Prowrit

Question 9. 9. What code(s) is/are assigned for a patient receiving home care after a kidney transplant? (Points : 2)

Z48.29 Z48.298, Z94.0 N18.6 Z94.0

Question 10. 10. An elderly patient has an abscess formation around a pacemaker pocket on his chest wall that requires that the device be removed and the pocket reformed in another location. Which of the following code sets is appropriate for this outpatient surgical service? (Points : 2)

T82.7XXA, L02.219, 33222 L02.219, 33222 T82.7XXA, 33223 T82.857A, L02.219, 33999

Question 11. 11. A 48-year-old man came in to the emergency department complaining of vomiting material resembling coffee grounds several times within the past hour. He has abdominal pain and has been unable to eat for the past 24 hours. He is dizzy and lightheaded. Two stools today have been black and tarry. While in the emergency department, he vomited bright-red blood and some material resembling coffee grounds. A nasogastric tube was inserted by the ED physician and attached to suction. An abdominal exam showed a fluid wave consistent with ascites. CBC and clotting studies were drawn. A detailed history and physical exam with high-complexity medical decision making were documented. A GI consultant was called and the patient was taken to the Endoscopy for further evaluation of upper GI bleeding. Diagnosis: Hematemesis, rule out esophageal varices; blood loss anemia, acute; ascites. Which of the follow is the correct diagnosis and CPT procedure assignment for the independent ED physician? (Points : 5)

K92.0, D62, R18.8, 99285, 43752 K92.0, R10.9, R42, 99284-25, 91105 R18.0, K92.0, D50.0, 99284, 43752 K92.0, D62, R18.8, 99284-25, 43752

Question 12. 12. A 20-year-old patient was brought into the emergency department in nearly comatose condition following an evening of drinking beer and vodka with friends. Vital signs were depressed. A blood-alcohol level was measured, which was reported as 0.38. The patient had vomited several times before passing out. There was a 1-cm laceration on the patient’s eyebrow. This was treated with a Steri-Strip. The patient was stabilized in the ED for one and a half hours and admitted to intensive care by the Internal Medicine physician on call. Documentation in the ED record supports a level 5 ED visit. Diagnosis was alcohol poisoning, acute alcohol intoxication, and 1-cm laceration, right eyebrow. (Points : 5)

F10.229, 99291, 99292 T51.92XA, F10.129, 99285-25, 12011 F10.129, Y90.1, S01.80XA, T51.0X1A, 99285 F10.229, T51.92X, 99291, 12011

Question 13. 13. The following documentation is from the health record of a 3-year-old child. Parents bring their 3-year-old boy, who was born with hydrocephalus, to the pediatric neurology clinic at Unive3rsity Hospital to have the child evaluated by the pediatric neurologist and have his VP shunt lengthened to accommodate a growth spurt. Their pediatrician requested a consultation to evaluate the shunt and replace the peritoneal catheter if needed. Outpatient surgery had been previously scheduled tentatively pending this evaluation for the afternoon. The catheter used in the shunt was removed and replaced in the outpatient surgery suite following a follow-up consultation, which included a detailed interim history, a detailed examination, and medical decision making of moderate complexity. Findings documented in the consultation include “Assessment: Shunt valve malfunction requiring replacement”. The VP shunt valve was replaced along with a new peritoneal catheter in a longer length. Which of the following code sets will be reported for this service? (Points : 5)

Z45.41, 62230 T8503XA, Q03.9, 62230 Q03.9, Z45.41, 62225 Q03.9, 62230

Question 14. 14. Dr. Smith sent a patient to observation care at the local hospital following his visit to the nursing facility. The patient was admitted for observation to rule out stoke due to a change in mental status. The next morning, Dr. Smith left town, and his partner, Dr., Johnson, admitted the patient to inpatient care because of sudden worsening symptoms. The patient expired later the same day. Assuming documentation guidelines were met, how would E/M services for these two physician be coded? (Points : 5)

Dr. Smith: 99315; 99219; Dr. Johnson: 99236 Dr. Smith: 99219; Dr. Johnson: 99217, 99236 Dr. Smith: 99219; Dr. Johnson: 99236 Dr. Smith: 99315; 99222; Dr. Johnson: 99238

Question 15. 15. The patient is a four-year-old male with acute lymphocytic leukemia who has had a fever for the last 24 hours. It has been nine days since his last chemotherapy, which was his first. A comprehensive history is documented. On examination, the skin over his Hickman site is extremely red and starting to break down. No other abnormal findings are noted in the comprehensive exam. Labs show that the patient is not neuropenic. The physician lists the diagnoses as : ALL not in remission, infected Hickman. The patient is given 770 mg of Ceptz over 10 minutes through a new peripheral IV site and admitted for continued treatment. Medical decision making is moderate. What code set is reported for the services of the emergency physician? (Points : 5)

C91.00, T827XXA, R50.9, 99284-25, 96374 T80218A, Y83.8, 99284 C91.00, T8579XA, R50.81, 99285 C91.00, T80219A, 99285-25, 96374