CAISS EXAM 2026 Updated Version
QUESTIONS AND ANSWERS | Complete
Test Bank with Rationales | Grade A+
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Section 1: AIS Fundamentals and Scoring Principles
Questions 1-20
Question 1 The Abbreviated Injury Scale (AIS) severity score for a "critical" injury is:
A. 3
B. 4
C. 5 [CORRECT]
D. 6
Correct Answer: C
Rationale: The AIS severity scale is: 1 = Minor, 2 = Moderate, 3 = Serious, 4 = Severe, 5 =
Critical, 6 = Maximal (currently untreatable). A critical injury (AIS 5) represents conditions that
are life-threatening but potentially survivable with optimal medical care, such as severe brain
injury with GCS 3-5 or cardiac tamponade. Option A (3) is "serious," not critical. Option B (4) is
"severe." Option D (6) is "maximal/untreatable," which is beyond critical and indicates virtually
unsurvivable injuries.
Question 2 An AIS score of 6 indicates:
A. Minor injury
B. Moderate injury
C. Critical injury
D. Maximal injury (currently untreatable) [CORRECT]
Correct Answer: D
Rationale: AIS 6 represents a maximal injury that is currently untreatable and virtually always
fatal, such as massive brain stem disruption, high cervical cord transection, or hepatic avulsion.
This differs from AIS 5 (critical), which includes severe but potentially survivable injuries.
,Options A, B, and C represent progressively severe but treatable injuries. The distinction
between AIS 5 and 6 is crucial for trauma research and outcomes analysis.
Question 3 The AIS code is a 7-digit number. The first digit represents:
A. Severity
B. Body region [CORRECT]
C. Type of anatomic structure
D. Specific anatomic structure
Correct Answer: B
Rationale: The 7-digit AIS code structure follows this format: Digit 1 = Body Region (1=Head,
2=Face, 3=Neck, 4=Thorax, 5=Abdomen, 6=Spine, 7=Upper Extremity, 8=Lower Extremity,
9=External and other). Digit 2 = Type of Anatomic Structure. Digits 3-4 = Specific Anatomic
Structure. Digit 5 = Level. Digits 6-7 = Severity. Severity appears at the end (digits 6-7), not the
beginning (A). The type of structure is digit 2 (C), and specific structure is digits 3-4 (D).
Question 4 When a patient has multiple injuries to the same body region, the AIS coding rule for
ISS calculation is to:
A. Code all injuries separately
B. Code only the most severe injury in that region [CORRECT]
C. Code the average severity of all injuries
D. Code only the first injury documented
Correct Answer: B
Rationale: For ISS calculation, only the single highest AIS severity score from each body region
is used. If a patient has multiple head injuries (e.g., skull fracture AIS 3, brain contusion AIS 4,
epidural hematoma AIS 4), only the highest (AIS 4) counts toward ISS. However, for trauma
registry completeness, all injuries should be coded (A). Averaging (C) or using first documented
(D) would inaccurately represent injury severity and violate AIS guidelines. This rule prevents
inflation of ISS from multiple injuries in one region.
Question 5 A patient has bilateral pulmonary contusions. How should this be coded according to
AIS 2025?
A. Code as a single injury with laterality specified [CORRECT]
B. Code as two separate injuries with different codes
,C. Code only the more severe side
D. Code as unilateral with a severity modifier
Correct Answer: A
Rationale: AIS 2025 allows coding of bilateral injuries as a single code with laterality specified
(often indicated by specific codes or modifiers). The severity assigned reflects the combined
effect of the bilateral injury. Coding as two separate injuries (B) would inappropriately allow
both to count toward ISS calculation, artificially inflating the score. Coding only one side (C)
underrepresents severity. Option D is not a valid AIS convention—laterality must be accurately
captured.
Question 6 Which of the following statements about penetrating versus blunt trauma coding is
correct?
A. Penetrating trauma always receives higher AIS severity than blunt trauma
B. The mechanism does not affect AIS coding; only anatomical severity matters [CORRECT]
C. Penetrating trauma to the abdomen is automatically AIS 5
D. Blunt trauma cannot result in AIS 5 or 6 injuries
Correct Answer: B
Rationale: AIS is an anatomically-based severity scale, not a mechanism-based scale. The same
anatomical injury receives the same AIS severity regardless of whether it was caused by blunt
force, penetrating trauma, blast, or other mechanisms. While penetrating trauma may have
different clinical implications, the AIS code reflects the anatomical disruption. Options A, C, and
D incorrectly suggest mechanism-based coding. A minor penetrating wound (e.g., superficial
skin laceration) would be AIS 1, while massive blunt trauma (e.g., aortic rupture) could be AIS 5
or 6.
