MEDICAL CODING EXAM 3 | MEDICAL CODER
| LATEST 2025-2026 QUESTION AND CORRECT
ANSWER WITH EXPLANATION WEST COAST
UNIVERSITY
1. A patient with type 2 diabetes mellitus is admitted with hyperosmolar
hyperglycemic state (HHS), acute renal failure, and dehydration. Which
is the correct sequencing?
A. N17.9, E11.00, E86.0
B. E11.00, E86.0, N17.9
C. E11.00, N17.9, E86.0
D. E86.0, E11.00, N17.9
Correct Answer: C
Rationale: E11.00 (Type 2 DM with HHS) is sequenced first, followed by
acute renal failure (N17.9), then dehydration (E86.0).
2. A patient is admitted with sepsis due to aspiration pneumonia
following vomiting. The patient develops acute respiratory failure. What
is the correct sequencing?
A. J96.00, A41.9, J69.0
B. A41.9, J69.0, J96.00
C. J69.0, A41.9, J96.00
D. A41.9, J96.00, J69.0
Correct Answer: B
Rationale: Sepsis is sequenced first, followed by the localized infection
(aspiration pneumonia), then respiratory failure.
3. A patient undergoes excision of a malignant lesion (3.2 cm) on the
forearm with complex repair. Which is the correct coding approach?
A. Excision code only
B. Repair code only
C. Both excision and complex repair codes
D. Unlisted procedure
,Correct Answer: C
Rationale: Malignant excision and complex repair are coded separately
when documentation supports both.
4. A patient with chronic hypertension presents with acute pulmonary
edema and acute systolic heart failure. Which codes are appropriate?
A. I10, J81.0
B. I50.21, J81.0
C. I11.0, I50.21, J81.0
D. I50.9 only
Correct Answer: C
Rationale: I11.0 links hypertension with heart failure, followed by
specific HF code and pulmonary edema.
5. A patient is admitted with anemia due to gastrointestinal bleeding from
a gastric ulcer. What is the correct sequencing?
A. D62, K25.0
B. K25.0, D62
C. D50.0, K25.0
D. K92.2, D62
Correct Answer: B
Rationale: The underlying cause (gastric ulcer with bleeding) is
sequenced first, followed by acute blood loss anemia.
6. A patient undergoes laparoscopic colectomy converted to open due to
extensive adhesions. Which coding is correct?
A. Laparoscopic code only
B. Open code only
C. Both codes
D. Modifier 22 required
Correct Answer: B
Rationale: Only the completed open procedure is reported.
, 7. A patient presents with chest pain and is diagnosed with unstable
angina progressing to NSTEMI during hospitalization. Which code is
assigned?
A. I20.0 only
B. I21.4 only
C. I20.0 and I21.4
D. R07.9
Correct Answer: B
Rationale: NSTEMI supersedes unstable angina; only MI is coded.
8. A patient has CKD stage 5 due to diabetes and is on dialysis. Which
codes are required?
A. E11.22 only
B. N18.5, Z99.2
C. E11.22, N18.6, Z99.2
D. N18.6 only
Correct Answer: C
Rationale: Diabetes with CKD (E11.22), ESRD (N18.6), and dialysis
status (Z99.2) are all required.
9. A patient undergoes bilateral inguinal hernia repair with mesh
placement. Which coding is correct?
A. Single CPT code
B. CPT code with modifier 50
C. CPT code with modifier 51
D. Two separate codes
Correct Answer: B
Rationale: Modifier 50 indicates bilateral procedure.
10. A patient is admitted for severe sepsis with septic shock due to UTI.
Which codes are required?
| LATEST 2025-2026 QUESTION AND CORRECT
ANSWER WITH EXPLANATION WEST COAST
UNIVERSITY
1. A patient with type 2 diabetes mellitus is admitted with hyperosmolar
hyperglycemic state (HHS), acute renal failure, and dehydration. Which
is the correct sequencing?
A. N17.9, E11.00, E86.0
B. E11.00, E86.0, N17.9
C. E11.00, N17.9, E86.0
D. E86.0, E11.00, N17.9
Correct Answer: C
Rationale: E11.00 (Type 2 DM with HHS) is sequenced first, followed by
acute renal failure (N17.9), then dehydration (E86.0).
2. A patient is admitted with sepsis due to aspiration pneumonia
following vomiting. The patient develops acute respiratory failure. What
is the correct sequencing?
A. J96.00, A41.9, J69.0
B. A41.9, J69.0, J96.00
C. J69.0, A41.9, J96.00
D. A41.9, J96.00, J69.0
Correct Answer: B
Rationale: Sepsis is sequenced first, followed by the localized infection
(aspiration pneumonia), then respiratory failure.
3. A patient undergoes excision of a malignant lesion (3.2 cm) on the
forearm with complex repair. Which is the correct coding approach?
A. Excision code only
B. Repair code only
C. Both excision and complex repair codes
D. Unlisted procedure
,Correct Answer: C
Rationale: Malignant excision and complex repair are coded separately
when documentation supports both.
4. A patient with chronic hypertension presents with acute pulmonary
edema and acute systolic heart failure. Which codes are appropriate?
A. I10, J81.0
B. I50.21, J81.0
C. I11.0, I50.21, J81.0
D. I50.9 only
Correct Answer: C
Rationale: I11.0 links hypertension with heart failure, followed by
specific HF code and pulmonary edema.
5. A patient is admitted with anemia due to gastrointestinal bleeding from
a gastric ulcer. What is the correct sequencing?
A. D62, K25.0
B. K25.0, D62
C. D50.0, K25.0
D. K92.2, D62
Correct Answer: B
Rationale: The underlying cause (gastric ulcer with bleeding) is
sequenced first, followed by acute blood loss anemia.
6. A patient undergoes laparoscopic colectomy converted to open due to
extensive adhesions. Which coding is correct?
A. Laparoscopic code only
B. Open code only
C. Both codes
D. Modifier 22 required
Correct Answer: B
Rationale: Only the completed open procedure is reported.
, 7. A patient presents with chest pain and is diagnosed with unstable
angina progressing to NSTEMI during hospitalization. Which code is
assigned?
A. I20.0 only
B. I21.4 only
C. I20.0 and I21.4
D. R07.9
Correct Answer: B
Rationale: NSTEMI supersedes unstable angina; only MI is coded.
8. A patient has CKD stage 5 due to diabetes and is on dialysis. Which
codes are required?
A. E11.22 only
B. N18.5, Z99.2
C. E11.22, N18.6, Z99.2
D. N18.6 only
Correct Answer: C
Rationale: Diabetes with CKD (E11.22), ESRD (N18.6), and dialysis
status (Z99.2) are all required.
9. A patient undergoes bilateral inguinal hernia repair with mesh
placement. Which coding is correct?
A. Single CPT code
B. CPT code with modifier 50
C. CPT code with modifier 51
D. Two separate codes
Correct Answer: B
Rationale: Modifier 50 indicates bilateral procedure.
10. A patient is admitted for severe sepsis with septic shock due to UTI.
Which codes are required?
