ICD 10 CM PCS Coding Theory and

Practice 2016 Edition 1st Edition

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Chapter 10: Neoplasms
Lovaasen: ICD-10-CM/PCS Coding: Theory and Practice, 2016 Edition

MULTIPLE CHOICE

1. All of the following are considered by the National Cancer Institute to be the most common
sites for cancer in the United States EXCEPT ____.
a. breast
b. lung
c. brain
d. skin
ANS: C DIF: E OBJ: 2 TOP: Anatomy and Physiology

2. ____ carcinoma is primary neoplasm of the liver.

a. Squamous cell
b. Bronchogenic
c. Hepatocellular
d. Invasive ductal
ANS: C DIF: D OBJ: 3 TOP: Disease Conditions

3. ____ is the placement of radioactive material directly in or near the site of the cancer.
a. Chemotherapy
b. Radiation
c. Brachytherapy
d. Palliative procedure
ANS: C DIF: M OBJ: 4 TOP: Procedures

4. ____ is the use of high-energy radiation to treat cancer.

a. Chemotherapy
b. Radiation
c. Brachytherapy
d. Palliative procedure
ANS: B DIF: M OBJ: 4 TOP: Procedures

5. All of the following are factors influencing which kind of biopsy will be performed for a
patient EXCEPT the ____.
a. weight of the patient
b. location of the mass
c. age of the patient
d. available technology
ANS: A DIF: D OBJ: 4 TOP: Procedures

6. An example of a carcinoma malignancy is a malignant ____.

a. tumor in the bone marrow
b. stomach tumor
c. tumor in the muscle
 d. tumor of the breast
ANS: B DIF: M OBJ: 2 TOP: Anatomy and Physiology

7. 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
ANS: C DIF: M OBJ: 2 TOP: Anatomy and Physiology

8. Cells that are slightly abnormal and well differentiated are classified as grade ____ cells.
a. 1
b. 2
c. 3
d. 4
ANS: A DIF: M OBJ: 2 TOP: Anatomy and Physiology

9. What drug could be given to treat neutropenia due to chemotherapy?

a. Neulasta
b. Procrit
c. Aranesp
d. Tamoxifen
ANS: A DIF: M OBJ: 5 TOP: Medications

10. What drug could be given to treat anemia due to malignancy?

a. Nolvadex
b. Neupogen
c. Neulasta
d. Epogen
ANS: D DIF: M OBJ: 5 TOP: Medications

11. A patient is admitted with severe anemia due to inoperable pancreatic cancer. Four units of
PRC are given (via peripheral vein). What codes are applicable?
a. D63.0, C25.9, 30253N0
b. C25.9, D63.0, 30233N1
c. C25.9, D64.81, 30243N1
d. C25.0, D63.0 30233N1
ANS: B DIF: M OBJ: 1 | 4 TOP: Coding

12. A patient is admitted and taken to surgery for an open wedge resection of metastatic
carcinoma to the liver. The patient was diagnosed with small-cell lung carcinoma 3 months
ago. What codes are applicable?
a. C78.7, C34.90, 0FB04ZX
b. C34.90, C78.7, 0FB00ZZ
c. C78.7, C34.90, 0FB00ZZ
d. C34.90, C78.7, 0FB04ZX
 ANS: C DIF: M OBJ: 1 | 4 TOP: Coding

13. A patient is admitted for chemotherapy (via central vein) for non-Hodgkin lymphoma of the
spleen. The patient developed severe nausea and vomiting and was treated for dehydration
with IV fluids. What codes are applicable?
a. Z51.11, C85.97, 3E04305
b. Z51.11, C85.97, E86.0, R11.2, 3E04305
c. Z51.11, E86.0, R11.2, 3E04305
d. C85.97, R11.2, 3E04305
ANS: B DIF: M OBJ: 1 | 4 TOP: Coding

14. The patient is a 30-year-old woman who has multiple intramural fibroids. She has become
more symptomatic with menorrhagia, resulting in anemia because of chronic blood loss. The
patient would like to maintain fertility, so an open myomectomy is performed.
Final Diagnosis: Intramural uterine fibroids.
Procedure: Myomectomy.
a. D25.1, N92.0, D50.0, 0UB90ZZ
b. D50.0, N92.0, D25.9, 0UB93ZX
c. D25.0, N92.0, D50.0, 0UB90ZZ
d. D25.1, 0UB90ZZ
ANS: A DIF: M OBJ: 1 | 4 TOP: Coding

