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 with hypertension and chronic kidney disease stage 4 is admitted. Per ICD-10-CM guidelines, how should these be coded?
Answer: I12.1 and N18.4
ICD-10-CM presumes a causal relationship between hypertension and CKD; I12.1 captures hypertensive CKD with stage 4 CKD, and N18.4 identifies the CKD stage.
Which of the following is the correct approach to code a wound closure performed with adhesive strips (Steri-Strips)?
Answer: Report only an E/M code — no separate repair code
Closure with adhesive strips alone does not warrant a separate CPT repair code; only the E/M service is reported.
The health record states 'patient presents with chest pain, rule out MI.' This is an outpatient encounter. What should be coded?
Answer: Chest pain
For outpatient visits, coders report the sign/symptom (chest pain) — 'rule out' diagnoses are not coded.
A coder is assigning CPT codes for a surgical procedure. The provider performed a medically necessary service and a service that is bundled per the National Correct Coding Initiative (NCCI). What should the coder do?
Answer: Report only the more complex bundled code
When NCCI bundles a component service into a comprehensive code, only the comprehensive code should be reported unless a specific exception applies.
In ICD-10-PCS, what character position identifies the root operation?
Answer: Third character
The third character in an ICD-10-PCS code identifies the root operation (e.g., Excision, Repair, Replacement).
A patient undergoes a right knee replacement. In ICD-10-PCS, which device value is assigned for the prosthetic joint?
Answer: Synthetic Substitute
A total knee replacement prosthesis is classified as a Synthetic Substitute in ICD-10-PCS device character.
Which organization publishes the Official Guidelines for Coding and Reporting that coders must follow for ICD-10-CM/PCS?
Answer: CMS and NCHS (cooperating parties)
The ICD-10-CM/PCS Official Guidelines are published by the four cooperating parties, led by CMS and the National Center for Health Statistics (NCHS).