Medical Coding Quiz On Endocrine, Nutritional, And Metabolic Diseases (E00-e89)

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| By Naushad207

Naushad207

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Quizzes Created: 7 | Total Attempts: 12,101

Questions: 10 | Attempts: 1,712 | Updated: Mar 22, 2023

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Questions and Answers

1.

The patient is a 16-year-old with obesity and diabetes mellitus, type 2, uncontrolled (hyperglycemic):
- A.
  
  E66.01, E11.69
- B.
  
  E66.9, E11.649
- C.
  
  E11.65, E66.9
- D.
  
  E11.00, E66.01
Correct Answer
C. E11.65, E66.9

Explanation
diabetes type 2 mellitus, uncontrolled, can be coded as diabetes type 2 with hyperglycemia/hypoglycemia depending on the given scenario as per the new updated coding guidelines.

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2.

Patient has type 1 diabetes with hyperglycemia due to mechanical breakdown of insulin pump, which resulted in underdosing:
- A.
  
  T38.3X6D, T85.694S, E11.65
- B.
  
  T85.614A, T38.3x6A, E10.65
- C.
  
  T38.3X1A, T85.614A, E08.65
- D.
  
  T85.614D, T38.3X7D, E89.1
Correct Answer
B. T85.614A, T38.3x6A, E10.65

Explanation
Underdose of insulin due to insulin pump failure
An underdose of insulin due to an insulin pump failure should be assigned to a code from subcategory T85.6, Mechanical complication of other specified internal and external prosthetic
CHAPTER 13 Endocrine, Nutritional, and Metabolic Diseases 279
devices, implants and grafts, that specifies the type of pump malfunction, as the principal or first-listed code, followed by code T38.3x6-, Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs. Additional codes for the type of diabetes mellitus and any associated complications due to the underdosing should also be assigned.

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3.

Patient has type 1 diabetes with hypoglycemia due to mechanical breakdown of insulin pump, which resulted in overdosing:
- A.
  
  T85.694S, T38.3X2S, E11.65
- B.
  
  T38.3X6A, T85.633A, E08.65
- C.
  
  T85.633D, T38.3x1D, E10.641
- D.
  
  T85.614A, T38.3x1A, E10.649
Correct Answer
D. T85.614A, T38.3x1A, E10.649

Explanation
Overdose of insulin due to insulin pump failure
The principal or first-listed code for an encounter due to an insulin pump malfunction resulting in an overdose of insulin, should also be T85.6-, Mechanical complication of other specified internal and external prosthetic devices, implants and grafts, followed by code T38.3x1-, Poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, accidental (unintentional).

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4.

Uncontrolled diabetes mellitus (hyperglycemic) due to Cushing's syndrome. Patient has been on insulin for the last year:
- A.
  
  E11.65, E24.4, Z79.84
- B.
  
  E24.9, E08.65, Z79.4
- C.
  
  E08.65, E24.9, Z79.4
- D.
  
  E10.65, E24.9, Z79.84
Correct Answer
B. E24.9, E08.65, Z79.4

Explanation
Assigning and sequencing secondary diabetes codes and its causes
The sequencing of the secondary diabetes codes in relationship to codes for the cause of the diabetes is based on the Tabular List instructions for categories E08, E09 and E13.

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5.

A patient is admitted with diabetic gangrene of the left little toe. The toe was completely amputated. The patient has uncontrolled type 1 diabetes (hyperglycemic):
- A.
  
  E13.52, E10.649, 0Y6X0Z0
- B.
  
  E11.52, E11.649, 0Y3L0ZZ
- C.
  
  E10.52, E10.65, 0Y6Y0Z0
- D.
  
  E08.52, E08.655, 0Y974ZX
Correct Answer
C. E10.52, E10.65, 0Y6Y0Z0

Explanation
the terms listed under "diabetes" "with" should be taken as a combination (even if not stated cause-and-effect relationship) as per new coding clinic guidelines.

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6.

Patient with diabetic CKD, stage 4 and hypertension:
- A.
  
  E09.22,112.9, N18.4
- B.
  
  I13.9, E10.22, N18.9
- C.
  
  E11.22, I10, N18.4
- D.
  
  E11.22, I12.9, N18.4
Correct Answer
D. E11.22, I12.9, N18.4

Explanation
The correct answer is E11.22, I12.9, N18.4. This combination of codes indicates that the patient has type 2 diabetes with chronic kidney disease (CKD) stage 4 and hypertension. The code E11.22 represents type 2 diabetes with diabetic CKD, while I12.9 represents hypertensive CKD and N18.4 represents CKD stage 4. Therefore, this answer accurately captures the patient's conditions.

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7.

