Certified Coding Associate Exam Certified Coding Associate Classification 5 — Questions and Answers
Question 1: In ICD-10-CM, what does the placeholder character 'X' serve when used within a code?
- It indicates an unspecified body site
- It holds a position so that a required character can be placed in the correct position (Correct answer)
- It marks the code as a manifestation code
- It designates the code for use in pediatric patients only
Correct answer: It holds a position so that a required character can be placed in the correct position
The placeholder 'X' is used to fill character positions in ICD-10-CM codes so that a 7th character extension can be added in the correct position.
Question 2: Under CPT guidelines, which modifier indicates that a procedure was performed bilaterally?
- -51
- -59
- -50 (Correct answer)
- -RT and -LT
Correct answer: -50
CPT modifier -50 is used to report bilateral procedures performed during the same operative session.
Question 3: When coding an encounter for chemotherapy administration in ICD-10-CM, which code is sequenced first?
- The malignancy code
- The Z code for encounter for antineoplastic chemotherapy (Correct answer)
- The adverse effect code for the chemotherapy drug
- The symptom code related to the cancer
Correct answer: The Z code for encounter for antineoplastic chemotherapy
ICD-10-CM guidelines instruct sequencing the Z51.11 (encounter for antineoplastic chemotherapy) code first, followed by the malignancy code.
Question 4: A coder finds that a diagnosis code in the ICD-10-CM Tabular List has an Excludes1 note. This means:
- The excluded code should be reported in addition to the current code
- The excluded condition cannot be coded at the same time as the current code (Correct answer)
- The excluded code is an alternative code that may be used instead
- The excluded condition is included in the current code and need not be listed separately
Correct answer: The excluded condition cannot be coded at the same time as the current code
An Excludes1 note is a 'pure' exclusion indicating that the two conditions cannot occur together and therefore cannot be coded simultaneously.
Question 5: Which approach character in ICD-10-PCS represents a procedure performed entirely through orifices?
- Open (0)
- Percutaneous (3)
- Via Natural or Artificial Opening (7) (Correct answer)
- External (X)
Correct answer: Via Natural or Artificial Opening (7)
The approach character '7' in ICD-10-PCS represents procedures performed via natural or artificial openings without incision into the body.
Question 6: A patient is diagnosed with Type 2 diabetes mellitus with diabetic chronic kidney disease stage 4. Which ICD-10-CM guideline applies?
- Code the diabetes and CKD separately with no linkage assumed
- Assume a causal relationship between the diabetes and CKD without physician confirmation (Correct answer)
- Query the physician before assuming any relationship
- Code only the CKD since it is the more severe condition
Correct answer: Assume a causal relationship between the diabetes and CKD without physician confirmation
ICD-10-CM guidelines state that a causal relationship between diabetes and CKD is assumed unless the physician documents otherwise, allowing direct combination coding.
Question 7: Which of the following is the correct sequence for looking up a diagnosis code in ICD-10-CM?
- Verify in Tabular List first, then confirm in Alphabetic Index
- Locate in Alphabetic Index first, then verify the code in the Tabular List (Correct answer)
- Use only the Tabular List for all code selection
- Use only the Alphabetic Index for final code assignment
Correct answer: Locate in Alphabetic Index first, then verify the code in the Tabular List
The correct process is to locate the term in the Alphabetic Index to find a code, then verify and finalize the code in the Tabular List.
