FREE COC ICD-10-CM Coding Questions and Answers
A 6-year-old boy is diagnosed with childhood asthma with exacerbation by the emergency room physician. His caretakers are chain smokers and the physician documents exposure to environmental tobacco smoke. What diagnosis code(s) are reported?
Explanation:
In the ICD-10-CM index, look up Asthma/ childhood/ with exacerbation (acute) which points to J45.901. Verify this code in the tabular. There is an instructional note under category J45 which states to use an additional code to identify exposure to environmental tobacco smoke (Z77.22). Verify this code in the tabular. It would be inappropriate to code tobacco use (Z72.0) on this encounter for the child because it is not the child who is a chain smoker. Also, there is an Excludes1 note under Z77.22 for tobacco use (Z72.0) indicating that these codes cannot be coded together.
What is the diagnosis code for post-traumatic osteoarthritis of the left elbow?
Explanation:
In the ICD-10-CM index, look up Osteoarthritis/ post-traumatic/ elbow/ which directs to M19.12-. Checking the tabular, the correct code is M19.122 which indicates the left elbow.
A patient who admits to alcohol abuse is diagnosed with acute gastritis with bleeding.
Explanation:
In the ICD-10-CM index, look up Gastritis/ acute/ with bleeding which points to K29.01. Verify this code in the tabular. There is an instructional note stating to use an additional code to identify alcohol abuse and dependence (F10.-). The correct code is F10.10 Alcohol abuse, uncomplicated.
Cardiomegaly due to hypertension with chronic kidney disease. What diagnosis code(s) are reported?
Explanation:
Cardiomegaly is an enlarged heart. If it were the only diagnosis it would be coded with I51.7. Since cardiomegaly is due to hypertension, we look up the ICD-10-CM index, Hypertension/ heart (disease) (conditions in I51.4-I51.9 due to hypertension with kidney disease), which directs us to see Hypertension, cardiorenal. Lookup Hypertension / cardiorenal (disease)/ without heart failure/ which points to I13.10. This is covered by guideline I.C.9.a.3 Hypertensive Heart and Chronic Kidney Disease. Here it states ""If a patient has hypertension, heart disease, and chronic kidney disease then a code from I13 should be used, not individual codes for hypertension, heart disease, and chronic kidney disease, or codes from I11 or I12. Note, in this scenario the stage of chronic kidney disease is not stated. Verifying the code I13.10 we see that it is correct for "Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease" However, there is an instructional note to use additional code to identify the stage of chronic kidney disease (N18.1 -N18.4, N18.9). Code N18.9 is appropriate for unspecified chronic kidney disease.
Acute combined systolic and diastolic heart failure following cardiac surgery. What diagnosis code(s) are reported?
Explanation:
In the ICD.10 Index, look up Complication/ postprocedural/ heart failure/ following cardiac surgery/ which points to I97.130. Also, look up Failure/ heart/ diastolic/ combined with systolic/ acute/ which points to I50.41. Checking the tabular, there is an instructional note below I97.13 which applies to I97.130 and I97.131 which states to use an additional code to identify the heart failure (I50.-). In other words, sequence I97.130 before the I50.41.
A 37-year-old female, who was 39 weeks pregnant presents to the hospital in labor. She gives birth to a healthy baby boy.
Explanation:
ICD-10-CM Guideline I.C.15.n "Normal Delivery, Code O80" states that Code O80 should be assigned when a woman is admitted for a full-term normal delivery and delivers a single, healthy infant without any complications antepartum, during delivery, or postpartum during the delivery episode. Code O80 is always a principal diagnosis. In guideline I.C.15.n.3 "Outcome of delivery of O80" it states Z37.0, Single live birth, is the only outcome of delivery code appropriate for use with O80.
A 45-year-old female presents to the CT lab for a coronary calcium score exam. The lab report is reviewed by the cardiologist who diagnosed CAD in the patient. What diagnosis codes are reported?
Explanation:
CAD stands for Coronary Artery Disease. In the ICD-10-CM index, look up Screening/ cardiovascular disorder/ which points to Z13.6. Also look up Disease/ coronary (artery) / which says to see Disease, heart, ischemic, atherosclerotic. This entry points to I25.10.
What is the diagnosis code for a furuncle of the groin?
Explanation:
A furuncle is coded differently than a carbuncle in ICD-10-CM. Always use the ICD-10-CM Index to find the correct code. In the ICD-10-CM Index, look up Furuncle/ groin/ which directs to L02.224. Verify this code in the tabular. L02.234 is the code for carbuncle of groin and is incorrect for this question, as are L02.32 Furuncle of buttock, and L02.214 cutaneous abscess of groin.
A patient reports to the ASC for excision of a lipoma of the neck. The lab report later indicated a diagnosis of malignant neoplasm of the neck. What diagnosis code(s) are reported?
Explanation:
ICD-10-CM guideline IV.N Ambulatory surgery states if the postoperative diagnosis is known to be different from the preoperative diagnosis at the time the diagnosis is confirmed, select the postoperative diagnosis for coding since it is the most definitive. In the Table of Neoplasms, look up neck NEC/ malignant primary/ which directs to C76.0. Verify this code in the tabular.
Diabetes Mellitus due to immune-mediated pancreatic islet beta-cell destruction with diabetic amyotrophy. What diagnosis code(s) are reported?
Explanation:
If you happened to first look up "Amyotrophia, amyotrophy, amyotrophic" in the ICD-10-CM, you should notice that there is an entry for Amyotrophia/ diabetic/ which directs you to see "Diabetes, amyotrophy". The entry for "Diabetes, amyotrophy" points to E11.44. Checking the tabular, we see that Code E11.44 is the code for Type 2 diabetes mellitus with diabetic amyotrophy. To double check that "Diabetes Mellitus due to immune mediated pancreatic islet beta-cell destruction" is Type 2 diabetes, look under E11 Includes. It is not there, giving suspicion that E11.44 is incorrect. Instead, let's compare and contrast the answer choices. E10.44 is Type 1 diabetes mellitus with diabetic amyotrophy. E13.44 is Other specified diabetes mellitus with diabetic amyotrophy. E10 has an INCLUDES note for "pancreatic islet beta-cell destruction" and E13 does not. This means E10.44 Type 1 diabetes mellitus with diabetic amyotrophy is the correct code. We can eliminate choices B and D. The combination code, E10.44, is all that is needed, that is, coding G71.8 "Other primary disorders of muscles" is incorrect, eliminating answer choice C.
Screening for macular degeneration in a 60-year-old male. What diagnostic code(s) are reported?
Explanation:
Macular degeneration is an eye disease. In the ICD-10-CM index, look up Screening (for) / disease or disorder/ eye/ which points to Z13.5. Verify this code in the tabular.