Certified Coding Specialist – Physician-based (CCS-P®)
Exam Prep 2026 Updated Practice Questions –
Comprehensive Physician-Based Medical Coding Review
Detailed Explanations – Verified Answers – Complete
Success Workbook
SECTION 1: DIAGNOSIS CODING (24–26%)
Question 1
A 45-year-old male presents to his primary care physician with complaints of chest
pain. The physician documents the final diagnosis as "atypical chest pain." What is
the correct ICD-10-CM code ?
A) R07.1 Chest pain on breathing
B) R07.89 Other chest pain
C) R07.9 Chest pain, unspecified
D) I20.9 Angina pectoris, unspecified
Rationale: Atypical chest pain is classified to R07.89 (Other chest pain) in ICD-
10-CM. R07.1 is for pain on breathing, R07.9 is unspecified chest pain, and I20.9
is angina pectoris. Since the physician documented "atypical chest pain," which is
a specific type of chest pain not otherwise classified, R07.89 is the most
appropriate code.
Question 2
A patient with Type 2 diabetes mellitus is seen for a routine follow-up. The
physician documents "diabetic neuropathy, unspecified." How should this be
coded?
A) E11.9 Type 2 diabetes without complications
B) E11.40 Type 2 diabetes with diabetic neuropathy, unspecified
C) E11.42 Type 2 diabetes with diabetic polyneuropathy
D) G62.9 Polyneuropathy, unspecified
,Rationale: When a patient with diabetes has a documented diabetic complication,
both the diabetes code and the manifestation code must be reported. E11.40 is the
combination code for Type 2 diabetes with diabetic neuropathy, unspecified. The
coder must first look up the diabetic neuropathy in the ICD-10-CM Alphabetic
Index to identify the correct combination code.
Question 3
A patient is admitted for dehydration due to viral gastroenteritis. According to
ICD-10-CM coding guidelines, which diagnosis should be sequenced as
the principal diagnosis ?
A) Dehydration
B) Viral gastroenteritis
C) Both are equally appropriate
D) The condition that required the most resources
Rationale: When a patient is admitted with a condition that is a manifestation of
an underlying disease, the underlying disease is sequenced first. Viral
gastroenteritis is the underlying cause of the dehydration. The ICD-10-CM
guideline states that when a patient is admitted with a condition that is a
manifestation of an underlying disease, the underlying disease is sequenced first.
Dehydration would be coded as a secondary diagnosis.
Question 4
A patient is diagnosed with pneumonia due to COVID-19. What is the correct
ICD-10-CM code assignment?
A) U07.1 COVID-19 only
B) J12.9 Viral pneumonia, unspecified only
C) U07.1 COVID-19 followed by J12.82 Pneumonia due to coronavirus disease
2019
D) J12.82 Pneumonia due to coronavirus disease 2019 only
Rationale: When COVID-19 is the cause of pneumonia, both codes are required.
The correct sequencing is U07.1 (COVID-19) followed by J12.82 (Pneumonia due
,to coronavirus disease 2019). The COVID-19 code is sequenced first as the
underlying disease.
Question 5
A patient with a history of breast cancer (status post mastectomy 5 years ago)
presents for a routine screening mammogram. The mammogram is normal. What
ICD-10-CM code should be assigned?
A) Z80.3 Family history of breast cancer
B) Z12.31 Encounter for screening mammogram for malignant neoplasm of
breast
C) Z85.3 Personal history of malignant neoplasm of breast
D) Z92.3 Personal history of chemotherapy
Rationale: Since this is a screening mammogram and the patient has no current
signs or symptoms, the appropriate code is Z12.31 (Encounter for screening
mammogram for malignant neoplasm of breast). The history code (Z85.3) should
not be used as the primary diagnosis for a screening encounter. The screening code
is sequenced first, and the history code may be added as a secondary diagnosis.
Question 6
A patient is seen for hypertensive heart disease with heart failure. The physician
documents both conditions. What is the correct ICD-10-CM code?
