1
A-IPC Exam Study Guide Practice Test 2
Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales |
Pass Guaranteed – A+ Graded
[SECTION 1: ICD-10-CM Diagnosis Coding — Questions 1-25]
Q1: According to the ICD-10-CM Official Guidelines for Coding and Reporting, which of the
following is TRUE regarding the use of "Excludes1" notes?
A. The condition excluded is not part of the code represented.
B. The condition excluded is a different coding choice; the two conditions cannot occur together.
[CORRECT]
C. The condition excluded may occur together, but the coder must determine if the patient has
both.
D. The Excludes1 note is synonymous with the "Code Also" instruction.
Correct Answer: B
Rationale: An "Excludes1" note indicates that the excluded condition is not part of the code
being looked up, and the two conditions cannot occur together in the same patient (e.g.,
congenital vs acquired conditions). Option A describes an "Excludes2" note, and Option D is
incorrect because "Code Also" means both conditions should be coded.
Q2: A patient with Type 2 diabetes mellitus has mild diabetic kidney disease with
macroalbuminuria. The patient also has diabetic cataracts. How are these conditions coded in
ICD-10-CM?
A. One combination code for diabetes with kidney complications; cataracts coded separately.
B. One combination code for diabetes with multiple complications (Z79.4). [CORRECT] - Wait,
let me re-verify specific codes. Correction: One combination code for diabetes with kidney
complications (E11.2) and a separate code for diabetic cataract (E11.36).
C. One combination code for diabetes with kidney complications (E11.2) and a separate code for
diabetic cataract (E11.36). [CORRECT]
D. One code for diabetes (E11.9) and codes for cataracts and kidney disease separately.
,2
Correct Answer: C
Rationale: ICD-10-CM assumes a hierarchical relationship for diabetes complications. You code
the specific manifestation (kidney) using a combination code and then code any other
manifestations (cataract) using additional specific combination codes. Option D is incorrect
because combination codes are required for the manifestations.
Q3: When coding a traumatic fracture, what is the significance of the 7th character "A"?
A. It indicates the fracture is for subsequent encounter.
B. It indicates the fracture is for routine healing.
C. It indicates the fracture is for initial encounter (active treatment). [CORRECT]
D. It indicates the fracture is a sequela (late effect).
Correct Answer: C
Rationale: The 7th character "A" denotes the initial encounter for treatment of the fracture, such
as closed reduction, open reduction, or internal fixation. Option B is character "D" (subsequent),
and Option D is character "S" (sequela).
Q4: A patient is seen for a burn on the forearm. The documentation states the burn is "second
degree, erythema, blisters, and involves 2% of the body surface." Which is the correct approach
to coding burns?
A. Code only the highest degree of burn (second degree).
B. Code the burn site (forearm) and the highest degree (second degree). [CORRECT]
C. Code the erythema and blisters as separate injuries.
D. Code as "unspecified degree" because the percentage is low.
Correct Answer: B
Rationale: When coding burns, you classify the burn by the highest degree (in this case, second
degree) and list the site. You do not code lower-degree burns from the same site/injury incident
(e.g., erythema) separately.
Q5: A physician documents "benign hypertension" in a patient with chronic kidney disease
(CKD) stage 3. According to ICD-10-CM guidelines, which code is sequenced first?
,3
A. The code for CKD Stage 3 (N18.3).
B. The code for Benign Hypertension (I10).
C. The combination code for Hypertensive Chronic Kidney Disease (I12). [CORRECT]
D. The combination code for Hypertensive Heart and Chronic Kidney Disease (I13).
Correct Answer: C
Rationale: When a patient has hypertension and CKD, a combination code (I12) is used to link
the two conditions, assuming a causal relationship is documented. Option A is incorrect because
the combination code takes precedence; Option D includes heart disease which is not indicated.
Q6: In the Alphabetic Index of the ICD-10-CM, what does the notation NEC (Not Elsewhere
Classifiable) indicate?
A. The code is not covered by Medicare.
B. The condition is not specifically named in the classification but is listed as part of a broader
category. [CORRECT]
C. The coder needs to seek more information from the provider.
D. The code is for "Not Elsewhere Classified," meaning it is an unspecified code.
Correct Answer: B
Rationale: "NEC" is used when the specific condition is not listed as a distinct entry, but the
diagnosis falls within a broader category of diseases. Option D refers to NOS (Not Otherwise
Specified), which implies the documentation is not specific enough.