15. The patient was admitted for chemotherapy for stage IIIA 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 IIIA (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
ANS: B DIF: M OBJ: 1 | 4 TOP: Coding

16. The patient has a history of chronic hepatitis C. On routine ultrasonography, a suspicious
mass of the liver was discovered. Biopsy confirmed primary hepatocellular carcinoma, and
the patient was admitted for open partial hepatectomy.
Final Diagnoses: Chronic hepatitis C. Hepatocellular carcinoma.
Procedure: Partial hepatectomy for resection of HCC.
a. C22.0, B18.2, 0FB00ZZ
b. C22.9, B18.2, 0FB00ZX
c. C22.0, B18.9, 0FB00ZZ
d. B18.2, C22.9, 0FB00ZX
ANS: A DIF: M OBJ: 1 | 4 TOP: Coding

17. Patient was admitted for back pain due to vertebral metastasis. An MRI indicates that the
disease has progressed. Patient has a history of prostate cancer. Beam radiation with heavy
particles was administered.
a. G89.28, C79.51, Z85.46, DPOC3ZZ
 b. C61, G89.28, C79.51, DP0C4ZZ
c. G89.3, C79.51, Z85.46, DP0C3ZZ
d. C79.51, G89.3, Z85.46, DP0C4ZZ
ANS: D DIF: M OBJ: 1 | 4 TOP: Coding

18. Patient was admitted for prophylactic removal of ovaries due to genetic susceptibility and
positive family history of ovarian cancer with laparoscopic removal of both ovaries.
a. Z40.02, Z80.41, Z15.02, 0UT04ZZ, 0UT14ZZ
b. Z15.02, Z80.41, Z40.02, 0UT20ZZ
c. Z40.09, Z80.41, Z15.02, 0UT24ZZ
d. Z40.02, Z80.41, Z15.02, 0UT24ZZ
ANS: D DIF: M OBJ: 1 | 4 TOP: Coding

19. 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
ANS: C DIF: D OBJ: 1 TOP: Coding

20. Ovarian (left) malignancy with malignant ascites. Diagnostic paracentesis was performed.
a. R18.0, Z85.43, 0W9G30Z
b. R18.0, C56.2, 0W9G3ZX
c. C56.1, R18.8, 0W9G3ZZ
d. C56.2, R18.0, 0W9G3ZX
ANS: D DIF: M OBJ: 1 | 4 TOP: Coding

21. Patient has known adenocarcinoma of the right lower lobe of the lung. Thoracentesis was
done to evaluate the patient’s pleural effusion. Discharge summary documents malignant
pleural effusion.
a. C34.32, J90, 0W9B3ZX
b. J91.0, C34.32, 0W9B30Z
c. C34.31, J91.0, 0W993ZX
d. C34.31, J90, 0W9930Z
ANS: C DIF: M OBJ: 1 | 4 TOP: Coding

22. Patient was admitted with an intestinal obstruction due to peritoneal metastasis from
inoperable rectosigmoid cancer.
a. C78.6, C19
b. K56.69, C19, C78.6
c. C78.6, K56.60
d. C19, C78.6
ANS: A DIF: M OBJ: 1
TOP: Coding (see Excludes1 note under code K56.60 and K56.69)

23. Removal of right tonsil due to squamous cell carcinoma.

a. D37.05, 0CBP0ZX
 b. C09.8, 0CBP3ZX
c. C09.9, 0CTPXZZ
d. D10.4, 0CTP0ZZ
ANS: C DIF: M OBJ: 1 | 4 TOP: Coding

24. Pancytopenia due to myelodysplastic syndrome.

a. D46.9
b. D61.818, D46.9
c. D46.9, D61.818
d. D46.Z
ANS: A DIF: M OBJ: 1 TOP: Coding

25. Patient was seen in the clinic for Burkitt’s lymphoma. Patient is HIV positive.
a. B20, C83.79
b. C83.70, Z21
c. B20, C83.70
d. C83.79, B20
ANS: C DIF: M OBJ: 1 TOP: Coding