A) I10 Essential (primary) hypertension
B) I50.9 Heart failure, unspecified
C) I11.0 Hypertensive heart disease with heart failure
D) I11.9 Hypertensive heart disease without heart failure
Rationale: ICD-10-CM has combination codes for hypertensive heart disease with
heart failure. I11.0 (Hypertensive heart disease with heart failure) is the correct
code. The coder should not code both I10 and I50.9 separately when a combination
code exists.
Question 7
, A patient is seen in the emergency department for chest pain. After evaluation, the
physician determines the chest pain is non-cardiac and related
to gastroesophageal reflux disease (GERD) . What is the correct ICD-10-CM
code assignment?
A) R07.9 Chest pain, unspecified
B) K21.9 Gastro-esophageal reflux disease without esophagitis
C) R07.89 Other chest pain
D) Both R07.89 and K21.9
Rationale: When the physician has established a definitive diagnosis (GERD) that
explains the symptom (chest pain), the definitive diagnosis is coded instead of the
symptom. The chest pain is a symptom of the GERD and should not be coded
separately. K21.9 is the correct code for GERD without esophagitis.
Question 8
A patient is diagnosed with acute bronchitis and chronic obstructive pulmonary
disease (COPD) with acute exacerbation . What is the correct ICD-10-CM code?
A) J20.9 Acute bronchitis, unspecified
B) J44.0 Chronic obstructive pulmonary disease with acute lower respiratory
infection
C) J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
D) J44.9 Chronic obstructive pulmonary disease, unspecified
Rationale: When a patient with COPD has an acute exacerbation, J44.1 (Chronic
obstructive pulmonary disease with (acute) exacerbation) is the correct code. Acute
bronchitis is a lower respiratory infection that is included in the exacerbation and
should not be coded separately.
Question 9
A patient is seen for a well-woman exam. During the exam, the physician detects
a breast lump and documents "breast mass, right breast." What ICD-10-CM code
should be assigned?
A) Z00.00 Encounter for general adult medical examination without abnormal
findings
Exam Prep 2026 Updated Practice Questions –
Comprehensive Physician-Based Medical Coding Review
Detailed Explanations – Verified Answers – Complete
Success Workbook
SECTION 1: DIAGNOSIS CODING (24–26%)
Question 1
A 45-year-old male presents to his primary care physician with complaints of chest
pain. The physician documents the final diagnosis as "atypical chest pain." What is
the correct ICD-10-CM code ?
A) R07.1 Chest pain on breathing
B) R07.89 Other chest pain
C) R07.9 Chest pain, unspecified
D) I20.9 Angina pectoris, unspecified
Rationale: Atypical chest pain is classified to R07.89 (Other chest pain) in ICD-
10-CM. R07.1 is for pain on breathing, R07.9 is unspecified chest pain, and I20.9
is angina pectoris. Since the physician documented "atypical chest pain," which is
a specific type of chest pain not otherwise classified, R07.89 is the most
appropriate code.
Question 2
A patient with Type 2 diabetes mellitus is seen for a routine follow-up. The
physician documents "diabetic neuropathy, unspecified." How should this be
coded?
A) E11.9 Type 2 diabetes without complications
B) E11.40 Type 2 diabetes with diabetic neuropathy, unspecified
C) E11.42 Type 2 diabetes with diabetic polyneuropathy
D) G62.9 Polyneuropathy, unspecified
,Rationale: When a patient with diabetes has a documented diabetic complication,
both the diabetes code and the manifestation code must be reported. E11.40 is the
combination code for Type 2 diabetes with diabetic neuropathy, unspecified. The
coder must first look up the diabetic neuropathy in the ICD-10-CM Alphabetic
Index to identify the correct combination code.
Question 3
A patient is admitted for dehydration due to viral gastroenteritis. According to
ICD-10-CM coding guidelines, which diagnosis should be sequenced as
the principal diagnosis ?
