Certified Coding Associate Exam Certified Coding Associate Clinical 5 — Questions and Answers
Question 1: A patient with hypertension and chronic kidney disease stage 4 is admitted. Per ICD-10-CM guidelines, how should these be coded?
- I10 and N18.4 separately
- I12.9 and N18.4
- I12.1 and N18.4 (Correct answer)
- I13.10 and N18.4
Correct 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.
Question 2: Which of the following is the correct approach to code a wound closure performed with adhesive strips (Steri-Strips)?
- Report a repair code with simple closure
- Report only an E/M code — no separate repair code (Correct answer)
- Report a complex closure code
- Report an intermediate repair code
Correct 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.
Question 3: The health record states 'patient presents with chest pain, rule out MI.' This is an outpatient encounter. What should be coded?
- Myocardial infarction
- Chest pain (Correct answer)
- Both chest pain and MI
- Angina pectoris
Correct answer: Chest pain
For outpatient visits, coders report the sign/symptom (chest pain) — 'rule out' diagnoses are not coded.
Question 4: 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?
- Report both codes
- Report only the more complex bundled code (Correct answer)
- Report both codes with modifier -59 to bypass the bundle
- Query the payer before coding
Correct 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.
Question 5: In ICD-10-PCS, what character position identifies the root operation?
- First character
- Second character
- Third character (Correct answer)
- Fourth character
Correct answer: Third character
The third character in an ICD-10-PCS code identifies the root operation (e.g., Excision, Repair, Replacement).
Question 6: A patient undergoes a right knee replacement. In ICD-10-PCS, which device value is assigned for the prosthetic joint?
- No Device
- Synthetic Substitute (Correct answer)
- Nonautologous Tissue Substitute
- Autologous Tissue Substitute
Correct answer: Synthetic Substitute
A total knee replacement prosthesis is classified as a Synthetic Substitute in ICD-10-PCS device character.
Question 7: Which organization publishes the Official Guidelines for Coding and Reporting that coders must follow for ICD-10-CM/PCS?
- AMA
- CMS and NCHS (cooperating parties) (Correct answer)
- AHIMA
- Joint Commission
Correct 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).
Certified Coding Associate Exam Certified Coding Associate Clinical 5
A patient with hypertension and chronic kidney disease stage 4 is admitted.
Per ICD-10-CM guidelines, how should these be coded?