26. Patient is being treated for chemotherapy-induced anemia. Patient is receiving chemotherapy
for right renal cell carcinoma.
a. C64.9, D63.0, T45.1X1A
b. D64.89, T45.1X1A, C64.2
c. C64.1, D64.81, T45.1X5A
d. D64.81, T45.1X5A, C64.1
ANS: D DIF: D OBJ: 1 TOP: Coding

27. Patient has a malignancy in the right upper outer quadrant of the breast. There is another
primary malignancy in the right lower outer quadrant. She will be scheduled for a mastectomy
soon.
a. C50.421, C50.422
b. C50.411, C50.511
c. C50.811
d. C50.821, C79.81
ANS: B DIF: D OBJ: 1 TOP: Coding

28. Patient is currently undergoing treatment for primary left non–small-cell lung cancer which
has been metastasized to the right lung.
a. C34.92, C34.91
b. C34.92
c. C34.91
d. C34.92, C78.01
ANS: D DIF: D OBJ: 1 TOP: Coding

TRUE/FALSE
 1. When admission is for the management of dehydration due to malignancy or therapy and only
dehydration is being treated, the dehydration is coded first, followed by the code(s) from the
malignancy.

ANS: T DIF: M OBJ: 1 | 6

TOP: ICD-10-CM Official Guidelines for Coding and Reporting

2. When admission is for treatment of a complication resulting from a surgical procedure, the
complication should be the principal diagnosis if the treatment is directed at resolving the
complication.

ANS: T DIF: M OBJ: 1 | 6

TOP: ICD-10-CM Official Guidelines for Coding and Reporting

3. Neoplasms can affect ONLY certain specific body systems.

ANS: F DIF: M OBJ: 2 | 3 TOP: Anatomy and Physiology

4. Smoking is associated with 100% of all oral cancers.

ANS: F DIF: M OBJ: 3 TOP: Disease Conditions

5. Carcinomas in situ are malignant cells that remain within the original site with no spread to or
invasion of neighboring tissues.

ANS: T DIF: M OBJ: 2 TOP: Anatomy and Physiology

6. In ICD-10-CM, there is an Instructional note to code the malignancy first even when the
encounter is for the management of anemia due to the malignancy.

ANS: T DIF: M OBJ: 1 TOP: Coding

COMPLETION

1. A(n) ____________________ is an abnormal tissue that grows by cellular proliferation more

rapidly than normal and continues to grow after the stimuli that initiated the new growth
cease.

ANS: neoplasm

DIF: M OBJ: 2 TOP: Anatomy and Physiology

2. Cancer of the white blood cells that begins in the blood-forming cells of the bone marrow is
called ____________________.

ANS: leukemia

DIF: M OBJ: 3 TOP: Disease Conditions

3. The administration of cancer-killing drugs is called ____________________.

 ANS: chemotherapy

DIF: M OBJ: 4 TOP: Procedures

4. Cancer of the lymphatic system is called ____________________.

ANS: lymphoma

DIF: M OBJ: 3 TOP: Disease Conditions

5. Preventive or ____________________ surgery is performed to remove tissue that has the

potential to become cancerous.

ANS: prophylactic

DIF: M OBJ: 4 TOP: Procedures

6. CDC stands for ____________________.

ANS: Centers for Disease Control and Prevention

DIF: M OBJ: 1 TOP: Abbreviations

7. When cancers are staged, stage ____________________ means that the cancer has spread into
surrounding tissues but not beyond the location of origin.

ANS: II

DIF: M OBJ: 2 TOP: Anatomy and Physiology

MATCHING

Match the following terms to the correct definition.

a. Well differentiated
b. Sarcomas
c. Fibromas
d. Metastasis
e. Leukemias
f. Melanomas
g. Carcinomas
h. Undifferentiated
i. Myeloma
j. Grading
k. Primary site
l. Staging
m. Adenocarcinoma

