Medical Coding Quiz On Diseases Of The Circulatory System (I00-i99)

1. Patient has stage 3 chronic kidney disease. They are admitted with acute on chronic diastolic congestive heart failure which is hypertensive in nature:

I10, N18.3, I50.21, I50.22

113.0, I50.33, N18.3

I12.9, N18.3, I50.21, I50.22

I11.9, I50.33, N18.3

Hypertensive Heart and Chronic Kidney Disease
Assign codes from combination category 113, Hypertensive heart and chronic kidney disease, when both hypertensive kidney disease and hypertensive heart disease are stated in the diagnosis. Assume a relationship between the hypertension and the chronic kidney disease, whether or not the condition is so designated. If heart failure is present, assign an additional code from category I50 to identify the type of heart failure.
The appropriate code from category N18. Chronic kidney disease, should be used as a secondary code with a code from category 113 to identify the stage of chronic kidney disease.
See Section I.C. 14. Chronic kidney disease.
The codes in category 113, Hypertensive heart and chronic kidney disease, are combination codes that include hypertension, heart disease and chronic kidney disease. The Includes note at 113 specifies that the conditions included at 111 and 112 are included together in 113. If a patient has hypertension, heart disease and chronic kidney disease then a code from 113 should be used, not individual codes for hypertension, heart disease and chronic kidney disease, or codes from 111 or 112.
For patients with both acute renal failure and chronic kidney disease an additional code for acute renal failure is required.

Explanation

Hypertensive Heart and Chronic Kidney Disease
Assign codes from combination category 113, Hypertensive heart and chronic kidney disease, when both hypertensive kidney disease and hypertensive heart disease are stated in the diagnosis. Assume a relationship between the hypertension and the chronic kidney disease, whether or not the condition is so designated. If heart failure is present, assign an additional code from category I50 to identify the type of heart failure.
The appropriate code from category N18. Chronic kidney disease, should be used as a secondary code with a code from category 113 to identify the stage of chronic kidney disease.
See Section I.C. 14. Chronic kidney disease.
The codes in category 113, Hypertensive heart and chronic kidney disease, are combination codes that include hypertension, heart disease and chronic kidney disease. The Includes note at 113 specifies that the conditions included at 111 and 112 are included together in 113. If a patient has hypertension, heart disease and chronic kidney disease then a code from 113 should be used, not individual codes for hypertension, heart disease and chronic kidney disease, or codes from 111 or 112.
For patients with both acute renal failure and chronic kidney disease an additional code for acute renal failure is required.

2. Atherosclerosis of left leg autologous bypass graft with intermittent claudication:

I70.419

I70.411

170.412

I70.413

not-available-via-ai

Explanation

not-available-via-ai

3. The patient is being treated for bilateral retinopathy due to labile hypertension:

H35.033

H35.103

H35.033, I10

H35.031, H35.032, I10, X58.XXXD

Hypertensive Retinopathy
Subcategory H35.0, Background retinopathy and retinal vascular changes, should be used with a code from category 110 -115, Hypertensive disease to include the systemic hypertension. The sequencing is based on the reason for the encounter.

Explanation

Hypertensive Retinopathy
Subcategory H35.0, Background retinopathy and retinal vascular changes, should be used with a code from category 110 -115, Hypertensive disease to include the systemic hypertension. The sequencing is based on the reason for the encounter.

4. Patient suffered an embolic stroke in the left middle cerebral artery. She presented with hemiplegia affecting right side and aphasia due to stroke:

I63.512, I69.354

163.412, R47.01, G81.91

I69.320, I69.352

I69.320, I69.352, I63.512

Often, a patient is admitted with a stroke with deficits. These deficits are often gone by the time the patient is discharged. Any deficits that a patient exhibits from the stroke, whether present at discharge or not, should be assigned codes.

Explanation

Often, a patient is admitted with a stroke with deficits. These deficits are often gone by the time the patient is discharged. Any deficits that a patient exhibits from the stroke, whether present at discharge or not, should be assigned codes.

5. The patient was admitted with acute renal failure. The patient also has diagnoses of benign hypertension and chronic kidney disease, stage 3:

I10, N17.9, N18.9

I12.9, N18.3, Z99.2

N18.3, N17.9, I13.10

N17.9, 112.9, N18.3

Hypertensive Chronic Kidney Disease
Assign codes from category 112, Hypertensive chronic kidney disease, when both hypertension and a condition classifiable to category N18, Chronic kidney disease (CKO), are present. Unlike hypertension with heart disease, ICD-10-CM presumes a cause-and-effect relationship and classifies chronic kidney disease with hypertension as hypertensive chronic kidney disease.
The appropriate code from category N18 should be used as a secondary code with a code from category 112 to identify the stage of chronic kidney disease.
See Section I.C. 14. Chronic kidney disease.
If a patient has hypertensive chronic kidney disease and acute renal failure, an additional code for the acute renal failure is required.

