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Test: Tell ticked Ans is Right/wrong. If wrong, then tell the right one with explanation. And give result in % 1. A patient with known HIV disease is admitted with MRSA sepsis, severe sepsis with acute kidney failure, and septic shock. Which is the correct code sequence? A. B20, A41.02, R65.21, N17.9✅ B. A41.02, B20, R65.21, N17.9 C. B20, A41.02, R65.20, N17.9 D. A41.9, B20, R65.21, N17.9 2. A patient with AIDS develops E. coli sepsis secondary to UTI with severe sepsis and acute respiratory failure. Which coding is correct? A. B20, A41.51, N39.0, R65.20, J96.00✅ B. B20, A41.51, N39.0, R65.21, J96.00 C. A41.51, B20, N39.0, J96.00 D. N39.0, A41.51, B20, R65.20 3. A patient with HIV disease is admitted with pneumococcal sepsis, septic shock, DIC, and acute liver failure. A. B20, A40.3, R65.21, D65, K72.00✅ B. A40.3, B20, R65.21, D65, K72.00 C. B20, A40.3, R65.20, D65, K72.00 D. B20, A41.9, R65.21, D65 4. A patient without HIV has Klebsiella sepsis due to pneumonia with severe sepsis and ARDS. A. A41.59, J15.0, R65.20, J80✅ B. J15.0, A41.59, R65.20, J80 C. A41.9, J15.0, J80 D. A41.59, R65.21, J80 5. HIV patient with infected pressure ulcer due to Pseudomonas causing sepsis, severe sepsis, acute renal failure, and septic shock. A. B20, A41.52, R65.21, N17.9✅ B. A41.52, B20, R65.21, N17.9 C. B20, A41.9, R65.21 D. L89.-, B20, A41.52 6. MSSA bacteremia causes sepsis, severe sepsis with encephalopathy, and septic shock. A. A41.01, R65.21, G93.41✅ B. R65.21, A41.01, G93.41 C. A41.9, G93.41 D. A41.01, R65.20, G93.41 7. AIDS patient develops disseminated tuberculosis and streptococcal sepsis with severe sepsis and acute respiratory failure. A. B20, A40.0, A19.9, R65.20, J96.00✅ B. A40.0, B20, R65.20, J96.00 C. B20, A19.9, J96.00 D. A40.9, B20, R65.21 8. HIV disease with candidal esophagitis and Enterococcus sepsis causing severe sepsis with AKI. A. B20, A41.81, B37.81, R65.20, N17.9✅ B. A41.81, B20, R65.20 C. B20, A41.9, B37.81 D. B37.81, A41.81, B20 9. Septic shock due to Proteus mirabilis UTI with acute respiratory failure and AKI. A. A41.59, N39.0, R65.21, J96.00, N17.9✅ B. N39.0, A41.59, R65.21 C. A41.9, R65.20, N17.9 D. A41.59, J96.00 only 10. HIV disease with Salmonella sepsis, severe sepsis, metabolic encephalopathy, and thrombocytopenia. A. B20, A02.1, R65.20, G93.41, D69.6✅ B. A02.1, B20, R65.20 C. B20, A02.1 only D. B20, A41.9, R65.20 11. A patient with HIV disease is admitted with MRSA pneumonia, MRSA sepsis, severe sepsis, septic shock, and acute liver failure. A. B20, A41.02, J15.212, R65.21, K72.00✅ B. A41.02, B20, J15.212, R65.21, K72.00 C. B20, J15.212, A41.02, K72.00 D. B20, A41.9, R65.20, K72.00 12. A patient develops postoperative E. coli sepsis after colon surgery with severe sepsis and acute kidney injury. A. T81.44XA, A41.51, R65.20, N17.9✅ B. A41.51, T81.44XA, R65.20, N17.9 C. T81.44XA, R65.20, N17.9 D. A41.9, N17.9 13. A patient with AIDS develops cryptococcal meningitis and Staphylococcus aureus sepsis resulting in septic shock. A. B20, A41.01, B45.1, R65.21✅ B. A41.01, B20, B45.1, R65.21 C. B20, B45.1, A41.01 D. A41.9, R65.21 14. A diabetic patient with HIV disease develops gangrene of the foot with Pseudomonas sepsis, severe sepsis, and acute respiratory failure. A. B20, A41.52, R65.20, J96.00✅ B. A41.52, B20, R65.20, J96.00 C. B20, E11.52, A41.52 only D. B20, A41.9, J96.00 15. A newborn develops Group B Streptococcal sepsis with septic shock. A. P36.0, R65.21✅ B. A40.1, R65.21 