, Solution manual for Understanding Current
Procedural Terminology and HCPCS Coding
Systems, 2021, 8th 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
Solution and Answer Guide
Peer Coding Audit Activities
Table of Contents
Activities............................................................................................................................................3
Activity 1: Infectious and Parasitic Diseases (A00–B99)...........................................................................3
Activity 2: Neoplasms (C00–D49) ............................................................................................................. 4
Activity 3: Coding Practice for Diseases of Blood and Blood-Forming Organs (D50–D89).......................6
Activity 4: Coding Practice for Endocrine, Nutritional, and Metabolic Diseases (E00–E89).....................6
Activity 5: Coding Practice for Mental, Behavioral, and Neurodevelopmental Diseases (F01–F99)........8
Activity 6: Coding Practice for Diseases of the Nervous System (G00–G99)............................................8
Activity 7: Coding Practice for Disorders of the Sensory Organs (Eye and Adnexa (H00–H59)/ Ear and
Mastoid Process (H60–H95).....................................................................................................................9
Activity 8: Coding Practice for Diseases of the Circulatory System (I00–I99).........................................10
Activity 9: Coding Practice for Diseases of the Respiratory System (J00–J99)........................................12
Activity 10: Coding Practice for Diseases of the Digestive System (K00–K95)........................................13
Activity 11: Coding Practice for Diseases of the Skin and Subcutaneous Tissue (L00–L99)....................15
Activity 12: Coding Practice for Diseases of the Musculoskeletal System and Connective Tissue
(M00–M99).............................................................................................................................................16
Activity 13: Coding Practice for Diseases of the Genitourinary System (N00–N99)...............................17
Activity 14: Coding Practice for Pregnancy, Childbirth, and the Puerperium (O00–O9A)].....................18
Activity 15: Coding Practice for Certain Conditions Originating in the Perinatal Period(P00–P96)........20
Activity 16: Coding Practice for Congenital Malformations, Deformations, and Chromosomal
Abnormalities (Q00–Q99).......................................................................................................................21
Activity 17: Coding Practice for Symptoms, Signs, and Abnormal Clinical laboratory Findings (R00–R99)
................................................................................................................................................................22
Activity 18: Coding Practice for Injury and Poisoning (S00–T88)............................................................22
Activity19: Coding Practice for External Causes of Morbidity (V00–Y99)...............................................24
Activity 20: Coding Practice for Factors Influencing Health Status (Z00–Z99)] ...................................... 25
Activity 21: Coding Practice for Evaluation and Management...............................................................26
Activity 22: Coding Practice for Anesthesia............................................................................................28
Activity 23: Coding Practice for Procedures of the Integumentary System............................................29
Activity 24: Coding Practice for Procedures of the Musculoskeletal System ......................................... 31
Activity 25: Coding Practice for Procedures of the Respiratory System.................................................33
Activity 26: Coding Practice for Procedures of the Cardiovascular System............................................34
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 1
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
Activity 27: Coding Practice for Procedures of the Hemic/Lymphatic Systems and the Mediastinum
and Diaphragm.......................................................................................................................................35
Activity 28: Coding Practice for Procedures of the Digestive System.....................................................36
Activity 29: Coding Practice for Procedures of the Urinary System........................................................38
Activity 30: Coding Practice for Procedures of the Male Reproductive System.....................................39
Activity 31: Coding Practice for Procedures of the Female Reproductive System and Maternity and
Delivery Services.....................................................................................................................................40
Activity 32: Coding Practice for Procedures of the Endocrine System ................................................... 41
Activity 33: Coding Practice for Procedures of the Nervous System......................................................43
Activity 34: Coding Practice for Procedures of the Sensory Organ Systems...........................................44
Activity 35: Coding Practice for Radiology Services and Procedures......................................................45
Activity 36: Coding Practice for Pathology and Laboratory Services......................................................47
Activity 37: Coding Practice for Procedures and Services from the Medicine Section...........................48
Activity 38: Coding Practice for HCPCS Level II.......................................................................................50
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 2
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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.
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 AIDS
instead of asymptomatic HIV. 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.
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 3
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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.
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.
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website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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.
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.
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 5
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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. What ICD-10-CM code(s)
is/are reported?
D70.9
In the ICD-10-CM Alphabetic Index, look for Agranulocytosis. You will see the cross-reference
note—see also Neutropenia and the default code D70.9.
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?
N18.3, 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,
diseased/kidney/chronic/stage 3 (moderate) guiding you to code N18.3.
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?
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
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 6
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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 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 are signs and symptoms of dehydration and would not be coded. This is
supported by General Coding Guideline 1.B.5, Conditions that are an integral part of a
disease process.
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 7
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
Activity 5: Coding Practice for Mental, Behavioral, and Neurodevelopmental
Diseases (F01–F99)
Code Set 1
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 anxiety disorder.
What ICD-10-CM code is reported?
F12.180
The diagnosis is abuse of marijuana (cannabis). 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 confirms that we should code also the dementia. 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
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 8
website, in whole or in part.
