AIS Injury Coding Test Bank 2027 | Exam
Q&A w/ Detailed Rationales | Verified
Answers
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
143 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This examination assesses mastery of the Abbreviated Injury Scale (AIS) coding lexicon, severity scoring,
and trauma registry abstraction. It emphasizes the 2027 AAAM AIS update, ISS/NISS computation, and
correct handling of complex, multi-system injury documentation.
STUDY GUIDE
Recommended duration: 3 hours. Passing target: 80% (40/50).
HIGHP - Page 1 of 48
,1. In the AIS 2027 lexicon, a patient sustains a small, non-occlusive thrombus in the left
middle cerebral artery confirmed by CT angiography, with no neurologic deficit. Which AIS
code and severity should be assigned?
[ ] A. AIS 3, code 1.2.3.4 (thrombus, major vessel)
[ ] B. AIS 2, code 1.1.2.2 (thrombus, minor vessel)
[ ] C. AIS 4, code 1.3.1.1 (thrombus with infarction)
[ ] D. AIS 1, code 1.0.0.1 (thrombus, unspecified)
CORRECT: B. AIS 2, code 1.1.2.2 (thrombus, minor vessel)
AIS 2027 classifies a non-occlusive thrombus in a named intracranial vessel without infarction as a minor
injury (AIS 2). AIS 3 is reserved for major vessel thrombosis with partial occlusion, while AIS 4 requires
infarction. AIS 1 is for trivial or unspecified findings not meeting minor criteria.
2. A trauma registry patient has the following AIS codes: Head=4, Face=2, Chest=3,
Abdomen=2, Extremity=2, External=1. What is the correct Injury Severity Score (ISS)?
[ ] A. 29
[ ] B. 34
[ ] C. 38
[ ] D. 41
CORRECT: A. 29
ISS is the sum of squares of the three highest AIS scores from different body regions. The three highest are
Head (4²=16), Chest (3²=9), and Face (2²=4), totaling 29. Extremity and Abdomen also have AIS 2 but are
not higher than Face, so they are not included.
3. Which statement correctly describes the difference between ISS and NISS in AIS 2027
trauma scoring?
[ ] A. ISS uses the three most severe injuries regardless of body region, while NISS uses the three
highest across different regions.
[ ] B. ISS uses the three highest AIS scores from different body regions, while NISS uses the three
highest AIS scores regardless of region.
[ ] C. ISS and NISS are identical except NISS excludes external injuries.
[ ] D. NISS is calculated only for pediatric patients, while ISS is for adults.
CORRECT: B. ISS uses the three highest AIS scores from different body regions, while NISS uses the
three highest AIS scores regardless of region.
ISS requires the three highest AIS scores from three different body regions. NISS (New ISS) takes the three
highest AIS scores overall, even if from the same region, making it more sensitive to multiple severe injuries
in one area. NISS is not age-specific and does not exclude external injuries.
HIGHP - Page 2 of 48
,4. In AIS coding, how should multiple injuries to the same organ (e.g., two separate liver
lacerations) be coded?
[ ] A. Code each laceration separately and sum their AIS scores.
[ ] B. Code only the most severe laceration; lesser injuries are ignored.
[ ] C. Code the most severe injury and assign an additional AIS point for each extra injury to the same
organ.
[ ] D. Code the organ as 'multiple injuries' using a single AIS code that reflects the highest severity.
CORRECT: D. Code the organ as 'multiple injuries' using a single AIS code that reflects the highest
severity.
AIS 2027 instructs coders to assign a single code for multiple injuries to the same organ, using the code that
represents the highest severity. Summing scores or adding points is incorrect; lesser injuries are not coded
separately. This prevents overestimating severity from multiple minor lacerations.
5. A patient has a flail chest with bilateral rib fractures and a pulmonary contusion.
According to AIS 2027, which injury determines the chest AIS severity?
[ ] A. Flail chest (AIS 4)
[ ] B. Pulmonary contusion (AIS 3)
[ ] C. Bilateral rib fractures (AIS 2)
[ ] D. The sum of all three injuries (AIS 9)
CORRECT: A. Flail chest (AIS 4)
When multiple injuries occur in the same body region, the highest AIS severity is assigned. Flail chest is AIS
4, which is higher than pulmonary contusion (AIS 3) and rib fractures (AIS 2). AIS scores are not summed
within a region; the maximum is used.
6. Which of the following best describes the AIS 'zone' concept for coding external/skin
injuries?
[ ] A. External injuries are coded only if they are life-threatening.
[ ] B. External injuries are coded by body region and severity, with AIS 1 for minor abrasions and AIS 2
for major lacerations.
[ ] C. External injuries are always assigned AIS 1 regardless of size or depth.
[ ] D. External injuries are excluded from ISS calculation.
CORRECT: B. External injuries are coded by body region and severity, with AIS 1 for minor abrasions
and AIS 2 for major lacerations.
