COC ICD-10-CM Coding 2

Question 1

A patient presents to an outpatient clinic with a pathological fracture of the right femur due to metastatic bone disease from breast cancer. Which code is sequenced first?

Accepted Answer

The metastatic bone disease code

Answer

In outpatient coding, metastatic disease is coded first when it is the reason for the encounter, with the fracture as a secondary code.

Question 2

Which ICD-10-CM placeholder character 'X' is used when?

Accepted Answer

To fill a code position so a 7th character can be added to a code with fewer than 6 characters

Answer

The placeholder 'X' is inserted at empty positions so the required 7th character extension falls in the correct position.

Question 3

A patient is seen in the ED for acute exacerbation of COPD with acute bronchitis. How should these conditions be coded?

Accepted Answer

Code the combination code J44.0 (COPD with acute lower respiratory infection)

Answer

ICD-10-CM provides combination code J44.0 which captures COPD with acute lower respiratory infection, including acute bronchitis.

Question 4

Under ICD-10-CM, how is hypertensive chronic kidney disease coded?

Accepted Answer

A combination code from category I12 linking hypertension and CKD

Answer

ICD-10-CM assumes a causal relationship between hypertension and CKD, requiring a combination code from category I12.

Question 5

A patient is seen for a routine follow-up visit after completing treatment for malignant neoplasm of the colon; no evidence of disease is found. Which code is appropriate?

Accepted Answer

Z08 – Encounter for follow-up examination after completed treatment for malignant neoplasm

Answer

Z08 is used when the patient has completed treatment and presents for a follow-up with no current disease evidence.

COC - Certified Outpatient Coder Practice Test

COC - Certified Outpatient Coder Practice Test

COC ICD-10-CM Coding 2