Code Specialist Module - CS National Certification Exam
1. Which organization maintains and publishes the ICD-10-CM code set in the
United States?
A) American Medical Association (AMA)
B) Centers for Medicare & Medicaid Services (CMS)
C) Centers for Disease Control and Prevention (CDC)
D) National Center for Health Statistics (NCHS)
ANSWER: D
EXPLANATION: The NCHS, part of the CDC, maintains ICD-10-CM for morbidity
coding in the U.S.
2. What is the primary purpose of the Alphabetic Index in ICD-10-CM?
A) To provide complete coding instructions
B) To list all codes in numerical order
C) To locate codes for diseases, injuries, and symptoms
D) To determine medical necessity
ANSWER: C
EXPLANATION: The Alphabetic Index helps locate terms and corresponding codes;
final code selection must be verified in the Tabular List.
3. A coder may assign a diagnosis code as "probable," "suspected," "likely," or
"rule out" when:
A) The physician documents these terms
B) Never - only code confirmed diagnoses
C) For outpatient encounters only
D) When the coder believes it's appropriate
ANSWER: B
EXPLANATION: ICD-10-CM Official Guidelines prohibit coding uncertain diagnoses
in any setting except for inpatient admissions.
4. Which ICD-10-CM chapter contains codes for factors influencing health status
and contact with health services?
A) Chapter 1
B) Chapter 15
C) Chapter 18
D) Chapter 21
ANSWER: D
, EXPLANATION: Chapter 21 (Z00-Z99) contains codes for circumstances other than
diseases or injuries.
5. What does the 7th character "A" typically indicate in injury codes?
A) Initial encounter
B) Subsequent encounter
C) Sequela
D) Routine follow-up
ANSWER: A
EXPLANATION: "A" indicates initial encounter (active treatment); "D" indicates
subsequent encounter; "S" indicates sequela.
6. A patient is seen for chemotherapy treatment. What ICD-10-CM code category
should be sequenced first?
A) The malignancy being treated
B) Z51.11, Encounter for antineoplastic chemotherapy
C) Adverse effects of chemotherapy
D) The patient's symptoms
ANSWER: B
EXPLANATION: According to coding guidelines, when a patient receives
chemotherapy, Z51.11 should be sequenced first, followed by the malignancy.
7. Which of the following is NOT a mandatory component of an ICD-10-CM code?
A) Category
B) Subcategory
C) Extension
D) 7th character
ANSWER: D
EXPLANATION: Not all codes require 7th characters. Only specific categories (like
injuries, pregnancy, external causes) require them.
8. What does the term "code also" indicate in ICD-10-CM?
A) Code the condition first
B) An additional code should be used if applicable
C) Do not code the condition
D) Use an external cause code
ANSWER: B
EXPLANATION: "Code also" instructs the coder to use an additional code to provide
more complete information.
, 9. The "Excludes1" note in ICD-10-CM means:
A) Conditions can be coded together if both are present
B) Two conditions cannot be coded together
C) The condition is included elsewhere
D) Use an additional code
ANSWER: B
EXPLANATION: Excludes1 indicates the conditions are mutually exclusive and
should not be coded together.
10. What is the correct code for "essential hypertension"?
A) I10
B) I11.9
C) I12.9
D) I15.0
ANSWER: A
EXPLANATION: I10 is the code for essential (primary) hypertension without heart or
kidney involvement.
11. Which organization publishes and maintains the CPT code set?
A) CMS
B) NCHS
C) AMA
D) AAPC
ANSWER: C
EXPLANATION: The American Medical Association owns, maintains, and updates
CPT codes annually.
12. CPT Category I codes are used for:
A) Procedures and services performed by physicians
B) Performance measurement
C) Emerging technology
D) Temporary procedures
ANSWER: A
EXPLANATION: Category I codes represent procedures/services consistent with
contemporary medical practice performed by physicians.
13. Modifier -25 indicates:
A) Significant, separately identifiable E/M service same day as procedure
B) Multiple procedures
C) Reduced services
1. Which organization maintains and publishes the ICD-10-CM code set in the
United States?
