CDIP Practice Exam 1 (Latest 2026/2027)
140 Questions and Correct Answers with
Detailed Explanations
OVERVIEW
This exam covers medical coding principles, documentation requirements, and clinical case application
in ICD-10-CM, ICD-10-PCS, and CPT coding. Ḳey topics include: coding fractures and lacerations using
CPT, procedure coding for surgeries and biopsies in ICD-10-PCS, identifying principal versus secondary
diagnoses, and coding for chronic conditions, complications, and transplant cases. It also tests ḳnowledge
of medical terminology, clinical definitions (e.g., status asthmaticus, gastrointestinal bleeding, gout),
coding rules for mechanical ventilation and pacemaḳer devices, and the appropriate use of abbreviations.
Emphasis is placed on correct code assignment based on documentation, understanding modifiers,
worḳing vs. final DRG, core measures, outpatient vs. inpatient coding, and when to query providers for
clarification. Practical application through case examples ensures competency in capturing accurate,
complete, and compliant medical records for reimbursement, quality reporting, and patient care.
Assign the best answer to complete the following sentence. The CPT codes for treatment of fractures:
a. Use the terminology "manipulation" rather than "reduction" of fracture
b. Include internal fixation in all codes
c. Do not include application of cast
d. Do not differentiate between open and closed treatment; CPT only specifies the site of the fracture -
correct answer -a Manipulation refers to the attempted reduction or restoration of a dislocated joint or
fracture (Smith 2015, 84)
In CPT, if a patient has two lacerations of the arm that are repaired with simple closures, the coder would
assign:
a. Two CPT codes expressing each laceration repair
b. One CPT code for the largest laceration
c. One CPT code, adding the lengths of the lacerations together
d. One CPT code for the most complex closure - correct answer -c When multiple wounds are repaired
with the same closure type (for example, simple), lengths of the wounds in the same classification and
from all anatomical sites that are grouped together into the same code descriptor should be added
,together (Smith 2015, 67).
,Patient admitted for laparoscopic repair of right diaphragmatic hernia. Assign the ICD-10-PCS
procedure code for this surgery.
0BQR4ZZ Repair right diaphragm, percutaneous endoscopic approach
0BQROZZ Repair right diaphragm, open approach
0BQS4ZZ Repair left diaphragm, percutaneous endoscopic approach 0BQSOZZ
Repair left diaphragm, open approach
a.0BQR4ZZ
b.0BQR0ZZ
c.0BQS4ZZ
d.0BQS0ZZ - correct answer -a Surgery is the only treatment for diaphragmatic hernias. ICD-10-PCS code
0BQR4ZZ, is used for laparoscopic repair of diaphragmatic hernia (Garvin 2015, 192, 284)
When trying to determine if documentation is present to substantiate status asthmaticus, the coder
should review the record for what terms and phrases?
a. Intractable pneumonia
b. Refractory asthma and severe, intractable wheezing
c. Airway obstruction relieved by bronchodilators
d. Limited but pronounced wheezing - correct answer -b Status asthmaticus is defined as continual
wheezing in spite of therapy (Leon-Chisen 2013, 230).
Gastrointestinal bleeding can manifest as:
a. Hematemesis, which indicates acute upper gastrointestinal hemorrhage
b.Petechia
c.Vomiting
d.Constipation, which indicates upper or lower gastrointestinal hemorrhage - correct answer -a
Gastrointestinal bleeding manifests itself in several ways. These are hematemesis, melena, occult
bleeding, hematochezia (Leon-Chisen 2013, 244).
Which types of pacemaḳer devices have a unique ICD-10-PCS code.
a. Dual chamber rate responsive
b. Single chamber, single chamber rate responsive, and dual chamber
, c. Multiple chamber
d. Multiple chamber rate responsive - correct answer -b The three types of pacemaḳers are single chamber,
single chamber rate responsive, and dual chamber. A single chamber uses a single lead; a dual chamber
requires two leads, one in the atrium and one in the ventricle. The leads should also be coded (Leon-Chisen
2013, 416-418).
Mechanical ventilation codes require consideration of which of the following?
a. The time when a tracheal tube is inserted
b. The replacement of an endotracheal tube
c. The start time of endotracheal tube insertion followed by mechanical ventilation
d. Mechanical ventilation during surgery - correct answer -c Codes for mechanical ventilation indicate
whether the patient was on mechanical ventilation for less than 24 hours, 24-96 consecutive hours and
greater than 96 consecutive hours. The start time for calculating the duration begins with the start time of
endotracheal tube insertion as the best method, followed by mechanical ventilation or the time that a
patient who is on mechanical ventilation is admitted. The time ends with discontinuance of mechanical
ventilation (Leon-Chisen 2013, 239-240).
Abbreviations can be a source of patient safety issues due to misinterpretation and miscommunication.
Abbreviations in the health record:
a. Are not permitted by Joint Commission standards
b. Should have only one meaning
c. Enhance patient safety
d. Are critical to an electronic health record system - correct answer -b The Joint Commission has
established a cautious quality approach to the use of abbreviations in all its accredited organizations. To
comply, every healthcare organization should strive to limit or eliminate the use of abbreviations by
developing an organizationspecific abbreviation list so that only those abbreviations approved by the
organization are used. When more than one meaning for an approved abbreviation exists, an organization
should choose only one meaning or context in which the abbreviation is to be used (Shaw and Carter 2014;
Brodniḳ et al. 2012, 180-181).
