2010 Cpc Exam Review: Digestive System Pathophysiology

By Author: Nancy Rose
Total Articles: 53
Comment this article

In this article, we are going to review some of the diseases and conditions that can crop up in questions about the digestive system on the CPC exam.


Tip for test prep: While reading this post, open up the ICD-10 manual you plan to use in the open-book exam and mark it.


Cholecystitis / Colitis


Do not confuse these two medical terminology ‘dopplegangers', words that look so similar that they could trip you up if you do not handle it carefully.


Cholecystitis (575.xx) is inflammation of the gallbladder, which often accompanies cholelithiasis (gall stones, 574.xx). Symptoms cover right upper quadrant pain and tenderness, sometimes accompanied by fever, chills, nausea and vomiting.


Colitis (556.x) is ulcerative inflammation of the mucosa lining the colon; the most common symptom is bloody diarrhea. Other symptoms include abdominal pain or tenderness, fever, and swelling or redness of the colon ...
... tissue. In order to diagnose colitis, the physician may administer x-rays, stool tests, sigmoidoscopy or colonoscopy. Treatments cover antibiotic therapy or, in some cases, surgery.


Pseudomembraneous colitis (008.45) results from infection, usually by a bacterium called Clostridium difficile. People who have been on certain antibiotics, the elderly, and diabetics are particularly prone to this kind of infectious colitis.


Two more dopplegangers: diverticulitis / diverticulosis


Diverticulosis is the simple presence of diverticula and around 80 percent of patients are not aware they have it. Diverticulitis takes place when the diverticula get inflamed and it is more likely to cause symptoms.


Open Book Tip: In your code book, underline the ends of these ‘doppleganger' words when they appear in order to be sure you are paying attention to the difference when you are looking them up.


You need three pieces of information to code colonic polyps correctly


Colonic polyps are growths of tissue that stick out from the bowel wall into the lumen. Some are neoplastic which means abnormal growth has taken place and there's potential for malignancy. Some are non-neoplastic which means that the growth comprises normal tissue with little or no potential for malignancy.


Tips for test takers: While answering a test question that asks you to choose the correct diagnosis code for a polyp


The location of the polyp: For malignant primary neoplastic polyps in the colon documentation must indicate the specific colon site. And for all other behaviors, the code descriptors refer to the colon, large intestine or digestive system.


The behavior of polyp and capacity to spread: Benign (noncancerous) and malignant (cancerous) are two types of behavior. To add to it, a colonic polyp could be classified as uncertain (234.2), which means further investigation is required to determine whether the polyp is malignant. It could also be unspecified (239.0), which means that lab tests are important to determine the polyp's behavior.


Whether the malignancy is primary, secondary or in situ: A primary malignant colonic polyp (153.0-154.8) is one in which the colon is the original site of the cancer. A secondary malignant colonic polyp (197.5) is one in which the cancer has metastasized from a different site to the colon. While an in situ malignant colonic polyp (230.3-230) is one in which the cancer is restricted to the colon.


The world of medical coding is one of the fastest growing in the medical field, but many would-be medical coders do not realize the full spectrum of employment opportunities. So getting updated and knowing more about 2010 cpc exam review