................................................ 20
Activity 19: Coding Practice for External Causes of Morbidity (V00–Y99) ........................................ 21
Activity 20: Coding Practice for Factors Influencing Health Status (Z00–Z99)] ................................... 22
Activity 21: Coding Practice for Evaluation and Management .............................................................. 23
Activity 22: Coding Practice for Anesthesia........................................................................................... 24
Activity 23: Coding Practice for Procedures of the Integumentary System ........................................... 27
Activity 24: Coding Practice for Procedures of the Musculoskeletal System ........................................ 28
Activity 25: Coding Practice for Procedures of the Respiratory System ................................................ 30
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
Activity 26: Coding Practice for Procedures of the Cardiovascular System .......................................... 31
Activity 27: Coding Practice for Procedures of the Hemic/Lymphatic Systems and the Mediastinum
and Diaphragm ........................................................................................................................................ 32
Activity 28: Coding Practice for Procedures of the Digestive System ................................................... 33
Activity 29: Coding Practice for Procedures of the Urinary System ...................................................... 34
Activity 30: Coding Practice for Procedures of the Male Reproductive System .................................... 35
Activity 31: Coding Practice for Procedures of the Female Reproductive System and Maternity and
Delivery Services .................................................................................................................................... 37
Activity 32: Coding Practice for Procedures of the Endocrine System .................................................. 38
Activity 33: Coding Practice for Procedures of the Nervous System ..................................................... 39
Activity 34: Coding Practice for Procedures of the Sensory Organ Systems ......................................... 39
Activity 35: Coding Practice for Radiology Services and Procedures.................................................... 40
Activity 36: Coding Practice for Pathology and Laboratory Services .................................................... 42
Activity 37: Coding Practice for Procedures and Services from the Medicine Section ......................... 43
Activity 38: Coding Practice for HCPCS Level II .................................................................................. 44
ACTIVITIES
ACTIVITY 1: INFECTIOUS AND PARASITIC DISEASES (A00–B99)
Code Set 1
1. A 22-year-old female patient was seen in the ED with complaints of diarrhea and lower abdominal pain.
After examination, the patient was diagnosed with viral gastroenteritis. What diagnosis code(s) would be
reported for this encounter?
A08.4
Lower abdominal pain and diarrhea are symptoms of the viral gastroenteritis. See ICD-10-CM guideline
I.B.5. Look in the ICD-10-CM Alphabetic Index for Gastroenteritis/viral NEC, which directs the coder to
A08.4.
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
2. The patient had a blood test for HIV that has come back as inconclusive, what ICD-10-CM code is
assigned?
R75
ICD-10-CM guideline I.C.1.a.2.e instructs us to use R75 for patients with inconclusive HIV serology and
without definitive diagnosis or manifestations of the illness. To locate the code in the ICD-10-CM
Alphabetic Index, look for Human/immunodeficiency virus (HIV) disease (infection)/laboratory evidence
R75.
3. An HIV-positive patient was admitted to the hospital with skin lesions on the chest and back. Biopsies were
taken, and the pathologic diagnosis was HIV-related Kaposi’s sarcoma. What ICD-10-CM code(s) should
be reported?
B20, C46.0
According to ICD-10-CM guideline I.C.1.a.2.a, if a patient is admitted for an HIV-related condition, the
principal diagnosis should be B20, followed by additional diagnosis codes for all reported HIV-related
conditions. In the ICD-10-CM Alphabetic Index, look for Human/immunodeficiency virus (HIV) disease
(infection), which directs you to B20. Because Kaposi’s sarcoma is documented as related to the patient’s
HIV status, it is coded as B20 instead of asymptomatic HIV. Patients previously diagnosed with any HIV
illness (B20) should never be assigned to R75 or Z21, Asymptomatic human immunodeficiency virus
[HIV] infection status. In the ICD-10-CM Alphabetic Index look for Kaposi’s/sarcoma/skin (multiple sites)
directing you to C46.0.
Code Set 2
1. A 72-year-old male is admitted to the hospital for MRSA. Which ICD-10-CM code(s) should be reported
for the admission?
A49.02
Look in the ICD-10-CM Alphabetic Index for MRSA (Methicillin resistant Staphylococcus
aureus)/infection referring you to code A49.02.
2. The patient had a blood test for HIV that has come back as positive. There is no documentation of
symptoms, what ICD-10-CM code is assigned?
Z21
ICD-10-CM guideline I.C.1.a.2.d instructs us to use Z21 for patients with positive HIV serology and
without documentation of symptoms. To locate the code in the ICD-10-CM Alphabetic Index, look for
Human/immunodeficiency virus (HIV) disease (infection)/asymptomatic status Z21.
3. A patient is seen in the office because she recently found out an individual, she had unprotected sexual
intercourse with a few months prior has been diagnosed with HIV. She is here to be tested for HIV. What
ICD-10-CM code(s) is/are reported?
Z11.4
Per ICD-10-CM guideline I.C.1.a.2.h, if a patient is being seen to determine HIV status, use code Z11.4. In
the ICD-10-CM Alphabetic Index, look for Screening/disease/human immunodeficiency virus (HIV),
which guides you to Z11.4.