Procedural Terminology and HCPCS Coding
Systems, 2021, 8th 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
Solution and Answer Guide
Peer Coding Audit Activities
Table of Contents
Activities............................................................................................................................................3
Activity 1: Infectious and Parasitic Diseases (A00–B99)...........................................................................3
Activity 2: Neoplasms (C00–D49) ............................................................................................................. 4
Activity 3: Coding Practice for Diseases of Blood and Blood-Forming Organs (D50–D89).......................6
Activity 4: Coding Practice for Endocrine, Nutritional, and Metabolic Diseases (E00–E89).....................6
Activity 5: Coding Practice for Mental, Behavioral, and Neurodevelopmental Diseases (F01–F99)........8
Activity 6: Coding Practice for Diseases of the Nervous System (G00–G99)............................................8
Activity 7: Coding Practice for Disorders of the Sensory Organs (Eye and Adnexa (H00–H59)/ Ear and
Mastoid Process (H60–H95).....................................................................................................................9
Activity 8: Coding Practice for Diseases of the Circulatory System (I00–I99).........................................10
Activity 9: Coding Practice for Diseases of the Respiratory System (J00–J99)........................................12
Activity 10: Coding Practice for Diseases of the Digestive System (K00–K95)........................................13
Activity 11: Coding Practice for Diseases of the Skin and Subcutaneous Tissue (L00–L99)....................15
Activity 12: Coding Practice for Diseases of the Musculoskeletal System and Connective Tissue
(M00–M99).............................................................................................................................................16
Activity 13: Coding Practice for Diseases of the Genitourinary System (N00–N99)...............................17
Activity 14: Coding Practice for Pregnancy, Childbirth, and the Puerperium (O00–O9A)].....................18
Activity 15: Coding Practice for Certain Conditions Originating in the Perinatal Period(P00–P96)........20
Activity 16: Coding Practice for Congenital Malformations, Deformations, and Chromosomal
Abnormalities (Q00–Q99).......................................................................................................................21
Activity 17: Coding Practice for Symptoms, Signs, and Abnormal Clinical laboratory Findings (R00–R99)
................................................................................................................................................................22
Activity 18: Coding Practice for Injury and Poisoning (S00–T88)............................................................22
Activity19: Coding Practice for External Causes of Morbidity (V00–Y99)...............................................24
Activity 20: Coding Practice for Factors Influencing Health Status (Z00–Z99)] ...................................... 25
Activity 21: Coding Practice for Evaluation and Management...............................................................26
Activity 22: Coding Practice for Anesthesia............................................................................................28
Activity 23: Coding Practice for Procedures of the Integumentary System............................................29
Activity 24: Coding Practice for Procedures of the Musculoskeletal System ......................................... 31
Activity 25: Coding Practice for Procedures of the Respiratory System.................................................33
Activity 26: Coding Practice for Procedures of the Cardiovascular System............................................34
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 1
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
Activity 27: Coding Practice for Procedures of the Hemic/Lymphatic Systems and the Mediastinum
and Diaphragm.......................................................................................................................................35
Activity 28: Coding Practice for Procedures of the Digestive System.....................................................36
Activity 29: Coding Practice for Procedures of the Urinary System........................................................38
Activity 30: Coding Practice for Procedures of the Male Reproductive System.....................................39
Activity 31: Coding Practice for Procedures of the Female Reproductive System and Maternity and
Delivery Services.....................................................................................................................................40
Activity 32: Coding Practice for Procedures of the Endocrine System ................................................... 41
Activity 33: Coding Practice for Procedures of the Nervous System......................................................43
Activity 34: Coding Practice for Procedures of the Sensory Organ Systems...........................................44
Activity 35: Coding Practice for Radiology Services and Procedures......................................................45
Activity 36: Coding Practice for Pathology and Laboratory Services......................................................47
Activity 37: Coding Practice for Procedures and Services from the Medicine Section...........................48
Activity 38: Coding Practice for HCPCS Level II.......................................................................................50
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 2
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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.
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 AIDS
instead of asymptomatic HIV. 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.
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 3
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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.
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.
© 2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 4
website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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.
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.
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website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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. What ICD-10-CM code(s)
is/are reported?
D70.9
In the ICD-10-CM Alphabetic Index, look for Agranulocytosis. You will see the cross-reference
note—see also Neutropenia and the default code D70.9.
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?
N18.3, 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,
diseased/kidney/chronic/stage 3 (moderate) guiding you to code N18.3.
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?
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
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website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
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 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 are signs and symptoms of dehydration and would not be coded. This is
supported by General Coding Guideline 1.B.5, Conditions that are an integral part of a
disease process.
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website, in whole or in part.
, Solution and Answer Guide: Peer Coding Audit Activities
Activity 5: Coding Practice for Mental, Behavioral, and Neurodevelopmental
Diseases (F01–F99)
Code Set 1
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 anxiety disorder.
What ICD-10-CM code is reported?
F12.180
The diagnosis is abuse of marijuana (cannabis). 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 confirms that we should code also the dementia. 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
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website, in whole or in part.
