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ICD-10-CM: General Coding, Guidelines
and Conventions Questions and Answers
2026 Latest Update
Define: medical necessity Ans: - Care that is reasonable,
necessary, and/or appropriate
- Evidence-based clinical standards of care
What does ICD-10-CM stand for? Ans: - International Classification
of Diseases - Tenth Revision - Clinical Modification
What is the ICD-10-CM? Ans: - diagnosis code set used to report
diagnoses in all clinical settings
What does ICD-10-PCS stand for? Ans: - International
Classification of Diseases - Tenth Revision - Procedure
Classification System
What is the ICD-10-PCS? Ans: - Procedure code set used to report
hospital inpatient procedures only
What is the purpose of the ICD-10? Ans: - Developed by the World
Health Organization (WHO)
- A standard diagnostic tool for epidemiology, health management,
and clinical purposes
© 2025 All rights reserved
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- Designed to compile and present statistical data on morbidity
(the rate or frequency of disease) and mortality (the rate or
frequency of deaths)
- Classification system use to identify and record health conditions
-Key storyteller to insurance companies (see medical necessity)
How often is the ICD-10 updated? Dates? Ans: - ICD-10-CM/PCS is
updated every year
- October 1st -> major updates
- April 1st -> updates
ICD-10 Codebook Layout Ans: - A. Official ICD-10-CM guidelines
for Coding and Reporting
-- I.Coding Conventions
-- II. General Coding Guidelines
-- III. Chapter Specific Coding Guidelines
- B. Alphabetic Index
-- I. Index to Diseases and Injuries
--- a. Table of Neoplasms
--- b. Table of Drugs and Chemicals
-- II. Index to External Causes of Injuries
© 2025 All rights reserved
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- Tabular List of Diseases and Injuries
What is a Neoplasm? Ans: - a tumor or an abnormal clump of
tissue that may be benign or malignant. It serves no useful
function but grows at the expense of the healthy organism.
What is a Benign Neoplasm? Ans: - growth not spreading by
metastases or infiltration of tissue
What is a Histoid Neoplasm? Ans: - a neoplasm in which structure
resembles the tissues and elements that surround it.
What is a Malignant Neoplasm? Ans: - growth that infiltrates
tissue, metastasizes, and often recurs after attempts at surgical
removal.
- SYN: cancer
What are the four types of Coding Conventions? Ans: 1.
Instructional Notes
2. Punctuation Marks
3. Abbreviations
4. Symbols
Define: Metastasis Ans: - movement of bacteria or body cells (esp.,
cancer cells) from one part of the body to another
- change in location of a disease or of its manifestations or
transfer from one organ or part to another not directly connected
© 2025 All rights reserved
ICD-10-CM: General Coding, Guidelines
and Conventions Questions and Answers
2026 Latest Update
Define: medical necessity Ans: - Care that is reasonable,
necessary, and/or appropriate
- Evidence-based clinical standards of care
What does ICD-10-CM stand for? Ans: - International Classification
of Diseases - Tenth Revision - Clinical Modification
What is the ICD-10-CM? Ans: - diagnosis code set used to report
diagnoses in all clinical settings
What does ICD-10-PCS stand for? Ans: - International
Classification of Diseases - Tenth Revision - Procedure
Classification System
What is the ICD-10-PCS? Ans: - Procedure code set used to report
hospital inpatient procedures only
What is the purpose of the ICD-10? Ans: - Developed by the World
Health Organization (WHO)
- A standard diagnostic tool for epidemiology, health management,
and clinical purposes
© 2025 All rights reserved
, 2 | Page
- Designed to compile and present statistical data on morbidity
(the rate or frequency of disease) and mortality (the rate or
frequency of deaths)
- Classification system use to identify and record health conditions
-Key storyteller to insurance companies (see medical necessity)
How often is the ICD-10 updated? Dates? Ans: - ICD-10-CM/PCS is
updated every year
- October 1st -> major updates
- April 1st -> updates
ICD-10 Codebook Layout Ans: - A. Official ICD-10-CM guidelines
for Coding and Reporting
-- I.Coding Conventions
-- II. General Coding Guidelines
-- III. Chapter Specific Coding Guidelines
- B. Alphabetic Index
-- I. Index to Diseases and Injuries
--- a. Table of Neoplasms
--- b. Table of Drugs and Chemicals
-- II. Index to External Causes of Injuries
© 2025 All rights reserved
, 3 | Page
- Tabular List of Diseases and Injuries
What is a Neoplasm? Ans: - a tumor or an abnormal clump of
tissue that may be benign or malignant. It serves no useful
function but grows at the expense of the healthy organism.
What is a Benign Neoplasm? Ans: - growth not spreading by
metastases or infiltration of tissue
What is a Histoid Neoplasm? Ans: - a neoplasm in which structure
resembles the tissues and elements that surround it.
What is a Malignant Neoplasm? Ans: - growth that infiltrates
tissue, metastasizes, and often recurs after attempts at surgical
removal.
- SYN: cancer
What are the four types of Coding Conventions? Ans: 1.
Instructional Notes
2. Punctuation Marks
3. Abbreviations
4. Symbols
Define: Metastasis Ans: - movement of bacteria or body cells (esp.,
cancer cells) from one part of the body to another
- change in location of a disease or of its manifestations or
transfer from one organ or part to another not directly connected
© 2025 All rights reserved
