CIC Certification Exam Prep 2026 Updated Practice
Questions, Comprehensive Inpatient Medical Coding
Review, Detailed Explanations, Verified Answers, Complete
Success Workbook
SECTION I: ICD-10-CM DIAGNOSIS CODING (25 Questions)
1. A 72-year-old patient with known HIV is admitted for treatment of
Pneumocystis jirovecii pneumonia (PJP). The provider documents "HIV,
symptomatic." What is the correct ICD-10-CM principal diagnosis?
A) B20
B) B20
C) Z21
D) B20 + J12.0
Answer: B) B20
Rationale: B20 (Human immunodeficiency virus [HIV] disease) is assigned
whenever a patient with HIV develops an HIV-related condition (such as
Pneumocystis jirovecii pneumonia). B20 is coded as the principal diagnosis, and
the HIV-related condition is coded as an additional diagnosis. Z21 is for
asymptomatic HIV.
2. A patient with Type 2 diabetes mellitus is admitted with diabetic
ketoacidosis. The provider documents "Type 2 diabetes mellitus with diabetic
ketoacidosis." What ICD-10-CM codes should be assigned?
A) E11.9
B) E11.10
C) E11.65
D) E10.10
Answer: B) E11.10
Rationale: E11.10 (Type 2 diabetes mellitus with ketoacidosis without coma) is
the correct code for Type 2 diabetes with diabetic ketoacidosis. The combination
code captures both the diabetes and the ketoacidosis. E11.9 is for diabetes without
complications. E10.10 is for Type 1 diabetes with ketoacidosis.
,3. A patient with chronic kidney disease (CKD) stage 5 due to diabetes
mellitus is admitted for hemodialysis. The provider documents "end-stage
renal disease on hemodialysis." What ICD-10-CM codes should be assigned?
A) N18.5
B) E11.22, N18.6, Z99.2
C) E11.9, N18.6
D) Z99.2
Answer: B) E11.22, N18.6, Z99.2
Rationale: The correct codes are E11.22 (Type 2 diabetes mellitus with diabetic
nephropathy), N18.6 (End-stage renal disease), and Z99.2 (Dependence on renal
dialysis). ICD-10-CM guidelines require sequencing the diabetes code first as the
underlying etiology, followed by the CKD/ESRD code, and then the dialysis
dependence code.
4. A patient is admitted with an acute exacerbation of chronic obstructive
pulmonary disease (COPD). The provider documents "acute exacerbation of
COPD." What ICD-10-CM code should be assigned?
A) J44.9
B) J44.1
C) J43.9
D) J45.901
Answer: B) J44.1
Rationale: J44.1 (Chronic obstructive pulmonary disease with acute exacerbation)
is the correct code for COPD with acute exacerbation. J44.9 is for COPD without
exacerbation. J43.9 is for emphysema without mention of chronic bronchitis.
5. A patient is admitted with community-acquired pneumonia. The provider
documents "pneumonia due to Streptococcus pneumoniae." What ICD-10-
CM code should be assigned?
A) J18.9
B) J13
,C) J15.9
D) J14
Answer: B) J13
Rationale: J13 (Pneumonia due to Streptococcus pneumoniae) is the correct code
when the specific organism is documented. J18.9 is for unspecified pneumonia.
J14 is for pneumonia due to Hemophilus influenzae.
6. A patient is admitted for a cerebrovascular accident (CVA) with left-sided
hemiplegia. The provider documents "acute ischemic stroke with left
hemiplegia." What ICD-10-CM codes should be assigned?
A) I63.9, G81.9
B) I63.9, G81.94
C) I63.9, I69.354
D) Z86.73
Answer: B) I63.9, G81.94
Rationale: I63.9 (Cerebral infarction, unspecified) is assigned for the acute
CVA. G81.94 (Hemiplegia, unspecified affecting left dominant side) is assigned
for the left-sided hemiplegia. For an acute CVA with residual deficits, the acute
CVA code is sequenced first. I69 codes are for late effects of cerebrovascular
disease.
