Case Studies & Practical Application Flashcards
7 cards from real Certified Medical Coding Specialist practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Case Studies & Practical Application flashcards as text
A patient is admitted for a planned right total knee arthroplasty. Postoperatively, the patient develops a pulmonary embolism. How is the PE coded?
Answer: As a secondary diagnosis since the TKA was the planned reason for admission
The total knee arthroplasty remains the principal diagnosis; the postoperative PE is coded as a secondary complication (I26.xx) along with a complication code if applicable.
A physician documents removal of a 1.5 cm malignant lesion from the face with a 0.5 cm margin on each side. What diameter is used to select the excision code?
Answer: 2.5 cm — lesion plus one margin
CPT guidelines require adding the widest diameter of the lesion plus the narrowest margin on each side, so 1.5 + 0.5 + 0.5 = 2.5 cm is used for code selection.
A patient with stage III chronic kidney disease (CKD) is also hypertensive. Per ICD-10-CM, how is this coded?
Answer: With the combination code I12.9 and N18.3
ICD-10-CM presumes a cause-and-effect relationship between hypertension and CKD; the combination code I12.9 (hypertensive CKD) plus N18.3 (stage III) are assigned.
A patient undergoes a bilateral diagnostic mammogram. The CPT code 77067 is reported. A radiologist reviews and interprets the images separately. How is the interpretation billed?
Answer: With modifier -26 appended to 77067
Modifier -26 designates the professional component (interpretation and report) when the physician bills separately from the facility that owns the equipment.
A coder reviews a record where the physician used the term 'alcoholic cirrhosis.' Which ICD-10-CM code is most appropriate?
Answer: K70.30 — alcoholic cirrhosis of liver without ascites
K70.30 specifically captures alcoholic cirrhosis of the liver without ascites, reflecting the physician's documentation of the etiology.
An encounter note states the patient is a 28-year-old pregnant woman at 32 weeks gestation seen for supervision of a normal pregnancy. Which code is reported?
Answer: Z34.32 — encounter for supervision of normal pregnancy, third trimester
Z34.32 is the correct code for supervision of a normal pregnancy in the third trimester (weeks 28–40).
A surgeon performs a complex repair of a 4.5 cm laceration of the neck and a simple repair of a 2.0 cm laceration of the arm during the same encounter. How are these coded?
Answer: Code both repairs separately using appropriate CPT codes
Repairs of different complexity (simple vs. complex) at different anatomic sites are coded separately with their respective CPT codes.