Certified Coding Associate Exam Certified Coding Associate Classification 2 — Questions and Answers
Question 1: In ICD-10-CM, what does a 7th character 'A' indicate when appended to a fracture code?
- Subsequent encounter for fracture with routine healing
- Initial encounter for closed fracture (Correct answer)
- Sequela of fracture
- Subsequent encounter for fracture with delayed healing
Correct answer: Initial encounter for closed fracture
The 7th character 'A' in ICD-10-CM fracture codes designates the initial encounter, meaning the patient is receiving active treatment for the fracture.
Question 2: Which coding classification system is used exclusively for inpatient hospital procedure coding in the United States?
- CPT
- ICD-10-PCS (Correct answer)
- HCPCS Level II
- ICD-10-CM
Correct answer: ICD-10-PCS
ICD-10-PCS (Procedure Coding System) is the classification system mandated for coding inpatient hospital procedures in the US.
Question 3: A patient is seen for essential hypertension with chronic kidney disease stage 3. How many ICD-10-CM codes are required?
- Three separate codes
- One combination code (Correct answer)
- Two codes: one for hypertension and one for CKD
- No code — hypertension is assumed with CKD
Correct answer: One combination code
ICD-10-CM provides a combination code (I12.9) that captures both hypertensive chronic kidney disease, eliminating the need for two separate codes.
Question 4: Which of the following is the correct definition of 'principal diagnosis' in the inpatient setting?
- The condition that prompted the patient to seek outpatient care
- The condition established after study to be chiefly responsible for the admission (Correct answer)
- The most severe diagnosis listed in the chart
- The first diagnosis written on the face sheet
Correct answer: The condition established after study to be chiefly responsible for the admission
Per UHDDS guidelines, the principal diagnosis is the condition determined after study to be chiefly responsible for occasioning the hospital admission.
Question 5: In CPT coding, what does the term 'unbundling' refer to?
- Combining multiple services into one comprehensive code
- Billing component services separately when a comprehensive code exists (Correct answer)
- Adding a modifier to indicate multiple procedures
- Using an unlisted procedure code for a new service
Correct answer: Billing component services separately when a comprehensive code exists
Unbundling is the inappropriate practice of reporting separate codes for component services when a single comprehensive CPT code covers all those services.
Question 6: Which section of ICD-10-PCS uses a 7-character alphanumeric code structure?
- Only the Medical and Surgical section
- Only the Obstetrics section
- All sections of ICD-10-PCS (Correct answer)
- Only the Imaging and Nuclear Medicine sections
Correct answer: All sections of ICD-10-PCS
Every section of ICD-10-PCS uses a 7-character alphanumeric code structure, with each character position carrying a specific meaning.
Question 7: A code listed in the Tabular List of ICD-10-CM with the notation 'Code first' instructs the coder to:
- Always sequence that condition as the principal diagnosis
- Sequence an underlying condition or cause before the current code (Correct answer)
- Use the code only in outpatient settings
- Report only that single code with no additional codes
Correct answer: Sequence an underlying condition or cause before the current code
'Code first' instructs the coder to sequence the underlying disease or etiology before the manifestation or current condition code.
Certified Coding Associate Exam Certified Coding Associate Classification 2
In ICD-10-CM, what does a 7th character 'A' indicate when appended to a fracture code?