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
ACTIVITY 2: NEOPLASMS (C00–D49)
Code Set 1
1. A 62-year-old female patient is seen by her primary care provider for persistent lower intestinal cramps.
The physician performed a colonoscopy with biopsy. The results confirm the patient has a malignant
neoplasm in her sigmoid colon. What ICD-10-CM code(s) is/are reported?
C18.7
According to the ICD-10-CM guideline when a definitive diagnosis is known, the related symptoms are not
coded. In this case, only the malignant neoplasm of the sigmoid colon is reported. Look in the ICD-10-CM
Table of Neoplasms for Colon and you are directed to see also Neoplasm, intestine, large. Look for
intestine, intestinal/large/colon/sigmoid (flexure). Use the code from the Malignant Primary column C18.7.
2. The patient is seen today for a secondary neoplasm that has metastasized to the descending colon. What
ICD-10-CM code(s) is/are reported?
C78.5, C80.1
In the ICD-10-CM Table of Neoplasms, look for Neoplasm/colon referring you to see also Neoplasm,
intestine, large. Look for Neoplasm/intestine/large/colon/descending and use the code from the Malignant
Secondary column guiding you to code C78.5. Primary cancer is unknown, report code C80.1.
3. A 39-year-old female was seen today for the removal of two lipomas. One was located on her back and the
other was located on the right forearm. Both involved subcutaneous tissue. What ICD-10-CM code(s) is/are
reported?
D17.21, D17.1
In the ICD-10-CM Alphabetic Index, look for Lipoma/site classification/arms (skin) (subcutaneous), which
directs you to D17.2-. In the Tabular List, a fifth character 1 is selected to indicate the right arm. Next, look
for Lipoma/site classification/trunk (skin) (subcutaneous) D17.1.
Code Set 2
1. The patient is seen today to have a benign tumor removed from her chest. What ICD-10-CM code(s) is/are
reported?
D36.7
In the ICD-10-CM Alphabetic Index, in the Table of Neoplasms, look for Chest (wall) NEC and report the
code from the benign column, D36.7.
2. Mrs. Long is here today because her malignancy has metastasized to her bones in her thoracic spine. What
ICD-10-CM code(s) is/are reported?
C79.51, C80.1
The patient has metastatic cancer (secondary malignancy) of the thoracic spine. Look in the ICD-10-CM
Table of Neoplasms for Neoplasm, neoplastic/spine, spinal (column)/and use the code from the Malignant
Secondary column directing you to code C79.51. Primary cancer is unknown, report code C80.1.
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
3. A 53-year-old patient is scheduled for chemotherapy to treat his primary liver cancer. What ICD-10-CM
code(s) is/are reported?
Z51.11, C22.8
ICD-10-CM Guideline I.C.2.e.2 indicates an encounter for chemotherapy code is to be reported as the
primary code with a code for the cancer as secondary when the reason for the visit is solely for
chemotherapy. Look in the ICD-10-CM Alphabetic Index for Chemotherapy (session) (for)/cancer Z51.11.
For the malignancy, look in the ICD-10-CM Table of Neoplasms for liver/primary and use the code from
the Malignant Primary column which directs the coder to C22.8.
ACTIVITY 3: CODING PRACTICE FOR DISEASES OF BLOOD AND BLOOD-FORMING
ORGANS (D50–D89)
Code Set 1
1. A 26-year-old female patient is given a blood transfusion to treat postoperative anemia due to acute blood
loss during surgery. What ICD-10-CM code is reported?
D62
In the ICD-10-CM Alphabetic Index, look for Anemia/postoperative (postprocedural)/due to (acute) blood
loss guiding you to code D62.
2. A 54-year-old patient is seen by his primary physician for fever and chills developing after he began his
chemotherapy treatments. Test results revealed a severe low white blood cell count, and the physician
diagnosed the patient with agranulocytosis, secondary to his cytoreductive cancer chemotherapy. What
ICD-10-CM code(s) is/are reported?
D70.1, C80.1
In the ICD-10-CM Alphabetic Index, look for Agranulocytosis/secondary/due to cytoreductive cancer
chemotherapy, guiding you to D70.1. The note directs coders to use additional code to identify neoplasm.
Primary cancer is unknown, report code C80.1.
Code Set 2
1. Mrs. Winter is seen today for management of her acquired polycythemia. What ICD-10-CM code is
reported?
D75.1
In the ICD-10-CM Alphabetic Index, look for Polycythemia/acquired guiding you to code D75.1.
2. Mr. Freeze sees the nephrologist for a B-12 injection to treat erythropoietin-resistant anemia due to stage 3
chronic kidney disease. What ICD-10-CM code(s) is/are reported?
N18.30, D63.1
In the ICD-10-CM Alphabetic Index, look for Anemia/in (due to) (with)/chronic kidney disease or
Anemia/erythropoietin-resistant anemia (EPO-resistant anemia) guiding you to code D63.1. In the Tabular
List at D63.1 there is an instructional note stating to code first underlying chronic kidney disease. Look in
the ICD-10-CM Alphabetic Index for Disease/kidney/chronic/stage 3 (moderate) guiding you to code
N18.30.
