ICD-10-CM and ICD-10-PCS Chapter 23 Test Yourself: (Latest 2026/2027
Update) Medical Coding | Q&A | Grade A | 100% Correct (Verified
Answers) – Coding Program
Subject: ICD-10-CM and ICD-10-PCS Coding
Source: Chapter 23 Test Yourself – Symptoms, Signs, and Abnormal Clinical/Lab Findings (Chapter 18)
Format: Q&A Guide with Coding Rationale | All Questions Exhausted
Total questions: 24 (every question from raw data)
1: Office Progress Note: "Tim is being seen today due to a complaint of painful urination.
This may be caused by stenosis of the urethra." This case would be reported with code(s)
________ .
Correct Answer: a. R30.9
1. Coding Guideline: When a definitive diagnosis (stenosis of urethra) is qualified as "may be" or
"probable," the symptom is coded because the diagnosis is not confirmed. Outpatient rules for
probable/possible diagnoses are coded as if they exist only for inpatient.
2. R30.9 (Dysuria, unspecified) is the correct code for painful urination. N35.9 (Urethral stricture) is not
coded because the physician stated "may be caused by" indicating uncertainty.
3. Answer d (R30.9, N35.9) would be incorrect because coding uncertain diagnoses as confirmed is not
permitted in outpatient settings.
2: Which of the following would NOT be reported with a code from Chapter 18 of ICD-10-
CM?
Correct Answer: a. renal colic
1. Chapter 18 (Symptoms, Signs, and Abnormal Clinical/Lab Findings) codes are for conditions without a
definitive diagnosis.
2. Renal colic (N23) is classified in Chapter 14 (Diseases of the Genitourinary System) because it is a specific
condition linked to kidney stones, not just a symptom.
3. Epigastric pain (R10.13), aphagia (R13.10), and anosmia (R43.0) are symptoms without definitive cause
and are coded in Chapter 18.
3: Which of the following would be reported with a code from Chapter 18 of ICD-10-CM?
Correct Answer: b. dysuria
1. Dysuria (painful urination, R30.9) is a symptom without an established cause and is classified in Chapter
18.
2. Joint pain (M25.50) is classified in Chapter 13 (Musculoskeletal) but can also be found in Chapter 18 as
arthralgia (M25.5). Note: Specific joint pain codes are in Chapter 13, but dysuria is clearly symptom-based.
3. Increased estrogen (E28.0) is an endocrine disorder; indigestion (K30) is in Chapter 11 (Digestive System)
as a specific functional disorder.
, 4: General physical deterioration is reported with code ________ .
Correct Answer: d. R53.81
1. R53.81 is the correct code for "general physical deterioration" (also known as debility or decline in
physical function).
2. R50.9 is Fever, unspecified; R54 is Age-related physical debility (senility); R52 is Pain, unspecified.
3. Index reference: Deterioration → physical → general R53.81.
5: Febrile seizure is reported with code ________ .
Correct Answer: d. R56.00
1. Febrile seizures are classified as simple febrile convulsions R56.00 (unspecified) or complex R56.01.
2. R55 is Syncope and collapse; R57.8 is Other shock; P90 is Convulsions of newborn.
3. Index: Seizure(s) → febrile → R56.00.
6: When coding the phrase "acute enlarged cervical lymph nodes," the main term to
reference in the index is ________ .
Correct Answer: d. enlarged
1. In ICD-10-CM indexing, the main term is typically the condition or finding. "Enlarged" is the correct main
term because lymphadenopathy (enlarged lymph nodes) is the key finding.
2. Index sequence: Enlarged → lymph nodes → cervical → acute → code R59.0 (Localized enlarged lymph
nodes).
3. Coding tip: For physical findings (abnormal exam findings), use the finding as the main term, not the
anatomical site.
7: The instructional notation that appears for the code for a drug induced fever is ________ .
Correct Answer: d. use additional code for adverse effect, if applicable
1. Code R50.84 (Fever due to drug) has an instructional note: "Use additional code for adverse effect, if
applicable, to identify drug (T36-T50 with fifth or sixth character 5)."
2. This follows ICD-10-CM guideline to code both the manifestation (fever) and the cause (adverse effect
of drug).
3. Index: Fever → due to → drug → R50.84.
8: A pediatric office note records that a child is a late walker. The code to assign for this is
_______.
Correct Answer: R62.0
1. R62.0 is Delayed milestone in childhood (including late walking, late talking).
2. Index: Walker → late → R62.0.
3. Note: This code is used when there is no specific underlying neurological or musculoskeletal diagnosis.
9: Drug testing has revealed cocaine in a blood sample. This would be reported with code
_______.
Correct Answer: R78.2
1. R78.2 is the code for "Finding of cocaine in blood."
2. Chapter 18 includes codes for finding of drugs and other substances not normally found in blood.
3. If this is a poisoning or adverse effect, additional codes from T40.5 would be used with intent
(accidental, intentional, etc.).
