Healthcare Data Management Exam Review
Course Introduction
Healthcare Data Management explores the principles and practices essential for effectively managing data within healthcare organizations. The course covers topics such as data collection, storage, retrieval, and analysis, as well as the use of electronic health records (EHRs), data quality assurance, data security, and patient privacy regulations. Students will gain insights into the role of data management in supporting clinical decision-making, improving patient outcomes, and ensuring regulatory compliance. The course also examines emerging trends in healthcare informatics, the integration of big data and analytics, and the challenges associated with interoperability and data governance in complex healthcare ecosystems.
Recommended Textbook
ICD 10 CM PCS Coding Theory and Practice 2018 Edition 1st Edition by Karla R. Lovaasen
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26 Chapters
1616 Verified Questions
1616 Flashcards
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Chapter 1: The Rationale for and History of Coding
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47 Verified Questions
47 Flashcards
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Sample Questions
Q1) Official coding advice is published in the publication ____.
A)Coding Edge
B)AHA Coding Clinic
C)Journal of the American Health Information Management Association
D)In Record Time
Answer: B
Q2) All of the following are members of the cooperating parties EXCEPT ____.
A)NCHS
B)AHA
C)AAPC
D)AHIMA
Answer: C
Q3) Personal health information can be shared with ____.
A)those who have a need to know
B)people requesting information on the phone
C)your neighbors
D)all of the above
Answer: A
Q4) Without the __________ system, the comparison of data would be impossible.
Answer: classification
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Chapter
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42 Verified Questions
42 Flashcards
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Sample Questions
Q1) The AHIMA practice brief says that a physician query should____.
A)"lead" the physician
B)contain precise language
C)be written on scratch paper
D)sound presumptive
Answer: B
Q2) UHDDS
A)Centers for Medicare and Medicaid Services
B)Temperature, pulse, and respiration
C)Uniform Hospital Discharge Data Set
D)Gastroesophageal reflux disease
Answer: C
Q3) How long after admission is it required by TJC that the admission history and physical be completed?
Answer: Within 24 hours
Q4) One of the most important aspects of developing an effective query form is the manner in which the form is worded.
A)True
B)False
Answer: True
Page 4
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Chapter 3: ICD-10-Cm Format and Conventions
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39 Verified Questions
39 Flashcards
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Sample Questions
Q1) __________, a form of punctuation, are used in the index to identify manifestation codes in the Alphabetic Index.
Answer: Brackets
Q2) The bolded subterm in the diagnostic statement aspiration pneumonia is a(n) ____ modifier.
A)essential
B)nonessential
Answer: A
Q3) What does NEC stand for?
Answer: Not elsewhere classifiable
Q4) The bolded subterm in the diagnostic statement poorly controlled diabetes is a(n) ____ modifier.
A)essential
B)nonessential
Answer: A
Q5) The bolded subterm in the diagnostic statement purulent pneumonia is a(n) ____ modifier.
A)essential
B)nonessential
Answer: B
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Chapter 4: Basic Steps of Coding
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) In the discharge summary, a physician lists the __________ that were evaluated and treated and any procedures that were performed.
Q2) When evaluating an ER record, a coder should look for the ____.
A)diagnosis
B)chief complaint
C)probable diagnosis
D)differential diagnosis
Q3) Have no effect on the main term
A)Tabular List
B)See also
C)Subterms
D)Discharge summary
E)Coding Clinic
F)ER
G)Differential diagnosis
H)Chief complaint
I)The first basic step in coding the principal diagnosis
J)Nonessential modifiers
Q4) What is the main term in "rheumatoid arthritis"?
Q5) What is the subterm in "infantile eczema"?
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Chapter 5: General Coding Guidelines for Diagnosis
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) Conditions that are routinely associated with a disease or condition should not be coded as additional diagnoses unless instructed by the classification or unless they affect the patient's condition or treatment given.
A)True
B)False
Q2) What is/are the diagnosis code(s) for acute and chronic bronchitis?
Q3) List one reason when it is NOT acceptable to code a symptom code from Chapter 18.
Q4) Principal diagnosis is defined in the Uniform Hospital Discharge Data Set (UHDDS) as that condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care.
