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CDIP Practice Exam 2 Questions with complete Solutions
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CDIP Practice Exam 2 Questions with complete Solutions
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CDIP Practice Exam 2 Questions with complete SolutionsA ________ assists in educating medical staff members on
documentation needed for accurate billing.
a.Physician champion
b.Compliance officer
c.Chargemaster coordinator
d.Data monitor Correct Answer a Physician champion. The
health information manager must continuously promote
complete, accurate, and timely documentation to ensure
appropriate coding, billing, and reimbursement. This requires a
close working relationship with the medical staff, perhaps
through the use of a physician champion. Physician champions
assist in educating medical staff members on documentation
needed for accurate billing. The medical staff is more likely to
listen to a peer than to a facility employee, especially when the
topic is documentation needed to ensure appropriate
reimbursement (Shaw and Carter 2014; Schraffenberger and
Kuehn 2011, 381).
A 18 year-old male was admitted with exacerbation of asthma.
To assign this diagnosis for coding, the diagnosis should be
clarified for:
a.Mild persistent
b.Persistent persistent
c.Moderate persistent
d.Unspecified
e.All of the above Correct Answer e All of the diagnoses listed
could further describe the state of the patient's asthma. (CMS
2016b)
,A 40-year-old female presented with a malignancy of the right
ovary diagnoses 1 week ago. The patient also exhibited
symptoms of confusion, headache, difficulty walking, and
blurred vision. Following extensive workup, it was determined
the patient had a malignancy of the cerebrum of the brain. The
CDS should query to determine:
a.Primary site.
b.Metastasis from and to.
c.Secondary site.
d.POA indicator for the cerebrum malignancy. Correct Answer
b Chapter 2 of the ICD-10-CM contains the codes for most
benign and all malignant neoplasms. Certain benign neoplasms,
such as prostatic adenomas, may be found in the specific body
system chapters. To properly code a neoplasm it is necessary to
determine from the record if the neoplasm is benign, in-situ,
malignant, or of uncertain histologic behavior. If malignant, any
secondary (metastatic) sites should also be determined (CMS
2016).
A 42-year-old female underwent an emergent total hysterectomy
due to tear of the uterus due to grapefruit-sized fibroid. The
patient was transfused 3 units of packed red blood cells for
anemia with a hemoglobin of 8.2. In this specific scenario,
which query is appropriate:
a.The CDI must query the cause of the fibroid
b.Patient noted to have tear of the uterus with hemoglobin 8.2
and transfusion of 3 units RBCs. Is the patient's anemia due to
blood loss? Yes or No
c.Query not warranted
,d.The CDI must ask an open ended query Correct Answer b
The CDI can perform a Yes and No query to determine if the
anemia is due to blood loss (AHIMA 2013b, 50-53)
A 45 year-old female had a necrotic cellulitis with ulcer of her
lower limb. The surgeon performed deep debridement of the
area with scalpel and pulsatile irrigation. Additional information
needed for accurate code assignment may be needed. Which of
the following best describes the most appropriate areas that
should be queried?
a.Excisional or nonexcisional; location of the wound; depth or
type of necrosis; cause of the condition, if known; stage of the
ulcer; present on admission indicator
b.Excisional or nonexcisional; depth or type of necrosis; cause
of the condition, if known; stage of the ulcer; present on
admission indicator
c.Excisional or nonexcisional, location of the wound, depth/type
of necrosis, present on admission indicator
d.No query needed Correct Answer a For the proper
assignment of cellulitis, ulcers, and debridement utilize Coding
Clinic advice and ICD-10-PCS Guidelines. Documentation
required by the physician/surgeon should include determination
of excisional/nonexcisional removal of tissue, the most specific
location of the wound, depth/type of necrosis such as muscle or
bone, cause of the condition if known; i.e., diabetic,
atherosclerotic, stage of the ulcer (I-IV), present on admission
indicator determination (AHIMA 2015a).
A 65-year-old white male was admitted to the hospital on 1/15
complaining of abdominal pain. The attending physician
requested an upper GI series and laboratory evaluation of CBC
, and UA. The x-ray revealed possible cholelithiasis and the UA
showed an increased white blood cell count. The patient was
taken to surgery for an exploratory laparoscopy and a ruptured
appendix was discovered. The chief complaint was:
a.Ruptured appendix
b.Exploratory laparoscopy
c.Abdominal pain
d.Cholelithiasis Correct Answer c The abdominal pain is the
chief complaint and is the reason the patient presented/reason
for visit (Shaw and Carter 2014; Fahrenholz and Russo 2013,
225).
A 68-year-old nursing home patient with status post CVA 2
weeks ago presents via the emergency department with a 1-day
history of fever, and elevated blood sugars in the 180-210 range.
The patient has stated they have significant pain of the right
buttock since the previous admission. The patient has a history
of diabetes, and is on long-term insulin. On physical exam, it is
noted the patient had a fever of 101.3 with purulent drainage
with exposure of subcutaneous fat. This type of ulcer can be
called a:
a.Stage I
b.Stage II
c.Stage III
d.Stage IV Correct Answer c This is a Stage III ulcer; Full
thickness skin loss. The National Pressure Ulcer Advisory Panel
(NPUAP) has redefined the definition of a pressure ulcer and the
stages of pressure ulcers. (AHA Fourth Quarter 2008, 132)
A CDI program should be governed by policies and procedures.
These policies and procedures should be developed with the
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