Q7: A patient is admitted for sepsis due to Methicillin-resistant Staphylococcus aureus (MRSA)
pneumonia. How is this coded?
A. Code sepsis (A41.9) and pneumonia (J18.9) separately.
B. Code only the severe sepsis code.
C. Code the combination code for Sepsis with MRSA (A41.02) and the pneumonia code
(J15.212). [CORRECT]
D. Code the urinary tract infection code as the principal diagnosis.
Correct Answer: C
, 4
Rationale: ICD-10-CM provides specific combination codes for sepsis due to MRSA (A41.02).
The pneumonia should be coded separately to capture the site of the infection. Option A is too
non-specific.
Q8: Which of the following scenarios requires the assignment of a Z code as the first-listed
diagnosis?
A. A patient undergoing chemotherapy for cancer.
B. A patient admitted for a planned Cesarean section. [CORRECT]
C. A patient receiving rehabilitation for a stroke.
D. A patient with a history of hypertension.
Correct Answer: B
Rationale: According to guidelines, Z codes (reasons for encounters) are listed first when the
primary reason for admission is a procedure or external cause rather than a disease or injury
(e.g., planned C-section). Option A and C are usually secondary to the condition being treated
(cancer, stroke).
Q9: What does the "Code Also" instructional note in ICD-10-CM signify to the coder?
A. The code listed is the mandatory code; no other codes are permitted.
B. The condition described is inherent to the code listed and should not be coded separately.
C. Two separate codes may be required to fully describe the condition, and both should be
assigned. [CORRECT]
D. The coder should look up the code in the "Alphabetic Index" again.
Correct Answer: C
Rationale: "Code Also" indicates that the condition being looked up is a manifestation or part of
a broader disease process, but an additional code is needed to provide a complete picture of the
patient's condition (e.g., coding HIV disease and "code also" for specific infections).
Q10: A patient presents for a follow-up visit after a total knee replacement. The surgery was
performed 30 days ago. The physician documents "post-procedural seroma." How is this coded?
A. Current complication code (T81.4) with a 7th character for subsequent encounter (D).
A-IPC Exam Study Guide Practice Test 2
Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales |
Pass Guaranteed – A+ Graded
[SECTION 1: ICD-10-CM Diagnosis Coding — Questions 1-25]
Q1: According to the ICD-10-CM Official Guidelines for Coding and Reporting, which of the
following is TRUE regarding the use of "Excludes1" notes?
A. The condition excluded is not part of the code represented.
B. The condition excluded is a different coding choice; the two conditions cannot occur together.
[CORRECT]
C. The condition excluded may occur together, but the coder must determine if the patient has
both.
D. The Excludes1 note is synonymous with the "Code Also" instruction.
Correct Answer: B
Rationale: An "Excludes1" note indicates that the excluded condition is not part of the code
being looked up, and the two conditions cannot occur together in the same patient (e.g.,
congenital vs acquired conditions). Option A describes an "Excludes2" note, and Option D is
incorrect because "Code Also" means both conditions should be coded.
Q2: A patient with Type 2 diabetes mellitus has mild diabetic kidney disease with
macroalbuminuria. The patient also has diabetic cataracts. How are these conditions coded in
ICD-10-CM?
A. One combination code for diabetes with kidney complications; cataracts coded separately.
B. One combination code for diabetes with multiple complications (Z79.4). [CORRECT] - Wait,
let me re-verify specific codes. Correction: One combination code for diabetes with kidney
complications (E11.2) and a separate code for diabetic cataract (E11.36).
C. One combination code for diabetes with kidney complications (E11.2) and a separate code for
diabetic cataract (E11.36). [CORRECT]
D. One code for diabetes (E11.9) and codes for cataracts and kidney disease separately.
,2
Correct Answer: C
Rationale: ICD-10-CM assumes a hierarchical relationship for diabetes complications. You code
the specific manifestation (kidney) using a combination code and then code any other
manifestations (cataract) using additional specific combination codes. Option D is incorrect
because combination codes are required for the manifestations.
Q3: When coding a traumatic fracture, what is the significance of the 7th character "A"?
