ICD 10 Practice Test 1

Question 1

How is it coded if a patient gets severe sepsis during a hospital stay that was not present on admission?

Accepted Answer

B) Systemic infection and appropriate code from R65.2 is assigned as a secondary diagnosis

Answer

According to ICD-10-CM coding guidelines, if severe sepsis develops during a hospital stay and was not present on admission (POA), the underlying systemic infection (e.g., specific bacterial infection) should be coded first. The code for severe sepsis (from category R65.2) is then assigned as a secondary diagnosis to indicate the severity and onset during the hospitalization. This accurately reflects that the sepsis was a complication of the hospital stay, not the initial reason for admission.

Question 2

Secondary glaucoma due to ocular inflammation was discovered in a patient with recurrent acute iridocyclitis in both eyes. The left eye is in 
a severe condition, while the right eye is at a moderate level. Which ICD-10-CM code (s) would you use to report this encounter?

Accepted Answer

H40.41X2, H40.42X3, H20.023

Answer

The correct codes are H40.41X2 for secondary glaucoma due to ocular inflammation, severe, in the left eye, and H40.42X3 for secondary glaucoma due to ocular inflammation, moderate, in the right eye. The 'X' is a placeholder for the seventh character, which is not applicable here. H20.023 is used for recurrent acute iridocyclitis in both eyes. These codes accurately reflect the specific type of glaucoma, its cause, laterality, severity, and the underlying inflammatory condition in both eyes.

Question 3

This HIV-positive patient has never had any opportunistic infections and is asymptomatic. His primary care physician is seeing him today for a single
 episode of moderate major depressive disorder. To report this encounter, what code (s) would you use?

Accepted Answer

F32.1, Z21

Answer

For an asymptomatic HIV-positive patient, code Z21 (Asymptomatic human immunodeficiency virus [HIV] infection status) is used, not B20 (HIV disease). The primary reason for the encounter, moderate major depressive disorder, is coded first as F32.1. Therefore, the correct sequence is F32.1 followed by Z21, prioritizing the condition being treated during the visit.

Question 4

A ten-year-old patient comes in with nausea, vomiting, a runny nose, and a sore throat. He's been unwell for a few days, but nausea and vomiting only started today. The mother claims that there are a lot of kids at school who have the same symptoms. The doctor diagnosed the patient with a viral infection after an examination. A streptococcal test was performed and found to be negative. What ICD-10-CM code (s) applies to this encounter?

Accepted Answer

B34.9

Answer

When a definitive diagnosis of a viral infection (B34.9, Viral infection, unspecified) is made, the individual symptoms (nausea, vomiting, runny nose, sore throat) are not coded separately. The negative streptococcal test further supports the viral diagnosis. Coding only the confirmed diagnosis avoids unnecessary and potentially misleading symptom codes.

Question 5

A patient has CKD stage III, edema, and hypertension. For this chart, the proper ICD-10 CM codes are:

Accepted Answer

N18.3, I12.9

Answer

N18.3 correctly identifies Chronic Kidney Disease (CKD) Stage III. When hypertension and CKD are both present and documented as related, the appropriate code for hypertensive chronic kidney disease is I12.9. This code implicitly links the hypertension to the kidney disease, making a separate code for essential hypertension (I10) redundant. Edema (R60.9) is a symptom and is not coded separately when it's a known manifestation of the primary conditions and not further specified.