A) American Medical Association (AMA)
B) Centers for Medicare & Medicaid Services (CMS)
C) Centers for Disease Control and Prevention (CDC)
D) National Center for Health Statistics (NCHS)
ANSWER: D
EXPLANATION: The NCHS, part of the CDC, maintains ICD-10-CM for morbidity
coding in the U.S.
2. What is the primary purpose of the Alphabetic Index in ICD-10-CM?
A) To provide complete coding instructions
B) To list all codes in numerical order
C) To locate codes for diseases, injuries, and symptoms
D) To determine medical necessity
ANSWER: C
EXPLANATION: The Alphabetic Index helps locate terms and corresponding codes;
final code selection must be verified in the Tabular List.
3. A coder may assign a diagnosis code as "probable," "suspected," "likely," or
"rule out" when:
A) The physician documents these terms
B) Never - only code confirmed diagnoses
C) For outpatient encounters only
D) When the coder believes it's appropriate
ANSWER: B
EXPLANATION: ICD-10-CM Official Guidelines prohibit coding uncertain diagnoses
in any setting except for inpatient admissions.
4. Which ICD-10-CM chapter contains codes for factors influencing health status
and contact with health services?
A) Chapter 1
B) Chapter 15
C) Chapter 18
D) Chapter 21
ANSWER: D
, EXPLANATION: Chapter 21 (Z00-Z99) contains codes for circumstances other than
diseases or injuries.
5. What does the 7th character "A" typically indicate in injury codes?
A) Initial encounter
B) Subsequent encounter
C) Sequela
D) Routine follow-up
ANSWER: A
EXPLANATION: "A" indicates initial encounter (active treatment); "D" indicates
subsequent encounter; "S" indicates sequela.
6. A patient is seen for chemotherapy treatment. What ICD-10-CM code category
should be sequenced first?
A) The malignancy being treated
B) Z51.11, Encounter for antineoplastic chemotherapy
C) Adverse effects of chemotherapy
D) The patient's symptoms
ANSWER: B
EXPLANATION: According to coding guidelines, when a patient receives
chemotherapy, Z51.11 should be sequenced first, followed by the malignancy.
7. Which of the following is NOT a mandatory component of an ICD-10-CM code?
A) Category
B) Subcategory
C) Extension
D) 7th character
ANSWER: D
EXPLANATION: Not all codes require 7th characters. Only specific categories (like
injuries, pregnancy, external causes) require them.
8. What does the term "code also" indicate in ICD-10-CM?
A) Code the condition first
B) An additional code should be used if applicable
C) Do not code the condition
D) Use an external cause code
ANSWER: B
EXPLANATION: "Code also" instructs the coder to use an additional code to provide
more complete information.
, 9. The "Excludes1" note in ICD-10-CM means:
A) Conditions can be coded together if both are present
B) Two conditions cannot be coded together
C) The condition is included elsewhere
D) Use an additional code
ANSWER: B
EXPLANATION: Excludes1 indicates the conditions are mutually exclusive and
should not be coded together.
10. What is the correct code for "essential hypertension"?
A) I10
B) I11.9
C) I12.9
D) I15.0
ANSWER: A
EXPLANATION: I10 is the code for essential (primary) hypertension without heart or
kidney involvement.
11. Which organization publishes and maintains the CPT code set?
A) CMS
B) NCHS
C) AMA
D) AAPC
ANSWER: C
EXPLANATION: The American Medical Association owns, maintains, and updates
CPT codes annually.
12. CPT Category I codes are used for:
A) Procedures and services performed by physicians
B) Performance measurement
C) Emerging technology
D) Temporary procedures
ANSWER: A
EXPLANATION: Category I codes represent procedures/services consistent with
contemporary medical practice performed by physicians.
13. Modifier -25 indicates:
A) Significant, separately identifiable E/M service same day as procedure
B) Multiple procedures
C) Reduced services
