ALABAMA MEDICAL CODING SPECIALIST EXAMINATION
COMPLETE EXAM QUESTIONS AND DETAILED SOLUTIONS
1. A patient is admitted to the hospital with chest pain. The physician
performs a full workup but does not establish a definitive diagnosis
before discharge. The final progress note documents "chest pain,
likely musculoskeletal in origin." Which diagnosis code should be
assigned for this encounter?
A. Code the musculoskeletal chest pain
B. Code the symptom of chest pain
C. Code both the symptom and the suspected condition
D. Code the suspected musculoskeletal condition
Answer: B
Rationale: According to ICD-10-CM official guidelines, if a definitive
diagnosis is not established at the time of discharge, the symptom code
is assigned rather than the suspected condition.
2. A patient presents for a follow-up visit after a recent myocardial
infarction. The physician documents "history of myocardial infarction,
currently asymptomatic." Which ICD-10-CM code category is
appropriate?
A. I21 (Acute myocardial infarction)
B. I22 (Subsequent myocardial infarction)
C. I25.2 (Old myocardial infarction)
D. I50 (Heart failure)
Answer: C
,Rationale: Category I25.2 is used for old myocardial infarctions that are
no longer acute and are not receiving active treatment.
3. A patient is diagnosed with diabetic neuropathy due to underlying
Type 1 diabetes. How should this be coded in ICD-10-CM?
A. Code Type 1 diabetes only
B. Code diabetic neuropathy only
C. Code Type 1 diabetes and diabetic neuropathy separately
D. Code Type 1 diabetes with neurological complications
Answer: D
Rationale: ICD-10-CM combines diabetes with its associated
manifestations into a single combination code. Type 1 diabetes with
neurological complications is the correct assignment.
4. During an outpatient encounter, a patient is seen for an annual
physical examination. The physician also addresses a mild case of
eczema. Which CPT modifier should be appended to the E/M service
for the eczema?
A. Modifier 24
B. Modifier 25
C. Modifier 59
D. Modifier 57
Answer: B
Rationale: Modifier 25 is used to indicate that a significant, separately
identifiable evaluation and management service was performed by the
same physician on the same day as a preventive medicine service.
5. A surgeon performs an appendectomy on a patient with acute
appendicitis. During the same operative session, the surgeon also
performs a lysis of adhesions to access the appendix. How should this
,be coded?
A. Code the appendectomy and lysis of adhesions separately
B. Code only the appendectomy as lysis of adhesions is integral
C. Code only the lysis of adhesions
D. Code the appendectomy with a modifier 59 on the lysis of adhesions
Answer: B
Rationale: Lysis of adhesions performed to access the primary surgical
site is considered an integral part of the primary procedure and is not
separately reportable.
6. A patient is prescribed a wheelchair for long-term use due to a
permanent disability. Which HCPCS Level II code range should be used
to bill for this equipment?
A. A codes
B. E codes
C. J codes
D. L codes
Answer: B
Rationale: HCPCS Level II E codes are designated for durable medical
equipment (DME), including wheelchairs.
7. A patient receives an injection of a chemotherapy drug in the
outpatient clinic. The drug is supplied by the hospital. Which code set
is used to report the administration of the drug?
A. ICD-10-CM
B. CPT
C. HCPCS Level II
D. ICD-10-PCS
Answer: B
Rationale: CPT codes in the Medicine section (specifically 96360-96379)
, are used to report the administration of drugs and biologics in
outpatient settings.
8. A physician documents a patient's condition as "acute exacerbation
of chronic obstructive pulmonary disease." How should this be coded?
A. Code only the acute exacerbation
B. Code only the chronic obstructive pulmonary disease
C. Code both the acute exacerbation and the chronic obstructive
pulmonary disease
D. Code the acute exacerbation with the chronic obstructive pulmonary
disease as an additional code
Answer: C
Rationale: ICD-10-CM provides a combination code for COPD with acute
exacerbation (J44.1). Both elements are inherent in the single code.
9. A patient is seen in the emergency department for a severe allergic
reaction to a bee sting. The physician documents anaphylactic shock
due to the bee sting. Which ICD-10-CM code is assigned first?
A. The code for the bee sting
B. The code for anaphylactic shock
C. The code for the allergic reaction
D. The code for the respiratory distress
Answer: B
Rationale: When a patient has an anaphylactic reaction due to a specific
cause, the anaphylactic shock is sequenced first, followed by the code
for the causative agent (the bee sting).
10. A coder is reviewing a medical record and notes that the physician
documented "probable pneumonia" in the progress notes but ordered
a chest X-ray that was negative. What should the coder do?
