Book



8/10/2009

2009 CCS Review Guide Errata

|Page |Question |Comments |

| | |Health Data Content, Requirements, and Standards |

|60 |25 |Under which of the following conditions can an original patient health record be physically removed from the hospital? |

| | |A. when the patient is brought to the hospital emergency department following a motor vehicle accident and, after assessment, is transferred with his health |

| | |record to a trauma designated emergency department at another hospital |

| | |B. when the director of health records is acting in response to a subpoena duces tecum and takes the health record to court |

| | |C. when the patient is discharged by the physician and at the time of discharge is transported to a long-term care facility with his health record |

| | |D. when the record is taken to a physician’s private office for a follow-up patient visit postdischarge |

| | |Correct answer: B |

| | |Use options A-D to correct error in typesetting question options in book. |

| | |Option B was left out and option C was changed to become B and option D became C. |

|61 |32 |Joint Commission standards require that a complete history and physical be documented on the health records of operative patients. Does this report carry a time|

| | |requirement? |

| | |A. yes, within 8 hours post-surgery |

| | |B. no, as long as it is dictated before surgery |

| | |C. yes, prior to surgery |

| | |D. yes, within 24 hours post-surgery |

| | |Correct answer: C |

| | |Use options A-D to correct error in typesetting question options in book. |

| | |Error in typesetting question options. Options B and D were left out. |

2009 CCS Review Guide Errata

(continued)

|Page |Question |Comments |

| | |Medical Science |

|85 |17 |Correct option D to read: either staphylococcus or streptococcus |

|100 | |Correct answer: D |

| | |Two types of bacteria cause impetigo — Staphylococcus aureus (staph), which is most common, and Streptococcus pyogenes (strep). Both types of bacteria can live |

| | |harmlessly on your skin until they enter through a cut or other wound and cause an infection. |

|92 |60 |The most common bloodborne infection in the United States is |

| | |Typographical error in question: change “State” to “States. |

|100 |65 |Correct answer: D |

|95 |83 |Correct Answer is: D |

| | |Information on vaginitis to support answer in book. |

| | |The most common types of vaginitis are: |

| | |Bacterial vaginosis. This type of vaginitis results from overgrowth of one of several organisms normally present in your vagina, upsetting the natural balance of |

| | |vaginal bacteria. |

| | |Yeast infections. A naturally occurring fungus called Candida albicans usually causes this type of vaginitis. An estimated three out of four women will have a yeast |

| | |infection in their lifetimes. |

| | |Trichomoniasis. This type is caused by a parasite and is commonly transmitted by sexual intercourse. |

| | |Atrophic vaginitis. This type results from reduced estrogen levels after menopause. The vaginal tissues become thinner and drier, which may lead to itching, burning |

| | |or pain. |

|163 |34 |Correct answer: A |

|146 |39 |Please omit using this question. |

| | |ICD-9-CM Coding |

|171 |2 | |

| | |Answer option “B” should read: B: 038.11, V09.0, 707.03, 995.92, 785.52, 707.20, 38.93, 00.11 |

|177 |39 |Answer option “D” should read: D: 410.41, 414.00, 427.31 |

|180 |59 |Answer option “C” should read: C: 403.90, 250.41, 585.9, V58.67 |

|185 |88 |Answer “D” should read: D: 771.82, 041.4 |

|190 |115 |Question should read: |

| | |The patient has hypertensive heart disease and nephrosclerosis with end stage renal disease |

2009 CCS Review Guide Errata

(continued)

|Page |Question |Comments |

|198 |138 |Add codes to box: |

| | |250.32 Diabetes mellitus with other coma, type II or unspecified type, uncontrolled |

| | |250.52 Diabetes mellitus with ophthalmic manifestations, type II or unspecified type, uncontrolled |

| | |Answer option “C” should read: C: 250.32, 250.52, 366.41 |

|222 | |Explanation should read: Diabetic ketoacidosis by definition is uncontrolled. |

|202 |148 |Correct option for code 303.90 in box: 303.90 Other and unspecified alcohol dependence, unspecified |

| | |Add option for code 303.91 in box: 303.91 Other and unspecified alcohol dependence, continuous |

| | |Answer “C” should read 303.90, 535.30 |

| | | |

|222 | |Add explanation to answer key: The term “continuous” refers to daily intake of large amounts of alcohol, or regular heavy drinking on weekends or days off. The |

| | |coder should not assume to use the fifth digit 1 unless documented as continuous. |

| | |CPT Coding |

|229- |10-18 |Questions from anesthesia need to have “anesthesia for” added at the beginning of the question on the interactive CD so that students know use the anesthesia code.|

|230 | | |

|239 |72 |Answer “A” should read: A: 43260, 43262, 43264 |

|246 |117 |Answer “D” should read: D: 59300 |

|256 |186 |Last sentence of question should read: The decubitus ulcer was debrided down to the bone. |

|258 |191 |Add code option -25 to code box: -25 Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure |

| | |or other service. |

| | |Answer “D” should read: D: 841.9, E927.2, 99281-25, 73080 |

|225 |193 |Add option -59 to code option box: -59 Distinct procedural service |

| | |Answer “B” should read: B: 727.61, 29826-59, 23412 |

| | | |

|275 | |Add to answer explanation: Modifier -59 must be added to code 29826 because it is a component of comprehensive procedure 23412. That is allowed if an appropriate |

| | |modifier is used per NCCI edits. |

2009 CCS Review Guide Errata

|Page |Question |Comments |

|269 |231 |Laparoscopic takedown of the splenic flexure and a partial colectomy with anastomosis |

| | |A. 44203, 44213 C. 44213 |

| | |B. 44204 D. 44204, 44213 |

| | |REFERENCE: CPT Assistant, April 2006, p 19 |

| | |Correction: Codes in answer A should read: 44203, 44213 |

| | |Answer D is correct. |

|269 |232 |Laryngoscopic submucosal removal of non-neoplastic lesion of the vocal cord with graft reconstruction. An operating microscope was used. |

| | |A. 31546, 69990 C. 31546 |

| | |B. 31546, 20926 D. 31546, 20926-51 |

| | |REFERENCE: CPT Assistant, May 2006, p 16-17 |

| | |Correction: First word in question should be: Laryngoscopic. |

|273 |119 |When tubal ligation is performed at the same time as hysterotomy, use 58611 in addition to 59100 |

| | |Case Study Coding Review |

|471 |Case 5 |DX 3 should read: 303.90 |

| |Answer | |

|347 |Case 10 |Add to Postoperative diagnoses: Uterine adhesions |

| | | |

|473 |Answer |Change Microscopic Diagnosis 1 to read: Uterus: Dense adhesions |

| | |Add: DX4 Intrauterine synechiae 621.5 |

|476 |Case 15 |Add: Additional DX Supplemental Oxygen V46.2 |

| |Answer | |

|373 |Case 17 |Add DX 2: Tobacco use disorder 305.1 (Added since many facilities are tracking tobacco use.) |

|394 |Case 21 |Delete Discharge Diagnosis 5. Osteoarthritis |

|479 | |Add: DX 5 Tobacco use disorder 305.1 (Added since many facilities are tracking tobacco use.) |

|479 |Case 22 |Add: Additional DX Long term (current) use of insulin V58.67 |

| | |Add: Additional DX History of tobacco use V15.82 (Added since many facilities are tracking tobacco use.) |

|480 |Case 23 |Change Principal Diagnosis to read: Other specified cardiac dysrhythmias 427.89 |

|483 |Case 29 |Add: DX9 History of tobacco use V15.82 (Added since many facilities are tracking tobacco use.) |

|483 |Case 30 |Add: DX9 History of tobacco use V15.82 (Added since many facilities are tracking tobacco use.) |

2009 CCS Review Guide Errata

|Page |Question |Comments |

| | |CCS Mock Part 1 Examination 1 |

|502 |Mock 1 |Answer D should read: 29881-LT |

|512 |54 |To Answer add: If debridement or shaving of articular cartilage and meniscectomy are performed in the same compartment of the knee, then code only 29881. |

| | |Add reference: CPT Assistant, April 2005, p14 |

| | |CCS Mock Part 1 Examination 2 |

|522 |Mock 2 |Answer B should read: 276.51, 584.9, 403.90, 585.9 |

| |22 | |

| | |CCS Mock Part II Coding Cases |

|548 |Mock Case 2 |Second sentence under Procedure heading, delete: “using the microscope” |

|611 | |Delete DX 2 |

|585 |Mock Case 10 |Delete Admitting diagnosis 4. Osteoarthritis |

| | |Delete Discharge diagnosis 8. Osteoarthritis |

|616 | |Add: Additional DX pacemaker (other postprocedural states) V45.01 |

|617 |Mock Case 11 |Add: DX 11 Tobacco use disorder 305.1 (Added since many facilities are tracking tobacco use.) |

| | |CCS Quiz |

|CD |16 |CD only: Answer Key should read: A |

| | |CCS Mock Examination Part II |

|549 |Case 1 |Note: In the case, it was mentioned twice that the patient was vomiting blood. In real life, we would probably query the physician to make sure that the |

| | |discharge summary was correct. The discharge summary in case could be amended in future editions to be more consistent or the two statements with vomiting blood|

| | |could be amended to follow the current discharge summary. So, as the case stands you could code it to discharge summary if you felt uncomfortable using the code|

| | |for vomiting blood. |

|550 |Case 4 |Note: The coding of smoking is becoming more prevalent as an individual facility choice. However, there is no "rule" in coding that it must be coded even if |

| | |there is a respiratory diagnosis.  You wouldn't necessarily be "wrong" in adding it, but it is not mandatory |

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