Certified Coding Associate Exam Certified Coding Associate Clinical 4 — Questions and Answers
Question 1: A patient is admitted following a car accident with a fractured femur and a head injury. After study, the femur fracture required surgery. Which is the principal diagnosis?
- Head injury, as it is more severe
- Fractured femur, as it required surgical treatment (Correct answer)
- Either condition per UHDDS
- The first condition listed by the physician
Correct answer: Fractured femur, as it required surgical treatment
The condition chiefly responsible for the admission after study is the principal diagnosis; in this case, the femur fracture prompted surgery.
Question 2: In CPT, what does the modifier '-26' indicate when appended to a radiology code?
- Global service
- Professional component only (Correct answer)
- Technical component only
- Bilateral procedure
Correct answer: Professional component only
Modifier -26 indicates the physician's professional component (interpretation and report) when billed separately from the technical component.
Question 3: Which section of ICD-10-PCS is used to code a blood transfusion?
- Medical and Surgical
- Administration (Correct answer)
- Measurement and Monitoring
- Extracorporeal Therapies
Correct answer: Administration
Transfusions are coded in the Administration section of ICD-10-PCS because they involve introducing a therapeutic substance into the body.
Question 4: When a patient is seen for a complication of a prior surgery, which code is assigned first?
- The complication code from the T80–T88 range (Correct answer)
- The original procedure code
- The symptom code
- The Z code for aftercare
Correct answer: The complication code from the T80–T88 range
Complications of surgery are reported with the appropriate complication code (T80–T88) as the principal or first-listed diagnosis.
Question 5: A patient with type 1 diabetes is admitted in diabetic ketoacidosis. What is the correct principal diagnosis code?
- E10.10 (Correct answer)
- E11.10
- E13.10
- E10.9
Correct answer: E10.10
E10.10 captures type 1 diabetes mellitus with ketoacidosis without coma, which is the correct code for this scenario.
Question 6: Which healthcare setting uses the UB-04 claim form for billing?
- Physician office
- Inpatient hospital and outpatient facilities (Correct answer)
- Ambulatory surgery centers only
- Skilled nursing facilities only
Correct answer: Inpatient hospital and outpatient facilities
The UB-04 (CMS-1450) is used by inpatient hospitals, outpatient hospitals, and other facility-based providers.
Question 7: What is the purpose of an Excludes2 note in ICD-10-CM?
- The excluded condition cannot occur with the code above
- The excluded condition may be coded together with the code above when both are present (Correct answer)
- The code should never be reported
- The condition is included in the code above
Correct answer: The excluded condition may be coded together with the code above when both are present
Excludes2 means the condition is not included here but may coexist and be coded together when both conditions are present.
Certified Coding Associate Exam Certified Coding Associate Clinical 4
A patient is admitted following a car accident with a fractured femur and a head injury.
After study, the femur fracture required surgery.
Which is the principal diagnosis?