COMPLETE EXAM QUESTIONS AND DETAILED SOLUTIONS
1. A patient is admitted to the hospital with chest pain. The physician
performs a full workup but does not establish a definitive diagnosis
before discharge. The final progress note documents "chest pain,
likely musculoskeletal in origin." Which diagnosis code should be
assigned for this encounter?
A. Code the musculoskeletal chest pain
B. Code the symptom of chest pain
C. Code both the symptom and the suspected condition
D. Code the suspected musculoskeletal condition
Answer: B
Rationale: According to ICD-10-CM official guidelines, if a definitive
diagnosis is not established at the time of discharge, the symptom code
is assigned rather than the suspected condition.
2. A patient presents for a follow-up visit after a recent myocardial
infarction. The physician documents "history of myocardial infarction,
currently asymptomatic." Which ICD-10-CM code category is
appropriate?
A. I21 (Acute myocardial infarction)
B. I22 (Subsequent myocardial infarction)
C. I25.2 (Old myocardial infarction)
D. I50 (Heart failure)
Answer: C
,Rationale: Category I25.2 is used for old myocardial infarctions that are
no longer acute and are not receiving active treatment.
3. A patient is diagnosed with diabetic neuropathy due to underlying
Type 1 diabetes. How should this be coded in ICD-10-CM?
A. Code Type 1 diabetes only
B. Code diabetic neuropathy only
C. Code Type 1 diabetes and diabetic neuropathy separately
D. Code Type 1 diabetes with neurological complications
Answer: D
Rationale: ICD-10-CM combines diabetes with its associated
manifestations into a single combination code. Type 1 diabetes with
neurological complications is the correct assignment.
4. During an outpatient encounter, a patient is seen for an annual
physical examination. The physician also addresses a mild case of
eczema. Which CPT modifier should be appended to the E/M service
for the eczema?
A. Modifier 24
B. Modifier 25
C. Modifier 59
D. Modifier 57
Answer: B
Rationale: Modifier 25 is used to indicate that a significant, separately
identifiable evaluation and management service was performed by the
same physician on the same day as a preventive medicine service.
5. A surgeon performs an appendectomy on a patient with acute
appendicitis. During the same operative session, the surgeon also
performs a lysis of adhesions to access the appendix. How should this
,be coded?
A. Code the appendectomy and lysis of adhesions separately
B. Code only the appendectomy as lysis of adhesions is integral
C. Code only the lysis of adhesions
D. Code the appendectomy with a modifier 59 on the lysis of adhesions
Answer: B
Rationale: Lysis of adhesions performed to access the primary surgical
site is considered an integral part of the primary procedure and is not
separately reportable.
6. A patient is prescribed a wheelchair for long-term use due to a
permanent disability. Which HCPCS Level II code range should be used
to bill for this equipment?
A. A codes
B. E codes
C. J codes
D. L codes
Answer: B
Rationale: HCPCS Level II E codes are designated for durable medical
equipment (DME), including wheelchairs.
7. A patient receives an injection of a chemotherapy drug in the
outpatient clinic. The drug is supplied by the hospital. Which code set
is used to report the administration of the drug?
A. ICD-10-CM
B. CPT
C. HCPCS Level II
D. ICD-10-PCS
Answer: B
Rationale: CPT codes in the Medicine section (specifically 96360-96379)
, are used to report the administration of drugs and biologics in
outpatient settings.
8. A physician documents a patient's condition as "acute exacerbation
of chronic obstructive pulmonary disease." How should this be coded?
A. Code only the acute exacerbation
B. Code only the chronic obstructive pulmonary disease
C. Code both the acute exacerbation and the chronic obstructive
pulmonary disease
D. Code the acute exacerbation with the chronic obstructive pulmonary
disease as an additional code
Answer: C
Rationale: ICD-10-CM provides a combination code for COPD with acute
exacerbation (J44.1). Both elements are inherent in the single code.
9. A patient is seen in the emergency department for a severe allergic
reaction to a bee sting. The physician documents anaphylactic shock
due to the bee sting. Which ICD-10-CM code is assigned first?
A. The code for the bee sting
B. The code for anaphylactic shock
C. The code for the allergic reaction
D. The code for the respiratory distress
Answer: B
Rationale: When a patient has an anaphylactic reaction due to a specific
cause, the anaphylactic shock is sequenced first, followed by the code
for the causative agent (the bee sting).
10. A coder is reviewing a medical record and notes that the physician
documented "probable pneumonia" in the progress notes but ordered
a chest X-ray that was negative. What should the coder do?
