MEDICAL CODING EXAM 2 | MEDICAL CODER
| LATEST 2025-2026 QUESTION AND CORRECT
ANSWER WITH EXPLANATION WEST COAST
UNIVERSITY
1. A patient with type 2 diabetes mellitus is admitted for diabetic
ketoacidosis (DKA). The provider also documents noncompliance with
insulin therapy. Which is the correct coding sequence?
A. E11.9, E11.10, Z91.14
B. E11.10, Z91.14
C. E11.65, Z91.14
D. E13.10, Z91.14
Correct Answer: B
Rationale: E11.10 (Type 2 DM with ketoacidosis without coma) is
sequenced first. Z91.14 (noncompliance with medication) is added as a
secondary code.
2. A patient is admitted with sepsis due to a urinary tract infection caused
by E. coli, progressing to severe sepsis with acute renal failure. What is
the correct sequencing?
A. N39.0, A41.51, R65.20, N17.9
B. A41.51, R65.20, N17.9, N39.0
C. R65.20, A41.51, N17.9, N39.0
D. A41.9, N39.0, R65.21
Correct Answer: B
Rationale: Code sepsis first (A41.51), followed by severe sepsis (R65.20),
then organ dysfunction (N17.9), and finally the source (UTI).
3. A patient undergoes laparoscopic cholecystectomy converted to open
procedure. How should this be coded?
A. Report laparoscopic code only
B. Report open procedure code only
C. Report both laparoscopic and open codes
D. Report unlisted procedure code
,Correct Answer: B
Rationale: When a laparoscopic procedure is converted to open, only the
open procedure is coded.
4. A patient is admitted for acute exacerbation of systolic heart failure
with pulmonary edema. Which coding is correct?
A. I50.21 only
B. I50.23 and J81.0
C. I50.23 only
D. J81.0 only
Correct Answer: B
Rationale: I50.23 (acute on chronic systolic HF) and J81.0 (pulmonary
edema) are both coded when documented separately.
5. A provider performs a colonoscopy and removes a polyp using snare
technique. Which CPT code is correct?
A. 45378
B. 45380
C. 45385
D. 45384
Correct Answer: C
Rationale: 45385 is used for colonoscopy with removal by snare
technique.
6. A patient presents with anemia due to chemotherapy. What is the
correct principal diagnosis?
A. D64.81
B. T45.1X5A
C. C80.1
D. Z51.11
, Correct Answer: A
Rationale: D64.81 (anemia due to antineoplastic chemotherapy) is
sequenced first, followed by the adverse effect code.
7. A patient is seen for follow-up after myocardial infarction 3 weeks ago.
Which code is correct?
A. I21.9
B. I25.2
C. Z09
D. Z86.79
Correct Answer: B
Rationale: I25.2 is used for old myocardial infarction within 4 weeks.
8. A patient has hypertension with heart failure. Which coding guideline
applies?
A. Code separately without linkage
B. Use combination code I11.-
C. Code hypertension only
D. Code heart failure only
Correct Answer: B
Rationale: ICD-10-CM presumes a relationship and requires
combination coding (I11.-).
9. A patient undergoes bilateral mastectomy. Which modifier is required?
A. 51
B. 50
C. 59
D. 26
Correct Answer: B
Rationale: Modifier 50 indicates bilateral procedure.
| LATEST 2025-2026 QUESTION AND CORRECT
ANSWER WITH EXPLANATION WEST COAST
UNIVERSITY
1. A patient with type 2 diabetes mellitus is admitted for diabetic
ketoacidosis (DKA). The provider also documents noncompliance with
insulin therapy. Which is the correct coding sequence?
A. E11.9, E11.10, Z91.14
B. E11.10, Z91.14
C. E11.65, Z91.14
D. E13.10, Z91.14
Correct Answer: B
Rationale: E11.10 (Type 2 DM with ketoacidosis without coma) is
sequenced first. Z91.14 (noncompliance with medication) is added as a
secondary code.
2. A patient is admitted with sepsis due to a urinary tract infection caused
by E. coli, progressing to severe sepsis with acute renal failure. What is
the correct sequencing?
A. N39.0, A41.51, R65.20, N17.9
B. A41.51, R65.20, N17.9, N39.0
C. R65.20, A41.51, N17.9, N39.0
D. A41.9, N39.0, R65.21
Correct Answer: B
Rationale: Code sepsis first (A41.51), followed by severe sepsis (R65.20),
then organ dysfunction (N17.9), and finally the source (UTI).
3. A patient undergoes laparoscopic cholecystectomy converted to open
procedure. How should this be coded?
A. Report laparoscopic code only
B. Report open procedure code only
C. Report both laparoscopic and open codes
D. Report unlisted procedure code
,Correct Answer: B
Rationale: When a laparoscopic procedure is converted to open, only the
open procedure is coded.
4. A patient is admitted for acute exacerbation of systolic heart failure
with pulmonary edema. Which coding is correct?
A. I50.21 only
B. I50.23 and J81.0
C. I50.23 only
D. J81.0 only
Correct Answer: B
Rationale: I50.23 (acute on chronic systolic HF) and J81.0 (pulmonary
edema) are both coded when documented separately.
5. A provider performs a colonoscopy and removes a polyp using snare
technique. Which CPT code is correct?
A. 45378
B. 45380
C. 45385
D. 45384
Correct Answer: C
Rationale: 45385 is used for colonoscopy with removal by snare
technique.
6. A patient presents with anemia due to chemotherapy. What is the
correct principal diagnosis?
A. D64.81
B. T45.1X5A
C. C80.1
D. Z51.11
, Correct Answer: A
Rationale: D64.81 (anemia due to antineoplastic chemotherapy) is
sequenced first, followed by the adverse effect code.
7. A patient is seen for follow-up after myocardial infarction 3 weeks ago.
Which code is correct?
A. I21.9
B. I25.2
C. Z09
D. Z86.79
Correct Answer: B
Rationale: I25.2 is used for old myocardial infarction within 4 weeks.
8. A patient has hypertension with heart failure. Which coding guideline
applies?
A. Code separately without linkage
B. Use combination code I11.-
C. Code hypertension only
D. Code heart failure only
Correct Answer: B
Rationale: ICD-10-CM presumes a relationship and requires
combination coding (I11.-).
9. A patient undergoes bilateral mastectomy. Which modifier is required?
A. 51
B. 50
C. 59
D. 26
Correct Answer: B
Rationale: Modifier 50 indicates bilateral procedure.
