AAPC CPC CODING GUIDELINES QUESTIONS
WITH CORRECT ANSWERS 2026
Finding main dx term--try reading dx right to leſt - CORRECT ANSWER -
EX: COPD (chronic obstructive pulmonary disease) can be found under "disease" as well as "obstru
ction"
Ex2: URI (upper respiratory infection) can be found under "infection"
Always code to the highest degree of specificity. - CORRECT ANSWER -
Ex: aged related Osteoporosis with current fracture of leſt shoulder, follow up visit;
M80.012D:
M80 (osteoporosis with current fracture) +
M80.0 (age related) +
M80.012 (age related w/current fracture of leſt shoulder +
M80.012D (subsequent visit)
Outpatient visits--SUSPECTED Dx NEVER coded.
If a definitive Dx has not been reported then code:
1--Signs
2--Sx
3--Abnormal Test results - CORRECT ANSWER -Terms of suspected Dx:
Probable
Suspected
Questionable
Rule Out
Differential
Working
Inpatient Visits--SUSPECTED Dx MAY BE CODED, with exception to HIV.
HIV Dx must be confirmed before coding. - CORRECT ANSWER -
, Sx that are an INTEGRAL part of a disease do NOT need to be coded. - CORRECT ANSWER -
Ex: Pt presents w/severe AB pain, nausea, vomiting. Diagnosed w/acute appendicitis. Code only ac
ute appendicitis K35.80.
Sx that are NOT INTEGRAL part to a disease DO NEED TO BE CODED. - CORRECT ANSWER -
Ex: Patient presents with runny nose & cough as well as Rt shoulder pain. Physician diagoses URI.
Code URI as well as Sx of Rt Shoulder pain.
URI--J06.9
Rt Shldr Pn--M25.511
MULTIPLEz CODINGz FORz Az SINGLEz CONDITION--
Somez Diseasesz requirez multiplez Dxz codesz andz willz indicatez ETIOLOGYz &z MANIFESTATION.z Itz willz app
earz inz thez alphabeticz indexz asz onez codez followedz byz anotherz codez inz brackets.z -
CORRECTz ANSWERz -Ex:z Amyloidz Heartz Diseasez E85.4z [I43]
BOTHz etiologyz ANDz manifestationz codesz arez requiredz toz recordz thisz condition.
ACUTEz &z CHRONICz CONDITIONSz DOCUMENTEDz ATz THEz SAMEz TIME--
whenz bothz arez documented,z codez acutez firstz thenz chronicz -z CORRECTz ANSWERz -
EX:z Acutez andz chronicz cystitis
N30.00z Acutez cystitisz w/oz hematuria
N30.20z Otherz Chronicz cystitisz w/oz hematuria
CHRONICz CONDITIONS--
canz bez codedz asz manyz timez asz applicablez toz treatment,z butz aſterz resolutionz willz appearz asz z
-
codesz ifz historyz ofz conditionz affectsz CURRENTz reasonz forz care.z -z CORRECTz ANSWERz -
EX:z colonz cancer
(lookz underz "history,z personalz of"--notz "cancer")
Ptz w/z personalz hxz ofz colonz cancerz presentsz forz colonoscopy.z Z85.038
Sequelae--
latez orz residualz effectsz aſterz anz acutez illness/injury.z TWOz codesz arez oſtenz required.z Residualz conditi
onz 1st,z thenz causez forz sequelaez 2nd.z Ifz noz residualz effectsz arez documented,z usez causez forz sequela
ez asz prinicpalz Dx.z -z CORRECTz ANSWERz -Lookz upz "sequelae"z inz alphabeticz index.
WITH CORRECT ANSWERS 2026
Finding main dx term--try reading dx right to leſt - CORRECT ANSWER -
EX: COPD (chronic obstructive pulmonary disease) can be found under "disease" as well as "obstru
ction"
Ex2: URI (upper respiratory infection) can be found under "infection"
Always code to the highest degree of specificity. - CORRECT ANSWER -
Ex: aged related Osteoporosis with current fracture of leſt shoulder, follow up visit;
M80.012D:
M80 (osteoporosis with current fracture) +
M80.0 (age related) +
M80.012 (age related w/current fracture of leſt shoulder +
M80.012D (subsequent visit)
Outpatient visits--SUSPECTED Dx NEVER coded.
If a definitive Dx has not been reported then code:
1--Signs
2--Sx
3--Abnormal Test results - CORRECT ANSWER -Terms of suspected Dx:
Probable
Suspected
Questionable
Rule Out
Differential
Working
Inpatient Visits--SUSPECTED Dx MAY BE CODED, with exception to HIV.
HIV Dx must be confirmed before coding. - CORRECT ANSWER -
, Sx that are an INTEGRAL part of a disease do NOT need to be coded. - CORRECT ANSWER -
Ex: Pt presents w/severe AB pain, nausea, vomiting. Diagnosed w/acute appendicitis. Code only ac
ute appendicitis K35.80.
Sx that are NOT INTEGRAL part to a disease DO NEED TO BE CODED. - CORRECT ANSWER -
Ex: Patient presents with runny nose & cough as well as Rt shoulder pain. Physician diagoses URI.
Code URI as well as Sx of Rt Shoulder pain.
URI--J06.9
Rt Shldr Pn--M25.511
MULTIPLEz CODINGz FORz Az SINGLEz CONDITION--
Somez Diseasesz requirez multiplez Dxz codesz andz willz indicatez ETIOLOGYz &z MANIFESTATION.z Itz willz app
earz inz thez alphabeticz indexz asz onez codez followedz byz anotherz codez inz brackets.z -
CORRECTz ANSWERz -Ex:z Amyloidz Heartz Diseasez E85.4z [I43]
BOTHz etiologyz ANDz manifestationz codesz arez requiredz toz recordz thisz condition.
ACUTEz &z CHRONICz CONDITIONSz DOCUMENTEDz ATz THEz SAMEz TIME--
whenz bothz arez documented,z codez acutez firstz thenz chronicz -z CORRECTz ANSWERz -
EX:z Acutez andz chronicz cystitis
N30.00z Acutez cystitisz w/oz hematuria
N30.20z Otherz Chronicz cystitisz w/oz hematuria
CHRONICz CONDITIONS--
canz bez codedz asz manyz timez asz applicablez toz treatment,z butz aſterz resolutionz willz appearz asz z
-
codesz ifz historyz ofz conditionz affectsz CURRENTz reasonz forz care.z -z CORRECTz ANSWERz -
EX:z colonz cancer
(lookz underz "history,z personalz of"--notz "cancer")
Ptz w/z personalz hxz ofz colonz cancerz presentsz forz colonoscopy.z Z85.038
Sequelae--
latez orz residualz effectsz aſterz anz acutez illness/injury.z TWOz codesz arez oſtenz required.z Residualz conditi
onz 1st,z thenz causez forz sequelaez 2nd.z Ifz noz residualz effectsz arez documented,z usez causez forz sequela
ez asz prinicpalz Dx.z -z CORRECTz ANSWERz -Lookz upz "sequelae"z inz alphabeticz index.