ACTIVITY 4: CODING PRACTICE FOR ENDOCRINE, NUTRITIONAL, AND
METABOLIC DISEASES (E00–E89)
Code Set 1
1. A 52-year-old patient with hyperthyroidism has an ultrasound that revealed a uninodular goiter. What ICD-
10-CM code is reported?
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
E05.10
In the ICD-10-CM Alphabetic Index, look for Hyperthyroidism/with/goiter/nodular/uninodular which
directs you to E05.10. The code can also be found by looking in the ICD-10-CM Alphabetic Index for
Goiter/uninodular/toxic or with hyperthyroidism which guides you to code E05.10.
2. Mr. Lawrence presents to the clinic with extreme nervousness and palpitations. He indicates he has lost 12
pounds in the last few months and his eyes appear bulging. Test results confirm Graves’ disease. What
ICD-10-CM code(s) is/are reported?
E05.00
Look in the ICD-10-CM Alphabetic Index for Disease/Graves’ (exophthalmic goiter)—see
Hyperthyroidism, with goiter (diffuse). Look for Hyperthyroidism/with/goiter (diffuse) directing you to
E05.00. Definitive diagnosis is Graves’ disease and the only code reported. The palpitations, weight loss,
bulging eyes, and extreme nervousness are symptoms of the Graves’ disease and not reported separately.
Refer to ICD-10-CM guidelines I.B.5.
3. Ms. Sinclair was seen in the ED for dizziness, loss of appetite, and fatigue for the past 2 days. Lab tests
showed the patient was experiencing an Addisonian crisis. What ICD-10-CM code(s) is/are reported?
E27.2
Look in the ICD-10-CM Alphabetic Index for Crisis/Addisonian directing you to E27.2. The symptoms of
dizziness, loss of appetite, and fatigue are associated with acute adrenal insufficiency and are not reported
separately.
Code Set 2
1. A lab screening for a 2-day-old male shows congenital iodine-deficiency hypothyroidism. What ICD-10-
CM code(s) is/are reported?
E00.9
In the ICD-10-CM Alphabetic Index, look for Hypothyroidism/iodine-deficiency/congenital. You are directed
to see Syndrome, iodine-deficiency, congenital. Syndrome/iodine-deficiency, congenital directs you to code
E00.9.
2. Sandra presents today with primary hyperparathyroidism. She is scheduled for an ultrasound to determine
the extent of her condition. The results of the ultrasound show only one diseased parathyroid. What ICD-
10-CM code(s) is/are reported?
E21.0
In the ICD-10-CM Alphabetic Index, look for Hyperparathyroidism/primary, which directs you to E21.0.
3. Mr. Trello presents to the ED with nausea and vomiting that has persisted for 4 days. The ED physician
treats the patient for dehydration caused by the nausea and vomiting, which is documented in the patient’s
record as the final diagnosis. What
ICD-10-CM code(s) is/are reported for this encounter?
E86.0
In the ICD-10-CM Alphabetic Index, look for Dehydration, which directs you to E86.0. Nausea and
vomiting in this case are the cause of the patient’s dehydration. Since the physician documented the
dehydration only as the final diagnosis, nausea and vomiting are not reported. This is supported by General
Coding Guideline 1.B.5, Conditions that are an integral part of a disease process.
ACTIVITY 5: CODING PRACTICE FOR MENTAL, BEHAVIORAL, AND
NEURODEVELOPMENTAL DISEASES (F01–F99)
Code Set 1
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
1. A 21-year-old male is brought into the ED by his father who states that his son is dizzy and has anxiety.
The ED provider runs a drug screen test, and the test comes back positive for marijuana use. The final
diagnosis is documented as marijuana abuse with induced anxiety disorder. What ICD-10-CM code is
reported?
F12.180
The diagnosis is abuse of marijuana (cannabis) with induced anxiety disorder. Look in the ICD-10-CM
Alphabetic Index for Abuse/drug NEC/cannabis/with/anxiety disorder, which directs you to F12.180.
Verify code selection in the Tabular List.
Code Set 2
1. A 58-year-old patient sees the provider for confusion and loss of memory. The provider diagnoses the
patient with early onset stages of Alzheimer’s disease with dementia. What ICD-10-CM codes are
reported?
G30.0, F02.80
In the ICD-10-CM Alphabetic Index, look for Alzheimer’s diseases or sclerosis. You are directed to see
Disease, Alzheimer’s. Look for Disease, diseased/Alzheimer’s/early onset, which directs you to G30.0
[F02.80]. The code in brackets indicates a manifestation code. When we verify the G30.0 code in the
Tabular List, there is an instructional note under code section G30 that directs coding of the dementia also.
F02.80 is the correct code because the provider does not mention any behavioral disturbances. Sequencing
rules tell us that the manifestation code always follows the etiology code. Codes F29 Psychosis and R41.3
Memory loss are not reported because these are signs and symptoms of Alzheimer’s. See ICD-10-CM
guideline I.B.4.
