CAISS-AIS Frequently Tested Exam
Questions With Verified Multiple Choice
and Conceptual Actual 100% Correct
Detailed Answers
Guaranteed Pass!!Current Update!!
1. Q: A patient arrives after an MVC in which the car rolled several times. CT
head - negative for injury, skull normal; CT cervical spine - occipital condyle
fracture, normal alignment; neurologic examination is normal- able to move all
extremities, GCS= 15; there is no drainage from the ears or nose, no
ecchymosis. - ANSWER A: 150202.3; The occipital condyles are part of the
base of the skull despite the diagnosis frequently appearing on the cervical CT
scan. As with any basilar skull fracture, an assessment for CSF leak as well as
head injury is important. In addition, since the occipital condyles articulate
with the first cervical vertebrae, assessment for spinal cord injury is also
important.
2. Q: A patient with clinical diagnosis of DAI recorded by the neurosurgeon and a
radiologic finding described as "petechial hemorrhages in the basal ganglia
and corpus callosum consistent with DAI" who remains comatose until he dies
15 hours after injury should be assigned which AIS code? - ANSWER A: The
correct code is 140627.5. This question highlights the rule box on page 45 of
the AIS dictionary, which directs the coder to "code only the more severe"
when both corpus callosum and basal ganglia are noted. An important
additional point to note is the directive. If coma exceeds 24 hours, use
, 161011.5 (THIS IS UNDER CONCUSSIVE INJURY) no matter what anatomic
description is recorded; p. 51. In all cases where coma exceeds 24 hours, DAI
should be coded in this section of the dictionary rather than under Cerebrum.
3. Q: The patient is an unrestrained passenger admitted following a high speed
MVC. He has been unconscious without sedation of paralytic medications
since admission 48 hours ago. His CT demonstrates petechial hemorrhages in
the area of the corpus callosum and basal ganglia. The neurosurgeon
diagnoses DAI. What is the correct AIS code? - ANSWER A: In AIS 2005,
there are two areas in which DAI may be coded. The correct code in AIS 2005
is 140627.5 Cerebrum, DAI involving corpus callosum. If the CT had noted only
hemorrhages in the basal ganglia, or more broadly, petechial hemorrhages in
the cerebrum, the correct codes would have been 140625.4 (for the basal
ganglia) or 140628.4 for the cerebrum NFS.
4. Q: How should you code asphyxia related to hanging? - ANSWER A:
Asphyxia codes are located in the Other Trauma section. Since we have no
information as to neurological deficit, the correct code to use is 020000.3.
There are also codes in the Head chapter for "hypoxic or ischemic brain
damage secondary to systemic hypoxemia, hypotension or shock" but these
codes have a severity code of 9.
5. Q: What is the correct code for a single tiny cerebral contusion? - ANSWER
A: It is 140605.2 tiny: < 1 cm in diameter
6. Q: What is the correct code for a single small (1-4 cm) cerebral contusion? -
ANSWER A: The correct code is 140606.3 which identifies a single "small"
contusion.
,7. Q: What is a torn septum pellucida and which code would you use if there was
as associated IVH? - ANSWER A: The septum pellucida is the structure that
separates the anterior horns of the lateral ventricles, so when it is torn we
would expect to see intraventricular hemorrhage. The cerebral laceration
should be coded (140688.3) in addition to the IVH. Although the IVH is a
sequela of the tear, it is a codeable sequela
8. Q: Is a pterygoid fracture considered to be a skull base fracture? - ANSWER
A: The pterygoid plates are a part of the sphenoid bone and are therefore
part of the skull base. The exception to this is if they are included in a
confirmed LeFort I fracture. In that case the injury is coded to the face and the
sphenoid (base fracture) and the pterygoid is not coded additionally.
9. Q: What is Uncal herniation - ANSWER A: Brain stem compression;
includes transtentorial (uncal)
10. Q: What constitutes a subacute SDH? - ANSWER A: Subacute subdural
hematomas are defined arbitrarily as those that present between 4 and 21
days after injury.
