COC Outpatient Coding Guidelines 2

Question 1

Which ICD-10-CM guideline applies to outpatient coding of HIV-related conditions?

Accepted Answer

Code B20 as first-listed when the encounter is for an HIV-related condition

Answer

When an HIV-positive patient is seen for an HIV-related illness, B20 (HIV disease) is sequenced first, followed by the specific HIV-related condition.

Question 2

An outpatient is seen for pain management after a recent fracture. The fracture has not fully healed. How should this be coded?

Accepted Answer

Code the fracture with the appropriate 7th character for subsequent encounter

Answer

Subsequent encounters for fracture care use the 7th character 'D' (routine healing), 'G' (delayed healing), or other appropriate subsequent-care characters — not 'A'.

Question 3

When a patient presents with signs and symptoms that are integral to a confirmed diagnosis, how are they coded?

Accepted Answer

They are NOT coded separately — they are included in the disease code

Answer

Signs and symptoms that are routinely associated with a confirmed disease process are not coded separately, as they are integral components of the diagnosis.

Question 4

In outpatient coding, how should a patient encounter for screening colonoscopy where a polyp is found and removed be coded?

Accepted Answer

Code the screening Z-code first, then the polyp finding

Answer

When a screening procedure reveals a finding, first-list the screening Z-code (e.g., Z12.11), then add the code for the finding (e.g., polyp of colon).

Question 5

A patient is seen in outpatient surgery for a knee replacement. The procedure is cancelled due to the patient developing acute respiratory distress preoperatively. What is the correct first-listed diagnosis?

Accepted Answer

The reason the procedure was cancelled (acute respiratory distress)

Answer

When a procedure is cancelled after the patient is prepared, the reason for cancellation (the complication or new condition) becomes the first-listed diagnosis.

COC - Certified Outpatient Coder Practice Test

COC - Certified Outpatient Coder Practice Test

COC Outpatient Coding Guidelines 2