ADVANCED MEDICAL CODING AND
ABSTRACTING PRACTICUM
QUESTIONS WITH VERIFIED ANSWERS
2026/2027
1. When abstracting a case for an inpatient admission where the patient is admitted with a
localized infection that progresses to sepsis, how should the sequencing be handled according
to ICD-10-CM guidelines?
A. The localized infection is sequenced first, followed by sepsis.
B. The sepsis code is sequenced first, followed by the localized infection.
C. Only the sepsis code is reported; the localized infection is redundant.
D. The code for the systemic inflammatory response syndrome (SIRS) is primary.
Answer: B
Conceptual Explanation: According to ICD-10-CM Official Guidelines, if sepsis is present
on admission and meets the definition of principal diagnosis, the systemic infection
(sepsis) should be sequenced first, followed by the code for the localized infection.
2. A patient undergoes a procedure that is terminated before completion due to a sudden
drop in blood pressure. Which CPT modifier is most appropriate for a physician reporting the
discontinued service in an office setting?
A. Modifier 52
,B. Modifier 73
C. Modifier 74
D. Modifier 53
Answer: D
Conceptual Explanation: Modifier 53 is used by physicians to report a service that was
started but discontinued due to extenuating circumstances or those that threaten the well-
being of the patient. Modifiers 73 and 74 are for facility use.
3. Which of the following is a requirement for coding ‘acute respiratory failure’ as a
secondary diagnosis?
A. It must be documented by a specialist only.
B. It must be present at the time of admission.
C. It must be the underlying cause of the principal diagnosis.
D. It must meet the UHDDS criteria for an additional diagnosis (clinical evaluation,
treatment, or increased stay).
Answer: D
Conceptual Explanation: For any secondary diagnosis to be reported in an inpatient
setting, it must meet the Uniform Hospital Discharge Data Set (UHDDS) criteria: clinical
evaluation, therapeutic treatment, diagnostic procedures, extended length of hospital stay,
or increased nursing care and/or monitoring.
, 4. When abstracting a medical record, the term ‘MEAT’ is often used to validate the reporting
of chronic conditions. What does the ‘E’ in MEAT stand for?
A. Evaluation
B. Evidence
C. Exam
D. Exclusion
Answer: A
Conceptual Explanation: MEAT stands for Monitor, Evaluate, Assess, and Treat. ‘Evaluate’
refers to reviewing lab results, physical exam findings, or the effectiveness of current
medications.
5. A patient is admitted for treatment of a primary malignancy of the lung with metastasis to
the brain. If the encounter is solely for the administration of chemotherapy, what is the
principal diagnosis?
A. The primary lung malignancy
B. The secondary brain malignancy
C. The encounter for antineoplastic chemotherapy (Z51.11)
D. The symptom causing the need for chemotherapy
Answer: C
ABSTRACTING PRACTICUM
QUESTIONS WITH VERIFIED ANSWERS
2026/2027
1. When abstracting a case for an inpatient admission where the patient is admitted with a
localized infection that progresses to sepsis, how should the sequencing be handled according
to ICD-10-CM guidelines?
A. The localized infection is sequenced first, followed by sepsis.
B. The sepsis code is sequenced first, followed by the localized infection.
C. Only the sepsis code is reported; the localized infection is redundant.
D. The code for the systemic inflammatory response syndrome (SIRS) is primary.
Answer: B
Conceptual Explanation: According to ICD-10-CM Official Guidelines, if sepsis is present
on admission and meets the definition of principal diagnosis, the systemic infection
(sepsis) should be sequenced first, followed by the code for the localized infection.
2. A patient undergoes a procedure that is terminated before completion due to a sudden
drop in blood pressure. Which CPT modifier is most appropriate for a physician reporting the
discontinued service in an office setting?
A. Modifier 52
,B. Modifier 73
C. Modifier 74
D. Modifier 53
Answer: D
Conceptual Explanation: Modifier 53 is used by physicians to report a service that was
started but discontinued due to extenuating circumstances or those that threaten the well-
being of the patient. Modifiers 73 and 74 are for facility use.
3. Which of the following is a requirement for coding ‘acute respiratory failure’ as a
secondary diagnosis?
A. It must be documented by a specialist only.
B. It must be present at the time of admission.
C. It must be the underlying cause of the principal diagnosis.
D. It must meet the UHDDS criteria for an additional diagnosis (clinical evaluation,
treatment, or increased stay).
Answer: D
Conceptual Explanation: For any secondary diagnosis to be reported in an inpatient
setting, it must meet the Uniform Hospital Discharge Data Set (UHDDS) criteria: clinical
evaluation, therapeutic treatment, diagnostic procedures, extended length of hospital stay,
or increased nursing care and/or monitoring.
, 4. When abstracting a medical record, the term ‘MEAT’ is often used to validate the reporting
of chronic conditions. What does the ‘E’ in MEAT stand for?
A. Evaluation
B. Evidence
C. Exam
D. Exclusion
Answer: A
Conceptual Explanation: MEAT stands for Monitor, Evaluate, Assess, and Treat. ‘Evaluate’
refers to reviewing lab results, physical exam findings, or the effectiveness of current
medications.
5. A patient is admitted for treatment of a primary malignancy of the lung with metastasis to
the brain. If the encounter is solely for the administration of chemotherapy, what is the
principal diagnosis?
A. The primary lung malignancy
B. The secondary brain malignancy
C. The encounter for antineoplastic chemotherapy (Z51.11)
D. The symptom causing the need for chemotherapy
Answer: C