Update) Medical Coding | Q&A | Grade A | 100% Correct (Verified
Answers) – Coding Program
Subject: ICD-10-CM and ICD-10-PCS Coding
Source: Chapter 23 Test Yourself – Symptoms, Signs, and Abnormal Clinical/Lab Findings (Chapter 18)
Format: Q&A Guide with Coding Rationale | All Questions Exhausted
Total questions: 24 (every question from raw data)
1: Office Progress Note: "Tim is being seen today due to a complaint of painful urination.
This may be caused by stenosis of the urethra." This case would be reported with code(s)
________ .
Correct Answer: a. R30.9
1. Coding Guideline: When a definitive diagnosis (stenosis of urethra) is qualified as "may be" or
"probable," the symptom is coded because the diagnosis is not confirmed. Outpatient rules for
probable/possible diagnoses are coded as if they exist only for inpatient.
2. R30.9 (Dysuria, unspecified) is the correct code for painful urination. N35.9 (Urethral stricture) is not
coded because the physician stated "may be caused by" indicating uncertainty.
3. Answer d (R30.9, N35.9) would be incorrect because coding uncertain diagnoses as confirmed is not
permitted in outpatient settings.
2: Which of the following would NOT be reported with a code from Chapter 18 of ICD-10-
CM?
Correct Answer: a. renal colic
1. Chapter 18 (Symptoms, Signs, and Abnormal Clinical/Lab Findings) codes are for conditions without a
definitive diagnosis.
2. Renal colic (N23) is classified in Chapter 14 (Diseases of the Genitourinary System) because it is a specific
condition linked to kidney stones, not just a symptom.
3. Epigastric pain (R10.13), aphagia (R13.10), and anosmia (R43.0) are symptoms without definitive cause
and are coded in Chapter 18.
3: Which of the following would be reported with a code from Chapter 18 of ICD-10-CM?
Correct Answer: b. dysuria
1. Dysuria (painful urination, R30.9) is a symptom without an established cause and is classified in Chapter
18.
2. Joint pain (M25.50) is classified in Chapter 13 (Musculoskeletal) but can also be found in Chapter 18 as
arthralgia (M25.5). Note: Specific joint pain codes are in Chapter 13, but dysuria is clearly symptom-based.
3. Increased estrogen (E28.0) is an endocrine disorder; indigestion (K30) is in Chapter 11 (Digestive System)
as a specific functional disorder.
, 4: General physical deterioration is reported with code ________ .
Correct Answer: d. R53.81
1. R53.81 is the correct code for "general physical deterioration" (also known as debility or decline in
physical function).
2. R50.9 is Fever, unspecified; R54 is Age-related physical debility (senility); R52 is Pain, unspecified.
3. Index reference: Deterioration → physical → general R53.81.
5: Febrile seizure is reported with code ________ .
Correct Answer: d. R56.00
1. Febrile seizures are classified as simple febrile convulsions R56.00 (unspecified) or complex R56.01.
2. R55 is Syncope and collapse; R57.8 is Other shock; P90 is Convulsions of newborn.
3. Index: Seizure(s) → febrile → R56.00.
6: When coding the phrase "acute enlarged cervical lymph nodes," the main term to
reference in the index is ________ .
Correct Answer: d. enlarged
1. In ICD-10-CM indexing, the main term is typically the condition or finding. "Enlarged" is the correct main
term because lymphadenopathy (enlarged lymph nodes) is the key finding.
2. Index sequence: Enlarged → lymph nodes → cervical → acute → code R59.0 (Localized enlarged lymph
nodes).
3. Coding tip: For physical findings (abnormal exam findings), use the finding as the main term, not the
anatomical site.
7: The instructional notation that appears for the code for a drug induced fever is ________ .
Correct Answer: d. use additional code for adverse effect, if applicable
1. Code R50.84 (Fever due to drug) has an instructional note: "Use additional code for adverse effect, if
applicable, to identify drug (T36-T50 with fifth or sixth character 5)."
2. This follows ICD-10-CM guideline to code both the manifestation (fever) and the cause (adverse effect
of drug).
3. Index: Fever → due to → drug → R50.84.
8: A pediatric office note records that a child is a late walker. The code to assign for this is
_______.
Correct Answer: R62.0
1. R62.0 is Delayed milestone in childhood (including late walking, late talking).
2. Index: Walker → late → R62.0.
3. Note: This code is used when there is no specific underlying neurological or musculoskeletal diagnosis.
9: Drug testing has revealed cocaine in a blood sample. This would be reported with code
_______.
Correct Answer: R78.2
1. R78.2 is the code for "Finding of cocaine in blood."
2. Chapter 18 includes codes for finding of drugs and other substances not normally found in blood.
3. If this is a poisoning or adverse effect, additional codes from T40.5 would be used with intent
(accidental, intentional, etc.).