Explanation

Hypertensive Chronic Kidney Disease
Assign codes from category 112, Hypertensive chronic kidney disease, when both hypertension and a condition classifiable to category N18, Chronic kidney disease (CKO), are present. Unlike hypertension with heart disease, ICD-10-CM presumes a cause-and-effect relationship and classifies chronic kidney disease with hypertension as hypertensive chronic kidney disease.
The appropriate code from category N18 should be used as a secondary code with a code from category 112 to identify the stage of chronic kidney disease.
See Section I.C. 14. Chronic kidney disease.
If a patient has hypertensive chronic kidney disease and acute renal failure, an additional code for the acute renal failure is required.

6. Patient is admitted with an STEMI of the anterolateral wall. During initial recovery in the hospital (within 3 weeks of initial AMI), the patient experiences a subsequent NSTEMI:

121.09, 122.2

I21.4, I22.0

I22.2, I21.09

I22.8, I21.19

Subsequent acute myocardial infarction
A code from category I22, Subsequent ST elevation (STEMI) and non ST elevation (NSTEMI) myocardial infarction, is to be used when a patient who has suffered an AMI has a new AMI within the 4 week time frame of the initial AMI. A code from category I22 must be used in conjunction with a code from category 121. The sequencing of the I22 and 121 codes depends on the circumstances of the encounter.

Explanation

Subsequent acute myocardial infarction
A code from category I22, Subsequent ST elevation (STEMI) and non ST elevation (NSTEMI) myocardial infarction, is to be used when a patient who has suffered an AMI has a new AMI within the 4 week time frame of the initial AMI. A code from category I22 must be used in conjunction with a code from category 121. The sequencing of the I22 and 121 codes depends on the circumstances of the encounter.

7. Patient has hypertension due to Cushing's disease:

E24.9, I15.1

E24.8, I10

I13.0, E24.9

E24.9, I15.2

The correct answer is E24.9, I15.2. This answer indicates that the patient has both Cushing's disease (E24.9) and hypertension (I15.2). Cushing's disease is a condition caused by excessive production of cortisol, which can lead to hypertension. Therefore, it is likely that the patient's hypertension is a result of their Cushing's disease.

Explanation

The correct answer is E24.9, I15.2. This answer indicates that the patient has both Cushing's disease (E24.9) and hypertension (I15.2). Cushing's disease is a condition caused by excessive production of cortisol, which can lead to hypertension. Therefore, it is likely that the patient's hypertension is a result of their Cushing's disease.

8. The patient was admitted with left-sided hemiplegia due to a cerebrovascular accident. The patient has a history of previous CVA with residual facial droop:

I69.354, I69.392, Z86.73

I63.9, G81.94, I69.392

I69.354, Z86.73, I69.992

R29.810, G81.94, I63.9, Z86.73

Codes from category 169 with codes from 160-167
Codes from category 169 may be assigned on a health care record with codes from 160-167, if the patient has a current cerebrovascular disease and deficits from an old cerebrovascular disease.

Codes from category 169 and Personal history of transient ischemic attack (TIA) and cerebral infarction (Z86.73)
Codes from category 169 should not be assigned if the patient does not have neurologic deficits.

Explanation

Codes from category 169 with codes from 160-167
Codes from category 169 may be assigned on a health care record with codes from 160-167, if the patient has a current cerebrovascular disease and deficits from an old cerebrovascular disease.

Codes from category 169 and Personal history of transient ischemic attack (TIA) and cerebral infarction (Z86.73)
Codes from category 169 should not be assigned if the patient does not have neurologic deficits.

9. Hypertension due to periarteritis nodosa:

I10, M30.0

I11.9, N30.0

M30.0.115.8

M30.0, I15.2

Hypertension, Secondary
Secondary hypertension is due to an underlying condition. Two codes are required: one to identify the underlying etiology and one from category 115 to identify the hypertension. Sequencing of codes is determined by the reason for admission/encounter.

Explanation

Hypertension, Secondary
Secondary hypertension is due to an underlying condition. Two codes are required: one to identify the underlying etiology and one from category 115 to identify the hypertension. Sequencing of codes is determined by the reason for admission/encounter.

10. Patient is admitted to the hospital with chest pain. After testing, it is determined that the patient has suffered a NSTEMI. Patient is discharged home. Two weeks later, patient returns to the hospital with severe chest pain. It is now determined that the patient has suffered a STEMI of the inferolateral wall:

I21.19, I22.2

I22.1, I22.8

122.1,121.4

I21.19, I22.8

ICD-10-CM also has codes for subsequent Mis that occur within 28 days of the previous Ml. The code category assigned for these subsequent Mis is 122. Category 122 can never be assigned without a code from 121 for the original. The sequencing of these codes is dependent upon the conditions of the admission to the hospital.

Explanation

ICD-10-CM also has codes for subsequent Mis that occur within 28 days of the previous Ml. The code category assigned for these subsequent Mis is 122. Category 122 can never be assigned without a code from 121 for the original. The sequencing of these codes is dependent upon the conditions of the admission to the hospital.