ACTIVITY 6: CODING PRACTICE FOR DISEASES OF THE NERVOUS SYSTEM
(G00–G99)
Code Set 1
1. A 56-year-old female patient is admitted after being found unresponsive at home. The patient had right-
sided hemiplegia and aphasia from a previous CVA. The provider documents a current cerebral infarction
due to occlusion of the right middle cerebral artery as the final diagnosis and the patient is transferred for
rehabilitation. What ICD-10-CM code(s) is/are reported?
I63.511, I69.351, I69.320
Refer to ICD-10-CM guideline I.C.9.d.2. Look in the ICD-10-CM Alphabetic Index for Infarct,
infarction/cerebral/due to/occlusion NEC/cerebral arteries, which directs you to code I63.5-. Report I63.511
Cerebral infarct due to unspecified occlusion or stenosis of right middle cerebral artery. This patient has a
history of CVA with right-sided hemiplegia and aphasia. Look in the ICD-10-CM Alphabetic Index for
Sequelae (of)/infarction/cerebral/hemiplegia, which directs you to I69.35-. Also look for
Sequelae/infarction/cerebral/aphasia I69.320. Verify in the Tabular List I69.351 Hemiplegia and
hemiparesis following cerebral infarction affecting right dominant side. Per ICD-10-CM guideline I.C.9.d.1
because the right side was affected and we do not know the dominant side, the default for dominance is
right.
Code Set 2
1. A 78-year-old male patient presents to the ED with weakness on his left side and aphasia. The ED
physician orders tests, and the patient is admitted with a cerebrovascular accident (CVA). What ICD-10-
CM code(s) is/are reported?
I63.9
In the ICD-10-CM Alphabetic Index, look for Accident/cerebrovascular (embolic) (ischemic) (thrombotic),
which guides you to I63.9. A CVA is also known as a stroke.
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
ACTIVITY 7: CODING PRACTICE FOR DISORDERS OF THE SENSORY ORGANS (EYE
AND ADNEXA (H00–H59)/ EAR AND MASTOID PROCESS (H60–H95)
Code Set 1
1. A 64-year-old patient has a significant category 2 visual impairment in her left eye which is corrected with
glasses. Her right eye has normal vision. What ICD-10-CM code(s) is/are reported?
H54.52A2
Look in the ICD-10-CM Alphabetic Index for Impaired, impairment (function)/vision NEC referring you to
H54.7. In the Tabular List category H54 has a note to see the definition of visual impairment categories.
Category 2 is considered low vision. Looking through the codes, low vision in the left eye is reported with
H54.52-. A2 is assigned as the sixth and seventh character to identify Category 2. Or you can look in the
ICD-10-CM Alphabetic Index for Low/vision/one eye/left (normal vision on right), which refers you to
H54.52. It is important to read the instructional notes in the Tabular List that are associated with categories
before selecting your code.
2. A 6-month-old female infant presents to the pediatrician’s office for ear pulling and excessive crying. The
infant is diagnosed with bilateral chronic and acute serous otitis media. What ICD-10-CM code(s) is/are
reported
H65.03, H65.23
Per ICD-10-CM guideline I.B.8, when a condition is diagnosed as acute and chronic, and there are different
codes for each, report both codes sequencing the acute code first. In the ICD-10-CM Alphabetic Index,
look for Otitis/media/serous, which directs you to see Otitis media, nonsuppurative.
Otitis/media/nonsuppurative/acute/serous leads you to H65.0-.
Otitis/media/nonsuppurative/chronic/serous leads you to H65.2-. The hyphen after both codes indicates you
will need additional character(s). In the Tabular List a fifth character 3 is selected for both codes to indicate
the condition is bilateral.
© 2025 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 8
accessible website, in whole or in part.
Procedural Terminology and HCPCS Coding Systems
2024 Edition, 11th Edition Mary Jo Bowie
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel
sheet if it exists.
4- We have all what you need, we make
update at every time. There are many new
editions waiting you.
5- If you think you purchased the wrong file
You can contact us at every time, we can
replace it with true one.
Our email:
, Solution and Answer Guide: Peer Coding Audit Activities (2024)
Solution and Answer Guide
PEER CODING AUDIT ACTIVITIES (2024)
TABLE OF CONTENTS
Activities ...................................................................................................................................................... 2
Activity 1: Infectious and Parasitic Diseases (A00–B99) ......................................................................... 2
Activity 2: Neoplasms (C00–D49) ........................................................................................................... 4
Activity 3: Coding Practice for Diseases of Blood and Blood-Forming Organs (D50–D89)................... 5
Activity 4: Coding Practice for Endocrine, Nutritional, and Metabolic Diseases (E00–E89) .................. 5
Activity 5: Coding Practice for Mental, Behavioral, and Neurodevelopmental Diseases (F01–F99) ...... 6
Activity 6: Coding Practice for Diseases of the Nervous System (G00–G99) ........................................ 7
Activity 7: Coding Practice for Disorders of the Sensory Organs (Eye and Adnexa (H00–H59)/ Ear and
Mastoid Process (H60–H95) ..................................................................................................................... 8
Activity 8: Coding Practice for Diseases of the Circulatory System (I00–I99) ........................................ 9
Activity 9: Coding Practice for Diseases of the Respiratory System (J00–J99) ..................................... 10
Activity 10: Coding Practice for Diseases of the Digestive System (K00–K95).................................... 12
Activity 11: Coding Practice for Diseases of the Skin and Subcutaneous Tissue (L00–L99) ................ 13
Activity 12: Coding Practice for Diseases of the Musculoskeletal System and Connective Tissue (M00–
M99)........................................................................................................................................................ 14
Activity 13: Coding Practice for Diseases of the Genitourinary System (N00–N99) ............................ 15
Activity 14: Coding Practice for Pregnancy, Childbirth, and the Puerperium (O00–O9A)] .................. 16
Activity 15: Coding Practice for Certain Conditions Originating in the Perinatal Period(P00–P96) ..... 18
Activity 16: Coding Practice for Congenital Malformations, Deformations, and Chromosomal
Abnormalities (Q00–Q99) ...................................................................................................................... 19
Activity 17: Coding Practice for Symptoms, Signs, and Abnormal Clinical laboratory Findings (R00–
R99) ........................................................................................................................................................ 19
Activity 18: Coding Practice for Injury and Poisoning (S00–T88) ........................................................ 20
Activity 19: Coding Practice for External Causes of Morbidity (V00–Y99) ........................................ 21
Activity 20: Coding Practice for Factors Influencing Health Status (Z00–Z99)] ................................... 22
Activity 21: Coding Practice for Evaluation and Management .............................................................. 23
Activity 22: Coding Practice for Anesthesia........................................................................................... 24
Activity 23: Coding Practice for Procedures of the Integumentary System ........................................... 27
Activity 24: Coding Practice for Procedures of the Musculoskeletal System ........................................ 28
Activity 25: Coding Practice for Procedures of the Respiratory System ................................................ 30
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accessible website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities (2024)
Activity 26: Coding Practice for Procedures of the Cardiovascular System .......................................... 31
Activity 27: Coding Practice for Procedures of the Hemic/Lymphatic Systems and the Mediastinum
and Diaphragm ........................................................................................................................................ 32
Activity 28: Coding Practice for Procedures of the Digestive System ................................................... 33
Activity 29: Coding Practice for Procedures of the Urinary System ...................................................... 34
Activity 30: Coding Practice for Procedures of the Male Reproductive System .................................... 35
Activity 31: Coding Practice for Procedures of the Female Reproductive System and Maternity and
Delivery Services .................................................................................................................................... 37
Activity 32: Coding Practice for Procedures of the Endocrine System .................................................. 38
Activity 33: Coding Practice for Procedures of the Nervous System ..................................................... 39
Activity 34: Coding Practice for Procedures of the Sensory Organ Systems ......................................... 39
Activity 35: Coding Practice for Radiology Services and Procedures.................................................... 40
Activity 36: Coding Practice for Pathology and Laboratory Services .................................................... 42
Activity 37: Coding Practice for Procedures and Services from the Medicine Section ......................... 43
Activity 38: Coding Practice for HCPCS Level II .................................................................................. 44
ACTIVITIES
ACTIVITY 1: INFECTIOUS AND PARASITIC DISEASES (A00–B99)
Code Set 1
1. A 22-year-old female patient was seen in the ED with complaints of diarrhea and lower abdominal pain.
After examination, the patient was diagnosed with viral gastroenteritis. What diagnosis code(s) would be
reported for this encounter?
A08.4
Lower abdominal pain and diarrhea are symptoms of the viral gastroenteritis. See ICD-10-CM guideline
I.B.5. Look in the ICD-10-CM Alphabetic Index for Gastroenteritis/viral NEC, which directs the coder to
A08.4.
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accessible website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities (2024)
2. The patient had a blood test for HIV that has come back as inconclusive, what ICD-10-CM code is
assigned?
R75
ICD-10-CM guideline I.C.1.a.2.e instructs us to use R75 for patients with inconclusive HIV serology and
without definitive diagnosis or manifestations of the illness. To locate the code in the ICD-10-CM
Alphabetic Index, look for Human/immunodeficiency virus (HIV) disease (infection)/laboratory evidence
R75.
3. An HIV-positive patient was admitted to the hospital with skin lesions on the chest and back. Biopsies were
taken, and the pathologic diagnosis was HIV-related Kaposi’s sarcoma. What ICD-10-CM code(s) should
be reported?
B20, C46.0
According to ICD-10-CM guideline I.C.1.a.2.a, if a patient is admitted for an HIV-related condition, the
principal diagnosis should be B20, followed by additional diagnosis codes for all reported HIV-related
conditions. In the ICD-10-CM Alphabetic Index, look for Human/immunodeficiency virus (HIV) disease
(infection), which directs you to B20. Because Kaposi’s sarcoma is documented as related to the patient’s
HIV status, it is coded as B20 instead of asymptomatic HIV. Patients previously diagnosed with any HIV
illness (B20) should never be assigned to R75 or Z21, Asymptomatic human immunodeficiency virus
[HIV] infection status. In the ICD-10-CM Alphabetic Index look for Kaposi’s/sarcoma/skin (multiple sites)
directing you to C46.0.
