CPC - Certified Professional Coder ICD-10-CM Diagnosis Coding Questions and Answers

Question 1

A patient is seen for painful urination and is diagnosed with an acute cystitis. The patient also has documented chronic cystitis. According to ICD-10-CM guidelines, how should these conditions be coded and sequenced?

Accepted Answer

Code both acute and chronic cystitis, and sequence the acute cystitis code first.

Answer

According to the ICD-10-CM Official Guidelines for Coding and Reporting, if the same condition is described as both acute and chronic, and separate subentries exist in the Alphabetic Index, both codes should be assigned. The acute code is sequenced first, followed by the chronic code.

Question 2

A patient presents to the emergency department with an altered mental status after accidentally taking a double dose of their prescribed oxycodone. How should the ICD-10-CM codes be sequenced?

Accepted Answer

Poisoning code for oxycodone first, followed by the altered mental status code.

Answer

For a poisoning, the ICD-10-CM guidelines state to sequence the poisoning code first (from categories T36-T50), followed by any code(s) for the manifestation(s). Since the patient took an incorrect dose, it is classified as a poisoning, not an adverse effect. The poisoning code (T40.2X1A) would be sequenced first, followed by the code for altered mental status (R41.82).

Question 3

A patient is treated for a keloid scar on their left forearm which is a result of a second-degree burn sustained one year ago. Which of the following is the correct coding and sequencing for this encounter?

Accepted Answer

Code for the keloid scar first, followed by the code for the burn with the 7th character 'S' for sequela.

Answer

Coding for a sequela (late effect) generally requires two codes. The residual condition (the sequela) is coded first, followed by the code for the cause of the sequela with the 7th character 'S'. In this case, the keloid scar (L91.0) is the sequela and is coded first. The burn (T22.212S) is the cause and is coded second with the 'S' to indicate it is a sequela of the original injury.

Question 4

Which of the following is a key convention when using the placeholder 'X' in an ICD-10-CM code?

Accepted Answer

The 'X' is used to allow for future expansion and must be used for the code to be valid if it fills empty character spaces up to the required 7th character.

Answer

The ICD-10-CM uses the placeholder character 'X' for two main reasons: to allow for future expansion and to fill in empty characters when a code requires a 7th character but is not 6 characters long. Where a placeholder exists, the 'X' must be used for the code to be considered a valid code.

Question 5

A patient with Type 2 diabetes mellitus is seen for a routine follow-up. The provider documents 'Type 2 DM with diabetic polyneuropathy'. How should this be coded in ICD-10-CM?

Accepted Answer

Use a single combination code, E11.42, which includes both the diabetes and the specific neurological complication.

Answer

ICD-10-CM has combination codes for diabetes that include the type of diabetes, the body system affected, and the complication. The 'with' convention in the Alphabetic Index presumes a causal relationship between diabetes and certain other conditions. For Type 2 diabetes with diabetic polyneuropathy, the correct code is E11.42, which is a specific combination code that captures both diagnoses.

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CPC - Certified Professional Coder ICD-10-CM Diagnosis Coding Questions and Answers