Advanced Coding Final Exam Questions with Verified Solutions Latest Update 2026/2027

Advanced Coding Final Exam Questions with Verified Solutions Latest Update 2026/2027 ICD-10-CM codes are composed of ____ to _____ characters - Answers 3 to 7 volume 1 - Answers tabular list volume 2 - Answers Index procedure check list - Answers 1. is the diagnosis diagnostic or therapeutic? 2. does the procedure carry a risk? (generally coded) 3. Is there an informed consent (code) 4. is the procedure invasive (code) ICD-10-CM implementation date - Answers October 1, 2014 why is the U.S. moving to ICD-10-CM - Answers ICD-9-CM is maxed out more detailed code descriptions streamlined claims submission PCS - Answers designed to replace volume 3 of ICD-9-CM, 7 digit codes use limited to hospitals and payers requires significant training designed by 3M Health information Management PCS has 71,000 codes what is HIPAA 5010 - Answers replaces 4010 standards for conducting data transmission. Developed to accommodate increased size and complexity of ICD-1--CM/PCS requires change of software systems and procedures used to bill Medicare implementation- effective April 1,2012 conventions similar to ICD-9-CM - Answers alphabetic index and tabular list format and structure are similar codes either 3, 4, 5, 6 or 7 characters long And used in narrative statement means "and/or" ICD-10-CM Code Structure - Answers categories, subcategories and codes codes contain both letters and numbers all categories contain 3 characters subcategories are either 4 or 5 characters long codes are 3, 4,5,6, or 7 characters long ICD-1--CM code structure - Answers first character of ICD-10-CM code is an alphabetic character all letters of the alphabet are used with the exception of U ICD-10-CM code format: 123.4567 first 3 characters = category next 3 characters = etiology, anatomic site, severity 7th character extension 7th character extensions - Answers an example of a 7th character extension occurs with pathological fractures ICD-10-CM code format - Answers uses a placeholder character, which is always the letter "X" and it has two uses when a codes has less than 6 characters and 7th character extension is required. the "X" is assigned for all characters less than six in order to meet the requirements of coding to the highest level of specificity key differences - Answers ICD-10-PCS code structure PCS requires all 7 codes ICD-10-CM tabular list - Answers 21 chapters for some chapters, the body or organ system is the axis other chapters group together conditions by etiology or nature of the disease process. ICD-10-CM additional chapters - Answers eye and adnexa chapter 7 ear and mastoid process chapter 8 external causes of morbidity chapter 20 factors influencing health status and contact with health services chapter 21 excludes 1 note - Answers is pure "excludes" means not coded here indicates that the code excluded should never be used at the same time as the code above the excludes 1 note. This note is used when two conditions cannot occur together, such as a congenital and acquired form of the same condition excludes 2 note - Answers means "not included here" the condition excluded is not part of the condition represented by the code but a patient may have both conditions at the same time. when it appears under a code, it is acceptable to use both the code and the excluded code together if the patient has both conditions includes notes - Answers used in the ICD-10-CM tabular list to clarify the conditions within a particular chapter, section, category, subcategory, or code. List of inclusion terms are not exhaustive. Inclusion notes are introduced by the word "includes" when appearing at the beginning of a chapter, section or category secondary DM - Answers coded as either due to an underlying condition E08 or chemical induced E09 coding instructions due to underlying condition state to code first the underlying condition drug or chemical induced DM instructions state to identify controlled or uncontrolled coding caution for Diabetes Mellitus - Answers selecting the first level sub-term is critical in order to arrive at the correct code because each type (type I or type II) of diabetes can have