A. It indicates the fracture is for subsequent encounter.
B. It indicates the fracture is for routine healing.
C. It indicates the fracture is for initial encounter (active treatment). [CORRECT]
D. It indicates the fracture is a sequela (late effect).
Correct Answer: C
Rationale: The 7th character "A" denotes the initial encounter for treatment of the fracture, such
as closed reduction, open reduction, or internal fixation. Option B is character "D" (subsequent),
and Option D is character "S" (sequela).
Q4: A patient is seen for a burn on the forearm. The documentation states the burn is "second
degree, erythema, blisters, and involves 2% of the body surface." Which is the correct approach
to coding burns?
A. Code only the highest degree of burn (second degree).
B. Code the burn site (forearm) and the highest degree (second degree). [CORRECT]
C. Code the erythema and blisters as separate injuries.
D. Code as "unspecified degree" because the percentage is low.
Correct Answer: B
Rationale: When coding burns, you classify the burn by the highest degree (in this case, second
degree) and list the site. You do not code lower-degree burns from the same site/injury incident
(e.g., erythema) separately.
Q5: A physician documents "benign hypertension" in a patient with chronic kidney disease
(CKD) stage 3. According to ICD-10-CM guidelines, which code is sequenced first?
,3
A. The code for CKD Stage 3 (N18.3).
B. The code for Benign Hypertension (I10).
C. The combination code for Hypertensive Chronic Kidney Disease (I12). [CORRECT]
D. The combination code for Hypertensive Heart and Chronic Kidney Disease (I13).
Correct Answer: C
Rationale: When a patient has hypertension and CKD, a combination code (I12) is used to link
the two conditions, assuming a causal relationship is documented. Option A is incorrect because
the combination code takes precedence; Option D includes heart disease which is not indicated.
Q6: In the Alphabetic Index of the ICD-10-CM, what does the notation NEC (Not Elsewhere
Classifiable) indicate?
A. The code is not covered by Medicare.
B. The condition is not specifically named in the classification but is listed as part of a broader
category. [CORRECT]
C. The coder needs to seek more information from the provider.
D. The code is for "Not Elsewhere Classified," meaning it is an unspecified code.
Correct Answer: B
Rationale: "NEC" is used when the specific condition is not listed as a distinct entry, but the
diagnosis falls within a broader category of diseases. Option D refers to NOS (Not Otherwise
Specified), which implies the documentation is not specific enough.
Q7: A patient is admitted for sepsis due to Methicillin-resistant Staphylococcus aureus (MRSA)
pneumonia. How is this coded?
A. Code sepsis (A41.9) and pneumonia (J18.9) separately.
B. Code only the severe sepsis code.
C. Code the combination code for Sepsis with MRSA (A41.02) and the pneumonia code
(J15.212). [CORRECT]
D. Code the urinary tract infection code as the principal diagnosis.
Correct Answer: C
, 4
Rationale: ICD-10-CM provides specific combination codes for sepsis due to MRSA (A41.02).
The pneumonia should be coded separately to capture the site of the infection. Option A is too
non-specific.
Q8: Which of the following scenarios requires the assignment of a Z code as the first-listed
diagnosis?
A. A patient undergoing chemotherapy for cancer.
B. A patient admitted for a planned Cesarean section. [CORRECT]
C. A patient receiving rehabilitation for a stroke.
D. A patient with a history of hypertension.
Correct Answer: B
Rationale: According to guidelines, Z codes (reasons for encounters) are listed first when the
primary reason for admission is a procedure or external cause rather than a disease or injury
(e.g., planned C-section). Option A and C are usually secondary to the condition being treated
(cancer, stroke).
Q9: What does the "Code Also" instructional note in ICD-10-CM signify to the coder?
A. The code listed is the mandatory code; no other codes are permitted.
B. The condition described is inherent to the code listed and should not be coded separately.
C. Two separate codes may be required to fully describe the condition, and both should be
assigned. [CORRECT]
D. The coder should look up the code in the "Alphabetic Index" again.
Correct Answer: C
Rationale: "Code Also" indicates that the condition being looked up is a manifestation or part of
a broader disease process, but an additional code is needed to provide a complete picture of the
patient's condition (e.g., coding HIV disease and "code also" for specific infections).
Q10: A patient presents for a follow-up visit after a total knee replacement. The surgery was
performed 30 days ago. The physician documents "post-procedural seroma." How is this coded?
A. Current complication code (T81.4) with a 7th character for subsequent encounter (D).