Question 7 A 7-year-old child sustains a femur fracture. According to AIS pediatric coding
principles:
A. The injury is coded using adult codes with automatic severity reduction
B. The injury is coded using the same anatomical criteria as adults, but physiological differences
may affect severity [CORRECT]
C. Children cannot be assigned AIS codes
D. All pediatric fractures are automatically AIS 3
Correct Answer: B
, Rationale: AIS coding uses the same anatomical criteria for children and adults. However, the
severity may be influenced by physiological differences (e.g., a child's greater blood volume
relative to body weight may tolerate hemorrhage better, but their smaller airway makes them
more vulnerable to respiratory compromise). There is no automatic severity reduction (A) or
universal assignment (D). Children are absolutely assignable AIS codes (C is false). The AIS
dictionary provides specific guidance for pediatric injuries where anatomical or physiological
differences exist.
Question 8 In AIS coding, "unspecified injury" codes should be used:
A. Whenever the coder is uncertain about the exact diagnosis
B. Only when the medical record lacks sufficient detail to assign a specific code [CORRECT]
C. As the default choice to save time
D. Never, as they are being phased out
Correct Answer: B
Rationale: Unspecified injury codes are reserved for situations where the medical record
genuinely lacks the detail necessary for specific coding (e.g., "internal injury, NOS" in an old
record). They should not be used for convenience (C) or when the coder hasn't thoroughly
reviewed the record (A). Unspecified codes are not being phased out (D) and remain necessary
for incomplete data. Overuse of unspecified codes reduces data quality and comparability.
Coders should query physicians for clarification when possible.
Question 9 The AIS 2025 update includes which of the following changes from AIS 2015?
A. Elimination of the 7-digit coding structure
B. Revised severity assignments for certain traumatic brain injuries and spinal cord injuries
[CORRECT]
C. Reduction of severity levels from 6 to 5
D. Elimination of body region 9 (External)
Correct Answer: B
Rationale: AIS 2025 incorporates updated medical evidence and refined severity assignments,
particularly for traumatic brain injuries (incorporating modern imaging findings) and spinal cord
injuries (refining completeness and level assessments). The 7-digit structure (A) remains
unchanged. The 6-level severity scale (C) is preserved. Body region 9 (External) (D) remains for
burns, soft tissue injuries, and other external trauma. AIS updates typically refine rather than
restructure the system.
QUESTIONS AND ANSWERS | Complete
Test Bank with Rationales | Grade A+
Assured | Pass Guaranteed - A+ Graded
Section 1: AIS Fundamentals and Scoring Principles
Questions 1-20
Question 1 The Abbreviated Injury Scale (AIS) severity score for a "critical" injury is:
A. 3
B. 4
C. 5 [CORRECT]
D. 6
Correct Answer: C
Rationale: The AIS severity scale is: 1 = Minor, 2 = Moderate, 3 = Serious, 4 = Severe, 5 =
Critical, 6 = Maximal (currently untreatable). A critical injury (AIS 5) represents conditions that
are life-threatening but potentially survivable with optimal medical care, such as severe brain
injury with GCS 3-5 or cardiac tamponade. Option A (3) is "serious," not critical. Option B (4) is
"severe." Option D (6) is "maximal/untreatable," which is beyond critical and indicates virtually
unsurvivable injuries.
Question 2 An AIS score of 6 indicates:
A. Minor injury
B. Moderate injury
C. Critical injury
D. Maximal injury (currently untreatable) [CORRECT]
Correct Answer: D
Rationale: AIS 6 represents a maximal injury that is currently untreatable and virtually always
fatal, such as massive brain stem disruption, high cervical cord transection, or hepatic avulsion.
This differs from AIS 5 (critical), which includes severe but potentially survivable injuries.
,Options A, B, and C represent progressively severe but treatable injuries. The distinction
between AIS 5 and 6 is crucial for trauma research and outcomes analysis.
Question 3 The AIS code is a 7-digit number. The first digit represents:
A. Severity
B. Body region [CORRECT]
C. Type of anatomic structure
D. Specific anatomic structure
Correct Answer: B
Rationale: The 7-digit AIS code structure follows this format: Digit 1 = Body Region (1=Head,
2=Face, 3=Neck, 4=Thorax, 5=Abdomen, 6=Spine, 7=Upper Extremity, 8=Lower Extremity,
9=External and other). Digit 2 = Type of Anatomic Structure. Digits 3-4 = Specific Anatomic
Structure. Digit 5 = Level. Digits 6-7 = Severity. Severity appears at the end (digits 6-7), not the
beginning (A). The type of structure is digit 2 (C), and specific structure is digits 3-4 (D).