Code Set 2
1. A 72-year-old male is admitted to the hospital for MRSA. Which ICD-10-CM code(s) should be reported
for the admission?
A49.02
Look in the ICD-10-CM Alphabetic Index for MRSA (Methicillin resistant Staphylococcus
aureus)/infection referring you to code A49.02.
2. The patient had a blood test for HIV that has come back as positive. There is no documentation of
symptoms, what ICD-10-CM code is assigned?
Z21
ICD-10-CM guideline I.C.1.a.2.d instructs us to use Z21 for patients with positive HIV serology and
without documentation of symptoms. To locate the code in the ICD-10-CM Alphabetic Index, look for
Human/immunodeficiency virus (HIV) disease (infection)/asymptomatic status Z21.
3. A patient is seen in the office because she recently found out an individual, she had unprotected sexual
intercourse with a few months prior has been diagnosed with HIV. She is here to be tested for HIV. What
ICD-10-CM code(s) is/are reported?
Z11.4
Per ICD-10-CM guideline I.C.1.a.2.h, if a patient is being seen to determine HIV status, use code Z11.4. In
the ICD-10-CM Alphabetic Index, look for Screening/disease/human immunodeficiency virus (HIV),
which guides you to Z11.4.
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
ACTIVITY 2: NEOPLASMS (C00–D49)
Code Set 1
1. A 62-year-old female patient is seen by her primary care provider for persistent lower intestinal cramps.
The physician performed a colonoscopy with biopsy. The results confirm the patient has a malignant
neoplasm in her sigmoid colon. What ICD-10-CM code(s) is/are reported?
C18.7
According to the ICD-10-CM guideline when a definitive diagnosis is known, the related symptoms are not
coded. In this case, only the malignant neoplasm of the sigmoid colon is reported. Look in the ICD-10-CM
Table of Neoplasms for Colon and you are directed to see also Neoplasm, intestine, large. Look for
intestine, intestinal/large/colon/sigmoid (flexure). Use the code from the Malignant Primary column C18.7.
2. The patient is seen today for a secondary neoplasm that has metastasized to the descending colon. What
ICD-10-CM code(s) is/are reported?
C78.5, C80.1
In the ICD-10-CM Table of Neoplasms, look for Neoplasm/colon referring you to see also Neoplasm,
intestine, large. Look for Neoplasm/intestine/large/colon/descending and use the code from the Malignant
Secondary column guiding you to code C78.5. Primary cancer is unknown, report code C80.1.
3. A 39-year-old female was seen today for the removal of two lipomas. One was located on her back and the
other was located on the right forearm. Both involved subcutaneous tissue. What ICD-10-CM code(s) is/are
reported?
D17.21, D17.1
In the ICD-10-CM Alphabetic Index, look for Lipoma/site classification/arms (skin) (subcutaneous), which
directs you to D17.2-. In the Tabular List, a fifth character 1 is selected to indicate the right arm. Next, look
for Lipoma/site classification/trunk (skin) (subcutaneous) D17.1.
Code Set 2
1. The patient is seen today to have a benign tumor removed from her chest. What ICD-10-CM code(s) is/are
reported?
D36.7
In the ICD-10-CM Alphabetic Index, in the Table of Neoplasms, look for Chest (wall) NEC and report the
code from the benign column, D36.7.
2. Mrs. Long is here today because her malignancy has metastasized to her bones in her thoracic spine. What
ICD-10-CM code(s) is/are reported?
C79.51, C80.1
The patient has metastatic cancer (secondary malignancy) of the thoracic spine. Look in the ICD-10-CM
Table of Neoplasms for Neoplasm, neoplastic/spine, spinal (column)/and use the code from the Malignant
Secondary column directing you to code C79.51. Primary cancer is unknown, report code C80.1.
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
3. A 53-year-old patient is scheduled for chemotherapy to treat his primary liver cancer. What ICD-10-CM
code(s) is/are reported?
Z51.11, C22.8
ICD-10-CM Guideline I.C.2.e.2 indicates an encounter for chemotherapy code is to be reported as the
primary code with a code for the cancer as secondary when the reason for the visit is solely for
chemotherapy. Look in the ICD-10-CM Alphabetic Index for Chemotherapy (session) (for)/cancer Z51.11.
For the malignancy, look in the ICD-10-CM Table of Neoplasms for liver/primary and use the code from
the Malignant Primary column which directs the coder to C22.8.
ACTIVITY 3: CODING PRACTICE FOR DISEASES OF BLOOD AND BLOOD-FORMING
ORGANS (D50–D89)
Code Set 1
1. A 26-year-old female patient is given a blood transfusion to treat postoperative anemia due to acute blood
loss during surgery. What ICD-10-CM code is reported?
D62
In the ICD-10-CM Alphabetic Index, look for Anemia/postoperative (postprocedural)/due to (acute) blood
loss guiding you to code D62.
