Present on Admission
Pt with known DM admitted for COVID. What is the POA status of DM?
POA Y
chronic conditions are poa Y
What type of codes are in the ICD-10-CM book?
diagnosis codes for both inpatient and outpatient
what type of category code/letter code must be PDX for all OB cases (ie pregnancy)
O-codes
If the type of diabetes is not documented - what is the default type of diabetes coded to
type 2
what does CAD stand for
coronary artery disease
Pt with hx of COPD admit for pneumonia. On day 3 pt COPD went into exacerbation.
What is POA status of COPD exacerbation?
POA N
while copd is chronic and was poa Y, the exacerbation component didn't happen until 3 day/after admit making it poa N
What type of codes are in ICD 10 PCS Book
inpatient procedure
What code range must be PDX on the NB delivery chart?
Z38*
Z3800 nb delivered vaginally
Z3801 nb delivered via c/s
a patient admitted with severe CAD and AMI. which dx must be sequenced first?
AMI
if a pt with cad is admitted due to a myocardial infarction, the infarction should be sequenced before the cad
what does CHF stand for
congestive heart failure
Congenital conditions are always considered what POA status?
POA Y
what type of codes are in the CPT book
outpatient procedure
OB patient delivers via c/s and develops anemia after delivery. what timeframe character gets assigned to the anemia code?
puerperium (ie postpartum) anything after delivery considered puerperium
timeframe code options:
first trimester
second trimester
third trimester
childbirth
puerperium
a patient admitted for UTI which caused sepsis. which dx must be sequenced first?
sepsis
if the reason for admission is sepsis and a local infection (ie pneumonia, uti, cellulitis) the sepsis code is sequenced first, followed by the infection
what does CKD stand for
chronic kidney disease
Pt admit for CHF exacerbation and also mentions a lump on breast. On day 4 a biopsy was done of the breast and dx of cancer made. What is the POA for the cancer?
POA Y
the pt had the condition on admission (lump) which was later diagnosed as cancer
How many characters are ICD 10 PCS codes
7 characters: both numerical and alpha
Z370 single liveborn belongs on the mom or nb chart?
Mom
Z37* range is the outcome of the mom's delivery (ie live birth, stillbirth)
which of these conditions are a presumed "with" relationship
copd, chf, gerd, cad, htn, ckd
all presumed, requiring combo code plus additional codes
what does LHC stand for?
left heart catherization
NB diagnosed with meconium aspiration at birth.
What is the POA status of meconium aspiration?
POA Y
conditions present at birth are considered POA for NB
How many characters are in CPT codes (excluding modifiers)
5: all numerical
what is the code for an uncomplicated delivery
O80
which condition/code must be sequenced first in a patient with htn, ckd, and chf?
htn code always goes first, followed by the ckd/chf
what does CABG stand for
coronary artery bypass graft