AHIMA CCA PRACTICE EXAM 2026 FULL
SOLUTION AND ANALYSIS
◉A patient is admitted with spotting. She had been treated two
weeks previously for a miscarriage with sepsis. The sepsis had
resolved, and she is afebrile at this time. She is treated with an
aspiration dilation and curettage. Products of conception are found.
Which of the following should be the principal diagnosis?
a. Miscarriage
b. Complications of spontaneous abortion with sepsis
c. Sepsis
d. Spontaneous abortion with sepsis. Answer: a. Miscarriage
Subsequent admissions for retained products of conception
following a spontaneous or legally induced abortion are assigned the
appropriate code from category 634, spontaneous abortion, or 635,
legally induced abortion, with a fifth digit of "1" [incomplete]. This
advice is appropriate even when the patient was discharged
previously with a discharge diagnosis of complete abortion.
◉An 80-year-old is admitted with fever, lethargy, hypotension,
tachycardia, oliguria, and elevated WBC. The patient has more than
,100,000 organisms of Escherichia coli per cc of urine. The attending
physician documents "urosepsis". How should the coder proceed to
code this case?
a. Code sepsis as the principal diagnosis with urinary tract infection
due to E. coli as secondary diagnosis.
b. Code urinary tract infection with sepsis as the principal diagnosis.
c. Query the physician to ask if the patient has septicemia because of
the symptomatology.
d. Query the physician to ask if the patient had septic shock so that
this may be used as the principal diagnosis.. Answer: c. Query the
physician to ask if the patient has septicemia because of the
symptomatology.
The term "urosepsis" is nonspecific term. If that is the only term
documented, only code 599.0 should be assigned based on the
default for the term in the ICD-9-CM index, in addition to the code
for the causal organism, if known. Septicemia results from the entry
of pathogens into the bloodstream. Symptoms include spiking fever,
chills, and skin eruptions in the form of petechiae or purpura. Blood
cultures are usually positive; however, a negative culture does not
exclude the diagnosis of septicemia. Several other clinical
indications symptomology could indicate the diagnosis of
septicemia. Only the physician can diagnose the condition based on
clinical indications. Query the physician when the diagnosis is not
clear to the coder.
, ◉A 65-year-old patient, with a history of lung cancer, is admitted to
a healthcare facility with ataxia and syncope and a fractured arm as
a result of falling. The patient undergoes a closed reduction of the
fracture in the emergency department and undergoes a complete
workup for metastatic carcinoma of the brain. The patient is found
to have metastatic carcinoma of the lung to the brain and undergoes
radiation therapy to the brain. Which of the following would be the
principal diagnosis in this case?
a. Ataxia
b. Fractured arm
c. Metastatic carcinoma of the brain
d. Carcinoma of the lung. Answer: c. Metastatic carcinoma of the
brain
If treatment is directed at the malignancy, designate the malignancy
as the principal diagnosis. The only exception to this guideline is if a
patient admission or encounter is solely for the administration of
chemotherapy, immunotherapy, or radiation therapy, assign the
appropriate V code as the first-listed or principal diagnosis and the
diagnosis or problem for which the service is being performed as a
secondary diagnosis.
◉A patient was admitted for abdominal pain with diarrhea and was
diagnosed with infectious gastroenteritis. The patient also has
SOLUTION AND ANALYSIS
◉A patient is admitted with spotting. She had been treated two
weeks previously for a miscarriage with sepsis. The sepsis had
resolved, and she is afebrile at this time. She is treated with an
aspiration dilation and curettage. Products of conception are found.
Which of the following should be the principal diagnosis?
a. Miscarriage
b. Complications of spontaneous abortion with sepsis
c. Sepsis
d. Spontaneous abortion with sepsis. Answer: a. Miscarriage
Subsequent admissions for retained products of conception
following a spontaneous or legally induced abortion are assigned the
appropriate code from category 634, spontaneous abortion, or 635,
legally induced abortion, with a fifth digit of "1" [incomplete]. This
advice is appropriate even when the patient was discharged
previously with a discharge diagnosis of complete abortion.
◉An 80-year-old is admitted with fever, lethargy, hypotension,
tachycardia, oliguria, and elevated WBC. The patient has more than
,100,000 organisms of Escherichia coli per cc of urine. The attending
physician documents "urosepsis". How should the coder proceed to
code this case?
a. Code sepsis as the principal diagnosis with urinary tract infection
due to E. coli as secondary diagnosis.
b. Code urinary tract infection with sepsis as the principal diagnosis.
c. Query the physician to ask if the patient has septicemia because of
the symptomatology.
d. Query the physician to ask if the patient had septic shock so that
this may be used as the principal diagnosis.. Answer: c. Query the
physician to ask if the patient has septicemia because of the
symptomatology.
The term "urosepsis" is nonspecific term. If that is the only term
documented, only code 599.0 should be assigned based on the
default for the term in the ICD-9-CM index, in addition to the code
for the causal organism, if known. Septicemia results from the entry
of pathogens into the bloodstream. Symptoms include spiking fever,
chills, and skin eruptions in the form of petechiae or purpura. Blood
cultures are usually positive; however, a negative culture does not
exclude the diagnosis of septicemia. Several other clinical
indications symptomology could indicate the diagnosis of
septicemia. Only the physician can diagnose the condition based on
clinical indications. Query the physician when the diagnosis is not
clear to the coder.
, ◉A 65-year-old patient, with a history of lung cancer, is admitted to
a healthcare facility with ataxia and syncope and a fractured arm as
a result of falling. The patient undergoes a closed reduction of the
fracture in the emergency department and undergoes a complete
workup for metastatic carcinoma of the brain. The patient is found
to have metastatic carcinoma of the lung to the brain and undergoes
radiation therapy to the brain. Which of the following would be the
principal diagnosis in this case?
a. Ataxia
b. Fractured arm
c. Metastatic carcinoma of the brain
d. Carcinoma of the lung. Answer: c. Metastatic carcinoma of the
brain
If treatment is directed at the malignancy, designate the malignancy
as the principal diagnosis. The only exception to this guideline is if a
patient admission or encounter is solely for the administration of
chemotherapy, immunotherapy, or radiation therapy, assign the
appropriate V code as the first-listed or principal diagnosis and the
diagnosis or problem for which the service is being performed as a
secondary diagnosis.
◉A patient was admitted for abdominal pain with diarrhea and was
diagnosed with infectious gastroenteritis. The patient also has