11. Q: What constitutes a chronic SDH? - ANSWER A: Chronic subdural
hematomas are arbitrarily defined as those hematomas presenting 21 days or
more after injury.
12. Q: When and how do I code LOC? - ANSWER A: You may use codes
161002.2 through 161006.3 when the MD confirms "positive LOC". This does
, not have to be witnessed by the MD. If they believe there was LOC and
document it, we may code it. We do not need to have the word "concussion"
in the chart in order to code LOC. If the EMS agency notes LOC, the physician
must corroborate this finding in the medical record for you to code it in AIS.
13. Q: If there is a cerebral hemorrhage NFS and LOC of some duration, how
should this be coded? May we use concussive injury codes in addition to the
hemorrhage code? - ANSWER A: Do not code coma in addition to the
hemorrhage. When there is an anatomic brain injury the concussive codes are not
used additionally. If the only injury is a skull fracture (no damage to the brain
substance) and there is documented LOC you may use the concussive injury codes
additionally.
14. Q: A patient is admitted after an assault with a baseball bat to the head;
among his injuries, a tympanic membrane rupture; How do you code this injury? -
ANSWER A: a tympanic membrane rupture is coded as 240216.1; note that
frequently this injury is also associated with a basilar skull fracture so look for that
on the CT scan or a clinical diagnosis of such.
15. Q: A woman is in MVC with facial trauma multiple fractures of R orbit
complains of loss of visual acuity in R eye. Her globe is intact but a hole in her R
macula is discovered. Please code this injury to the eye. - ANSWER A: Code
240904.2; Macula: hole
16. Q: How would you code this finding? Acute left parasymphyseal fracture of the
left hemi mandible. Fracture of the angle of the right hemi mandible. When
reviewing the physician notes they state, "right angle and left parasymphyseal
displaced mandible fractures." - ANSWER A: The mandible is one of the ring-
like bony structures that only receives 1 code. You should code it to the largest
Questions With Verified Multiple Choice
and Conceptual Actual 100% Correct
Detailed Answers
Guaranteed Pass!!Current Update!!
1. Q: A patient arrives after an MVC in which the car rolled several times. CT
head - negative for injury, skull normal; CT cervical spine - occipital condyle
fracture, normal alignment; neurologic examination is normal- able to move all
extremities, GCS= 15; there is no drainage from the ears or nose, no
ecchymosis. - ANSWER A: 150202.3; The occipital condyles are part of the
base of the skull despite the diagnosis frequently appearing on the cervical CT
scan. As with any basilar skull fracture, an assessment for CSF leak as well as
head injury is important. In addition, since the occipital condyles articulate
with the first cervical vertebrae, assessment for spinal cord injury is also
important.
2. Q: A patient with clinical diagnosis of DAI recorded by the neurosurgeon and a
radiologic finding described as "petechial hemorrhages in the basal ganglia
and corpus callosum consistent with DAI" who remains comatose until he dies
15 hours after injury should be assigned which AIS code? - ANSWER A: The
correct code is 140627.5. This question highlights the rule box on page 45 of
the AIS dictionary, which directs the coder to "code only the more severe"
when both corpus callosum and basal ganglia are noted. An important
additional point to note is the directive. If coma exceeds 24 hours, use
, 161011.5 (THIS IS UNDER CONCUSSIVE INJURY) no matter what anatomic
description is recorded; p. 51. In all cases where coma exceeds 24 hours, DAI
should be coded in this section of the dictionary rather than under Cerebrum.
3. Q: The patient is an unrestrained passenger admitted following a high speed
MVC. He has been unconscious without sedation of paralytic medications
since admission 48 hours ago. His CT demonstrates petechial hemorrhages in
the area of the corpus callosum and basal ganglia. The neurosurgeon
diagnoses DAI. What is the correct AIS code? - ANSWER A: In AIS 2005,
there are two areas in which DAI may be coded. The correct code in AIS 2005
is 140627.5 Cerebrum, DAI involving corpus callosum. If the CT had noted only
hemorrhages in the basal ganglia, or more broadly, petechial hemorrhages in
the cerebrum, the correct codes would have been 140625.4 (for the basal
ganglia) or 140628.4 for the cerebrum NFS.