Question 4 When a patient has multiple injuries to the same body region, the AIS coding rule for
ISS calculation is to:
A. Code all injuries separately
B. Code only the most severe injury in that region [CORRECT]
C. Code the average severity of all injuries
D. Code only the first injury documented
Correct Answer: B
Rationale: For ISS calculation, only the single highest AIS severity score from each body region
is used. If a patient has multiple head injuries (e.g., skull fracture AIS 3, brain contusion AIS 4,
epidural hematoma AIS 4), only the highest (AIS 4) counts toward ISS. However, for trauma
registry completeness, all injuries should be coded (A). Averaging (C) or using first documented
(D) would inaccurately represent injury severity and violate AIS guidelines. This rule prevents
inflation of ISS from multiple injuries in one region.
Question 5 A patient has bilateral pulmonary contusions. How should this be coded according to
AIS 2025?
A. Code as a single injury with laterality specified [CORRECT]
B. Code as two separate injuries with different codes
,C. Code only the more severe side
D. Code as unilateral with a severity modifier
Correct Answer: A
Rationale: AIS 2025 allows coding of bilateral injuries as a single code with laterality specified
(often indicated by specific codes or modifiers). The severity assigned reflects the combined
effect of the bilateral injury. Coding as two separate injuries (B) would inappropriately allow
both to count toward ISS calculation, artificially inflating the score. Coding only one side (C)
underrepresents severity. Option D is not a valid AIS convention—laterality must be accurately
captured.
Question 6 Which of the following statements about penetrating versus blunt trauma coding is
correct?
A. Penetrating trauma always receives higher AIS severity than blunt trauma
B. The mechanism does not affect AIS coding; only anatomical severity matters [CORRECT]
C. Penetrating trauma to the abdomen is automatically AIS 5
D. Blunt trauma cannot result in AIS 5 or 6 injuries
Correct Answer: B
Rationale: AIS is an anatomically-based severity scale, not a mechanism-based scale. The same
anatomical injury receives the same AIS severity regardless of whether it was caused by blunt
force, penetrating trauma, blast, or other mechanisms. While penetrating trauma may have
different clinical implications, the AIS code reflects the anatomical disruption. Options A, C, and
D incorrectly suggest mechanism-based coding. A minor penetrating wound (e.g., superficial
skin laceration) would be AIS 1, while massive blunt trauma (e.g., aortic rupture) could be AIS 5
or 6.
Question 7 A 7-year-old child sustains a femur fracture. According to AIS pediatric coding
principles:
A. The injury is coded using adult codes with automatic severity reduction
B. The injury is coded using the same anatomical criteria as adults, but physiological differences
may affect severity [CORRECT]
C. Children cannot be assigned AIS codes
D. All pediatric fractures are automatically AIS 3
Correct Answer: B
, Rationale: AIS coding uses the same anatomical criteria for children and adults. However, the
severity may be influenced by physiological differences (e.g., a child's greater blood volume
relative to body weight may tolerate hemorrhage better, but their smaller airway makes them
more vulnerable to respiratory compromise). There is no automatic severity reduction (A) or
universal assignment (D). Children are absolutely assignable AIS codes (C is false). The AIS
dictionary provides specific guidance for pediatric injuries where anatomical or physiological
differences exist.
Question 8 In AIS coding, "unspecified injury" codes should be used:
A. Whenever the coder is uncertain about the exact diagnosis
B. Only when the medical record lacks sufficient detail to assign a specific code [CORRECT]
C. As the default choice to save time
D. Never, as they are being phased out
Correct Answer: B
Rationale: Unspecified injury codes are reserved for situations where the medical record
genuinely lacks the detail necessary for specific coding (e.g., "internal injury, NOS" in an old
record). They should not be used for convenience (C) or when the coder hasn't thoroughly
reviewed the record (A). Unspecified codes are not being phased out (D) and remain necessary
for incomplete data. Overuse of unspecified codes reduces data quality and comparability.
Coders should query physicians for clarification when possible.
Question 9 The AIS 2025 update includes which of the following changes from AIS 2015?
A. Elimination of the 7-digit coding structure
B. Revised severity assignments for certain traumatic brain injuries and spinal cord injuries
[CORRECT]
C. Reduction of severity levels from 6 to 5
D. Elimination of body region 9 (External)
Correct Answer: B
Rationale: AIS 2025 incorporates updated medical evidence and refined severity assignments,
particularly for traumatic brain injuries (incorporating modern imaging findings) and spinal cord
injuries (refining completeness and level assessments). The 7-digit structure (A) remains
unchanged. The 6-level severity scale (C) is preserved. Body region 9 (External) (D) remains for
burns, soft tissue injuries, and other external trauma. AIS updates typically refine rather than
restructure the system.