A)True
B)False
Q5) A(n) __________ code is a single code used to classify two diagnoses, a diagnosis with an associated secondary process, or a diagnosis with an associated complication.
Q6) What is/are the diagnosis code(s) for posttraumatic osteoarthritis due to previous left femoral neck fracture (hip)?
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Page 7
Chapter 6: Introduction to Icd-10-PCS
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127 Verified Questions
127 Flashcards
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Sample Questions
Q1) When a patient is having a hip replacement, a code for the resection of a joint is assigned in addition to the joint replacement code.
A)True
B)False
Q2) How many characters are in an ICD-10-PCS code?
Q3) The resection of tonsils is coded to an external approach.
A)True
B)False
Q4) Cutting into a body part without draining fluids and/or gases from the body part in order to separate or transect a body part is called ____.
A)reattachment
B)release
C)transfer
D)division
Q5) The root operation "insertion" always involves a device.
A)True
B)False
Q6) The omentum is in what body system?
Q7) Total lobectomy of right upper lobe lung, open approach
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Chapter 7: General Coding Guidelines for Other Medicaland
Surgical-Related Procedures and Ancillary Procedures
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109 Verified Questions
109 Flashcards
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Sample Questions
Q1) Mechanical respiratory ventilation longer than 96 hours
Q2) Hypnosis is a procedure that can be coded in the mental health section.
A)True
B)False
Q3) The first character value for a mental health procedure is G.
A)True
B)False
Q4) In the Administration section the fourth character, body system/region, identifies the site where the substance is administered.
A)True
B)False
Q5) In the Administration section, character "2" is used to identify the substance being introduced.
A)True
B)False
Q6) The first character value for a physical rehabilitation or diagnostic audiology procedure is B.
A)True
B)False
Q7) Mechanical respiratory ventilation less than 24 hours Page 9
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Page 10
Chapter 8: Coding Medical and Surgical Procedures
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66 Verified Questions
66 Flashcards
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Sample Questions
Q1) Moving all or a portion of a body part to its normal location or other suitable location is called ____.
Q2) Percutaneous aspiration of left perirenal abscess
Q3) Open endarterectomy of right internal carotid artery
Q4) ESWL-right ureter
Q5) In some instances, a surgical wound is not closed at the time of a surgical operation and is allowed to heal and will be closed at a later date. This is an example of when a ____ would be coded.
A)closure
B)bilateral procedure
C)biopsy
D)limited coverage
Q6) If a patient's procedure is canceled before he or she shows up at the hospital, what is the correct Z code to assign?
A)Z53.09 Surgical or other procedure not carried out because of contraindication
B)Z53.20 Surgical or other procedure not carried out because of patient's decision
C)Z53.9 Procedure not carried out for other reasons
D)None of the above
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Chapter 9: Symptoms, Signs, and Abnormal Clinical and
Laboratory Findings Not Elsewhere Classified, and Z Codes
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60 Verified Questions
60 Flashcards
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Sample Questions
Q1) The infant was seen in the ER for fever. Physician documented fever due to vaccination.
A)R50.81
B)R50.82
C)R50.83
D)R50.2
Q2) Done in the absence of any signs or symptoms
A)A primary circumstance for using Z codes
B)Symptom
C)Screening exam
D)Is a main term in the Alphabetic Index
E)Sign
Q3) Observation codes are to be used if an injury or illness or any signs or symptoms related to the suspected condition is present.
A)True
B)False
Q4) Patient is admitted with an acute cerebrovascular accident. The NIHSS score on admission is 35: _____________________________
Q5) Camp physical: __________
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Chapter 10: Certain Infectious and Parasitic Diseases
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64 Verified Questions
64 Flashcards
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Sample Questions
Q1) According to ICD-10-CM Guidelines, it is not necessary to identify infections documented as antibiotic resistant.
A)True
B)False
Q2) Assign the code for infectious diarrhea.
Q3) Assign the code for screening for HIV.
Q4) Category B20 is assigned for ____________________.
Q5) Assign the code(s) for intertrigo under both breasts due to candidiasis.
Q6) Trench mouth is coded to ____.
A)A69.0
B)A69.1
C)A27.9
D)A36.3
Q7) Assign the code for asymptomatic HIV.