4. Q: How should you code asphyxia related to hanging? - ANSWER A:
Asphyxia codes are located in the Other Trauma section. Since we have no
information as to neurological deficit, the correct code to use is 020000.3.
There are also codes in the Head chapter for "hypoxic or ischemic brain
damage secondary to systemic hypoxemia, hypotension or shock" but these
codes have a severity code of 9.
5. Q: What is the correct code for a single tiny cerebral contusion? - ANSWER
A: It is 140605.2 tiny: < 1 cm in diameter
6. Q: What is the correct code for a single small (1-4 cm) cerebral contusion? -
ANSWER A: The correct code is 140606.3 which identifies a single "small"
contusion.
,7. Q: What is a torn septum pellucida and which code would you use if there was
as associated IVH? - ANSWER A: The septum pellucida is the structure that
separates the anterior horns of the lateral ventricles, so when it is torn we
would expect to see intraventricular hemorrhage. The cerebral laceration
should be coded (140688.3) in addition to the IVH. Although the IVH is a
sequela of the tear, it is a codeable sequela
8. Q: Is a pterygoid fracture considered to be a skull base fracture? - ANSWER
A: The pterygoid plates are a part of the sphenoid bone and are therefore
part of the skull base. The exception to this is if they are included in a
confirmed LeFort I fracture. In that case the injury is coded to the face and the
sphenoid (base fracture) and the pterygoid is not coded additionally.
9. Q: What is Uncal herniation - ANSWER A: Brain stem compression;
includes transtentorial (uncal)
10. Q: What constitutes a subacute SDH? - ANSWER A: Subacute subdural
hematomas are defined arbitrarily as those that present between 4 and 21
days after injury.
11. Q: What constitutes a chronic SDH? - ANSWER A: Chronic subdural
hematomas are arbitrarily defined as those hematomas presenting 21 days or
more after injury.
12. Q: When and how do I code LOC? - ANSWER A: You may use codes
161002.2 through 161006.3 when the MD confirms "positive LOC". This does
, not have to be witnessed by the MD. If they believe there was LOC and
document it, we may code it. We do not need to have the word "concussion"
in the chart in order to code LOC. If the EMS agency notes LOC, the physician
must corroborate this finding in the medical record for you to code it in AIS.
13. Q: If there is a cerebral hemorrhage NFS and LOC of some duration, how
should this be coded? May we use concussive injury codes in addition to the
hemorrhage code? - ANSWER A: Do not code coma in addition to the
hemorrhage. When there is an anatomic brain injury the concussive codes are not
used additionally. If the only injury is a skull fracture (no damage to the brain
substance) and there is documented LOC you may use the concussive injury codes
additionally.
14. Q: A patient is admitted after an assault with a baseball bat to the head;
among his injuries, a tympanic membrane rupture; How do you code this injury? -
ANSWER A: a tympanic membrane rupture is coded as 240216.1; note that
frequently this injury is also associated with a basilar skull fracture so look for that
on the CT scan or a clinical diagnosis of such.
15. Q: A woman is in MVC with facial trauma multiple fractures of R orbit
complains of loss of visual acuity in R eye. Her globe is intact but a hole in her R
macula is discovered. Please code this injury to the eye. - ANSWER A: Code
240904.2; Macula: hole
16. Q: How would you code this finding? Acute left parasymphyseal fracture of the
left hemi mandible. Fracture of the angle of the right hemi mandible. When
reviewing the physician notes they state, "right angle and left parasymphyseal
displaced mandible fractures." - ANSWER A: The mandible is one of the ring-
like bony structures that only receives 1 code. You should code it to the largest
