Medical Coding Principles Flashcards
7 cards from real RHIT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medical Coding Principles flashcards as text
Which coding guideline applies when a patient is admitted with a condition that develops into a more specific diagnosis during the stay?
Answer: Code the final confirmed diagnosis as the principal diagnosis
The UHDDS guideline requires coding the condition established after study as the principal diagnosis, not the admitting diagnosis.
In ICD-10-CM, what does an 'X' placeholder in a code indicate?
Answer: A dummy placeholder used to allow for future expansion or to reach a required character position
The 'X' placeholder fills a character position so a required character (often 7th) can be assigned correctly.
When coding a patient with type 2 diabetes mellitus and diabetic chronic kidney disease stage 3, what is the correct coding approach?
Answer: Code the diabetes with CKD combination code, then add the CKD stage code
ICD-10-CM provides combination codes for diabetes with complications; the CKD stage is coded additionally per guidelines.
In CPT coding, what distinguishes a 'new patient' from an 'established patient' for E/M services?
Answer: A new patient has not received professional services from the physician or same group practice within the past 3 years
CPT defines a new patient as one who has not received professional services from the physician/group within the past 3 years.
What is the purpose of the 'Table of Neoplasms' in the ICD-10-CM index?
Answer: To guide coders to the correct code based on site and behavior (malignant, benign, uncertain, etc.)
The Table of Neoplasms organizes codes by anatomic site and neoplasm behavior, directing coders to the appropriate code.
A patient undergoes a laparoscopic appendectomy that is converted to an open procedure. How should this be coded in CPT?
Answer: Code only the open appendectomy
When a laparoscopic procedure is converted to open, only the open procedure code is reported per CPT guidelines.
Which ICD-10-CM guideline governs the sequencing of a complication code versus the underlying condition?
Answer: The underlying condition is sequenced first unless the complication is the reason for the encounter
Sequencing depends on the reason for the encounter; if the complication prompted the visit, it may be principal.