Q8) Category A00-A09 contains codes for ____________________.
Q9) Z21 is a code used for patients with HIV who have no symptoms and who have never had an AIDS-defining or AIDS-related illness.
A)True
B)False
Q10) Assign the code for Ebola virus. Page 13
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Page 14
Chapter 11: Neoplasms
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70 Verified Questions
70 Flashcards
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Sample Questions
Q1) Neutropenic fever with neutropenia due to chemotherapy for acute lymphocytic leukemia.
A)C91.00, T45.1x5A, C91.00
B)T45.1x5A, D70.1, R50.81, C91.00
C)D70.1, T45.1x5A, R50.81, C91.00
D)R50.81, T45.1x5A, D70.1, C91.00
Q2) The patient was admitted for chemotherapy for stage 3A breast (left) cancer. The patient tolerated the chemotherapy regimen with no complications and will return as arranged for cycle 3.Final Diagnosis: Breast cancer, stage 3A (spread to axillary lymph nodes) Procedure: Chemotherapy via central vein
A)C50.912, Z51.11, C77.89, 3E04305
B)Z51.11, C50.912, C77.3, 3E04305
C)Z51.12, C50.912, C77.3, 3E03305
D)Z51.11, Z85.3, C77.89, 3E03305
Q3) An example of a sarcoma malignancy is a malignant ____.
A)tumor in the bone marrow
B)stomach tumor
C)tumor in the muscle
D)tumor of the breast
Q4) The administration of cancer-killing drugs is called ____________________.
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Chapter 12: Diseases of the Blood and Blood-Forming
Organs and Certain Disorders Involving the Immune
Mechanism
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72 Verified Questions
72 Flashcards
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Sample Questions
Q1) A patient is being admitted for a total splenectomy (open approach) for treatment of idiopathic thrombocytopenic purpura.
A)D69.0, 07BP0ZZ
B)D69.3, 07TP4ZZ
C)D69.2, 07TP4ZZ
D)D69.3, 07TP0ZZ
Q2) Anemia due to gastric cancer: __________
Q3) Plasmacytosis: __________
Q4) Anemia due to chronic kidney disease can be used as the principal diagnosis code in ICD-10-CM if the reason for the encounter is to treat the anemia.
A)True B)False
Q5) Scorbutic anemia: __________
Q6) Platelets are also called thrombocytes.
A)True B)False
Q7) ____________________ give blood its red color. Page 16
Q8) ____________________ is an inherited clotting disorder.
Q9) Coagulopathy due to chronic liver disease: __________
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Page 17
Chapter 13: Endocrine, Nutritional, and Metabolic Diseases
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68 Verified Questions
68 Flashcards
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Sample Questions
Q1) A patient is an elderly gentleman who was admitted from the ER with pain and swelling of his right knee. The pain is throbbing in nature, and the knee feels warm and is very tender to touch. The patient has a knee X-ray, and uric acid levels are elevated. Colchicine is started, and the patient's symptoms are much improved within 48 hours. The patient has diabetes. The patient is advised to limit alcohol consumption and to avoid dietary purines.Final Diagnosis: Gouty arthropathy right knee, idiopathic Diabetes mellitus, type 2 on insulin
A)M10.361, E11.8, Z79.4
B)M10.061, E11.8, Z79.4
C)M10.061, E11.9, Z79.4
D)M10.062, E11.9, Z79.4
Q2) DKA in patient with type 1 diabetes: __________
Q3) All of the following are possible signs of malnutrition EXCEPT ____.
A)loss of energy
B)diarrhea
C)rapid hair growth
D)skin lesion
E)none of the above are correct
Q4) Diabetes mellitus with hypoglycemic coma: __________
Q5) The correct abbreviation for diabetes mellitus is ____________________.
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Chapter 14: Mental, Behavioral, and Neurodevelopmental Disorders
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72 Verified Questions
72 Flashcards
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Sample Questions
Q1) Patient was admitted to the psychiatric floor for evaluation of mood disorder. After extensive testing and evaluation, it was determined that patient has major depression that is severe in nature and that some psychotic features are present.Final Diagnosis: Major depressive disorder, severe with psychosis
A)F34.1
B)F33.3
C)F32.3
D)F32.4
Q2) Adjustment disorder with depressed mood due to unemployment.