2. A 54-year-old patient is seen by his primary physician for fever and chills developing after he began his
chemotherapy treatments. Test results revealed a severe low white blood cell count, and the physician
diagnosed the patient with agranulocytosis, secondary to his cytoreductive cancer chemotherapy. What
ICD-10-CM code(s) is/are reported?
D70.1, C80.1
In the ICD-10-CM Alphabetic Index, look for Agranulocytosis/secondary/due to cytoreductive cancer
chemotherapy, guiding you to D70.1. The note directs coders to use additional code to identify neoplasm.
Primary cancer is unknown, report code C80.1.
Code Set 2
1. Mrs. Winter is seen today for management of her acquired polycythemia. What ICD-10-CM code is
reported?
D75.1
In the ICD-10-CM Alphabetic Index, look for Polycythemia/acquired guiding you to code D75.1.
2. Mr. Freeze sees the nephrologist for a B-12 injection to treat erythropoietin-resistant anemia due to stage 3
chronic kidney disease. What ICD-10-CM code(s) is/are reported?
N18.30, D63.1
In the ICD-10-CM Alphabetic Index, look for Anemia/in (due to) (with)/chronic kidney disease or
Anemia/erythropoietin-resistant anemia (EPO-resistant anemia) guiding you to code D63.1. In the Tabular
List at D63.1 there is an instructional note stating to code first underlying chronic kidney disease. Look in
the ICD-10-CM Alphabetic Index for Disease/kidney/chronic/stage 3 (moderate) guiding you to code
N18.30.
ACTIVITY 4: CODING PRACTICE FOR ENDOCRINE, NUTRITIONAL, AND
METABOLIC DISEASES (E00–E89)
Code Set 1
1. A 52-year-old patient with hyperthyroidism has an ultrasound that revealed a uninodular goiter. What ICD-
10-CM code is reported?
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, Solution and Answer Guide: Peer Coding Audit Activities (2024)
E05.10
In the ICD-10-CM Alphabetic Index, look for Hyperthyroidism/with/goiter/nodular/uninodular which
directs you to E05.10. The code can also be found by looking in the ICD-10-CM Alphabetic Index for
Goiter/uninodular/toxic or with hyperthyroidism which guides you to code E05.10.
2. Mr. Lawrence presents to the clinic with extreme nervousness and palpitations. He indicates he has lost 12
pounds in the last few months and his eyes appear bulging. Test results confirm Graves’ disease. What
ICD-10-CM code(s) is/are reported?
E05.00
Look in the ICD-10-CM Alphabetic Index for Disease/Graves’ (exophthalmic goiter)—see
Hyperthyroidism, with goiter (diffuse). Look for Hyperthyroidism/with/goiter (diffuse) directing you to
E05.00. Definitive diagnosis is Graves’ disease and the only code reported. The palpitations, weight loss,
bulging eyes, and extreme nervousness are symptoms of the Graves’ disease and not reported separately.
Refer to ICD-10-CM guidelines I.B.5.
3. Ms. Sinclair was seen in the ED for dizziness, loss of appetite, and fatigue for the past 2 days. Lab tests
showed the patient was experiencing an Addisonian crisis. What ICD-10-CM code(s) is/are reported?
E27.2
Look in the ICD-10-CM Alphabetic Index for Crisis/Addisonian directing you to E27.2. The symptoms of
dizziness, loss of appetite, and fatigue are associated with acute adrenal insufficiency and are not reported
separately.
Code Set 2
1. A lab screening for a 2-day-old male shows congenital iodine-deficiency hypothyroidism. What ICD-10-
CM code(s) is/are reported?
E00.9
In the ICD-10-CM Alphabetic Index, look for Hypothyroidism/iodine-deficiency/congenital. You are directed
to see Syndrome, iodine-deficiency, congenital. Syndrome/iodine-deficiency, congenital directs you to code
E00.9.
2. Sandra presents today with primary hyperparathyroidism. She is scheduled for an ultrasound to determine
the extent of her condition. The results of the ultrasound show only one diseased parathyroid. What ICD-
10-CM code(s) is/are reported?
E21.0
In the ICD-10-CM Alphabetic Index, look for Hyperparathyroidism/primary, which directs you to E21.0.
3. Mr. Trello presents to the ED with nausea and vomiting that has persisted for 4 days. The ED physician
treats the patient for dehydration caused by the nausea and vomiting, which is documented in the patient’s
record as the final diagnosis. What
ICD-10-CM code(s) is/are reported for this encounter?
E86.0
In the ICD-10-CM Alphabetic Index, look for Dehydration, which directs you to E86.0. Nausea and
vomiting in this case are the cause of the patient’s dehydration. Since the physician documented the
dehydration only as the final diagnosis, nausea and vomiting are not reported. This is supported by General
Coding Guideline 1.B.5, Conditions that are an integral part of a disease process.
ACTIVITY 5: CODING PRACTICE FOR MENTAL, BEHAVIORAL, AND
NEURODEVELOPMENTAL DISEASES (F01–F99)
Code Set 1
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1. A 21-year-old male is brought into the ED by his father who states that his son is dizzy and has anxiety.