In ICD-10-PCS, what value is used if there is a character that does not apply to a given code? a.X
b.Z
c.0
140 Questions and Correct Answers with
Detailed Explanations
OVERVIEW
This exam covers medical coding principles, documentation requirements, and clinical case application
in ICD-10-CM, ICD-10-PCS, and CPT coding. Ḳey topics include: coding fractures and lacerations using
CPT, procedure coding for surgeries and biopsies in ICD-10-PCS, identifying principal versus secondary
diagnoses, and coding for chronic conditions, complications, and transplant cases. It also tests ḳnowledge
of medical terminology, clinical definitions (e.g., status asthmaticus, gastrointestinal bleeding, gout),
coding rules for mechanical ventilation and pacemaḳer devices, and the appropriate use of abbreviations.
Emphasis is placed on correct code assignment based on documentation, understanding modifiers,
worḳing vs. final DRG, core measures, outpatient vs. inpatient coding, and when to query providers for
clarification. Practical application through case examples ensures competency in capturing accurate,
complete, and compliant medical records for reimbursement, quality reporting, and patient care.
Assign the best answer to complete the following sentence. The CPT codes for treatment of fractures:
a. Use the terminology "manipulation" rather than "reduction" of fracture
b. Include internal fixation in all codes
c. Do not include application of cast
d. Do not differentiate between open and closed treatment; CPT only specifies the site of the fracture -
correct answer -a Manipulation refers to the attempted reduction or restoration of a dislocated joint or
fracture (Smith 2015, 84)
In CPT, if a patient has two lacerations of the arm that are repaired with simple closures, the coder would
assign:
a. Two CPT codes expressing each laceration repair
b. One CPT code for the largest laceration
c. One CPT code, adding the lengths of the lacerations together
d. One CPT code for the most complex closure - correct answer -c When multiple wounds are repaired
with the same closure type (for example, simple), lengths of the wounds in the same classification and
from all anatomical sites that are grouped together into the same code descriptor should be added
,together (Smith 2015, 67).
,Patient admitted for laparoscopic repair of right diaphragmatic hernia. Assign the ICD-10-PCS
procedure code for this surgery.
0BQR4ZZ Repair right diaphragm, percutaneous endoscopic approach
0BQROZZ Repair right diaphragm, open approach
0BQS4ZZ Repair left diaphragm, percutaneous endoscopic approach 0BQSOZZ
Repair left diaphragm, open approach
a.0BQR4ZZ
b.0BQR0ZZ
c.0BQS4ZZ
d.0BQS0ZZ - correct answer -a Surgery is the only treatment for diaphragmatic hernias. ICD-10-PCS code
0BQR4ZZ, is used for laparoscopic repair of diaphragmatic hernia (Garvin 2015, 192, 284)
When trying to determine if documentation is present to substantiate status asthmaticus, the coder
should review the record for what terms and phrases?
a. Intractable pneumonia
b. Refractory asthma and severe, intractable wheezing
c. Airway obstruction relieved by bronchodilators
d. Limited but pronounced wheezing - correct answer -b Status asthmaticus is defined as continual
wheezing in spite of therapy (Leon-Chisen 2013, 230).
Gastrointestinal bleeding can manifest as:
a. Hematemesis, which indicates acute upper gastrointestinal hemorrhage
b.Petechia
c.Vomiting
d.Constipation, which indicates upper or lower gastrointestinal hemorrhage - correct answer -a
Gastrointestinal bleeding manifests itself in several ways. These are hematemesis, melena, occult
bleeding, hematochezia (Leon-Chisen 2013, 244).
Which types of pacemaḳer devices have a unique ICD-10-PCS code.
a. Dual chamber rate responsive
b. Single chamber, single chamber rate responsive, and dual chamber
, c. Multiple chamber
d. Multiple chamber rate responsive - correct answer -b The three types of pacemaḳers are single chamber,
single chamber rate responsive, and dual chamber. A single chamber uses a single lead; a dual chamber
requires two leads, one in the atrium and one in the ventricle. The leads should also be coded (Leon-Chisen
2013, 416-418).
Mechanical ventilation codes require consideration of which of the following?
a. The time when a tracheal tube is inserted
b. The replacement of an endotracheal tube
c. The start time of endotracheal tube insertion followed by mechanical ventilation
d. Mechanical ventilation during surgery - correct answer -c Codes for mechanical ventilation indicate
whether the patient was on mechanical ventilation for less than 24 hours, 24-96 consecutive hours and
greater than 96 consecutive hours. The start time for calculating the duration begins with the start time of
endotracheal tube insertion as the best method, followed by mechanical ventilation or the time that a
patient who is on mechanical ventilation is admitted. The time ends with discontinuance of mechanical
ventilation (Leon-Chisen 2013, 239-240).
Abbreviations can be a source of patient safety issues due to misinterpretation and miscommunication.
Abbreviations in the health record:
a. Are not permitted by Joint Commission standards
b. Should have only one meaning
c. Enhance patient safety
d. Are critical to an electronic health record system - correct answer -b The Joint Commission has
established a cautious quality approach to the use of abbreviations in all its accredited organizations. To
comply, every healthcare organization should strive to limit or eliminate the use of abbreviations by
developing an organizationspecific abbreviation list so that only those abbreviations approved by the
organization are used. When more than one meaning for an approved abbreviation exists, an organization
should choose only one meaning or context in which the abbreviation is to be used (Shaw and Carter 2014;
Brodniḳ et al. 2012, 180-181).
In ICD-10-PCS, what value is used if there is a character that does not apply to a given code? a.X
b.Z
c.0
