MEDICAL CODING EXAM 6 | MEDICAL CODER
| LATEST 2025-2026 QUESTION AND CORRECT
ANSWER WITH EXPLANATION WEST COAST
UNIVERSITY
1. A patient is admitted with septic shock due to perforated sigmoid
colon, acute hypoxic respiratory failure, and acute renal failure. ED
documents “respiratory failure as reason for admission.” What is
correct sequencing?
A. J96.01, K57.20, N17.9, A41.-
B. A41.-, R65.21, K57.20, J96.01, N17.9
C. K57.20, A41.-, R65.21, J96.01
D. J96.01 only
Correct Answer: B
Rationale: Sepsis with septic shock is always principal regardless of
presenting symptom.
2. A patient presents with chest pain; troponins mildly elevated. Final
diagnosis: “demand ischemia due to severe GI bleed,” not type 1 MI.
What is coded?
A. I21.-
B. I20.0
C. I24.8, K92.2
D. R07.9 only
Correct Answer: C
Rationale: Type 2 MI/demand ischemia is coded with underlying cause.
3. Laparoscopic procedure converted to open due to hemorrhage.
Surgeon documents both stages. What is correct?
A. Laparoscopic only
B. Both procedures
C. Open only
D. Unlisted procedure
,Correct Answer: C
Rationale: Only completed procedure is coded.
4. A patient has DKA, acute MI, CKD stage 3, and dehydration.
What is correct sequencing?
A. I21.-, E11.10, N18.3, E86.0
B. E11.10, E86.0, I21.-, N18.3
C. N18.3, E11.10, I21.-
D. E86.0 only
Correct Answer: B
Rationale: DKA is principal; other conditions follow hierarchy.
5. Postoperative hemorrhage requiring transfusion only. What
applies?
A. T81.0XXA only
B. D62 only
C. Both T81.0XXA and D62
D. R58 only
Correct Answer: C
Rationale: Complication + anemia both coded.
6. MI complicated by cardiogenic shock and acute pulmonary edema.
What is required?
A. I21.- only
B. R57.0 only
C. I21.-, R57.0, J81.0
D. J81.0 only
Correct Answer: C
Rationale: All complications must be coded.
7. CKD stage 4 with anemia due to CKD. What sequencing applies?
, A. D63.1, N18.4
B. N18.4, D63.1
C. D64.9 only
D. N17.9 only
Correct Answer: B
Rationale: CKD is principal.
8. Dehydration with acute kidney injury. What is principal?
A. N17.9
B. E86.0
C. Both equal
D. Symptom only
Correct Answer: B
Rationale: Dehydration is underlying cause.
9. Diagnostic colonoscopy followed by polypectomy. What is coded?
A. Diagnostic only
B. Polypectomy only
C. Both
D. Neither
Correct Answer: B
Rationale: Therapeutic procedure only.
10. Opioid overdose with respiratory failure. First?
A. J96.00
B. T40.2X1A
C. J69.0
D. R09.02
Correct Answer: B
Rationale: Poisoning first.
| LATEST 2025-2026 QUESTION AND CORRECT
ANSWER WITH EXPLANATION WEST COAST
UNIVERSITY
1. A patient is admitted with septic shock due to perforated sigmoid
colon, acute hypoxic respiratory failure, and acute renal failure. ED
documents “respiratory failure as reason for admission.” What is
correct sequencing?
A. J96.01, K57.20, N17.9, A41.-
B. A41.-, R65.21, K57.20, J96.01, N17.9
C. K57.20, A41.-, R65.21, J96.01
D. J96.01 only
Correct Answer: B
Rationale: Sepsis with septic shock is always principal regardless of
presenting symptom.
2. A patient presents with chest pain; troponins mildly elevated. Final
diagnosis: “demand ischemia due to severe GI bleed,” not type 1 MI.
What is coded?
A. I21.-
B. I20.0
C. I24.8, K92.2
D. R07.9 only
Correct Answer: C
Rationale: Type 2 MI/demand ischemia is coded with underlying cause.
3. Laparoscopic procedure converted to open due to hemorrhage.
Surgeon documents both stages. What is correct?
A. Laparoscopic only
B. Both procedures
C. Open only
D. Unlisted procedure
,Correct Answer: C
Rationale: Only completed procedure is coded.
4. A patient has DKA, acute MI, CKD stage 3, and dehydration.
What is correct sequencing?
A. I21.-, E11.10, N18.3, E86.0
B. E11.10, E86.0, I21.-, N18.3
C. N18.3, E11.10, I21.-
D. E86.0 only
Correct Answer: B
Rationale: DKA is principal; other conditions follow hierarchy.
5. Postoperative hemorrhage requiring transfusion only. What
applies?
A. T81.0XXA only
B. D62 only
C. Both T81.0XXA and D62
D. R58 only
Correct Answer: C
Rationale: Complication + anemia both coded.
6. MI complicated by cardiogenic shock and acute pulmonary edema.
What is required?
A. I21.- only
B. R57.0 only
C. I21.-, R57.0, J81.0
D. J81.0 only
Correct Answer: C
Rationale: All complications must be coded.
7. CKD stage 4 with anemia due to CKD. What sequencing applies?
, A. D63.1, N18.4
B. N18.4, D63.1
C. D64.9 only
D. N17.9 only
Correct Answer: B
Rationale: CKD is principal.
8. Dehydration with acute kidney injury. What is principal?
A. N17.9
B. E86.0
C. Both equal
D. Symptom only
Correct Answer: B
Rationale: Dehydration is underlying cause.
9. Diagnostic colonoscopy followed by polypectomy. What is coded?
A. Diagnostic only
B. Polypectomy only
C. Both
D. Neither
Correct Answer: B
Rationale: Therapeutic procedure only.
10. Opioid overdose with respiratory failure. First?
A. J96.00
B. T40.2X1A
C. J69.0
D. R09.02
Correct Answer: B
Rationale: Poisoning first.