The ED provider runs a drug screen test, and the test comes back positive for marijuana use. The final
diagnosis is documented as marijuana abuse with induced anxiety disorder. What ICD-10-CM code is
reported?
F12.180
The diagnosis is abuse of marijuana (cannabis) with induced anxiety disorder. Look in the ICD-10-CM
Alphabetic Index for Abuse/drug NEC/cannabis/with/anxiety disorder, which directs you to F12.180.
Verify code selection in the Tabular List.
Code Set 2
1. A 58-year-old patient sees the provider for confusion and loss of memory. The provider diagnoses the
patient with early onset stages of Alzheimer’s disease with dementia. What ICD-10-CM codes are
reported?
G30.0, F02.80
In the ICD-10-CM Alphabetic Index, look for Alzheimer’s diseases or sclerosis. You are directed to see
Disease, Alzheimer’s. Look for Disease, diseased/Alzheimer’s/early onset, which directs you to G30.0
[F02.80]. The code in brackets indicates a manifestation code. When we verify the G30.0 code in the
Tabular List, there is an instructional note under code section G30 that directs coding of the dementia also.
F02.80 is the correct code because the provider does not mention any behavioral disturbances. Sequencing
rules tell us that the manifestation code always follows the etiology code. Codes F29 Psychosis and R41.3
Memory loss are not reported because these are signs and symptoms of Alzheimer’s. See ICD-10-CM
guideline I.B.4.
ACTIVITY 6: CODING PRACTICE FOR DISEASES OF THE NERVOUS SYSTEM
(G00–G99)
Code Set 1
1. A 56-year-old female patient is admitted after being found unresponsive at home. The patient had right-
sided hemiplegia and aphasia from a previous CVA. The provider documents a current cerebral infarction
due to occlusion of the right middle cerebral artery as the final diagnosis and the patient is transferred for
rehabilitation. What ICD-10-CM code(s) is/are reported?
I63.511, I69.351, I69.320
Refer to ICD-10-CM guideline I.C.9.d.2. Look in the ICD-10-CM Alphabetic Index for Infarct,
infarction/cerebral/due to/occlusion NEC/cerebral arteries, which directs you to code I63.5-. Report I63.511
Cerebral infarct due to unspecified occlusion or stenosis of right middle cerebral artery. This patient has a
history of CVA with right-sided hemiplegia and aphasia. Look in the ICD-10-CM Alphabetic Index for
Sequelae (of)/infarction/cerebral/hemiplegia, which directs you to I69.35-. Also look for
Sequelae/infarction/cerebral/aphasia I69.320. Verify in the Tabular List I69.351 Hemiplegia and
hemiparesis following cerebral infarction affecting right dominant side. Per ICD-10-CM guideline I.C.9.d.1
because the right side was affected and we do not know the dominant side, the default for dominance is
right.
Code Set 2
1. A 78-year-old male patient presents to the ED with weakness on his left side and aphasia. The ED
physician orders tests, and the patient is admitted with a cerebrovascular accident (CVA). What ICD-10-
CM code(s) is/are reported?
I63.9
In the ICD-10-CM Alphabetic Index, look for Accident/cerebrovascular (embolic) (ischemic) (thrombotic),
which guides you to I63.9. A CVA is also known as a stroke.
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accessible website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities (2024)
ACTIVITY 7: CODING PRACTICE FOR DISORDERS OF THE SENSORY ORGANS (EYE
AND ADNEXA (H00–H59)/ EAR AND MASTOID PROCESS (H60–H95)
Code Set 1
1. A 64-year-old patient has a significant category 2 visual impairment in her left eye which is corrected with
glasses. Her right eye has normal vision. What ICD-10-CM code(s) is/are reported?
H54.52A2
Look in the ICD-10-CM Alphabetic Index for Impaired, impairment (function)/vision NEC referring you to
H54.7. In the Tabular List category H54 has a note to see the definition of visual impairment categories.
Category 2 is considered low vision. Looking through the codes, low vision in the left eye is reported with
H54.52-. A2 is assigned as the sixth and seventh character to identify Category 2. Or you can look in the
ICD-10-CM Alphabetic Index for Low/vision/one eye/left (normal vision on right), which refers you to
H54.52. It is important to read the instructional notes in the Tabular List that are associated with categories
before selecting your code.
2. A 6-month-old female infant presents to the pediatrician’s office for ear pulling and excessive crying. The
infant is diagnosed with bilateral chronic and acute serous otitis media. What ICD-10-CM code(s) is/are
reported
H65.03, H65.23
Per ICD-10-CM guideline I.B.8, when a condition is diagnosed as acute and chronic, and there are different
codes for each, report both codes sequencing the acute code first. In the ICD-10-CM Alphabetic Index,
look for Otitis/media/serous, which directs you to see Otitis media, nonsuppurative.
Otitis/media/nonsuppurative/acute/serous leads you to H65.0-.
Otitis/media/nonsuppurative/chronic/serous leads you to H65.2-. The hyphen after both codes indicates you
will need additional character(s). In the Tabular List a fifth character 3 is selected for both codes to indicate
the condition is bilateral.
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