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ACCOUNTING 2015 CHAPTER 8 Case Studies from Ambulatory Health Records
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Unless otherwise stated, code set answers given in chapter 8 are ICD-10-CM, CPT, or HCPCS Level II. Disorders of the Blood and Blood-Forming Organs 8.1. a. D57.1, R10.30, E11.9, I48.2, 99285 Incorrect answer. The sickle-cell anemia is in crisis, so 282.61 is not correct. It would not be necess...

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  • April 15, 2023
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Exercise Answer Key CCW: Practice Exercises for Skill Development With Online Answers 1




ACCOUNTING 2015
CHAPTER 8

Case Studies from
Ambulatory Health Records



Unless otherwise stated, code set answers given in chapter 8 are ICD-10-CM, CPT, or HCPCS Level II.

Disorders of the Blood and Blood-Forming Organs
8.1. a. D57.1, R10.30, E11.9, I48.2, 99285
Incorrect answer. The sickle-cell anemia is in crisis, so 282.61 is not correct. It
would not be necessary to code the inguinal pain because pain, fever, and so on
are part of a sickle-cell crisis. The level is four for the E/M code per the
documentation, so code 99285 is not correct. It is correct to add the x-ray codes.
b. D57.00, M87.051, 99284, 73552, 73502
Incorrect answer. The avascular necrosis was not confirmed, but only
documented as “rule out.” This would not be coded in the outpatient setting.
The diabetes and chronic fibrillation should be coded. A modifier of -25 should
be appended to the 99284 code.
c. D57.00, E11.9, I48.2, 73552, 73502
Incorrect answer. The emergency department service should be reported
with 99284-25. d. D57.00, E11.9, I48.2, 99284-25, 73552, 73502
Correct answer. The CMS website (http://www.cms.gov/Regulations-and-
Guidance/Guidance/Manuals/index.html) states that modifier -25 should be
appended to an evaluation and management code when reported with a
significant procedure (status indicator S or T) on the same day of service.
The Alphabetic Index main term is Crisis, subterm sickle-cell. The diabetes is found
under main term Diabetes, subterm Type 2. Main term Fibrillation, subterms atrial,
chronic gives code I48.2.
8.2. a. D50.0, E11.9, I25.10, Z95.1, Z82.49, 36430, P9051-BL, (3 units), P9051-BL (3 units)
Correct answer. The Alphabetic Index main term is Anemia with subterm blood
loss. Main term is Diabetes with subterm Type 2. Main term is Arteriosclerosis with
subterm coronary (artery). Main term is Status (post) with subterm aortocoronary
bypass. Main term is History with subterms family (of), disease or disorder (of),
cardiovascular. Per CMS, whenever an OPPS provider reports a charge for blood or
blood products using Revenue Code 038X, the OPPS provider must also report a
charge for processing and storage services on a separate line using Revenue Code
0390 or 0399. Further, the same LIDOS, the same number of units, the same
HCPCS code, and HCPCS modifier BL must be reported on both lines.
b. D64.9, R53.1, 36430, P9051-BL (3 units), P9051-BL (3 units)
Copyright ©2016 American Health Information Management Association

,Exercise Answer Key CCW: Practice Exercises for Skill Development With Online Answers 2


Incorrect answer. The anemia is specified as severe blood loss anemia, so code
D64.9 is not the correct answer. Indexing Anemia, blood loss (chronic) results in
code D50.0. It is not correct to code the weakness because it is a symptom of the
more definitive diagnosis of




Copyright ©2016 American Health Information Management Association

,Exercise Answer Key CCW: Practice Exercises for Skill Development With Online Answers 3


anemia. The additional diagnoses of diabetes, ASHD, status post bypass, and
family history of cardiovascular disease may be coded because they were treated
and/or are applicable to the case.
c. D50.0, K92.2, I25.10, Z95.1, Z82.49, 36430
Incorrect answer. It is not correct to assume that the patient has GI bleeding, and
the physician should be asked to add occult blood as a final diagnosis, if
appropriate, which is coded to R19.5. The HCPCS Level II code with the number of
units should also be added to account for the purchase of the packed cells from the
blood bank.
d. D64.9, E11.9, R19.5, I25.10, Z95.1, Z82.49, P9051 (3 units)
Incorrect answer. The anemia is specified as severe blood loss anemia, so code
D64.9 is not the correct answer. The transfusion administration code must be
assigned with a CPT code in order for the APC to be generated. The physician
should be asked to add occult blood as a final diagnosis, if appropriate.
8.3. a. N39.0, E86.0, I50.32, D69.5, E10.9
Incorrect answer. The thrombocytopenia was specified as primary, so code
D69.5 is not the best choice.
b. N39.0, E86.0, I50.32, J90, D69.5, E10.9
Incorrect answer. Pleural effusion is not separately coded when present
with CHF. The thrombocytopenia was specified as primary, so code D69.5 is
not the best choice.
c. N39.0, E86.0, I50.32, D69.49, E10.9
Correct answer. The Alphabetic Index main term is Infection, subterm urinary
(tract). The dehydration is found under main term Dehydration. The chronic diastolic
CHF is found under main term Failure, subterm heart, diastolic, chronic. Main term
Thrombocytopenia, subterm primary gives code D69.49. The diabetes mellitus is
coded by finding main term Diabetes, subterm type 1.
d. N39.0, E86.0, I50.32, J90, D69.49, R23.3, E10.9
Incorrect answer. Pleural effusion is not separately coded when present with CHF.
The petechia is not coded. It is part of the thrombocytopenia. There is an
excludes note present at R23.3 specifying that the petechia code is not to be
assigned with codes from category D69.
8.4. a. C78.7, D63.0, Z85.3
Correct answer. The code for the current liver metastasis is assigned as the
principal diagnosis according to Coding Guideline I.C.2.C.1 (CMS 2016a). Access
the Neoplasm Table and go to the subterm liver and select a code from the
Malignant Secondary column since the liver is a metastatic site. The Alphabetic
Index main term is Anemia with subterms in (due to) neoplastic disease and get
code D63.0. The Alphabetic Index main term is History with subterms personal (of)
malignant neoplasm, breast.
b. D63.0, C78.7, Z85.3
Incorrect answer. The code for the current liver metastasis is assigned as the
principal diagnosis according to Coding Guideline I.C.2.C.1 (CMS 2016a). Access
the Neoplasm Table and go to the subterm liver and select a code from the
Malignant Secondary column since the liver is a metastatic site. The Alphabetic
Index main term is Anemia with subterms in (due to), neoplastic disease to get
code D63.0. The Alphabetic Index main term is History with subterms personal (of)
malignant neoplasm, breast.
c. C78.7, D63.0
Incorrect answer. A code should also be assigned for the history of the breast
Copyright ©2016 American Health Information Management Association

, Exercise Answer Key CCW: Practice Exercises for Skill Development With Online Answers 4


carcinoma. d. D63.0, C78.7, C50.411




Copyright ©2016 American Health Information Management Association

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