ICD 10 Coding Guidelines 2 — Questions and Answers
Question 1: Under ICD-10-CM guidelines, when a patient is admitted for treatment of a complication of surgery, how should the complication be coded?
- As the principal diagnosis if it is the reason for admission (Correct answer)
- Never coded, only the original condition
- As a secondary diagnosis only
- Using a Z code exclusively
Correct answer: As the principal diagnosis if it is the reason for admission
A complication that occasions the admission is sequenced as the principal diagnosis.
Question 2: What does the ICD-10-CM convention 'Code first' instruct the coder to do?
- Sequence the underlying etiology before the manifestation (Correct answer)
- Code only the first-listed symptom
- Always use the first code in the index
- Report the most recent diagnosis first
Correct answer: Sequence the underlying etiology before the manifestation
'Code first' directs that the underlying condition be sequenced before the manifestation code.
Question 3: When the documentation states a diagnosis is 'probable' or 'suspected' in the OUTPATIENT setting, the coder should:
- Code the condition as if confirmed
- Code the signs, symptoms, or reason for the visit (Correct answer)
- Query the physician before any coding
- Assign a Z code for observation
Correct answer: Code the signs, symptoms, or reason for the visit
In outpatient settings, uncertain diagnoses are not coded; code the symptoms instead.
Question 4: The ICD-10-CM term 'Excludes1' indicates that:
- The two conditions cannot be coded together (Correct answer)
- The codes may both be used if conditions coexist
- An additional code is required
- The code is for the excluded body part only
Correct answer: The two conditions cannot be coded together
Excludes1 means 'not coded here'—the conditions are mutually exclusive.
Question 5: Which placeholder character is used in ICD-10-CM to fill empty positions when a 7th character is required?
- X (Correct answer)
- Z
- 0
- U
Correct answer: X
The dummy placeholder 'X' fills empty character positions to allow a valid 7th character.
Question 6: For a patient receiving therapy for an active malignancy and anemia due to the malignancy, the sequencing should be:
- Malignancy first, then the anemia (Correct answer)
- Anemia first, then the malignancy
- Only the anemia
- Only the malignancy
Correct answer: Malignancy first, then the anemia
When treating anemia associated with malignancy, the malignancy is sequenced first.
Question 7: The 7th character 'A' in injury coding designates:
- Initial encounter (Correct answer)
- Subsequent encounter
- Sequela
- Aftercare
Correct answer: Initial encounter
'A' denotes the initial encounter while the patient receives active treatment.
ICD 10 Coding Guidelines 2
Under ICD-10-CM guidelines, when a patient is admitted for treatment of a complication of surgery, how should the complication be coded?