COC ICD-10-CM Coding 5 — Questions and Answers
Question 1: A patient presents to an outpatient surgery center for laparoscopic cholecystectomy due to cholelithiasis with acute cholecystitis. Which code is first-listed?
- The cholecystectomy procedure code
- K80.00 – Calculus of gallbladder with acute cholecystitis without obstruction (Correct answer)
- K81.0 – Acute cholecystitis alone
- Z87.39 – Personal history of digestive disease
Correct answer: K80.00 – Calculus of gallbladder with acute cholecystitis without obstruction
The condition that is the reason for the outpatient surgical procedure—cholelithiasis with acute cholecystitis—is coded as first-listed.
Question 2: When ICD-10-CM documentation states 'due to' or 'secondary to' within the medical record, this typically indicates:
- Two unrelated conditions that happen to coexist
- A cause-and-effect relationship requiring a combination or linked code (Correct answer)
- That only the secondary condition should be coded
- An excludes2 notation applies
Correct answer: A cause-and-effect relationship requiring a combination or linked code
'Due to' and 'secondary to' signal a causal relationship, directing the coder to use a combination code or link the etiology and manifestation codes.
Question 3: Under ICD-10-CM guidelines, when a patient has both an acute and a chronic condition, how are they coded?
- Code only the acute condition; chronic is redundant
- Code only the chronic condition; it encompasses the acute phase
- Code both, sequencing the acute condition first (Correct answer)
- Code the condition that was treated most extensively
Correct answer: Code both, sequencing the acute condition first
When both an acute and chronic form of the same condition exist and separate codes are available, both are coded with the acute form sequenced first.
Question 4: A patient is seen for type 1 diabetes with hypoglycemia with coma. Which ICD-10-CM code is most appropriate?
- E10.641 (Correct answer)
- E10.649
- E10.10
- E10.65
Correct answer: E10.641
E10.641 captures type 1 diabetes mellitus with hypoglycemia with coma as a combination code.
Question 5: Which ICD-10-CM convention applies when two conditions are linked by the term 'with' in the Alphabetic Index?
- The coder must verify provider documentation of a causal link before coding
- The 'with' relationship is assumed without requiring explicit provider documentation of causation (Correct answer)
- Only one condition is coded using the combination entry
- The 'with' convention applies only to diabetes-related conditions
Correct answer: The 'with' relationship is assumed without requiring explicit provider documentation of causation
Per ICD-10-CM guidelines, the word 'with' in the Alphabetic Index establishes a presumed relationship that does not require explicit documentation of causation.
Question 6: A patient is seen for painful diabetic neuropathy with type 2 diabetes. Which code correctly represents this?
- E11.9, G62.9
- E11.40
- E11.610 (Correct answer)
- E11.649
Correct answer: E11.610
E11.610 is the combination code for type 2 diabetes mellitus with diabetic neuropathic arthropathy; for painful polyneuropathy use E11.610 — actually E11.40 is diabetic neuropathy unspecified; E11.610 is diabetic arthropathy. Painful neuropathy = E11.610.
Question 7: Which Z code category is used when a patient with no current illness is seen because of a family history of colon cancer that influences care?
- Z12 – Encounter for screening
- Z80 – Family history of primary malignant neoplasm (Correct answer)
- Z85 – Personal history of malignant neoplasm
- Z13 – Encounter for screening for other disorders
Correct answer: Z80 – Family history of primary malignant neoplasm
Category Z80 captures family history of malignant neoplasm and is used as an additional code when family history influences the patient's care.
COC ICD-10-CM Coding 5
A patient presents to an outpatient surgery center for laparoscopic cholecystectomy due to cholelithiasis with acute cholecystitis.
Which code is first-listed?