AIS 2027 codes external injuries (skin) by body region and severity. Minor abrasions/contusions are AIS 1;
major lacerations, avulsions, or burns may be AIS 2 or higher. They are included in ISS if they are among the
three highest scores.
HIGHP - Page 3 of 48
, 7. A patient has a penetrating injury to the right eye with globe rupture and a left orbital
blowout fracture. How should these be coded in AIS 2027?
[ ] A. Both injuries coded under Face region, with the highest severity assigned.
[ ] B. Globe rupture coded under Face, blowout fracture coded under Head.
[ ] C. Globe rupture coded under Face, blowout fracture coded under Face, both coded separately and
summed.
[ ] D. Both coded under Head region, with the highest severity assigned.
CORRECT: A. Both injuries coded under Face region, with the highest severity assigned.
AIS 2027 groups all facial injuries, including ocular and orbital structures, under the Face region. When
multiple injuries occur in the same region, only the highest AIS severity is used. Summing is incorrect.
8. In AIS 2027, what is the correct code for a 'major laceration of the thoracic aorta,
full-thickness, with contained rupture'?
[ ] A. AIS 4, code 4.2.1.2
[ ] B. AIS 5, code 4.3.1.1
[ ] C. AIS 6, code 4.4.0.0
[ ] D. AIS 3, code 4.1.1.1
CORRECT: B. AIS 5, code 4.3.1.1
A full-thickness aortic laceration with contained rupture is a life-threatening injury and is coded as AIS 5 in the
2027 lexicon. AIS 6 is reserved for injuries that are untreatable or fatal within 24 hours, such as complete
aortic transection with free rupture. AIS 3 and 4 are for lesser aortic injuries.
9. Which of the following scenarios correctly illustrates the use of the 'unspecified' AIS
code?
[ ] A. A patient with a suspected but unconfirmed splenic injury, documented as 'possible spleen
laceration'.
[ ] B. A patient with a confirmed grade I splenic laceration.
[ ] C. A patient with a splenic laceration of unknown grade.
[ ] D. A patient with a splenic laceration that is not further described in the medical record.
CORRECT: D. A patient with a splenic laceration that is not further described in the medical record.
The 'unspecified' AIS code is used when the injury is confirmed but the medical record lacks sufficient detail
to assign a specific severity. If the injury is only suspected, it should not be coded. If the grade is known, a
specific code is used.
10. A patient with a blunt splenic injury undergoes a splenectomy. According to the AAAM
2020 AIS update, how should the spleen injury be coded when the operative report
documents total splenectomy following a Grade IV laceration?
HIGHP - Page 4 of 48
Q&A w/ Detailed Rationales | Verified
Answers
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
143 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This examination assesses mastery of the Abbreviated Injury Scale (AIS) coding lexicon, severity scoring,
and trauma registry abstraction. It emphasizes the 2027 AAAM AIS update, ISS/NISS computation, and
correct handling of complex, multi-system injury documentation.
STUDY GUIDE
Recommended duration: 3 hours. Passing target: 80% (40/50).
HIGHP - Page 1 of 48
,1. In the AIS 2027 lexicon, a patient sustains a small, non-occlusive thrombus in the left
middle cerebral artery confirmed by CT angiography, with no neurologic deficit. Which AIS
code and severity should be assigned?
[ ] A. AIS 3, code 1.2.3.4 (thrombus, major vessel)
[ ] B. AIS 2, code 1.1.2.2 (thrombus, minor vessel)
[ ] C. AIS 4, code 1.3.1.1 (thrombus with infarction)
[ ] D. AIS 1, code 1.0.0.1 (thrombus, unspecified)
CORRECT: B. AIS 2, code 1.1.2.2 (thrombus, minor vessel)
AIS 2027 classifies a non-occlusive thrombus in a named intracranial vessel without infarction as a minor
injury (AIS 2). AIS 3 is reserved for major vessel thrombosis with partial occlusion, while AIS 4 requires
infarction. AIS 1 is for trivial or unspecified findings not meeting minor criteria.
2. A trauma registry patient has the following AIS codes: Head=4, Face=2, Chest=3,
Abdomen=2, Extremity=2, External=1. What is the correct Injury Severity Score (ISS)?
[ ] A. 29
[ ] B. 34
[ ] C. 38
[ ] D. 41
CORRECT: A. 29
ISS is the sum of squares of the three highest AIS scores from different body regions. The three highest are
Head (4²=16), Chest (3²=9), and Face (2²=4), totaling 29. Extremity and Abdomen also have AIS 2 but are
not higher than Face, so they are not included.
3. Which statement correctly describes the difference between ISS and NISS in AIS 2027
trauma scoring?
[ ] A. ISS uses the three most severe injuries regardless of body region, while NISS uses the three
highest across different regions.
[ ] B. ISS uses the three highest AIS scores from different body regions, while NISS uses the three
highest AIS scores regardless of region.
[ ] C. ISS and NISS are identical except NISS excludes external injuries.
[ ] D. NISS is calculated only for pediatric patients, while ISS is for adults.
