Certified Coding Associate Exam Certified Coding Associate Knowledge 4 — Questions and Answers
Question 1: Which organization publishes the Official Guidelines for Coding and Reporting for ICD-10-CM?
- AMA
- CMS and NCHS (Correct answer)
- AHIMA
- WHO
Correct answer: CMS and NCHS
The Official Guidelines for ICD-10-CM Coding and Reporting are published jointly by CMS (Centers for Medicare & Medicaid Services) and the NCHS (National Center for Health Statistics).
Question 2: A patient undergoes a procedure and develops a complication requiring a return to the OR. The complication code should be sequenced:
- Before the original procedure code
- As the principal or first-listed diagnosis (Correct answer)
- As an additional diagnosis only
- It should not be coded
Correct answer: As the principal or first-listed diagnosis
When a complication requires a return to the OR, it becomes the principal diagnosis for that subsequent encounter.
Question 3: What type of code is used when a patient has a condition that is not yet confirmed but is being evaluated?
- Confirmed diagnosis code
- Signs and symptoms codes (Correct answer)
- Uncertain diagnosis code
- Screening code
Correct answer: Signs and symptoms codes
In outpatient settings, coders report signs and symptoms rather than unconfirmed diagnoses; uncertain diagnoses may only be coded as confirmed in inpatient settings.
Question 4: The global surgical package typically includes all of the following EXCEPT:
- Preoperative care one day before surgery
- Intraoperative services
- Postoperative care for 90 days
- Treatment of unrelated conditions during the postoperative period (Correct answer)
Correct answer: Treatment of unrelated conditions during the postoperative period
The global surgical package does not include treatment of conditions unrelated to the surgery; those may be billed separately with appropriate modifiers.
Question 5: Which ICD-10-CM chapter contains codes for mental, behavioral, and neurodevelopmental disorders?
- Chapter 5 (Correct answer)
- Chapter 6
- Chapter 18
- Chapter 21
Correct answer: Chapter 5
Chapter 5 (F01–F99) of ICD-10-CM covers mental, behavioral, and neurodevelopmental disorders.
Question 6: A patient is admitted for chemotherapy for breast cancer. What is the correct sequencing?
- Breast cancer code first, then chemotherapy code
- Chemotherapy encounter code first, then the cancer code (Correct answer)
- Only the cancer code is required
- Only the chemotherapy code is required
Correct answer: Chemotherapy encounter code first, then the cancer code
When a patient is admitted specifically for chemotherapy, Z51.11 (encounter for antineoplastic chemotherapy) is sequenced first, followed by the malignancy code.
Question 7: Which of the following best describes the function of a 'crosswalk' in medical coding?
- A method for appealing claim denials
- A tool for translating codes between different coding systems (Correct answer)
- A compliance auditing checklist
- A way to group codes by reimbursement rate
Correct answer: A tool for translating codes between different coding systems
A crosswalk maps equivalent or corresponding codes between different coding systems (e.g., ICD-9-CM to ICD-10-CM) to facilitate translation during transitions.
Certified Coding Associate Exam Certified Coding Associate Knowledge 4
Which organization publishes the Official Guidelines for Coding and Reporting for ICD-10-CM?