ANCC IQ DOMAINS 1 TO 5 REVISION
HANDBOOK 2026 ETHICS POLICY AND
HEALTHCARE SYSTEMS
◉ ICD-10-PCS.
Answer: International Classification of Diseases, 10th Revision,
Procedure Coding System.
◉ CPT codes.
Answer: To describe medical, surgical, and diagnostic services.
◉ CPT modifier.
Answer: Two-digit codes that provide additional information about
the procedure.
◉ Difference between ICD-10-CM and ICD-10-PCS.
Answer: ICD-10-CM is for diagnoses; ICD-10-PCS is for inpatient
procedures.
◉ Sequencing in coding.
Answer: The order in which diagnoses and procedures are reported;
it affects reimbursement.
,◉ MCC.
Answer: Major Complication or Comorbidity—affects DRG
assignment and payment.
◉ CC.
Answer: Complication or Comorbidity—less severe than MCC but
still affects reimbursement.
◉ Upcoding.
Answer: Assigning codes that reflect more serious conditions or
services than documented.
◉ Unbundling.
Answer: Coding separate components of a procedure instead of one
comprehensive code.
◉ 7th character in ICD-10-CM.
Answer: It indicates episode of care (e.g., initial, subsequent,
sequela).
◉ PCS root operation 'Excision'.
Answer: Cutting out or off part of a body part.
, ◉ PCS root operation 'Resection'.
Answer: Cutting out or off all of a body part.
◉ PCS root operation 'Fusion'.
Answer: Joining body parts together to render them immobile.
◉ ICD-10-CM code for diabetes with nephropathy.
Answer: E11.21
◉ CPT code 45378.
Answer: Used for diagnostic colonoscopy.
◉ CPT modifier -25.
Answer: Used for significant, separately identifiable E/M service on
the same day.
◉ NCCI.
Answer: National Correct Coding Initiative—prevents improper
code pairings.
◉ ICD-10-CM code for sepsis due to E. coli.
HANDBOOK 2026 ETHICS POLICY AND
HEALTHCARE SYSTEMS
◉ ICD-10-PCS.
Answer: International Classification of Diseases, 10th Revision,
Procedure Coding System.
◉ CPT codes.
Answer: To describe medical, surgical, and diagnostic services.
◉ CPT modifier.
Answer: Two-digit codes that provide additional information about
the procedure.
◉ Difference between ICD-10-CM and ICD-10-PCS.
Answer: ICD-10-CM is for diagnoses; ICD-10-PCS is for inpatient
procedures.
◉ Sequencing in coding.
Answer: The order in which diagnoses and procedures are reported;
it affects reimbursement.
,◉ MCC.
Answer: Major Complication or Comorbidity—affects DRG
assignment and payment.
◉ CC.
Answer: Complication or Comorbidity—less severe than MCC but
still affects reimbursement.
◉ Upcoding.
Answer: Assigning codes that reflect more serious conditions or
services than documented.
◉ Unbundling.
Answer: Coding separate components of a procedure instead of one
comprehensive code.
◉ 7th character in ICD-10-CM.
Answer: It indicates episode of care (e.g., initial, subsequent,
sequela).
◉ PCS root operation 'Excision'.
Answer: Cutting out or off part of a body part.
, ◉ PCS root operation 'Resection'.
Answer: Cutting out or off all of a body part.
◉ PCS root operation 'Fusion'.
Answer: Joining body parts together to render them immobile.
◉ ICD-10-CM code for diabetes with nephropathy.
Answer: E11.21
◉ CPT code 45378.
Answer: Used for diagnostic colonoscopy.
◉ CPT modifier -25.
Answer: Used for significant, separately identifiable E/M service on
the same day.
◉ NCCI.
Answer: National Correct Coding Initiative—prevents improper
code pairings.
◉ ICD-10-CM code for sepsis due to E. coli.
