CPC Knowledge Skill 5 — Questions and Answers
Question 1: Which of the following is the correct sequencing rule for inpatient coding of a complication that arose during the stay?
- Always list the complication as the principal diagnosis
- Sequence the condition that prompted admission as principal diagnosis; the complication is secondary (Correct answer)
- List the complication first only if it required surgical intervention
- Complications are never coded separately during inpatient stays
Correct answer: Sequence the condition that prompted admission as principal diagnosis; the complication is secondary
The condition that prompted admission after study is the principal diagnosis; complications that develop during the stay are coded as additional diagnoses.
Question 2: Category III CPT codes are described as:
- Permanent codes for established procedures
- Temporary tracking codes for emerging technologies and services (Correct answer)
- Administrative performance measurement codes
- Codes for experimental drugs only
Correct answer: Temporary tracking codes for emerging technologies and services
Category III codes are temporary alphanumeric codes used to collect data on emerging technologies, services, and procedures.
Question 3: When coding burns in ICD-10-CM, what is the correct sequencing when a patient has both first-degree and third-degree burns at different sites?
- Sequence the first-degree burn first
- Sequence the third-degree (highest degree) burn first (Correct answer)
- Sequence burns in alphabetical order by body site
- Code only the most severe burn
Correct answer: Sequence the third-degree (highest degree) burn first
ICD-10-CM guidelines instruct coders to sequence the burn of highest degree first when multiple burns are present.
Question 4: Which modifier indicates that a procedure was performed bilaterally when the CPT descriptor is written for a unilateral procedure?
- -50 (Correct answer)
- -51
- -52
- -53
Correct answer: -50
Modifier -50 is appended to indicate a procedure was performed on both sides of the body during the same operative session.
Question 5: A provider documents 'diabetes mellitus due to underlying condition.' In ICD-10-CM, how should this be coded?
- E11.- (Type 2 diabetes) as principal diagnosis
- E08.- (Diabetes due to underlying condition) with the underlying condition coded first (Correct answer)
- E10.- (Type 1 diabetes) with a secondary code
- Code only the underlying condition, not the diabetes
Correct answer: E08.- (Diabetes due to underlying condition) with the underlying condition coded first
ICD-10-CM category E08 is used for diabetes due to an underlying condition, which is sequenced after the underlying cause per etiology/manifestation convention.
Question 6: What is the purpose of the 'Table of Drugs and Chemicals' in ICD-10-CM?
- To list approved medications for each diagnosis
- To help coders identify poisoning, adverse effect, and underdosing codes for substances (Correct answer)
- To provide drug interaction warnings
- To cross-reference NDC codes with ICD-10-CM codes
Correct answer: To help coders identify poisoning, adverse effect, and underdosing codes for substances
The Table of Drugs and Chemicals assists coders in selecting the correct codes for poisonings, adverse effects, and underdosing by substance and intent.
Question 7: Which CPT add-on code rule must coders always follow?
- Add-on codes can be reported alone without a primary procedure code
- Add-on codes must always be reported with the primary procedure code they supplement (Correct answer)
- Add-on codes require modifier -51 to indicate multiple procedures
- Add-on codes are used only for anesthesia services
Correct answer: Add-on codes must always be reported with the primary procedure code they supplement
Add-on codes (+) are always reported in conjunction with the primary procedure code and are never billed alone.
CPC Knowledge Skill 5
Which of the following is the correct sequencing rule for inpatient coding of a complication that arose during the stay?