ICD 9 Practice Exercises — Shaken Baby Syndrome

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This is truly hot off the press, my new recommendations for how to attack the CPC board exam. I have discovered just from feedback from students taking the 2012 version that… and they’ve always had it, multiple codes in the answers. But it seems like there are a majority of them are this way versus just a few.

ICD 9 Practice Exercises — Shaken Baby Syndrome

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So the question:

A student preparing for their medical coding certification asks:

“Hi Laureen. I have here a question. I get so confused with the choices. Please tell me how to approach the choices so I get the correct answer.” This must be from a practice test…

“A 9-month old baby boy is diagnosed with Shaken Infant Syndrome with subdural hematoma and retinal hemorrhages. The day care worker told the emergency department physician that she shook the baby to make him stop crying. ( Not a day care I want to take my kids to). Select the appropriate diagnosis codes for this patient.”

So this is typically what you would see on a board exam, multiple answers in each…

But it seems like there are a majority of them are this way versus just a few. I recently took the CPC Eye Exam, that’s the instructor exam put out by the AAPC and passed, thank you. And it was the whole thing. It was like there were no easy questions. That one’s supposed to be harder but I was like, “Whew!” I was tired after that.

So my new recommendation is to bring in highlighters because you can write in your exam booklet all you want. So bring in like multiple colored highlighters. Take the caps off, don’t worry about recapping them because you know, speed isn’t the issue, and look for pattern. So what I did was just pretend you know, the codes that I can use on this in red, I noticed 995.55 is in answer A, B, and C.

And then I quickly looked it up so I said, “Okay, that’s the Shaken Infant Syndrome. I’m pretty sure I’m going to need that.” And I noticed that it said below it, “Use additional codes to identify any associated injuries.” So that makes sense. So then I looked up… I noticed that 362.81 was also in 3 answers, B, C, and D. And this is something that I noticed the way my mind works and being visual that I was picking up on these patterns and I could almost, without reading the scenario, figure out what the correct answer is by seeing if there’s 3 of one code and 3 of another and only like one here or there of other ones. That it’s probably like 80% of the time, going to be the one where there’s 3 showing up like in 3 different answers, okay?

So the 362.81, I looked up, that’s retinal hemorrhage and we did see that up here in blue. And that goes along with ‘use additional codes to identify any associated injuries’. So then, we had these E codes and I looked up all the different ones. And if you notice the pattern, you’ll see, the only E code that we had 3 of was the E967.8. And sure enough, that’s the one we want, Child and Adult Battering and other Maltreatment by Non-related Caregiver. So it’s from the day care. It’s not going to be by another child. It’s not by another relative but it is by a caregiver. Okay, it wasn’t a human bite and it wasn’t assault by other means. Our best choice is .8.

So we could have probably figured out the answer with either the two main ICD codes or by one of them and an E code. But… so the answer is, if you guys want to type in the questions box, what do you think the answer is, A, B, C or D? We should do a poll next time.

Alright so the answer is C because we have the Shaken Baby… Infant Syndrome which we need and we needed a 362.81. Now answers A and B both had that in it, right? But the only one that had the correct E code was C. Alright so that’s how you really should attack it. I did read the question first for purposes of the webinar but what I recommend on the board exam is you look up the answers first and my revised recommendation is look up a few of them first because you can’t look up every single one like this. but once I figured that that 995.55 was definitely needed, I knew D wasn’t correct so I could cross that one off. And then once I looked up 362.81, I realized, yeah I need that as the additional code. So I knew that A wasn’t right. So now, I had narrowed it down to B and C then I used the E codes and the I figured out you know, that C had to be right. Okay so hopefully that will help with that one.

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