A)Z56.0, F43.21
B)F43.21, Z56.0
C)F43.20
D)F43.23, Z56.0
Q3) Homicidal ideation: __________
Q4) What drug could be given to treat ADD or ADHD?
A)Dilantin
B)Librium
C)Paxil
D)Ritalin
Q5) Name one occurrence during birth that can cause intellectual disability.
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Chapter 15: Diseases of the Nervous System, Diseases of
the Eye and Adnexa, and Diseases of the Ear and Mastoid Process
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55 Verified Questions
55 Flashcards
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Sample Questions
Q1) Amaurosis: __________
Q2) A patient with trigeminal neuralgia and a history of migraine headaches is admitted for an open rhizotomy. A day after the procedure, the patient develops a severe headache diagnosed as a migraine.
A)G50.0, G43.901, 008M3ZZ
B)G50.0, G43.909, 008K0ZZ
C)G50.0, G43.901, 008K0ZZ
D)G50.0, G43.909, 008K4ZZ
Q3) A(n) ____________________ is a device that is used to treat intractable epilepsy.
Q4) The central nervous system is made up of the ____________________ and ____________________.
Q5) Hydrocephalus can be acquired or congenital.
A)True
B)False
Page 20
Q6) Pseudohole of the macula of the right eye: __________
Q7) What are the two main divisions of the nervous system?
Q8) Bilateral retrolental fibroplasia: __________
Q9) How is hydrocephalus treated most commonly?
Q10) Meningitis due to Klebsiella: __________
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Chapter 16: Diseases of the Circulatory System
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65 Verified Questions
65 Flashcards
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Sample Questions
Q1) Patient presents with left carotid artery thrombosis with infarct and current right hemiparesis. Patient has residual aphasia from a previous stroke.
A)I69.854, I63.032, I69.320
B)I63.032, I69.032, I69.320
C)I63.032, G81.91, I69.320
D)I69.320, G81.90, I69.854
Q2) Postprocedural status unspecified cardiac device
A)Z82.3
B)Z94.1
C)Z95.811
D)Z95.9
E)Z76.82
Q3) Patient was admitted for treatment of gangrenous cellulitis of the left lower leg.
A)L03.116, I96
B)I96
C)L03.115, I96
D)I96, L03.116
Q4) What is the function of the heart?
Q5) Benign renovascular hypertension: __________
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Chapter 17: Diseases of the Respiratory System
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73 Verified Questions
73 Flashcards
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Sample Questions
Q1) A patient is admitted from a nursing home with cough and fever. The patient has a history of dysphagia and hemiparesis of right dominant side due to previous stroke. Sputum cultures reveal Pseudomonas. Patient went into acute respiratory failure after admission.Discharge Diagnosis: Pseudomonas pneumonia
A)J96.01, J15.0, I69.391, I69.359
B)J96.00, J15.1, I69.391, R13.10, I69.351
C)J15.1, J96.00, I69.391, R13.10, I69.351
D)J15.1, J96.01, I69.391, I69.359
Q2) Patient is a 67-year-old female who presented to the ER with shortness of breath. She was in her usual state of health until 1 week ago, when she began to have chills, fever, and a cough. Patient was admitted and started on IV antibiotics for pneumonia. Her COPD exacerbation was treated with albuterol treatments and oxygen by nasal cannula. Sputum cultures grew Klebsiella pneumoniae.Final Diagnoses: Pneumonia due to Klebsiella Chronic obstructive pulmonary disease with acute decompensation
A)J44.0, J15.0
B)J15.1, J44.9
C)J44.0, J15.0, J44.1
D)B96.1, J15.0, J44.1
Q3) Cork handlers' disease: __________
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Page 23
Chapter 18: Diseases of the Digestive System
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60 Verified Questions
60 Flashcards
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Sample Questions
Q1) ____ means vomiting of blood.
A)Hematuria
B)Hematochezia
C)Hematemesis
D)None of the above
Q2) Patient is admitted with hematochezia. A colonoscopy is performed and diverticulitis was found to be the source of the bleeding.
