Medical Coding Quiz On Nervous System, Diseases Of The Eye & Ear and Mastoid Process (G00-h95)

Neoplasm Related Pain
Code G89.3 is assigned to pain documented as being related, associated or due to cancer, primary or secondary malignancy, or tumor. This code is assigned regardless of whether the pain is acute or chronic.
This code may be assigned as the principal or first-listed code when the stated reason for the admission/encounter is documented as pain control/pain management. The underlying neoplasm should be reported as an additional diagnosis.

Codes in category G89, Pain, not elsewhere classified, may be used in conjunction with codes from other categories and chapters to provide more detail about acute or chronic pain and neoplasm-related pain, unless otherwise indicated below.
If the pain is not specified as acute or chronic, post-thoracotomy, postprocedural, or neoplasm- related, do not assign codes from category G89.
A code from category G89 should not be assigned if the underlying (definitive) diagnosis is known, unless the reason for the encounter is pain control/ management and not management of the underlying condition.
When an admission or encounter is for a procedure aimed at treating the underlying condition (e g., spinal fusion, kyphoplasty), a code for the underlying condition (e.g„ vertebral fracture, spinal stenosis) should be assigned as the principal diagnosis. No code from category G89 should be assigned.

Category G89 Codes as Principal or First-Listed Diagnosis
Category G89 codes are acceptable as principal diagnosis or the first-listed code:
• When pain control or pain management is the reason for the admission/encounter (e.g„ a patient with displaced intervertebral disc, nerve impingement and severe back pain presents for injection of steroid into the spinal canal). The underlying cause of the pain should be reported as an additional diagnosis, if known.

The correct answer is H40.63X2, T38.0X5A. This answer is correct because H40.63X2 represents bilateral moderate stage glaucoma, which is the condition the patient has. T38.0X5A represents the use of steroids, which is the cause of the glaucoma.

The correct answer is H65.111 because it specifically represents acute serous otitis media in the right ear. The code H65.112 represents acute serous otitis media in the left ear, H65.113 represents acute serous otitis media in bilateral ears, and H65.119 represents acute serous otitis media, unspecified ear. Since the question mentions that the patient has the condition in the right ear, H65.111 is the appropriate code.

Postoperative pain not associated with specific postoperative complication
Postoperative pain not associated with a specific postoperative complication is assigned to the appropriate postoperative pain code in category G89.
(b) Postoperative pain associated with specific postoperative complication
Postoperative pain associated with a specific postoperative complication (such as painful wire sutures) is assigned to the appropriate code(s) found in Chapter 19, Injury, poisoning, and certain other consequences of external causes. If appropriate, use additional code(s) from category G89 to identify acute or chronic pain (G89.18 or G89.28).

The correct answer is G91.0, 00160J6. G91.0 is the correct code for communicating hydrocephalus, which is the condition the patient is being treated for. 00160J6 is the correct code for the insertion of a ventriculoperitoneal shunt via an open approach, which is the procedure being performed.

Use of Category G89 Codes in Conjunction with Site Specific Pain Codes (i) Assigning Category G89 and Site-Specific Pain Codes
Codes from category G89 may be used in conjunction with codes that identify the site of pain (including codes from chapter 18) if the category G89 code provides additional information. For example, if the code describes the site of the pain, but does not fully describe whether the pain is acute or chronic, then both codes should be assigned

The correct answer is H25.89. This code represents a mature senile cataract, which is a common type of cataract that occurs due to aging. The term "mature" indicates that the cataract has reached an advanced stage of development. The code H25.9 is not specific enough as it represents an unspecified senile cataract. H25.10 represents an immature senile cataract, and H26.8 represents other specified cataracts. Therefore, H25.89 is the most appropriate code for a mature senile cataract.

When the reason for the admission/encounter is management of the neoplasm and the pain associated with the neoplasm is also documented, code G89.3 may be assigned as an additional diagnosis. It is not necessary to assign an additional code for the site of the pain.
See Section I.C.2 for instructions on the sequencing of neoplasms for all other stated reasons for the admission/encounter (except for pain control/pain management).