# Code It

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```					3-2-1 Code It!, 2e                                                                                          Corrections 2009
Textbook
Chapter 1
Page 6    Credentials
The American College of Medical Coding Specialists (ACMCS) Professionals (ACMCP), American Health
Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC) offer
certifi cation in coding. Credentials available from the ACMCS ACMPS include the following:

Chapter 10
Page 393     Note: Base unit values and modifying unit relative values are available as downloadable files at http://
www.cms.hhs.gov. Click on the All Fee-for-Service Providers link (located toward the bottom of the page), and
click on the Anesthesiologists Center link (located toward the bottom of the page) to locate the Anesthesia Base
Units file. Documents are also available for purchase from the ASA as a Relative Value Guide publication and The
Anesthesia Crosswalk.
394   EXAMPLE 2: A 22-year-old female patient who has chronic asthma was prepared for a planned vaginal delivery on
May 14, during which neuraxial labor anesthesia was administered by an anesthesiologist. Complications
required that an emergency cesarean delivery be performed instead of the planned vaginal delivery. Report
codes 01968-P2 and 99140 in addition to code 01967-P2. (Reimbursement for multiple anesthesia services is
based on the sum of each base unit value because code 01968 is an add-on code.) Anesthesia code 01967 has a
base unit value of 5, and code 01968 has a base unit value of 8 2. The total length of anesthesia time for
both procedures was 75 minutes, which is calculated as 5 anesthesia time units (75 ÷ 15 = 5). The patient is
assigned physical status modifier -P2, which has a relative value of 0, and code 99140 has a relative value of 2. If
the conversion factor is \$17.45, payment for anesthesia services is calculated as \$349. The formula for calculating
anesthesia services reimbursement is as follows:
STEP 1: (5 + 8 2 + 5 + 2) = \$17.45
STEP 2: 20 14 X \$17.45
AMOUNT: \$349 244.30

EXAMPLE 3: A 39-year-old male patient who has otherwise been healthy sustained multiple trauma and was
administered general anesthesia by an anesthesiologist during cranial surgery and upper abdominal surgery. Both
surgical procedures were performed during the same operative session. (Reimbursement for multiple anesthesia
services is based on the highest ASA base unit value when anesthesia for two separate procedures is provided.)
Assign codes 00210-P5, and 99140. (Do not report 00790 for administration of anesthesia for the upper
abdominal surgery because it was provided during the same operative episode as anesthesia for the cranial
surgery.) If anesthesia code 00210 has a base unit value of 15 7 and code 00790 has a base unit value of 13 11,
use value 15 when determining anesthesia reimbursement. The total length of anesthesia time for both
procedures was 120 minutes, which is calculated as 8 anesthesia time units (120 ÷ 15 = 8). Physical status
modifier -P5 is assigned a relative value of 3, and code 99140 is assigned a relative value of 2. If the conversion
factor is \$17.45, payment for anesthesia services is calculated as \$453.70. The formula for calculating anesthesia
services reimbursement is as follows:
STEP 1: (13 11+ 8 + [3 + 2]) X \$17.45
STEP 2: (21 19 + 5) X \$17.45
STEP 3: 26 24 X \$17.45
AMOUNT: \$453.70 \$418.80

PowerPoint
Chapter 11
Organization of Surgery Section
• 17 19 subsections (organ systems or anatomic sites):
– General
– Integumentary system (10040–19499)
– Musculoskeletal system (20000–29999)
– Respiratory system (30000–32999)
– Cardiovascular system (33010–37799)
– Hemic and lymphatic systems (38100–38999)
StudyWare
Chapter 6   Question:            A patient is referred to a radiologist for an abdominal ultrasound due to jaundice. After
review of the ultrasound, the interpreting physician discovers that the patient has an aortic
aneurysm.
Feedback:            Correct! Codes 782.4 and 441.9 are reported. The abdominal aneurysm is an incidental
finding, unrelated to jaundice, and reported second.
Feedback, 1st try:   Incorrect. The code for aortic aneurysm is incorrect. Try again.
Feedback, 2nd try:   Codes 782.4 and 441.9 are reported.
Feedback, 1st try:   Incorrect. Aortic aneurysm is reported. Try again.
Feedback, 2nd try:   Codes 782.4 and 441.9 are reported.
Feedback, 1st try:   Incorrect. The abdominal aneurysm is an incidental finding, unrelated to jaundice, and is
reported second. Incidental findings should are not reported be the first-listed diagnosis.
Try again.
Feedback, 2nd try:   Codes 782.4 and 441.9 are reported.
Computerized Test Bank
Chapter 1
Fill-in-the-Blank   eWebCoding by ChartOne Lexicode is an example of a(n) __________ __________ __________.
ANS:  application service provider
ASP

Chapter 13
Multiple Choice    A patient had a single-chamber atrial pacemaker inserted 15 years ago. The patient underwent replacement of
the pulse generator today. Report code(s) _____.
a. 33212                           c. 33212, 33206
b. 33213 33212, 33233              d. 33206, 33208
ANS:     ab

Chapter 18
Multiple Choice    OMT CMT of cervical, thoracic, and lumbar regions. Report code _____.
a. 98940                           c. 98925
b. 98941                           d. 98926
ANS: b
Instructor’s Manual
Page 31     25. NOTE: Cancer is not listed as a subterm below History (personal) of. Therefore, refer to subterm maliganant
(of) NEC to assign V16.9 V10.9. (You also don’t know what type of cancer was present.)
65    Chiropractic Office
26. 722.71, E927.0, E849.9                       27. 847.0, E917.0, E849.6
66    Hospital Emergency Department
31. 784.0                                        32. 719.41, E927.0, E849.9
128    Exercise 16.6
2. 77610 77620
142    21. b
22. b
23. c
24. d
25. c
154    12. A pregnant woman underwent outpatient termination of a pregnancy. The diagnosis was elective
abortion due to maternal rubella. Aspiration curettage was performed.
a. 635.92, 647.5, 655.33, 69.51              c. 635.92, 655.33, 69.52
b. 635.92, 655.30, 69.51                     d. 655.33, 635.90, 69.51

157    1.   A patient is admitted as a hospital inpatient for open reduction of fractured femur, sustained during a fall at
home. The patient was also treated for congestive heart failure during the inpatient stay.
a. 428.0, 79.25, E888.9, E849.0               c. 820.8 821.00, 428.0, E888.9, E849.0
b. 428.0, 820.8, E888.9, E849.0, 79.25        d. 820.8 821.00, 428.0, E888.9, E849.0, 79.25

4.   A hospital inpatient underwent sigmoidectomy with creation of temporary colostomy due to obstruction,
which was determined to be carcinoma of the colon. The patient received his first round of chemotherapy
during his inpatient stay.
a. 560.9, V58.11, 45.76, 46.11            c. 997.4, V58.11, 45.76, 46.11
b. 751.2, V58.11, 45.76, 46.11            d. 159.0 153.3, V58.11, 45.76, 46.11

WebTutor
Chapter 4
Quiz   A pregnant woman underwent outpatient termination of a pregnancy. The diagnosis was elective abortion due to
maternal rubella. Aspiration curettage was performed. Which is the proper coding and sequencing of ICD-9-CM
disease and procedure codes?
635.92, 647.53, 655.33, 69.51
Correct.
635.92, 655.30, 69.51
Incorrect. The elective abortion code is sequenced first. A code from category 647 is reported as an additional
code to indicate the complication leading to the termination of pregnancy.
655.33, 635.90, 69.51
Incorrect. The elective abortion code is sequenced first. A code from category 647 is reported as an additional
code to indicate the complication leading to the termination of pregnancy.
635.92, 655.33, 69.52
Incorrect. The code for elective abortion is sequenced first, and a code from category 647 is reported as an
additional code to indicate the complication that led to termination of the pregnancy.

Chapter 5
Quiz   A patient is admitted as a hospital inpatient for open reduction of fractured femur, sustained during a fall at
home. The patient was also treated for congestive heart failure during the inpatient stay.
820.8 821.00, 428.0, E888.9, E849.0, 79.25
Correct.
428.0, 79.25, E888.9, E849.0
Incorrect. The “fractured femur” code is reported first, followed by the external cause codes and the procedure
code.
428.0, 820.8 821.00, E888.9, E849.0, 79.25
Incorrect. The patient was admitted for open reduction of fractured femur; therefore, to not report the
congestive heart failure code first.
820.8 821.00, 428.0, E888.9, E849.0
Incorrect.The open reduction of fractured femur procedure code is missing from this answer.

A hospital inpatient underwent sigmoidectomy with creation of temporary colostomy due to obstruction, which
was determined to be carcinoma of the sigmoid colon. The patient received his first round of chemotherapy
during his inpatient stay.
159.0 153.3, V58.11, 45.76, 46.11
Correct.
560.9, V58.11, 45.76, 46.11
Incorrect. Do not report a code for the obstruction sign; instead, report a code for the carcinoma of the colon and
sequence it first.
751.2, V58.11, 45.76, 46.11
Incorrect. Do not report a congenital condition as the principal diagnosis; instead, report a code for the
carcinoma of the colon as the principal diagnosis.
997.4, V58.11, 45.76, 46.11
Incorrect. Do not report a complication of the digestive system as the first code; instead, report a code for the
carcinoma of the colon as the principal diagnosis.

A patient with HIV disease was admitted with a stab wound to the thoracic aorta, which resulted when the
patient fell on pitchfork that was hidden in hay. The patient had been working on his farm property when he
sustained the trauma. The wound was repaired with synthetic graft material.
901.0, 042, E920.4, E849.0, 39.57
Correct.
042, 901.0, E920.4, E849.0, 39.57
Incorrect. If a patient with HIV disease is admitted for an unrelated condition, the code for the unrelated
condition is reported as the principal diagnosis.
042, 901.0, E966, E849.0, 39.57
Incorrect. E966 is reported for intentional stabbing or assault. Main term Stab in the Index to Diseases instructs
you to “see cut” for an accidental stabbing.
879.8, 042, E920.4, E849.0, 39.57
Incorrect. The Index to Diseases contains a boxed note for main term Wound, which indicates that for a
penetrating wound of an organ, you should “see injury, internal.”

Chapter 11
Quiz   Complex repair of 8.5 cm wound, scalp, with extensive debridement of contaminated skin and subcutaneous
tissue.
13121, 13122, 13122, 11042
Correct. Codes 13121, 13122, 13122, and 11042 are reported.
13121
Incorrect. Code 13121 is reported for complex repair of 2.6 to 7.5 cm wounds. Since this wound is 8.5 cm, add-on
code 13122 must also be reported x 2. Repair (Closure) heading notes indicate that when gross contamination
requires prolonged cleansing, debridement is considered a separate procedure; therefore, code 11042 is
reported.
13122
Incorrect. Code 13122 is an add-on code and must be reported x 2 with code 13121. Repair (Closure) heading
notes indicate that when gross contamination requires prolonged cleansing, debridement is considered a
separate procedure; therefore, code 11042 is reported.
13121, 13122
Incorrect. Debridement is normally included in wound repair. Repair (Closure) heading notes indicate that when
gross contamination requires prolonged cleansing, debridement is considered a separate procedure; therefore,
code 11042 is reported.

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