CCS CCS ICD-10-CM Diagnosis Coding 1 — Questions and Answers
Question 1: What does an 'Excludes1' note in ICD-10-CM mean?
- The excluded code may be used together with this code
- The two conditions cannot occur together and cannot be coded simultaneously (Correct answer)
- The excluded code should always be sequenced first
- The condition is included in the default code
Correct answer: The two conditions cannot occur together and cannot be coded simultaneously
An Excludes1 note means the two conditions are mutually exclusive and cannot be reported together on the same claim.
Question 2: In ICD-10-CM, what is the purpose of a 7th character 'S' (sequela)?
- Indicates a subsequent encounter for the condition
- Indicates an initial encounter for the condition
- Indicates complications or conditions that arise as a direct result of a previous injury or illness (Correct answer)
- Indicates the condition is a placeholder
Correct answer: Indicates complications or conditions that arise as a direct result of a previous injury or illness
The 7th character 'S' identifies sequela, which are late effects or residual conditions resulting from a previous injury or illness.
Question 3: Which ICD-10-CM instruction requires the underlying condition to be coded first, followed by the manifestation?
- Code also
- Use additional code
- Code first (Correct answer)
- Excludes2
Correct answer: Code first
A 'Code first' note instructs the coder to sequence the underlying etiology before the manifestation code.
Question 4: What does the placeholder character 'X' serve in ICD-10-CM codes?
- Indicates the code is unspecified
- Fills an empty character position to allow a future 7th character to be added (Correct answer)
- Identifies bilateral conditions
- Marks a principal diagnosis
Correct answer: Fills an empty character position to allow a future 7th character to be added
The placeholder X is used to fill character positions that have no assigned value so a required 7th character can be added.
Question 5: According to ICD-10-CM guidelines, how should an uncertain diagnosis be handled in the inpatient setting?
- Code only signs and symptoms, never the uncertain diagnosis
- Code the condition as if confirmed (Correct answer)
- Query the physician before coding anything
- Leave the diagnosis field blank
Correct answer: Code the condition as if confirmed
For inpatient encounters, ICD-10-CM guidelines allow coding a condition described as 'probable,' 'suspected,' or 'possible' as if established.
Question 6: What is the correct sequencing when coding a condition with both an acute and chronic presentation in ICD-10-CM?
- Code only the chronic condition
- Code only the acute condition
- Code the acute condition first, followed by the chronic condition (Correct answer)
- Code the chronic condition first, followed by the acute condition
Correct answer: Code the acute condition first, followed by the chronic condition
When both acute and chronic forms of the same condition exist, the acute (subacute) code is sequenced first.
CCS CCS ICD-10-CM Diagnosis Coding 1
What does an 'Excludes1' note in ICD-10-CM mean?