COMPLETE REAL EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS/ ALREADY GRADED A+
(MOST RECENT!!)
Q1. A patient is diagnosed with essential hypertension and chronic kidney disease
stage 4. What is the correct coding principle?
A) Code hypertension and CKD as separate codes with no sequencing requirement
B) Code hypertension first, then CKD
C) Code CKD first, then hypertension
D) Use a combination code for hypertensive CKD
Answer: D
Rationale: ICD-10-CM has combination codes for hypertensive chronic kidney
disease (I12.-). The CKD stage is added with a fifth digit or additional code.
Q2. An Excludes1 note under a code in the Tabular List indicates:
A) The two conditions can be coded together if the physician documents both
B) The two conditions are mutually exclusive and cannot be coded together
C) The excluded code should be used as a secondary diagnosis
D) The coder must query the physician for clarification
Answer: B
Rationale: Excludes1 means "not coded here" – the condition is not part of the
code's definition and the two codes should never be used together.
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,Q3. A patient has type 2 diabetes with diabetic neuropathy and diabetic
retinopathy. How many codes are required?
A) One combination code for diabetes with multiple manifestations
B) Two codes: one for diabetes, one for neuropathy and retinopathy combined
C) Three codes: diabetes, neuropathy, retinopathy
D) One code for diabetes only; manifestations are implied
Answer: C
Rationale: Diabetes with multiple manifestations requires the diabetes code
(E11.-) plus a separate code for each manifestation (E11.40 for neuropathy,
E11.31 for retinopathy – note different fourth digits).
Q4. The seventh character "S" in ICD-10-CM stands for:
A) Subsequent encounter
B) Sequela (late effect)
C) Surgical site infection
D) Screening
Answer: B
Rationale: "S" is used for sequela (late effects of a condition, e.g., scar after a
burn). "D" is subsequent encounter, "A" initial.
Q5. What is the correct use of placeholder character "X" in ICD-10-CM?
A) To indicate a bilateral condition
B) To fill a position in a code that requires a certain number of characters when no
specific value applies
C) To mark a code that is exempt from POA reporting
D) To replace a missing diagnosis when documentation is incomplete
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,Answer: B
Rationale: Example: T36.0X1A – the X fills the fifth character position because the
poisoning code structure requires it, but no specific value is needed.
Q6. A patient is seen for follow-up after a hip replacement surgery performed 3
months ago. The patient has no current complications. What type of Z code
should be used?
A) Z96.6 (presence of orthopedic joint implant)
B) Z47.1 (aftercare following joint replacement surgery)
C) Z09 (follow-up examination after treatment)
D) Z76.1 (healthy person accompanying sick person)
Answer: B
Rationale: Z47.1 is specifically for aftercare following joint replacement surgery.
Z96.6 is for the presence of the implant without aftercare. Z09 is for follow-up
after treatment of a condition that is no longer present, but aftercare is more
specific here.
Q7. A patient with sepsis due to E. coli develops septic shock. What is the correct
sequencing?
A) Septic shock first, then sepsis, then E. coli
B) Sepsis first, then septic shock, then E. coli
C) E. coli first, then sepsis, then septic shock
D) Only code sepsis and septic shock as a combination code
Answer: B
Rationale: Guidelines state: For septic shock, code the underlying systemic
infection (sepsis) first, then septic shock (R65.21). The organism (E. coli) is
additional.
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, Q8. What does the abbreviation "NEC" indicate in the Alphabetic Index?
A) No diagnosis code exists for the condition
B) A more specific code exists but the documentation does not provide enough
detail
C) The condition is not included in the chapter
D) The coder should use an unspecified code
Answer: B
Rationale: NEC (Not Elsewhere Classified) means a specific code is available
elsewhere, but the documentation lacks detail to assign it. It is different from NOS
(unspecified).
Q9. A patient is admitted with acute appendicitis with generalized peritonitis.
What is the correct code?
A) K35.80 (unspecified appendicitis)
B) K35.2 (acute appendicitis with generalized peritonitis)
C) K35.89 (other acute appendicitis)
D) K65.9 (peritonitis, unspecified) plus K35.8
Answer: B
Rationale: K35.2 is the specific combination code for acute appendicitis with
generalized peritonitis.
Q10. A patient has chronic obstructive pulmonary disease (COPD) with acute
exacerbation. What is the correct coding?
A) J44.0 (COPD with acute lower respiratory infection)
B) J44.1 (COPD with acute exacerbation)
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