1. Neoplasms of fibrous connective tissue

2. Abnormal growth of melanin cells
3. Malignant growth originating from epithelial tissue
 4. Malignant tumors of glandular tissue
5. Malignant growth of connective tissue
6. Malignancies arising from white blood cells
7. Malignancy that originates in the bone marrow
8. The location in which the neoplasm begins
9. The spread of cancer from one body part to another, as in appearance of neoplasms in parts of
the body separate from the primary tumor
10. Pathologic examination of tumor cells
11. Tumor cells that closely resemble mature, specialized cells
12. Tumor cells that are highly abnormal
13. A means of categorizing a particular cancer that helps determine a patient’s treatment plan and
the need for further therapy

1. ANS: C DIF: M OBJ: 2 TOP: Anatomy and Physiology

2. ANS: F DIF: M OBJ: 2 TOP: Anatomy and Physiology
3. ANS: G DIF: M OBJ: 2 TOP: Anatomy and Physiology
4. ANS: M DIF: M OBJ: 2 TOP: Anatomy and Physiology
5. ANS: B DIF: M OBJ: 2 TOP: Anatomy and Physiology
6. ANS: E DIF: M OBJ: 2 TOP: Anatomy and Physiology
7. ANS: I DIF: M OBJ: 2 TOP: Anatomy and Physiology
8. ANS: K DIF: M OBJ: 2 TOP: Anatomy and Physiology
9. ANS: D DIF: M OBJ: 2 TOP: Anatomy and Physiology
10. ANS: J DIF: M OBJ: 2 TOP: Anatomy and Physiology
11. ANS: A DIF: M OBJ: 2 TOP: Anatomy and Physiology
12. ANS: H DIF: M OBJ: 2 TOP: Anatomy and Physiology
13. ANS: L DIF: M OBJ: 2 TOP: Anatomy and Physiology

SHORT ANSWER

1. What does it mean when a tumor is benign?

ANS:
Benign means the tumor is not malignant, and it will not spread to other parts of the body.

DIF: M OBJ: 3 TOP: Disease Conditions

2. What is the abbreviation for non–small-cell lung cancer?

ANS:
NSCLC

DIF: E OBJ: 3 TOP: Abbreviations

3. What is the abbreviation for small-cell lung cancer?

ANS:
SCLC

DIF: E OBJ: 1 TOP: Abbreviations

 4. Adrenocortical carcinoma, left gland: __________

ANS:
C74.02

DIF: M OBJ: 1 TOP: Coding

5. Primary cancer of the cauda equina: __________

ANS:
C72.1

DIF: M OBJ: 1 TOP: Coding

6. Pancytopenia due to myelodysplastic syndrome: __________

ANS:
D46.9

DIF: M OBJ: 1 TOP: Coding

7. Metastasis to Zuckerkandl’s organ: __________

ANS:
C80.1, C79.89

DIF: M OBJ: 1 TOP: Coding

8. Benign neoplasm of Cowper’s gland: __________

ANS:
D30.4

DIF: M OBJ: 1 TOP: Coding

9. Metastatic carcinoma of the omentum. History of ovarian carcinoma that was treated with
bilateral oophorectomy 5 years ago: __________

ANS:
C78.6, Z85.43, Z90.722

DIF: M OBJ: 1 | 4 TOP: Coding

10. Lymphangioendothelioma: __________

ANS:
D18.1 (unspecified)

DIF: M OBJ: 1 TOP: Coding

11. Benign neoplasm of the thymus: __________

 ANS:
D15.0

DIF: M OBJ: 1 TOP: Coding

12. Glossopalatine fold carcinoma: __________

ANS:
C09.1

DIF: M OBJ: 1 TOP: Coding

13. A patient is admitted with hematuria. The patient is a long-time cigarette smoker. A
diagnostic cystoscope is performed with excision of a bladder dome lesion. The pathology
report reveals transitional cell bladder carcinoma. A metastatic workup is performed with high
suspicion for bone lesion. Smoking cessation advised for nicotine dependence. Discharge
Diagnosis: Bladder cancer with metastasis to the bone. __________

ANS:
C67.1, C79.51, F17.210, 0TBB8ZX

DIF: M OBJ: 1 | 4 TOP: Coding

14. A patient is admitted with headache due to malignant glioblastoma multiforme. A workup is
performed to evaluate the progression of the frontal lobe tumor. __________

ANS:
C71.1

DIF: D OBJ: 1 TOP: Coding