Certified Coding Associate Clinical Flashcards
7 cards from real Certified Coding Associate Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Certified Coding Associate Clinical flashcards as text
A patient is admitted with acute respiratory failure due to pneumonia. Which condition should be sequenced as the principal diagnosis?
Answer: Either may be sequenced first per UHDDS
When two conditions equally meet the UHDDS definition of principal diagnosis, either may be sequenced first.
Which ICD-10-CM code category is used to report body mass index (BMI)?
Answer: Z68
BMI codes are found in category Z68 and are used as secondary codes when a provider documents obesity.
A patient undergoes a laparoscopic cholecystectomy. In ICD-10-PCS, what value represents the laparoscopic approach?
Answer: Percutaneous endoscopic
Laparoscopic procedures use the percutaneous endoscopic approach in ICD-10-PCS.
Which term describes coding a condition that the physician has documented as 'possible' or 'probable' in the outpatient setting?
Answer: Not allowed — code signs and symptoms instead
For outpatient/ED encounters, uncertain diagnoses (possible, probable, suspected) are NOT coded; instead, code the signs, symptoms, or findings.
A coder sees the note 'ESRD on dialysis.' Which code(s) should be assigned?
Answer: N18.6 and Z99.2
Both N18.6 (end-stage renal disease) and Z99.2 (dependence on renal dialysis) are assigned when a patient has ESRD on dialysis.
When a patient has a fracture coded to the seventh character 'D', what does this indicate?
Answer: Subsequent encounter for fracture with routine healing
The seventh character 'D' indicates a subsequent encounter for a fracture with routine healing.
A patient is treated for sepsis due to Staphylococcus aureus. How should this be coded?
Answer: A41.01 as principal diagnosis only
A41.01 (Sepsis due to Methicillin susceptible Staphylococcus aureus) fully captures both the sepsis and the organism in one combination code.