Certified Coding Specialist (CCS) Exam
Prep Questions -AHIMA 6th Edition
2023
Carcinoma in situ - Answer-Tumor cells that are undergoing malignant
... [Show More] changes but are
still confined to the point of origin without invasion of the surrounding normal tissue
Examples of carcinoma in situ - Answer-Intraepithelial infiltrating
The patient was admitted from the emergency department because of chest pain.
Following blood work, it was determined that the patient had elevated CPKs and MB
enzymes. The EKG shows nonspecific ST changes.
What type of diagnosis might this indicate?
a. Unstable angina
b. Myocardial infarction
c. Congestive heart failure
d. Mitral valve stenosis - Answer-b
The CPK elevation with MB enzymes elevated and the EKG ST changes denote a
possible Ml (Leon-Chisen 2013, 386-387).
A patient is admitted and diagnosed with fever and urinary burning. The discharge
diagnosis· is Escherichia coli, urinary tract infection.
Which of the following represents the correct diagnoses and appropriate sequence of
those conditions?
a. Fever, urinary burning, urosepsis
b. Fever, urinary burning, sepsis
c. Escherichia coli, urinary tract infection
d. Urinary tract infection, Escherichia coli - Answer-d
Symptoms are not coded when a definitive diagnosis is present on discharge. The
patient discharge diagnosis of urinary tract infection. The organism (E. coli) is coded
with a seco diagnosis code (B96.20) which is to be added as an additional code to
identify the bacterial agent (HHS 2014, Section II.A., 98).
A patient was admitted with heart failure within one week of a heart transplant. Due to
the timing, the coder thought that it may represent a postoperative transplant rejection
following heart transplant.
What action(s) should the coding staff take?
a. Query the physician.
b. Assign the codes for the postoperative transplant rejection.
c. Assign only the code for the transplant rejection.
d. Assign only the code for heart failure. - Answer-a
When the documentation is not clear regarding a potential complication, it is appropriate
query the physician (HHS 2014, Section I.B.16, 16; Leon-Chisen 2013, 43-44).
A patient is admitted to a psychiatric unit of an acute-care facility. The patient
experienced the following symptoms almost every day for the last month: loss of interest
or pleasure in most or all activities, which is a change from her prior level of functioning.
She has also gained 15 lbs, has difficulty falling asleep, feels fatigued, and has difficulty
making decisions.
What potential diagnosis most closely fits the patient's overall symptoms?
a. Insomnia
b. Major depression
c. Reye's syndrome
d. Bipolar disorder - Answer-b
The symptoms provided are indicative of a depressive disorder (Leon-Chisen 2013,
175).
Inpatient:
Admission for inguinal hernia repair. This 30-year-old patient has acquired
immunodeficiency syndrome (AIDS) but is not symptomatic at this time due to
medication regimen. The procedure performed was a right indirect inguinal
herniorrhaphy via open approach. - Answer-ICD-10-CM: K40.90, B20,
ICD-10-PCS: OYQ50ZZ (Schraffenberger 2013, 82-84,252)
Inpatient:
A 75-year-old male patient was admitted from a nursing home with dehydration and
dysphagia due to a previous stroke. During hospitalization the patient was rehydrated
and transferred back to the nursing home. - Answer-ICD-10-CM: E86.0, I69.391
(Schraffenberger 2013, 131, 209-210).
Stroke= cerebral infarction
Inpatient:
A patient is admitted to an acute care facility for detoxification from alcohol and
barbiturate intoxication with chronic alcoholism and barbiturate abuse. The patient also
has cirrhosis of the liver due to alcoholism. - Answer-ICD-10-CM: F10.229, F13.129,
K70.30,
(Schraffenberger 2013, 140-143.)
ICD-10-PCS HZ2ZZZZ
(Leon-Chisen 2014, 186).
Inpatient:
A 30-year-old patient was seen in the emergency department for recurrent epileptic
seizures. The patient also had tic douloureux. - Answer-ICD-10-CM: G40.909, G50.0
(Schraffenberger 2013,158-159).
Inpatient:
A patient was admitted to an acute care facility with a temperature of 102 and atrial
fibrillation. The chest x-ray reveals pneumonia with subsequent documentation by the
physician of pneumonia in the progress notes and discharge summary. The patient was
treated with oral antiarrhythmia medications and IV antibiotics. - Answer-ICD-10-CM:
J18.9, 148.91-
In accordance with the UHDDS, both conditions are not equally treated. The pneumonia
was treated with IV antibiotics. This diagnosis had greater utilization of resources of
medications and staff time compared with the atrial fibrillation, which was treated with
oral medication. Because of this, the pneumonia is sequenced first (HHS 2014, Section
II, C).
Inpatient:
A patient with chronic cholecystitis and gallbladder stones underwent a laparoscopic
cholecystectomy in an acute care facility. However, due to extensive gallbladder
adhesions the procedure was converted to an open cholecystectomy. - Answer-ICD-10-
CM: K80.10, K82.8 (Schraffenberger 2013, 249-250, 454); HHS 2011, Section I, 18. d,
14), ICD-10-PCS: OFT40ZZ, OFJ44ZZ (Leon-Chisen 2014, 250).
Inpatient:
A patient is admitted to the inpatient setting with hydronephrosis and a staghorn
calculus of the right kidney. The patient underwent an uretetoscopy with placement of
bilateral ureteral stents for dilation purposes and removal of calculus of right kidney. -
Answer-ICD-10-CM: N13.2,
ICD-10-PCS: OT788DZ, OTC08ZZ
(Leon-Chisen 2013, 269).
Inpatient:
A 77-year-old nursing home patient was admitted to the acute care setting for excisional
debridement of decubitus stage 3 ulcer of the right heel via surgical excision in the OR.
The patient also has degenerative joint disease of both knees. -..
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