C. P36.0 only D. A41.9 16. A patient with HIV disease develops Clostridioides difficile colitis complicated by Enterococcus sepsis, severe sepsis, and acute kidney failure. A. B20, A41.81, A04.72, R65.20, N17.9✅ B. A41.81, B20, A04.72, R65.20 C. B20, A04.72 only D. B20, A41.9 17. A patient with AIDS develops Haemophilus influenzae pneumonia leading to sepsis, severe sepsis, septic shock, and DIC. A. B20, A41.3, J14, R65.21, D65✅ B. A41.3, B20, J14, R65.21, D65 C. B20, J14 only D. A41.9, R65.21 18. A patient develops a catheter-related MRSA bloodstream infection causing sepsis, severe sepsis with acute respiratory failure, and septic shock. A. T80.211A, A41.02, R65.21, J96.00✅ B. A41.02, T80.211A, R65.21, J96.00 C. T80.211A, J96.00 only D. A41.9, R65.20 19. A patient with HIV disease develops CMV disease and E. coli sepsis with severe sepsis and acute hepatic failure. A. B20, A41.51, B25.9, R65.20, K72.00✅ B. A41.51, B20, B25.9, R65.20 C. B20, B25.9 only D. A41.9, K72.00 20. A diabetic patient develops an infected foot ulcer due to MSSA causing sepsis, septic shock, and acute kidney injury. A. A41.01, R65.21, N17.9, E11.621 B. E11.621, A41.01, R65.21, N17.9✅ C. A41.01 only D. R65.21 only 21. A patient with AIDS develops disseminated histoplasmosis and Klebsiella sepsis causing severe sepsis with acute respiratory failure. A. B20, A41.59, B39.9, R65.20, J96.00✅ B. A41.59, B20, R65.20, J96.00 C. B20, B39.9 only D. A41.9 22. A patient develops E. coli pyelonephritis with sepsis, severe sepsis, septic shock, and acute kidney failure. A. A41.51, N10, R65.21, N17.9✅ B. N10, A41.51, R65.21, N17.9 C. A41.51 only D. A41.9 23. A patient with HIV disease develops Enterococcal endocarditis with sepsis, severe sepsis, acute heart failure, and AKI. A. B20, A41.81, I33.0, R65.20, I50.9, N17.9✅ B. A41.81, B20, I33.0, R65.20 C. B20, I33.0 only D. A41.9 24. A patient with AIDS develops cerebral toxoplasmosis and MRSA sepsis with severe sepsis, septic shock, and acute respiratory failure. A. B20, A41.02, B58.2, R65.21, J96.00✅ B. A41.02, B20, B58.2, R65.21 C. B20, B58.2 only D. A41.9 25. A patient with HIV disease is admitted with meningococcal sepsis, severe sepsis, septic shock, DIC, and acute kidney injury. A. B20, A39.2, R65.21, D65, N17.9✅ B. A39.2, B20, R65.21, D65, N17.9 C. B20, A39.2 only D. A41.9 26. A patient with HIV disease develops Pseudomonas sepsis secondary to infected burns with severe sepsis and acute respiratory failure. A. B20, A41.52, R65.20, J96.00✅ B. A41.52, B20, R65.20, J96.00 C. B20, T30.0 only D. A41.9 27. A patient develops Enterobacter sepsis due to cholangitis with septic shock and acute liver failure. A. A41.59, K83.09, R65.21, K72.00✅ B. K83.09, A41.59, R65.21 C. A41.59 only D. R65.21 only 28. A patient with AIDS develops disseminated MAC infection and Streptococcus sepsis with severe sepsis and acute kidney injury. A. B20, A40.9, A31.0, R65.20, N17.9✅ B. A40.9, B20, R65.20, N17.9 C. B20, A31.0 only D. A41.9 29. A patient develops Serratia marcescens sepsis following a central venous catheter infection with severe sepsis and encephalopathy. A. T80.211A, A41.53, R65.20, G93.41✅ B. A41.53, T80.211A, R65.20 C. A41.9 only D. G93.41 only 30. A patient with HIV disease develops polymicrobial sepsis due to MRSA and E. coli, severe sepsis with septic shock, acute respiratory failure, and acute kidney injury. A. B20, A41.02, A41.51, R65.21, J96.00, N17.9✅ B. A41.02, A41.51, B20, R65.21, J96.00, N17.9 C. B20, A41.9, R65.21, J96.00 D. B20, A41.02 only

