MEDICAL CODING PRACTICUM I (CASES 1–100)
MEDICAL CODING PRACTICUM I – CASES 1–100 | CPT®, ICD-10-CM
AND HCPCS LEVEL II CASE REVIEW | EXAM QUESTIONS AND
CORRECT ANSWERS | 2026/2027
MEDICAL CODING PRACTICUM I
CASES 1–100 — OUTPATIENT CPT®, ICD-10-CM AND HCPCS LEVEL II
CASE REVIEW
1. A 52-year-old established patient is seen in the office with a
productive cough and a temperature of 101.4°F. The provider
documents "rule out pneumonia" and orders a chest x-ray. No definitive
diagnosis is made at this visit. What diagnosis codes are reported?
A. J18.9, R05.9, R50.9
B. Z03.89
C. R05.9, R50.9
D. J18.9
C. R05.9, R50.9
In the outpatient setting, conditions documented as rule out, probable,
or suspected are not coded. The signs and symptoms that prompted the
visit are reported instead.
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, MEDICAL CODING PRACTICUM I (CASES 1–100)
2. An Excludes1 note under a code in the Tabular List indicates which
of the following?
A. The code may only be used as a secondary diagnosis
B. A second code must always be added to fully describe the condition
C. The two conditions cannot be reported together because they cannot
occur together, unless the conditions are unrelated
D. The excluded condition is not part of the code but may be reported
separately when present
C. The two conditions cannot be reported together because they
cannot occur together, unless the conditions are unrelated
Excludes1 is a pure excludes note meaning NOT CODED HERE. The two
conditions are mutually exclusive, with the exception of when the two
conditions are unrelated to each other.
3. A "code also" note found in the Tabular List instructs the coder that:
A. The additional code must always be sequenced first
B. The condition is excluded from the category
C. The additional code is optional and should not be reported
D. Two codes may be needed to fully describe a condition, but the note
does not direct sequencing
D. Two codes may be needed to fully describe a condition, but the
note does not direct sequencing
A code also note alerts the coder that more than one code may be
required. Sequencing depends on the circumstances of the encounter
and the severity of the conditions.
4. A patient returns to the clinic for a cast check three weeks after a
closed fracture was set in the emergency department. Which 7th
character is assigned to the fracture code for this visit?
A. D
B. S
C. A
D. G
A. D
The 7th character D represents a subsequent encounter for routine
healing, used after active treatment is completed and the patient is in
the healing or recovery phase.
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, MEDICAL CODING PRACTICUM I (CASES 1–100)
5. A 4-year-old is brought to the emergency department after
accidentally swallowing several of his sister's amoxicillin tablets. The
child is drowsy but stable. Which code is reported for the poisoning?
A. T36.0X1A
B. T36.0X2A
C. T36.01A
D. T36.0X5A
A. T36.0X1A
Amoxicillin is a penicillin. The placeholder X holds the 5th character
position, 1 identifies accidental intent, and A identifies the initial
encounter. The 5 in the 6th position would indicate an adverse effect of
a properly taken drug.
6. When coding a sequela (late effect) of an injury, the official
guidelines instruct the coder to sequence which code first?
A. Only the injury code with 7th character S
B. The external cause code, followed by the residual condition
C. The injury code with 7th character S, followed by the residual
condition
D. The code for the nature of the sequela (the residual condition),
followed by the injury code with 7th character S
D. The code for the nature of the sequela (the residual condition),
followed by the injury code with 7th character S
The residual condition being treated is sequenced first. The sequela
code with 7th character S follows it to show the cause of the residual.
7. A patient is diagnosed with acute cholecystitis with cholelithiasis.
There is no mention of obstruction. Which code is reported?
A. K80.20
B. K80.10
C. K81.0, K80.20
D. K80.00
D. K80.00
ICD-10-CM provides a combination code for calculus of the gallbladder
with acute cholecystitis without obstruction. When a combination code
fully describes both conditions, it is used instead of separate codes.
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, MEDICAL CODING PRACTICUM I (CASES 1–100)
8. A provider documents acute and chronic bronchitis. ICD-10-CM has
separate subentries at the same indentation level for both forms. How
is this coded?
A. Code both the acute and chronic conditions, sequencing the acute
code first
B. Code only the chronic condition
C. Code both conditions, sequencing the chronic code first
D. Code only the acute condition
A. Code both the acute and chronic conditions, sequencing the
acute code first
When the same condition is described as both acute and chronic and
separate subentries exist at the same indentation level, both are coded
with the acute (subacute) code sequenced first.
9. A patient with carcinoma of the lower-inner quadrant of the right
breast presents to the outpatient infusion center solely for a scheduled
chemotherapy session. What is the first-listed diagnosis?
A. Z51.11
B. Z51.0
C. Z08
D. C50.311
A. Z51.11
When the encounter is solely for the administration of antineoplastic
chemotherapy, Z51.11 is listed first, followed by the code for the
malignancy.