A)K92.1, K57.33, 0DJD8ZZ
B)K57.33, 0DJD8ZZ
C)K57.32, K92.1, 0DJD7ZZ
D)K92.1, K57.32, 0DJD7ZZ
Q3) A(n) ____ is a protrusion of an organ or tissue through an abnormal opening of the body.
A)ulcer
B)diverticulum
C)hernia
D)gallstone
Q4) Assign the code for choledochoduodenal fistula: __________
Q5) Name one purpose of the small intestine.
Q6) What is an ulcer (such as of the stomach or intestine)?
Page 24
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Chapter 19: Diseases of the Skin and Subcutaneous System
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57 Verified Questions
57 Flashcards
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Sample Questions
Q1) What usually causes hives?
Q2) When dermatitis is caused by contact with a substance, it is called ____ dermatitis.
A)exogenous
B)endogenous
C)mesogenous
D)outer contact
Q3) Nail horn, left thumb: __________
Q4) A skin condition also known as urticaria wherein the skin reacts with welts characterized by itching
A)Decubitus ulcer
B)Skin ulcers
C)Cellulitis
D)Stasis ulcer
E)Stasis dermatitis
F)Intertriginous dermatitis
G)Gangrene
H)Hives
I)Dermatitis
Q5) The outer layer of skin is called the ____________________.
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Chapter 20: Diseases of the Musculoskeletal System and Connective Tissue
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63 Verified Questions
63 Flashcards
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Sample Questions
Q1) Myelopathy is compression of the ____________________.
Q2) What does the abbreviation AKA stand for?
Q3) Toward the head
A)Medial
B)Cranial
C)Ventral
D)Superior
E)Caudal
F)Dorsal
G)Lateral
Q4) Subacute osteomyelitis of sacrum with decubitus sacral ulcer, stage 3. Staphylococcus aureus is the causative organism.
A)M46.28, L89.153, B95.61
B)M46.28, L89.153, B95.62
C)B95.61, M46.28, L89.153
D)M46.27, L89.152, B95.62
Q5) Alendronate, calcitonin, and calcium with vitamin D are common medications used to treat osteoporosis.
A)True
B)False
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Chapter 21: Diseases of the Genitourinary System
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72 Flashcards
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Sample Questions
Q1) Hydronephrosis is the abnormal ____________________ of the renal pelvis caused by pressure from urine that cannot flow past an obstruction in the urinary tract.
Q2) ____ is a lower urinary tract infection that affects the bladder.
A)Urethritis
B)Pyelonephritis
C)Cystitis
D)None of the above
Q3) Leukoplakia of vulva: __________
Q4) Stress incontinence is the involuntary loss of small amounts of ____________________ due to increased pressure from coughing, sneezing, or laughing.
Q5) Patient is seen for CKD stage 4. The patient's kidney transplant has failed, and he may have to receive dialysis in the near future.
A)T86.12, N18.4, Y83.0
B)N18.4, T86.12, Y83.0
C)N18.4, Z94.0
D)N18.6, T86.12
Q6) GN stands for ____________________.
Q7) Tight hymenal ring: __________
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Chapter 22: Pregnancy, Childbirth, and the Puerperium
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Sample Questions
Q1) A 40-week primigravida patient comes to the hospital in labor. Labor progresses, and she delivers a normal 7.6-lb infant. An episiotomy is performed and repaired. The patient had a UTI during the fourth month of pregnancy that was treated with antibiotics. She developed hyperemesis gravidarum early in the pregnancy. She is discharged on day 2 with no complaints. What codes are applicable? __________
Q2) Early separation of placenta third trimester (38 weeks'gestation); delivered a single liveborn via vaginal delivery: __________
Q3) The process of milk production is ______________________.
Q4) What does postpartum mean?
Q5) A patient is admitted at 37 weeks'gestation in labor, and she delivers a 7-lb baby boy. After vaginal delivery, she hemorrhages. The physician documents that the hemorrhage is due to a retained placenta accreta.
A)O43.213, Z38.00, O72, Z3A.37, 10E0XZZ
B)O80, O72.0, Z37.0, Z3A.37, 10E0XZZ
C)Z38.00, O72.0, Z3A.37, 10E0XZZ
D)O72.0, O43.213, Z37.0, Z3A.37, 10E0XZZ
Q6) A pregnancy in which the egg is implanted outside the cavity of the uterus is an __________ pregnancy.