7. A patient is admitted for congestive heart failure (CHF) with acute
pulmonary edema. The provider documents "acute on chronic systolic heart
failure with pulmonary edema." What ICD-10-CM code should be assigned?
A) I50.1
B) I50.23
C) I50.9
D) J81.0
Answer: B) I50.23
Rationale: I50.23 (Acute on chronic systolic heart failure) is the correct code. This
combination code captures both the acute and chronic nature of the heart failure.
, The pulmonary edema is included in the heart failure code when it is due to heart
failure.
8. A patient is admitted with a urinary tract infection due to Escherichia coli.
What ICD-10-CM code should be assigned?
A) N39.0
B) N39.0
C) B96.20
D) N39.0, B96.20
Answer: B) N39.0
Rationale: N39.0 (Urinary tract infection, site not specified) is the correct code for
a UTI when the site is not specified. The organism (E. coli) is not coded separately
in ICD-10-CM for UTIs; only the infection code is assigned. If the provider
documents the site (e.g., cystitis, pyelonephritis), the specific site code is used
instead.
9. A patient with a history of breast cancer is admitted for chemotherapy. The
provider documents "history of breast cancer, currently receiving
chemotherapy." What ICD-10-CM codes should be assigned?
A) Z85.3
B) Z85.3, Z51.11
C) C50.9, Z51.11
D) Z08
Answer: B) Z85.3, Z51.11
Rationale: Z85.3 (Personal history of malignant neoplasm of breast) is assigned
for the history of breast cancer. Z51.11 (Encounter for antineoplastic
chemotherapy) is assigned for the chemotherapy encounter. C50.9 would be used
only if the patient has active cancer. Z08 is for follow-up after completed
treatment.
10. A patient is admitted with sepsis due to a urinary tract infection. The
provider documents "sepsis due to urinary tract infection." What ICD-10-CM
Questions, Comprehensive Inpatient Medical Coding
Review, Detailed Explanations, Verified Answers, Complete
Success Workbook
SECTION I: ICD-10-CM DIAGNOSIS CODING (25 Questions)
1. A 72-year-old patient with known HIV is admitted for treatment of
Pneumocystis jirovecii pneumonia (PJP). The provider documents "HIV,
symptomatic." What is the correct ICD-10-CM principal diagnosis?
A) B20
B) B20
C) Z21
D) B20 + J12.0
Answer: B) B20
Rationale: B20 (Human immunodeficiency virus [HIV] disease) is assigned
whenever a patient with HIV develops an HIV-related condition (such as
Pneumocystis jirovecii pneumonia). B20 is coded as the principal diagnosis, and
the HIV-related condition is coded as an additional diagnosis. Z21 is for
asymptomatic HIV.
2. A patient with Type 2 diabetes mellitus is admitted with diabetic
ketoacidosis. The provider documents "Type 2 diabetes mellitus with diabetic
ketoacidosis." What ICD-10-CM codes should be assigned?
A) E11.9
B) E11.10
C) E11.65
D) E10.10
Answer: B) E11.10
Rationale: E11.10 (Type 2 diabetes mellitus with ketoacidosis without coma) is
the correct code for Type 2 diabetes with diabetic ketoacidosis. The combination
code captures both the diabetes and the ketoacidosis. E11.9 is for diabetes without
complications. E10.10 is for Type 1 diabetes with ketoacidosis.
,3. A patient with chronic kidney disease (CKD) stage 5 due to diabetes
mellitus is admitted for hemodialysis. The provider documents "end-stage
renal disease on hemodialysis." What ICD-10-CM codes should be assigned?
