Questions and Answers Updated
2026
TheMphysicianMvisitsMhisMpatientMinMtheMhospitalMandMindicatesMthatMtheMpatientMhas
Mdiabetes.MInsulinMisMprescribedMforMandMadministeredMtoMtheMpatient.MWhatMisMtheM
bestMdecisionMthatMtheMcodingMprofessionalMcanMmakeMinMthisMsituation?
A.AssignMaMcodeMforMtypeM1MdiabetesMmellitusMbecauseMinsulinMwasMadministered.
B.AssignMaMcodeMforMdrug-inducedMdiabetesMmellitus.
C.AssignMaMcodeMforMtypeM2MdiabetesMmellitusMwithMcomplications.
D.AssignMaMcodeMforMtypeM2MdiabetesMmellitusMalongMwithMaMcodeMforMtheMinsulinM
use.M-MAnswerMD.
IfMtheMtypeMofMdiabetesMmellitusMisMnotMdocumentedMinMtheMhealthMrecord,MtheMdef
aultMisMtypeM2MdiabetesMmellitus.MTheMcodingMprofessionalMwouldMalsoMwantMtoMcode
MtheMinsulinMuseMinMadditionMtoMtheMdiabeticMcodeMselectedM(CMSM2023a,MI.C.4.a.2)
TheMpatientMisMseenMinMtheMemergencyMdepartmentM(ED)MwithMacuteMlumbarMpain.MT
heMEDMphysicianMdocumentsMpossibleMkidneyMstonesMandMordersManMx-
ray.MTheMradiologistMdocumentsMbilateralMnephrolithiasis.MTheMcodingMprofessionalMwould
MassignMaMcodeMforMwhichMofMtheMfollowingMconditions?
A.MAcuteMlumbarMpain
B.BilateralMnephrolithiasis
C.PossibleMkidneyMstones
D.AbnormalMx-rayMfindingsM-MAnswerMB.M
AMradiologist'sMfindingsMmayMbeMusedMtoMclarifyManMoutpatient'sMdiagnosisMorMreason
MforMservices.MBasedMonMtheMfactMthatMtheMradiologistMisMaMphysician,MaMcodingMpro
fessionalMcanMuseMaMdiagnosisMfromMtheMx-rayM(CMSM2023a,MIV.K).
AMfemaleMinfantMwasMbornMinMtheMhospitalMatMtermMandMatMaMnormalMbirthMweight.
MItMwasMaMvaginalMdeliveryMwithMaMvertexMpresentation.MInMtheMhoursMafterMbirth,Mj
aundiceMwasMnotedMandMeventuallyMaMdiagnosisMofMerythroblastosisMfetalisMdueMtoMan
MABOMincompatibilityMwasMmade.MHowMwouldMthisMadmissionMbeMcoded?
Z38.00MSingleMlivebornMinfant,MbornMinMhospital,MdeliveredMvaginally
P55.0MRhMisoimmunizationMofMnewborn
, P55.1MABOMisoimmunizationMofMnewborn
P55.8MOtherMhemolyticMdiseasesMofMnewborn
P55.9MHemolyticMdiseaseMofMnewborn,Munspecified
A.Z38.00,MP55.0
B.Z38.00,MP55.1
C.Z38.00,MP55.8
D.Z38.00,MP55.9M-MAnswerMB.M
InfantsMbornMtoMRH-
negativeMmothersMoftenMdevelopMhemolyticMdiseaseMowingMtoMfetal-
maternalMbloodMgroupMincompatibility.MTheseMconditionsMareMclassifiedMtoMCategoryMP55
,MHemolyticMdiseaseMofMnewbornM(OptumM2022,M8;MICD-10-
CMMExpertMforMHospitals,MAlphabeticMIndex,MmainMtermMDisease,MsubtermMhemolytic).
TheMpatientMisMseenMinMhisMophthalmologist'sMofficeMandMtreatedMforMbilateralMopenM
angleMglaucoma,MmoderateMstage.MHowMwouldMthisMencounterMbeMcoded?
H40.10X2MUnspecifiedMopen-angleMglaucoma,MmoderateMstage
H40.1111MPrimaryMopen-angleMglaucoma,MrightMeye,MmildMstage
H40.1112MPrimaryMopen-angleMglaucoma,MrightMeye,MmoderateMstage
H40.9MUnspecifiedMglaucoma
A.H40.10X2
B.H40.1111
C.H40.9
D.H40.1112M-MAnswerMA.
WhenMaMpatientMhasMbilateralMglaucomaMandMbothMeyesMareMdocumentedMasMbeingMt
heMsameMtypeMandMstage,MandMtheMclassificationMdoesMnotMprovideMaMcodeMforMbilat
eralMglaucomaM(namely,MsubcategoriesMH40.10,MandMH40.20)MreportMonlyMoneMcodeMfor
MtheMtypeMofMglaucomaMwithMtheMseventhMcharacterMspecifyingMtheMstageM(CMSM202
3a,MI.C.7.a.2).
InpatientMadmission:MTheMpatientMisMaM78-year-
oldMfemaleMwithMheartMpalpitationsMandMabdominalMpainMwhoMwasMbroughtMtoMtheME
DMbyMherMgrandson.MTheMphysicianMorderedManMEKG,MaMcompleteMbloodMcount,Mand