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Chapter 23: Certain Conditions Originating in the Perinatal
Period and Congenital Malformations, Deformations, and
Chromosomal Abnormalities
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47 Verified Questions
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Sample Questions
Q1) Cleft lip occurs in approximately 1 in every 2000 babies.
A)True
B)False
Q2) Newborn is delivered vaginally. The baby was premature at 34 3/7 weeks'gestation and weighed 1842 g Meconium staining was noted at delivery.
A)Z38.00, P96.83, P07.16, P07.32
B)P07.17, P24.00, A38.00, P07.32
C)Z38.00, P07.17, P07.37, P96.83
D)Z37.0, P03.82, P07.17, P07.32
Q3) An infant is born via vaginal delivery with intrauterine growth retardation. The baby is premature, being born at 33 2/7 weeks' gestation and weighing 1800 g Meconium aspiration is noted at delivery. Jaundice due to prematurity, which was treated with phototherapy (ultraviolet), single session.
A)Z38.00, P05.9, P24.01, P59.0, 6A800ZZ
B)Z38.00, P07.17, P07.36, P24.00, P59.0, 6A800ZZ
C)Z37.0, P05.9, P07.35, P24.00, P59.0, 6A600ZZ
D)Z37.0, P07.36, P24.00, P59.0, 6A600ZZ
Q4) Imperforate hymen: __________
Q5) Congenital pigeon chest: __________ Page 29
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Page 30
Chapter 24: Injuries and Certain Other Consequences of
External Cases and External Causes of Morbidity
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70 Verified Questions
70 Flashcards
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Sample Questions
Q1) Personal history of TBI
A)Z94.6
B)Z89.211
C)Z89.432
D)Z87.820
E)Z91.81
Q2) External cause codes identify ____.
A)the activity at the time of the event
B)the cause of an injury
C)the intent or place of occurrence
D)all of the above
Q3) When air or gas bubbles get into the bloodstream, it is called a(n)
Q4) Upper limb amputation status-below elbow
A)Z94.6
B)Z89.211
C)Z89.432
D)Z87.820
E)Z91.81
Q5) Open-fracture
Chapter 25: Burns, Adverse Effects, and Poisonings
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Sample Questions
Q1) A side effect or reaction to a drug that has been taken properly is called a(n)
Q2) A patient combined prescription Percodan with beer and became stuporous and drowsy.
A)T40.2x1A, T51.0x1A, R40.1, R40.0
B)T40.2x1D, T51.0x1D, R40.1, R40.0
C)T40.2x1S, T51.0x1S, R40.1, R40.0
D)T40.2x1A, T51.0x1A
Q3) History of physical abuse, adult
A)Z69.020
B)Z88.8
C)Z91.030
D)Z88.7
E)Z91.010
F)Z91.89
G)Z91.011
H)Z91.410
Q4) Hives due to penicillin taken for strep throat. Patient took the medication as prescribed: __________
Q5) The abbreviation OR stands for ____________________.
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Chapter 26: Complications of Surgical and Medical Care
Available Study Resources on Quizplus for this Chatper
48 Verified Questions
48 Flashcards
Source URL: https://quizplus.com/quiz/42599
Sample Questions
Q1) Patient with acute osteomyelitis right femur due to infected right knee joint replacement, initial encounter: __________
Q2) There is a time limit for complications to occur.
A)True B)False
Q3) Codes for complications may be located in the chapter for specified body sites. A)True B)False
Q4) Code only complications that occur within 2 weeks of a transplant surgery. A)True B)False
Q5) A patient had a partial pancreatectomy for chronic pancreatitis and has now developed postpancreatectomy diabetes mellitus along with diabetic nephrosis.
A)E09.69, E89.1, E13.21
B)E08.21, E89.1, Z90.410, Y83.6
C)E89.1, E13.21, Z90.411, Y83.6
D)E89.1, E08.21, E13.21
Q6) What does DVT stand for?
Q7) Patient has left subclavian vein thrombosis due to PICC: __________
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