ADVANCED MEDICAL CODING AND
CASE STUDY ABSTRACTION
PRACTICUM QUESTIONS WITH
VERIFIED ANSWERS 2026/2027
1. When a patient is treated for both an acute and a chronic condition during the same
encounter and there are separate codes for each, how should they be sequenced according to
ICD-10-CM guidelines?
A. The chronic code is always sequenced first.
B. The acute code is sequenced first, followed by the chronic code.
C. Only the acute code is reported.
D. The physician must decide which condition was more resource-intensive.
Answer: B
Conceptual Explanation: According to ICD-10-CM Official Guidelines for Coding and
Reporting, if the same condition is described as both acute and chronic, and separate codes
exist in the Alphabetic Index at the same indentation level, the acute code is sequenced
first.
,2. In the context of CPT coding, which modifier should be appended to a procedure to
indicate that it was discontinued after the administration of anesthesia due to a threat to the
patient’s well-being?
A. Modifier 52
B. Modifier 53
C. Modifier 73
D. Modifier 58
Answer: B
Conceptual Explanation: Modifier 53 is used to report a failed or discontinued procedure
due to extenuating circumstances or those that threaten the well-being of the patient after
the procedure has started.
3. Which of the following is a requirement for a diagnosis to be coded as ‘Principal’ in an
inpatient setting?
A. The condition that matches the most expensive procedure performed.
B. The condition established after study to be chiefly responsible for occasioning the
admission.
C. The condition that the patient has had for the longest duration.
D. The condition identified by the patient during the intake interview.
Answer: B
, Conceptual Explanation: The Uniform Hospital Discharge Data Set (UHDDS) defines the
principal diagnosis as the condition established after study to be chiefly responsible for
occasioning the admission of the patient to the hospital for care.
4. A patient presents with a pressure ulcer that is documented as ‘healing.’ How should this
be coded in ICD-10-CM?
A. Assign the code for the stage documented at the time of admission.
B. Assign the code for the current stage documented in the record.
C. Assign the code for ‘unspecified stage.’
D. Do not code the ulcer if it is healing.
Answer: B
Conceptual Explanation: Pressure ulcers documented as ‘healing’ should be assigned the
code for the current stage documented. If the documentation does not provide a stage, the
‘unspecified stage’ code should be used.
5. When abstracting a case for a patient with a primary malignancy that has metastasized to a
secondary site, and the treatment is directed only toward the secondary site, what is
sequenced first?
A. The primary malignancy
B. The code for the symptoms of the malignancy
C. The secondary malignancy
CASE STUDY ABSTRACTION
PRACTICUM QUESTIONS WITH
VERIFIED ANSWERS 2026/2027
1. When a patient is treated for both an acute and a chronic condition during the same
encounter and there are separate codes for each, how should they be sequenced according to
ICD-10-CM guidelines?
A. The chronic code is always sequenced first.
B. The acute code is sequenced first, followed by the chronic code.
C. Only the acute code is reported.
D. The physician must decide which condition was more resource-intensive.
Answer: B
Conceptual Explanation: According to ICD-10-CM Official Guidelines for Coding and
Reporting, if the same condition is described as both acute and chronic, and separate codes
exist in the Alphabetic Index at the same indentation level, the acute code is sequenced
first.
,2. In the context of CPT coding, which modifier should be appended to a procedure to
indicate that it was discontinued after the administration of anesthesia due to a threat to the
patient’s well-being?
A. Modifier 52
B. Modifier 53
C. Modifier 73
D. Modifier 58
Answer: B
Conceptual Explanation: Modifier 53 is used to report a failed or discontinued procedure
due to extenuating circumstances or those that threaten the well-being of the patient after
the procedure has started.
3. Which of the following is a requirement for a diagnosis to be coded as ‘Principal’ in an
inpatient setting?
A. The condition that matches the most expensive procedure performed.
B. The condition established after study to be chiefly responsible for occasioning the
admission.
C. The condition that the patient has had for the longest duration.
D. The condition identified by the patient during the intake interview.
Answer: B
, Conceptual Explanation: The Uniform Hospital Discharge Data Set (UHDDS) defines the
principal diagnosis as the condition established after study to be chiefly responsible for
occasioning the admission of the patient to the hospital for care.
4. A patient presents with a pressure ulcer that is documented as ‘healing.’ How should this
be coded in ICD-10-CM?
A. Assign the code for the stage documented at the time of admission.
B. Assign the code for the current stage documented in the record.
C. Assign the code for ‘unspecified stage.’
D. Do not code the ulcer if it is healing.
Answer: B
Conceptual Explanation: Pressure ulcers documented as ‘healing’ should be assigned the
code for the current stage documented. If the documentation does not provide a stage, the
‘unspecified stage’ code should be used.
5. When abstracting a case for a patient with a primary malignancy that has metastasized to a
secondary site, and the treatment is directed only toward the secondary site, what is
sequenced first?
A. The primary malignancy
B. The code for the symptoms of the malignancy
C. The secondary malignancy