A) Dehydration
B) Viral gastroenteritis
C) Both are equally appropriate
D) The condition that required the most resources
Rationale: When a patient is admitted with a condition that is a manifestation of
an underlying disease, the underlying disease is sequenced first. Viral
gastroenteritis is the underlying cause of the dehydration. The ICD-10-CM
guideline states that when a patient is admitted with a condition that is a
manifestation of an underlying disease, the underlying disease is sequenced first.
Dehydration would be coded as a secondary diagnosis.
Question 4
A patient is diagnosed with pneumonia due to COVID-19. What is the correct
ICD-10-CM code assignment?
A) U07.1 COVID-19 only
B) J12.9 Viral pneumonia, unspecified only
C) U07.1 COVID-19 followed by J12.82 Pneumonia due to coronavirus disease
2019
D) J12.82 Pneumonia due to coronavirus disease 2019 only
Rationale: When COVID-19 is the cause of pneumonia, both codes are required.
The correct sequencing is U07.1 (COVID-19) followed by J12.82 (Pneumonia due
,to coronavirus disease 2019). The COVID-19 code is sequenced first as the
underlying disease.
Question 5
A patient with a history of breast cancer (status post mastectomy 5 years ago)
presents for a routine screening mammogram. The mammogram is normal. What
ICD-10-CM code should be assigned?
A) Z80.3 Family history of breast cancer
B) Z12.31 Encounter for screening mammogram for malignant neoplasm of
breast
C) Z85.3 Personal history of malignant neoplasm of breast
D) Z92.3 Personal history of chemotherapy
Rationale: Since this is a screening mammogram and the patient has no current
signs or symptoms, the appropriate code is Z12.31 (Encounter for screening
mammogram for malignant neoplasm of breast). The history code (Z85.3) should
not be used as the primary diagnosis for a screening encounter. The screening code
is sequenced first, and the history code may be added as a secondary diagnosis.
Question 6
A patient is seen for hypertensive heart disease with heart failure. The physician
documents both conditions. What is the correct ICD-10-CM code?
A) I10 Essential (primary) hypertension
B) I50.9 Heart failure, unspecified
C) I11.0 Hypertensive heart disease with heart failure
D) I11.9 Hypertensive heart disease without heart failure
Rationale: ICD-10-CM has combination codes for hypertensive heart disease with
heart failure. I11.0 (Hypertensive heart disease with heart failure) is the correct
code. The coder should not code both I10 and I50.9 separately when a combination
code exists.
Question 7
, A patient is seen in the emergency department for chest pain. After evaluation, the
physician determines the chest pain is non-cardiac and related
to gastroesophageal reflux disease (GERD) . What is the correct ICD-10-CM
code assignment?
A) R07.9 Chest pain, unspecified
B) K21.9 Gastro-esophageal reflux disease without esophagitis
C) R07.89 Other chest pain
D) Both R07.89 and K21.9
Rationale: When the physician has established a definitive diagnosis (GERD) that
explains the symptom (chest pain), the definitive diagnosis is coded instead of the
symptom. The chest pain is a symptom of the GERD and should not be coded
separately. K21.9 is the correct code for GERD without esophagitis.
Question 8
A patient is diagnosed with acute bronchitis and chronic obstructive pulmonary
disease (COPD) with acute exacerbation . What is the correct ICD-10-CM code?
A) J20.9 Acute bronchitis, unspecified
B) J44.0 Chronic obstructive pulmonary disease with acute lower respiratory
infection
C) J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
D) J44.9 Chronic obstructive pulmonary disease, unspecified
Rationale: When a patient with COPD has an acute exacerbation, J44.1 (Chronic
obstructive pulmonary disease with (acute) exacerbation) is the correct code. Acute
bronchitis is a lower respiratory infection that is included in the exacerbation and
should not be coded separately.
Question 9
A patient is seen for a well-woman exam. During the exam, the physician detects
a breast lump and documents "breast mass, right breast." What ICD-10-CM code
should be assigned?
A) Z00.00 Encounter for general adult medical examination without abnormal
findings
