Certified Inpatient Coder (CIC) AAPC Exam 2026: Professional
Certification Practice Examination — ICD-10-CM, ICD-10-PCS,
Inpatient Coding Guidelines, Clinical Documentation, DRG
Reimbursement & Compliance — 190 Multiple-Choice Questions
with Answers & Detailed Rationales
1. A patient is admitted with acute exacerbation of COPD and community-acquired
pneumonia. The physician documents both conditions as active and treated during the stay.
Which condition should be sequenced as the principal diagnosis?
A. Acute exacerbation of COPD
B. Community-acquired pneumonia
C. Both conditions equally
D. The condition requiring more resources
Correct Answer: B
Explanation: The principal diagnosis is the condition after study that occasioned the
admission. Pneumonia typically requires more acute treatment and resources than COPD
exacerbation. Clinical Pearl: If both conditions meet criteria, sequence the condition
primarily responsible for admission.
2. In ICD-10-PCS, what is the correct root operation for a total knee replacement?
A. Excision
,B. Replacement
C. Resection
D. Repair
Correct Answer: B
Explanation: Replacement is defined as putting in or on biological or synthetic material that
physically takes the place of all or a portion of a body part. Best Practice: Joint replacements
are always coded to Replacement, not Resection, even though bone is removed.
3. A coder reviews a record where the physician documented "possible pneumonia" on
admission but the discharge summary states "pneumonia resolved with antibiotics." How
should this be coded?
A. Code pneumonia as confirmed
B. Code pneumonia as ruled out
C. Query the physician for clarification
D. Code signs and symptoms only
Correct Answer: C
Explanation: Conflicting documentation requires physician clarification before code
assignment. Clinical Pearl: "Possible" diagnoses on admission that resolve with treatment
still require query if discharge documentation is definitive.
,4. Under MS-DRG methodology, what is the primary purpose of the CC/MCC designation?
A. To identify hospital-acquired conditions
B. To adjust payment based on severity
C. To determine outpatient eligibility
D. To calculate length of stay
Correct Answer: B
Explanation: CC (Complication/Comorbidity) and MCC (Major CC) designations adjust DRG
assignment to reflect increased resource utilization. Best Practice: Accurate secondary
diagnosis coding directly impacts hospital reimbursement.
5. A patient is admitted for cellulitis of the right lower extremity. The physician documents
"diabetes with peripheral neuropathy" as a chronic condition. What is the appropriate
action?
A. Code only cellulitis as principal diagnosis
B. Code cellulitis and diabetes with neuropathy as secondary
C. Code cellulitis and neuropathy only
D. Query the physician about diabetic linkage
Correct Answer: B
, Explanation: Diabetes with documented neuropathy is a valid combination code
representing a chronic condition affecting care. Clinical Pearl: Always look for "with" linkage
in ICD-10-CM; it means presumed relationship.
6. Which root operation is assigned when a procedure is discontinued before any
therapeutic component is performed?
A. Repair
B. Inspection
C. Excision
D. Drainage
Correct Answer: B
Explanation: Per ICD-10-PCS guidelines, if a procedure is discontinued before any other root
operation is performed, code the root operation Inspection of the body part examined. Best
Practice: Never code a therapeutic root operation for an abandoned procedure.
7. A hospital coder identifies that a physician documented "AKI" but the clinical indicators
show a baseline creatinine of 2.5 mg/dL that has been stable for months. What is the best
course of action?
A. Code acute kidney injury as documented
B. Query the physician regarding acute versus chronic
Certification Practice Examination — ICD-10-CM, ICD-10-PCS,
Inpatient Coding Guidelines, Clinical Documentation, DRG
Reimbursement & Compliance — 190 Multiple-Choice Questions
with Answers & Detailed Rationales
1. A patient is admitted with acute exacerbation of COPD and community-acquired
pneumonia. The physician documents both conditions as active and treated during the stay.
Which condition should be sequenced as the principal diagnosis?
A. Acute exacerbation of COPD
B. Community-acquired pneumonia
C. Both conditions equally
D. The condition requiring more resources
Correct Answer: B
Explanation: The principal diagnosis is the condition after study that occasioned the
admission. Pneumonia typically requires more acute treatment and resources than COPD
exacerbation. Clinical Pearl: If both conditions meet criteria, sequence the condition
primarily responsible for admission.
2. In ICD-10-PCS, what is the correct root operation for a total knee replacement?
A. Excision
,B. Replacement
C. Resection
D. Repair
Correct Answer: B
Explanation: Replacement is defined as putting in or on biological or synthetic material that
physically takes the place of all or a portion of a body part. Best Practice: Joint replacements
are always coded to Replacement, not Resection, even though bone is removed.
3. A coder reviews a record where the physician documented "possible pneumonia" on
admission but the discharge summary states "pneumonia resolved with antibiotics." How
should this be coded?
A. Code pneumonia as confirmed
B. Code pneumonia as ruled out
C. Query the physician for clarification
D. Code signs and symptoms only
Correct Answer: C
Explanation: Conflicting documentation requires physician clarification before code
assignment. Clinical Pearl: "Possible" diagnoses on admission that resolve with treatment
still require query if discharge documentation is definitive.
,4. Under MS-DRG methodology, what is the primary purpose of the CC/MCC designation?
A. To identify hospital-acquired conditions
B. To adjust payment based on severity
C. To determine outpatient eligibility
D. To calculate length of stay
Correct Answer: B
Explanation: CC (Complication/Comorbidity) and MCC (Major CC) designations adjust DRG
assignment to reflect increased resource utilization. Best Practice: Accurate secondary
diagnosis coding directly impacts hospital reimbursement.
5. A patient is admitted for cellulitis of the right lower extremity. The physician documents
"diabetes with peripheral neuropathy" as a chronic condition. What is the appropriate
action?
A. Code only cellulitis as principal diagnosis
B. Code cellulitis and diabetes with neuropathy as secondary
C. Code cellulitis and neuropathy only
D. Query the physician about diabetic linkage
Correct Answer: B
, Explanation: Diabetes with documented neuropathy is a valid combination code
representing a chronic condition affecting care. Clinical Pearl: Always look for "with" linkage
in ICD-10-CM; it means presumed relationship.
6. Which root operation is assigned when a procedure is discontinued before any
therapeutic component is performed?
A. Repair
B. Inspection
C. Excision
D. Drainage
Correct Answer: B
Explanation: Per ICD-10-PCS guidelines, if a procedure is discontinued before any other root
operation is performed, code the root operation Inspection of the body part examined. Best
Practice: Never code a therapeutic root operation for an abandoned procedure.
7. A hospital coder identifies that a physician documented "AKI" but the clinical indicators
show a baseline creatinine of 2.5 mg/dL that has been stable for months. What is the best
course of action?
A. Code acute kidney injury as documented
B. Query the physician regarding acute versus chronic