Here's my evaluation of all 30 questions on ICD-10-CM coding for sepsis:

Results Summary

#TickedVerdictNotes
1A✅ CORRECT
2A✅ CORRECT
3A✅ CORRECT
4A✅ CORRECT
5A✅ CORRECT
6A✅ CORRECT
7A⚠️ PARTIALLY CORRECT - see below
8A✅ CORRECT
9A✅ CORRECT
10A✅ CORRECT
11A✅ CORRECT
12A✅ CORRECT
13A✅ CORRECT
14A⚠️ INCOMPLETE - see below
15A✅ CORRECT
16A✅ CORRECT
17A✅ CORRECT
18A✅ CORRECT
19A✅ CORRECT
20B✅ CORRECT
21A✅ CORRECT
22A✅ CORRECT
23A✅ CORRECT
24A✅ CORRECT
25A✅ CORRECT
26A✅ CORRECT
27A✅ CORRECT
28A⚠️ DEBATABLE - see below
29A✅ CORRECT
30A✅ CORRECT

Questions Needing Discussion

Q7 - ⚠️ Answer A is MOSTLY correct but sequence is debatable

Ticked: A. B20, A40.0, A19.9, R65.20, J96.00
This is essentially correct, but note:
  • A40.0 = Sepsis due to Streptococcus Group A. If the question means Streptococcus pyogenes (Group A), A40.0 is right. If it is a different strep species, the code may differ.
  • R65.20 = Severe sepsis without septic shock - correct, since only severe sepsis and acute respiratory failure are mentioned (no septic shock stated here).
  • A19.9 = Miliary tuberculosis, unspecified - correct for disseminated TB.
  • The sequence B20 first is correct per ICD-10-CM guidelines: when HIV disease is the reason for admission and other conditions are manifestations/complications, B20 is sequenced first.
Answer A is correct for the information given.

Q14 - ⚠️ Answer A is INCOMPLETE

Ticked: A. B20, A41.52, R65.20, J96.00
This sequence is correct as far as it goes, but it is missing important codes:
  • The diabetic gangrene of the foot should be coded: E11.52 (Type 2 diabetes with diabetic peripheral angiopathy with gangrene) - assuming Type 2 diabetes.
  • The pressure/infected ulcer/gangrene site code (e.g., L97.509 or similar) may also apply.
  • The HIV (B20) is first - correct.
  • A41.52 (Pseudomonas sepsis) - correct.
  • R65.20 (severe sepsis without septic shock) - correct since only severe sepsis is stated.
  • J96.00 (acute respiratory failure) - correct.
Among the given options, A is the best answer, but it omits the diabetic complication code. In a real coding scenario, E11.52 would be added. Option C (B20, E11.52, A41.52 only) is also incomplete. A is the best available choice.

Q28 - ⚠️ Code A40.9 is questionable

Ticked: A. B20, A40.9, A31.0, R65.20, N17.9
  • A40.9 = Streptococcal sepsis, unspecified. This is correct if no specific streptococcal species is identified.
  • A31.0 = Pulmonary mycobacterial infection - but disseminated MAC (Mycobacterium avium complex) is more precisely coded as A31.2 (Disseminated mycobacterium avium-intracellulare complex [DMAC]).
The more accurate code for disseminated MAC is A31.2, not A31.0. A31.0 is pulmonary, A31.2 is disseminated (DMAC). However, none of the answer options use A31.2, so A is the best available answer among the choices given, but strictly speaking A31.2 would be more precise for disseminated MAC in an AIDS patient.

Core ICD-10-CM Coding Rules Applied (for reference)

RulePrinciple
HIV firstB20 is always sequenced first when HIV/AIDS is present and is relevant to the admission
Sepsis sequencingThe organism-specific sepsis code (A40.x/A41.x) follows B20 in HIV patients
Severe sepsisR65.20 = severe sepsis without shock; R65.21 = with septic shock
Septic shockR65.21 subsumes shock - do NOT add separate R57.2
Organ dysfunctionCodes for acute organ failure (N17.9, J96.00, K72.00, etc.) follow R65.2x
Postop/device sepsisT-code (T81.44xA or T80.211A) sequences BEFORE the organism code
Newborn sepsisUses P36.x, not adult A40/A41 codes
Cause of UTI sepsisUTI (N39.0) or pyelonephritis (N10) coded after sepsis code

Final Score

28 out of 30 fully correct (with Q14 and Q28 being "best available answer" rather than ideal real-world coding)

🎯 Score: 93–100%

  • If scoring strictly on "best answer among options": 30/30 = 100%
  • If scoring on "complete real-world accuracy": 28/30 = 93%
Excellent performance - the main areas to reinforce are:
  1. Disseminated MAC = A31.2 (not A31.0)
  2. Always include diabetic complication codes (E11.52) when diabetes contributes to the condition
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