Patient with hyperglycemia due to long-term use of prednisone taken for rheumatoid arthritis:
- A.
  
  E11.65, T38.0X5A, M06.00, Z79.01
- B.
  
  E10.65, T38.0X4A, M05.9, Z79.02
- C.
  
  E08.65, T38.0X6A, M05.65, Z79.84
- D.
  
  R73.9, T38.0x5A, M06.9, Z79.52
Correct Answer
D. R73.9, T38.0x5A, M06.9, Z79.52

Explanation
The correct answer is R73.9, T38.0x5A, M06.9, Z79.52. This answer includes the appropriate codes for hyperglycemia (R73.9), adverse effect of prednisone (T38.0x5A), rheumatoid arthritis (M06.9), and long-term use of medication (Z79.52). The other options either do not include the correct codes or have incorrect codes for the given scenario.

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8.

Adult patient was seen in the clinic for dietary counseling for dysmetabolic syndrome X. Patient is obese with a BMI of 35 and has hypertriglyceridemia and hypertension:
- A.
  
  Z70.0, E88.81, E66.9, Z68.35, E78.1, I10
- B.
  
  E78.01, E66.01, Z71.9, Z68.34, I12.9
- C.
  
  Z71.3, E88.81, E66.9, Z68.35, E78.1, I10
- D.
  
  Z71.89, E66.0, Z68.40, E78.00, I11.9
Correct Answer
C. Z71.3, E88.81, E66.9, Z68.35, E78.1, I10

Explanation
The correct answer is Z71.3, E88.81, E66.9, Z68.35, E78.1, I10. This answer includes the appropriate codes for the patient's condition. Z71.3 represents dietary counseling and surveillance, which is relevant to the patient's visit. E88.81 represents metabolic syndrome, which aligns with the patient's dysmetabolic syndrome X. E66.9 represents obesity, which is indicated by the patient's BMI of 35. Z68.35 represents elevated body mass index (BMI) of 35. E78.1 represents hypertriglyceridemia, which the patient has. I10 represents essential (primary) hypertension, which the patient also has.

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9.

Goiter with complete thyroidectomy (open):
- A.
  
  E04.9, 0GTK0ZZ
- B.
  
  E04.0, 0GNK0ZZ
- C.
  
  E04.2, 0GQK0ZZ
- D.
  
  E04.8, 037U04Z
Correct Answer
A. E04.9, 0GTK0ZZ
10.

Morbidly obese adult patient (BMI 42) with diabetes mellitus. A laparoscopic gastric banding with extraluminal device was performed:
- A.
  
  E66.01, E11.9, Z68.41, 0DV64CZ
- B.
  
  E66.9, E10.9, Z68.40, 04N20ZZ
- C.
  
  E66.0, E08.00, Z68.41, 04L24CZ
- D.
  
  E66.9, E13.01, Z68.43,06U207Z
Correct Answer
A. E66.01, E11.9, Z68.41, 0DV64CZ

Explanation
The correct answer is E66.01, E11.9, Z68.41, 0DV64CZ. E66.01 represents morbid obesity due to excess calories, E11.9 represents type 2 diabetes mellitus without complications, Z68.41 represents body mass index (BMI) 40.0-44.9, and 0DV64CZ represents laparoscopic gastric banding with extraluminal device. This combination of codes accurately describes the patient's condition, comorbidities, and the specific procedure performed.

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Current Version
Mar 22, 2023

Quiz Edited by
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Mar 29, 2017

Quiz Created by
Naushad207

Medical Coding Quiz On Endocrine, Nutritional, And Metabolic Diseases (E00-e89)

The patient is a 16-year-old with obesity and diabetes mellitus, type 2, uncontrolled (hyperglycemic):

Patient has type 1 diabetes with hyperglycemia due to mechanical breakdown of insulin pump, which resulted in underdosing:

Patient has type 1 diabetes with hypoglycemia due to mechanical breakdown of insulin pump, which resulted in overdosing:

Uncontrolled diabetes mellitus (hyperglycemic) due to Cushing's syndrome. Patient has been on insulin for the last year:

A patient is admitted with diabetic gangrene of the left little toe. The toe was completely amputated. The patient has uncontrolled type 1 diabetes (hyperglycemic):

Patient with diabetic CKD, stage 4 and hypertension:

Patient with hyperglycemia due to long-term use of prednisone taken for rheumatoid arthritis:

Adult patient was seen in the clinic for dietary counseling for dysmetabolic syndrome X. Patient is obese with a BMI of 35 and has hypertriglyceridemia and hypertension:

Goiter with complete thyroidectomy (open):

Morbidly obese adult patient (BMI 42) with diabetes mellitus. A laparoscopic gastric banding with extraluminal device was performed: