ICD 10 Coding Guidelines 3 — Questions and Answers
Question 1: When coding a sequela (late effect), what is the correct sequencing?
- Condition/nature of the sequela first, then the sequela code (Correct answer)
- Sequela code first, then the residual condition
- Only the sequela code
- Only the original acute injury code
Correct answer: Condition/nature of the sequela first, then the sequela code
The residual condition is coded first, followed by the sequela code.
Question 2: The 7th character 'S' is used to indicate:
- Sequela (Correct answer)
- Subsequent encounter
- Surgical aftercare
- Suspected condition
Correct answer: Sequela
'S' identifies a sequela, a condition resulting from a previous injury.
Question 3: An 'Excludes2' note means:
- The excluded condition is not part of the code but may be reported separately (Correct answer)
- The conditions can never be reported together
- An additional 7th character is needed
- The code has been deleted
Correct answer: The excluded condition is not part of the code but may be reported separately
Excludes2 means 'not included here,' so both codes may be used if both conditions exist.
Question 4: For combination codes in ICD-10-CM, the coder should:
- Assign only the single combination code when it fully identifies both conditions (Correct answer)
- Always assign two separate codes
- Assign the combination plus each individual code
- Never use combination codes
Correct answer: Assign only the single combination code when it fully identifies both conditions
A single combination code is used when it captures both the diagnosis and its manifestation/complication.
Question 5: When a patient has bilateral involvement but no bilateral code exists, the coder should:
- Assign separate codes for left and right sides (Correct answer)
- Assign the unspecified side code
- Assign only one side
- Use a placeholder X
Correct answer: Assign separate codes for left and right sides
Without a bilateral option, code each side separately using right and left codes.
Question 6: The guideline 'Use additional code' typically signals the need to:
- Identify a secondary condition such as an infectious organism (Correct answer)
- Replace the primary code
- Add a placeholder character
- Report a Z status code only
Correct answer: Identify a secondary condition such as an infectious organism
'Use additional code' prompts coding of an associated condition like a causative organism.
Question 7: When the same condition is described as both acute and chronic with separate index subentries, the coder should:
- Code both, sequencing the acute code first (Correct answer)
- Code only the chronic condition
- Code only the acute condition
- Code a single combination code
Correct answer: Code both, sequencing the acute code first
Both are coded with the acute (subacute) condition sequenced first.
ICD 10 Coding Guidelines 3
When coding a sequela (late effect), what is the correct sequencing?