A) N18.5
B) E11.22, N18.6, Z99.2
C) E11.9, N18.6
D) Z99.2
Answer: B) E11.22, N18.6, Z99.2
Rationale: The correct codes are E11.22 (Type 2 diabetes mellitus with diabetic
nephropathy), N18.6 (End-stage renal disease), and Z99.2 (Dependence on renal
dialysis). ICD-10-CM guidelines require sequencing the diabetes code first as the
underlying etiology, followed by the CKD/ESRD code, and then the dialysis
dependence code.
4. A patient is admitted with an acute exacerbation of chronic obstructive
pulmonary disease (COPD). The provider documents "acute exacerbation of
COPD." What ICD-10-CM code should be assigned?
A) J44.9
B) J44.1
C) J43.9
D) J45.901
Answer: B) J44.1
Rationale: J44.1 (Chronic obstructive pulmonary disease with acute exacerbation)
is the correct code for COPD with acute exacerbation. J44.9 is for COPD without
exacerbation. J43.9 is for emphysema without mention of chronic bronchitis.
5. A patient is admitted with community-acquired pneumonia. The provider
documents "pneumonia due to Streptococcus pneumoniae." What ICD-10-
CM code should be assigned?
A) J18.9
B) J13
,C) J15.9
D) J14
Answer: B) J13
Rationale: J13 (Pneumonia due to Streptococcus pneumoniae) is the correct code
when the specific organism is documented. J18.9 is for unspecified pneumonia.
J14 is for pneumonia due to Hemophilus influenzae.
6. A patient is admitted for a cerebrovascular accident (CVA) with left-sided
hemiplegia. The provider documents "acute ischemic stroke with left
hemiplegia." What ICD-10-CM codes should be assigned?
A) I63.9, G81.9
B) I63.9, G81.94
C) I63.9, I69.354
D) Z86.73
Answer: B) I63.9, G81.94
Rationale: I63.9 (Cerebral infarction, unspecified) is assigned for the acute
CVA. G81.94 (Hemiplegia, unspecified affecting left dominant side) is assigned
for the left-sided hemiplegia. For an acute CVA with residual deficits, the acute
CVA code is sequenced first. I69 codes are for late effects of cerebrovascular
disease.
7. A patient is admitted for congestive heart failure (CHF) with acute
pulmonary edema. The provider documents "acute on chronic systolic heart
failure with pulmonary edema." What ICD-10-CM code should be assigned?
A) I50.1
B) I50.23
C) I50.9
D) J81.0
Answer: B) I50.23
Rationale: I50.23 (Acute on chronic systolic heart failure) is the correct code. This
combination code captures both the acute and chronic nature of the heart failure.
, The pulmonary edema is included in the heart failure code when it is due to heart
failure.
8. A patient is admitted with a urinary tract infection due to Escherichia coli.
What ICD-10-CM code should be assigned?
A) N39.0
B) N39.0
C) B96.20
D) N39.0, B96.20
Answer: B) N39.0
Rationale: N39.0 (Urinary tract infection, site not specified) is the correct code for
a UTI when the site is not specified. The organism (E. coli) is not coded separately
in ICD-10-CM for UTIs; only the infection code is assigned. If the provider
documents the site (e.g., cystitis, pyelonephritis), the specific site code is used
instead.
9. A patient with a history of breast cancer is admitted for chemotherapy. The
provider documents "history of breast cancer, currently receiving
chemotherapy." What ICD-10-CM codes should be assigned?
A) Z85.3
B) Z85.3, Z51.11
C) C50.9, Z51.11
D) Z08
Answer: B) Z85.3, Z51.11
Rationale: Z85.3 (Personal history of malignant neoplasm of breast) is assigned
for the history of breast cancer. Z51.11 (Encounter for antineoplastic
chemotherapy) is assigned for the chemotherapy encounter. C50.9 would be used
only if the patient has active cancer. Z08 is for follow-up after completed
treatment.
10. A patient is admitted with sepsis due to a urinary tract infection. The
provider documents "sepsis due to urinary tract infection." What ICD-10-CM
