COC ICD-10-CM Coding 3 — Questions and Answers
Question 1: A patient with type 2 diabetes mellitus is seen for diabetic chronic kidney disease, stage 3. Which code set is correct?
- E11.65, N18.3
- E11.22, N18.3 (Correct answer)
- E11.9, N18.3
- E11.649, N18.3
Correct answer: E11.22, N18.3
E11.22 is the combination code for type 2 diabetes with diabetic chronic kidney disease, and N18.3 specifies stage 3 CKD.
Question 2: Which ICD-10-CM guideline governs the use of code Z23 (Encounter for immunization)?
- Z23 is sequenced as an additional code only
- Z23 is always the principal or first-listed diagnosis code (Correct answer)
- Z23 is used only when the immunization is refused
- Z23 applies only to pediatric immunizations
Correct answer: Z23 is always the principal or first-listed diagnosis code
Z23 is assigned as the first-listed code when the sole reason for the encounter is to receive an immunization.
Question 3: A coder encounters the instruction 'Code also' in the ICD-10-CM Tabular List. What does this instruction mean?
- The additional code is mandatory and must always be sequenced first
- An additional code may be required to fully describe the condition, and sequencing depends on severity (Correct answer)
- The additional code is optional and should only be used if documented
- The instruction applies only to inpatient coding
Correct answer: An additional code may be required to fully describe the condition, and sequencing depends on severity
'Code also' instructs the coder to assign an additional code when applicable, with sequencing determined by the circumstances of the encounter.
Question 4: Under ICD-10-CM, how are pressure ulcers coded when a patient has a pressure ulcer that progresses from stage 2 to stage 3 during an outpatient encounter?
- Code the lower stage since it was present at the start
- Code only the higher stage that the ulcer progressed to (Correct answer)
- Code both stages with stage 2 sequenced first
- Code only when healing is documented
Correct answer: Code only the higher stage that the ulcer progressed to
Per ICD-10-CM guidelines, when a pressure ulcer progresses during an encounter, assign the code for the highest stage documented.
Question 5: A patient presents for an outpatient visit reporting pain in the left knee. The provider documents 'osteoarthritis versus internal derangement.' Which condition is coded?
- Both osteoarthritis and internal derangement
- Osteoarthritis, because it is listed first
- Pain in left knee, because outpatient uncertain diagnoses are not coded (Correct answer)
- Internal derangement, because it is more severe
Correct answer: Pain in left knee, because outpatient uncertain diagnoses are not coded
For outpatient encounters, uncertain diagnoses (versus, possible, probable) are not coded; code the sign or symptom—knee pain.
Question 6: When a patient has sepsis due to a postprocedural infection, which sequencing rule applies in the outpatient setting?
- Code sepsis first, then the postprocedural complication code (Correct answer)
- Code the postprocedural complication code first, then sepsis
- Code only the organism responsible
- Code the surgical procedure code first
Correct answer: Code sepsis first, then the postprocedural complication code
Sepsis is sequenced as the first-listed diagnosis; the postprocedural infection and causative organism codes follow.
Question 7: Which ICD-10-CM code category is used to report encounters related to contraceptive management?
- Z30 (Correct answer)
- Z34
- Z32
- Z36
Correct answer: Z30
Category Z30 covers encounters for contraceptive management, including initiation, monitoring, and removal of contraceptive devices.
COC ICD-10-CM Coding 3
A patient with type 2 diabetes mellitus is seen for diabetic chronic kidney disease, stage 3.
Which code set is correct?