Medical Coding Flashcards

Which ICD-10-CM code category is used to classify adverse effects of drugs when the drug was correctly administered?

Answer: T36-T50 with 5th character '5'

In ICD-10-CM, adverse effects (correctly prescribed and administered drugs) use the 5th character '5' in the T36-T50 range.

In clinical data management, why is standardized medical coding critical for clinical trial databases?

Answer: It enables consistent aggregate analysis and cross-study comparison

Standardized coding ensures that similar events are grouped consistently, enabling meaningful safety analyses and cross-study comparisons.

Which MedDRA hierarchy level is most granular and used to code individual adverse events?

Answer: Lowest Level Term (LLT)

The LLT is the most granular MedDRA term and directly maps to how a verbatim term is reported, though PTs are used for analysis.

A patient is enrolled in a trial and experiences 'upset stomach' as an adverse event. The coder maps this to the MedDRA PT 'Nausea.' This verbatim-to-code mapping is stored in a:

Answer: Coding bridge / synonym list

A coding bridge or synonym list (also called a company dictionary) stores verbatim-to-preferred-term mappings to ensure consistency across studies.

What CPT code range covers Evaluation and Management (E/M) services for outpatient office visits?

Answer: 99202-99215

CPT codes 99202-99215 cover new (99202-99205) and established (99211-99215) patient office/outpatient E/M visits.

In ICD-10-PCS, the root operation 'Excision' differs from 'Resection' in that Excision:

Answer: Removes only part of a body part without replacement

Excision (B) cuts out a portion of a body part, whereas Resection (T) cuts out all of a body part.

Which coding system is primarily used to code diagnoses and conditions in US inpatient and outpatient claims?

Answer: ICD-10-CM

ICD-10-CM (Clinical Modification) is the US standard for coding diagnoses on both inpatient and outpatient claims.