Page 4 of 67
MEDICAL CODING PRACTICUM I – CASES 1–100 | CPT®, ICD-10-CM
AND HCPCS LEVEL II CASE REVIEW | EXAM QUESTIONS AND
CORRECT ANSWERS | 2026/2027
MEDICAL CODING PRACTICUM I
CASES 1–100 — OUTPATIENT CPT®, ICD-10-CM AND HCPCS LEVEL II
CASE REVIEW
1. A 52-year-old established patient is seen in the office with a
productive cough and a temperature of 101.4°F. The provider
documents "rule out pneumonia" and orders a chest x-ray. No definitive
diagnosis is made at this visit. What diagnosis codes are reported?
A. J18.9, R05.9, R50.9
B. Z03.89
C. R05.9, R50.9
D. J18.9
C. R05.9, R50.9
In the outpatient setting, conditions documented as rule out, probable,
or suspected are not coded. The signs and symptoms that prompted the
visit are reported instead.
Page 1 of 67
, MEDICAL CODING PRACTICUM I (CASES 1–100)
2. An Excludes1 note under a code in the Tabular List indicates which
of the following?
A. The code may only be used as a secondary diagnosis
B. A second code must always be added to fully describe the condition
C. The two conditions cannot be reported together because they cannot
occur together, unless the conditions are unrelated
D. The excluded condition is not part of the code but may be reported
separately when present
C. The two conditions cannot be reported together because they
cannot occur together, unless the conditions are unrelated
Excludes1 is a pure excludes note meaning NOT CODED HERE. The two
conditions are mutually exclusive, with the exception of when the two
conditions are unrelated to each other.
3. A "code also" note found in the Tabular List instructs the coder that:
A. The additional code must always be sequenced first
B. The condition is excluded from the category
C. The additional code is optional and should not be reported
D. Two codes may be needed to fully describe a condition, but the note
does not direct sequencing
D. Two codes may be needed to fully describe a condition, but the
note does not direct sequencing
A code also note alerts the coder that more than one code may be
required. Sequencing depends on the circumstances of the encounter
and the severity of the conditions.
4. A patient returns to the clinic for a cast check three weeks after a
closed fracture was set in the emergency department. Which 7th
character is assigned to the fracture code for this visit?
A. D
B. S
C. A
D. G
A. D
The 7th character D represents a subsequent encounter for routine
healing, used after active treatment is completed and the patient is in
the healing or recovery phase.
Page 2 of 67
, MEDICAL CODING PRACTICUM I (CASES 1–100)
5. A 4-year-old is brought to the emergency department after
accidentally swallowing several of his sister's amoxicillin tablets. The
child is drowsy but stable. Which code is reported for the poisoning?
A. T36.0X1A
B. T36.0X2A
C. T36.01A
D. T36.0X5A
A. T36.0X1A
Amoxicillin is a penicillin. The placeholder X holds the 5th character
position, 1 identifies accidental intent, and A identifies the initial
encounter. The 5 in the 6th position would indicate an adverse effect of
a properly taken drug.
6. When coding a sequela (late effect) of an injury, the official
guidelines instruct the coder to sequence which code first?
A. Only the injury code with 7th character S
B. The external cause code, followed by the residual condition
C. The injury code with 7th character S, followed by the residual
condition
D. The code for the nature of the sequela (the residual condition),
followed by the injury code with 7th character S
D. The code for the nature of the sequela (the residual condition),
followed by the injury code with 7th character S
The residual condition being treated is sequenced first. The sequela
code with 7th character S follows it to show the cause of the residual.
7. A patient is diagnosed with acute cholecystitis with cholelithiasis.
There is no mention of obstruction. Which code is reported?
A. K80.20
B. K80.10
C. K81.0, K80.20
D. K80.00
D. K80.00
ICD-10-CM provides a combination code for calculus of the gallbladder
with acute cholecystitis without obstruction. When a combination code
fully describes both conditions, it is used instead of separate codes.
Page 3 of 67
, MEDICAL CODING PRACTICUM I (CASES 1–100)
8. A provider documents acute and chronic bronchitis. ICD-10-CM has
separate subentries at the same indentation level for both forms. How
is this coded?
A. Code both the acute and chronic conditions, sequencing the acute
code first
B. Code only the chronic condition
C. Code both conditions, sequencing the chronic code first
D. Code only the acute condition
A. Code both the acute and chronic conditions, sequencing the
acute code first
When the same condition is described as both acute and chronic and
separate subentries exist at the same indentation level, both are coded
with the acute (subacute) code sequenced first.
9. A patient with carcinoma of the lower-inner quadrant of the right
breast presents to the outpatient infusion center solely for a scheduled
chemotherapy session. What is the first-listed diagnosis?
A. Z51.11
B. Z51.0
C. Z08
D. C50.311
A. Z51.11
When the encounter is solely for the administration of antineoplastic
chemotherapy, Z51.11 is listed first, followed by the code for the
malignancy.
Page 4 of 67