CORRECT: B. ISS uses the three highest AIS scores from different body regions, while NISS uses the
three highest AIS scores regardless of region.
ISS requires the three highest AIS scores from three different body regions. NISS (New ISS) takes the three
highest AIS scores overall, even if from the same region, making it more sensitive to multiple severe injuries
in one area. NISS is not age-specific and does not exclude external injuries.
HIGHP - Page 2 of 48
,4. In AIS coding, how should multiple injuries to the same organ (e.g., two separate liver
lacerations) be coded?
[ ] A. Code each laceration separately and sum their AIS scores.
[ ] B. Code only the most severe laceration; lesser injuries are ignored.
[ ] C. Code the most severe injury and assign an additional AIS point for each extra injury to the same
organ.
[ ] D. Code the organ as 'multiple injuries' using a single AIS code that reflects the highest severity.
CORRECT: D. Code the organ as 'multiple injuries' using a single AIS code that reflects the highest
severity.
AIS 2027 instructs coders to assign a single code for multiple injuries to the same organ, using the code that
represents the highest severity. Summing scores or adding points is incorrect; lesser injuries are not coded
separately. This prevents overestimating severity from multiple minor lacerations.
5. A patient has a flail chest with bilateral rib fractures and a pulmonary contusion.
According to AIS 2027, which injury determines the chest AIS severity?
[ ] A. Flail chest (AIS 4)
[ ] B. Pulmonary contusion (AIS 3)
[ ] C. Bilateral rib fractures (AIS 2)
[ ] D. The sum of all three injuries (AIS 9)
CORRECT: A. Flail chest (AIS 4)
When multiple injuries occur in the same body region, the highest AIS severity is assigned. Flail chest is AIS
4, which is higher than pulmonary contusion (AIS 3) and rib fractures (AIS 2). AIS scores are not summed
within a region; the maximum is used.
6. Which of the following best describes the AIS 'zone' concept for coding external/skin
injuries?
[ ] A. External injuries are coded only if they are life-threatening.
[ ] B. External injuries are coded by body region and severity, with AIS 1 for minor abrasions and AIS 2
for major lacerations.
[ ] C. External injuries are always assigned AIS 1 regardless of size or depth.
[ ] D. External injuries are excluded from ISS calculation.
CORRECT: B. External injuries are coded by body region and severity, with AIS 1 for minor abrasions
and AIS 2 for major lacerations.
AIS 2027 codes external injuries (skin) by body region and severity. Minor abrasions/contusions are AIS 1;
major lacerations, avulsions, or burns may be AIS 2 or higher. They are included in ISS if they are among the
three highest scores.
HIGHP - Page 3 of 48
, 7. A patient has a penetrating injury to the right eye with globe rupture and a left orbital
blowout fracture. How should these be coded in AIS 2027?
[ ] A. Both injuries coded under Face region, with the highest severity assigned.
[ ] B. Globe rupture coded under Face, blowout fracture coded under Head.
[ ] C. Globe rupture coded under Face, blowout fracture coded under Face, both coded separately and
summed.
[ ] D. Both coded under Head region, with the highest severity assigned.
CORRECT: A. Both injuries coded under Face region, with the highest severity assigned.
AIS 2027 groups all facial injuries, including ocular and orbital structures, under the Face region. When
multiple injuries occur in the same region, only the highest AIS severity is used. Summing is incorrect.
8. In AIS 2027, what is the correct code for a 'major laceration of the thoracic aorta,
full-thickness, with contained rupture'?
[ ] A. AIS 4, code 4.2.1.2
[ ] B. AIS 5, code 4.3.1.1
[ ] C. AIS 6, code 4.4.0.0
[ ] D. AIS 3, code 4.1.1.1
CORRECT: B. AIS 5, code 4.3.1.1
A full-thickness aortic laceration with contained rupture is a life-threatening injury and is coded as AIS 5 in the
2027 lexicon. AIS 6 is reserved for injuries that are untreatable or fatal within 24 hours, such as complete
aortic transection with free rupture. AIS 3 and 4 are for lesser aortic injuries.
9. Which of the following scenarios correctly illustrates the use of the 'unspecified' AIS
code?
[ ] A. A patient with a suspected but unconfirmed splenic injury, documented as 'possible spleen
laceration'.
[ ] B. A patient with a confirmed grade I splenic laceration.
[ ] C. A patient with a splenic laceration of unknown grade.
[ ] D. A patient with a splenic laceration that is not further described in the medical record.
CORRECT: D. A patient with a splenic laceration that is not further described in the medical record.
The 'unspecified' AIS code is used when the injury is confirmed but the medical record lacks sufficient detail
to assign a specific severity. If the injury is only suspected, it should not be coded. If the grade is known, a
specific code is used.
10. A patient with a blunt splenic injury undergoes a splenectomy. According to the AAAM
2020 AIS update, how should the spleen injury be coded when the operative report
documents total splenectomy following a Grade IV laceration?
HIGHP - Page 4 of 48
