ABSTRACTING AND CASE STUDY
CODING PRACTICUM - 7TH EDITION
ADVANCED ASSESSMENT QUESTIONS
WITH VERIFIED ANSWERS 2026/2027
1. When abstracting a case study for a patient with multiple fractures, what is the correct
sequencing priority according to ICD-10-CM Official Guidelines?
A. The fracture associated with the most severe injury is sequenced first.
B. Fractures are sequenced in alphabetical order by anatomical site.
C. The distal-most fracture is sequenced as the principal diagnosis.
D. The fracture that required the least amount of resources is sequenced first.
Answer: A
Conceptual Explanation: According to ICD-10-CM guidelines for multiple injuries, the
code for the most severe injury as determined by the provider is sequenced first.
2. In ICD-10-PCS, which root operation is used when a provider performs a total mastectomy?
A. Excision
B. Resection
C. Extraction
D. Destruction
,Answer: B
Conceptual Explanation: Resection is defined as cutting out or off, without replacement,
all of a body part. A total mastectomy involves the entire body part (breast).
3. When coding for a ‘Late Effect’ (Sequela), which of the following is the standard sequencing
rule?
A. The sequela code is sequenced first, followed by the injury code.
B. Only the original injury code with the ‘S’ extension is used.
C. The condition or nature of the sequela is sequenced first, followed by the sequela
(injury) code.
D. The external cause code must be sequenced as the principal diagnosis.
Answer: C
Conceptual Explanation: Coding of sequela generally requires two codes: the condition or
nature of the sequela first, and then the sequela code (original injury/illness with 7th
character S).
4. A patient is admitted for a diagnostic biopsy of the sigmoid colon. During the procedure,
the surgeon decides to remove a polyp in the same site. How is this abstracted?
A. Code only the polyp removal (Excision).
B. Code only the biopsy.
C. Code both the biopsy and the excision with a modifier.
, D. Code the excision and the biopsy only if they were performed at different sites.
Answer: A
Conceptual Explanation: In ICD-10-PCS, if a diagnostic biopsy is followed by a more
definitive procedure at the same site, only the more definitive procedure
(excision/resection) is coded.
5. Which CPT modifier is most appropriate for a procedure that was planned but discontinued
due to the patient’s deteriorating condition after anesthesia was administered?
A. -52
B. -53
C. -73
D. -74
Answer: B
Conceptual Explanation: Modifier -53 is used for discontinued procedures due to
extenuating circumstances or those that threaten the well-being of the patient after
anesthesia.
6. During abstracting, you find a ‘Rule out’ diagnosis in an outpatient record. How should this
be coded?
A. Code it as if the condition exists.
B. Do not code the ‘rule out’ condition; code the symptoms.
CODING PRACTICUM - 7TH EDITION
ADVANCED ASSESSMENT QUESTIONS
WITH VERIFIED ANSWERS 2026/2027
1. When abstracting a case study for a patient with multiple fractures, what is the correct
sequencing priority according to ICD-10-CM Official Guidelines?
A. The fracture associated with the most severe injury is sequenced first.
B. Fractures are sequenced in alphabetical order by anatomical site.
C. The distal-most fracture is sequenced as the principal diagnosis.
D. The fracture that required the least amount of resources is sequenced first.
Answer: A
Conceptual Explanation: According to ICD-10-CM guidelines for multiple injuries, the
code for the most severe injury as determined by the provider is sequenced first.
2. In ICD-10-PCS, which root operation is used when a provider performs a total mastectomy?
A. Excision
B. Resection
C. Extraction
D. Destruction
,Answer: B
Conceptual Explanation: Resection is defined as cutting out or off, without replacement,
all of a body part. A total mastectomy involves the entire body part (breast).
3. When coding for a ‘Late Effect’ (Sequela), which of the following is the standard sequencing
rule?
A. The sequela code is sequenced first, followed by the injury code.
B. Only the original injury code with the ‘S’ extension is used.
C. The condition or nature of the sequela is sequenced first, followed by the sequela
(injury) code.
D. The external cause code must be sequenced as the principal diagnosis.
Answer: C
Conceptual Explanation: Coding of sequela generally requires two codes: the condition or
nature of the sequela first, and then the sequela code (original injury/illness with 7th
character S).
4. A patient is admitted for a diagnostic biopsy of the sigmoid colon. During the procedure,
the surgeon decides to remove a polyp in the same site. How is this abstracted?
A. Code only the polyp removal (Excision).
B. Code only the biopsy.
C. Code both the biopsy and the excision with a modifier.
, D. Code the excision and the biopsy only if they were performed at different sites.
Answer: A
Conceptual Explanation: In ICD-10-PCS, if a diagnostic biopsy is followed by a more
definitive procedure at the same site, only the more definitive procedure
(excision/resection) is coded.
5. Which CPT modifier is most appropriate for a procedure that was planned but discontinued
due to the patient’s deteriorating condition after anesthesia was administered?
A. -52
B. -53
C. -73
D. -74
Answer: B
Conceptual Explanation: Modifier -53 is used for discontinued procedures due to
extenuating circumstances or those that threaten the well-being of the patient after
anesthesia.
6. During abstracting, you find a ‘Rule out’ diagnosis in an outpatient record. How should this
be coded?
A. Code it as if the condition exists.
B. Do not code the ‘rule out’ condition; code the symptoms.
