AAPC CPC CODING GUIDELINES QUESTIONS
WITH CORRECT ANSWERS 2025
Finding main dx term--try reading dx right to left - CORRECT ANSWER -
EX: COPD (chronic obstructive pulmonary disease) can be found under "disease" as well as "obstru
ction"
Ex2: URI (upper respiratory infection) can be found under "infection"
Always code to the highest degree of specificity. - CORRECT ANSWER -
Ex: aged related Osteoporosis with current fracture of left shoulder, follow up visit;
M80.012D:
M80 (osteoporosis with current fracture) +
M80.0 (age related) +
M80.012 (age related w/current fracture of left shoulder +
M80.012D (subsequent visit)
Outpatient visits--SUSPECTED Dx NEVER coded.
If a definitive Dx has not been reported then code:
1--Signs
2--Sx
3--Abnormal Test results - CORRECT ANSWER -Terms of suspected Dx:
Probable
Suspected
Questionable
Rule Out
Differential
Working
Inpatient Visits--SUSPECTED Dx MAY BE CODED, with exception to HIV.
HIV Dx must be confirmed before coding. - CORRECT ANSWER -
, Sx S that S are S an S INTEGRAL S part S of S a S disease S do S NOT S need S to S be S coded. S - S CORRECT
S ANSWER S -
Ex: S Pt S presents S w/severe S AB S pain, S nausea, S vomiting. S Diagnosed S w/acute S appendicitis. S Code
S only S ac Sute S appendicitis S K35.80.
Sx S that S are S NOT S INTEGRAL S part S to S a S disease S DO S NEED S TO S BE S CODED. S - S CORRECT
S ANSWER S -
Ex: S Patient S presents S with S runny S nose S & S cough S as S well S as S Rt S shoulder S pain. S Physician
S diagoses S URI. SCode S URI S as S well S as S Sx S of S Rt S Shoulder S pain.
URI--J06.9
Rt S Shldr S Pn--M25.511
MULTIPLE S CODING S FOR S A S SINGLE S CONDITION--
Some S Diseases S require S multiple S Dx S codes S and S will S indicate S ETIOLOGY S & S MANIFESTATION. S It
S will S app Sear S in S the S alphabetic S index S as S one S code S followed S by S another S code S in S brackets.
S-
CORRECT S ANSWER S -Ex: S Amyloid S Heart S Disease S E85.4 S [I43]
BOTH S etiology S AND S manifestation S codes S are S required S to S record S this S condition.
ACUTE S & S CHRONIC S CONDITIONS S DOCUMENTED S AT S THE S SAME S TIME--
when S both S are S documented, S code S acute S first S then S chronic S - S CORRECT
S ANSWER S - SEX: S Acute S and S chronic S cystitis
N30.00 S Acute S cystitis S w/o S hematuria
N30.20 S Other S Chronic S cystitis S w/o S hematuria
CHRONIC S CONDITIONS--
can S be S coded S as S many S time S as S applicable S to S treatment, S but S after S resolution S will S appear
S as S z- Scodes S if S history S of S condition S affects S CURRENT S reason S for S care. S - S CORRECT
S ANSWER S -
EX: S colon S cancer
(look S under S "history, S personal S of"--not S "cancer")
Pt S w/ S personal S hx S of S colon S cancer S presents S for S colonoscopy. S Z85.038
Sequelae--
late S or S residual S effects S after S an S acute S illness/injury. S TWO S codes S are S often S required.
S Residual S conditi Son S 1st, S then S cause S for S sequelae S 2nd. S If S no S residual S effects S are
S documented, S use S cause S for S sequela Se S as S prinicpal S Dx. S - S CORRECT S ANSWER S -Look S up
WITH CORRECT ANSWERS 2025
Finding main dx term--try reading dx right to left - CORRECT ANSWER -
EX: COPD (chronic obstructive pulmonary disease) can be found under "disease" as well as "obstru
ction"
Ex2: URI (upper respiratory infection) can be found under "infection"
Always code to the highest degree of specificity. - CORRECT ANSWER -
Ex: aged related Osteoporosis with current fracture of left shoulder, follow up visit;
M80.012D:
M80 (osteoporosis with current fracture) +
M80.0 (age related) +
M80.012 (age related w/current fracture of left shoulder +
M80.012D (subsequent visit)
Outpatient visits--SUSPECTED Dx NEVER coded.
If a definitive Dx has not been reported then code:
1--Signs
2--Sx
3--Abnormal Test results - CORRECT ANSWER -Terms of suspected Dx:
Probable
Suspected
Questionable
Rule Out
Differential
Working
Inpatient Visits--SUSPECTED Dx MAY BE CODED, with exception to HIV.
HIV Dx must be confirmed before coding. - CORRECT ANSWER -
, Sx S that S are S an S INTEGRAL S part S of S a S disease S do S NOT S need S to S be S coded. S - S CORRECT
S ANSWER S -
Ex: S Pt S presents S w/severe S AB S pain, S nausea, S vomiting. S Diagnosed S w/acute S appendicitis. S Code
S only S ac Sute S appendicitis S K35.80.
Sx S that S are S NOT S INTEGRAL S part S to S a S disease S DO S NEED S TO S BE S CODED. S - S CORRECT
S ANSWER S -
Ex: S Patient S presents S with S runny S nose S & S cough S as S well S as S Rt S shoulder S pain. S Physician
S diagoses S URI. SCode S URI S as S well S as S Sx S of S Rt S Shoulder S pain.
URI--J06.9
Rt S Shldr S Pn--M25.511
MULTIPLE S CODING S FOR S A S SINGLE S CONDITION--
Some S Diseases S require S multiple S Dx S codes S and S will S indicate S ETIOLOGY S & S MANIFESTATION. S It
S will S app Sear S in S the S alphabetic S index S as S one S code S followed S by S another S code S in S brackets.
S-
CORRECT S ANSWER S -Ex: S Amyloid S Heart S Disease S E85.4 S [I43]
BOTH S etiology S AND S manifestation S codes S are S required S to S record S this S condition.
ACUTE S & S CHRONIC S CONDITIONS S DOCUMENTED S AT S THE S SAME S TIME--
when S both S are S documented, S code S acute S first S then S chronic S - S CORRECT
S ANSWER S - SEX: S Acute S and S chronic S cystitis
N30.00 S Acute S cystitis S w/o S hematuria
N30.20 S Other S Chronic S cystitis S w/o S hematuria
CHRONIC S CONDITIONS--
can S be S coded S as S many S time S as S applicable S to S treatment, S but S after S resolution S will S appear
S as S z- Scodes S if S history S of S condition S affects S CURRENT S reason S for S care. S - S CORRECT
S ANSWER S -
EX: S colon S cancer
(look S under S "history, S personal S of"--not S "cancer")
Pt S w/ S personal S hx S of S colon S cancer S presents S for S colonoscopy. S Z85.038
Sequelae--
late S or S residual S effects S after S an S acute S illness/injury. S TWO S codes S are S often S required.
S Residual S conditi Son S 1st, S then S cause S for S sequelae S 2nd. S If S no S residual S effects S are
S documented, S use S cause S for S sequela Se S as S prinicpal S Dx. S - S CORRECT S ANSWER S -Look S up
