Certified Coding Specialist (CCS)
Exam Preparation
Medical Coding Practice Questions
Question 1: Cardiac Catheterization Coding
In order to accurately code a cardiac catheterization, what needs to be determined
based on a review of the documentation?
A. The approach and the side of the heart (chambers) into which the catheter was
inserted
B. The approach, the side of the heart (chambers) into which the catheter was
inserted, as well as any additional procedures performed
C. The duration of the procedure
D. If there is documentation of the procedure in the medical record that stents are
considered
Answer: B
Question 2: Bronchoscopy with Bilateral
Transbronchial Biopsy
Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for each
lobe of each lung.
● 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial lung biopsy(s), single lobe
● 31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial needle aspiration biopsy(s), trachea, main
stem and/or lobar bronchus(i)
● 31632 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial lung biopsy(s), each additional lobe
● −50 Bilateral procedure
A. 31628
,B. 31628-50
C. 31628, 31632
D. 31629
Answer: C
Explanation: 31628 is for single lobe biopsy and 31632 is the add-on code for each
additional lobe. The code description specifies "single lobe" so an additional code is
needed rather than a modifier to denote bilateral biopsy.
Question 3: Closed Reduction of Fracture Right
Proximal Ulna
A 12-year-old boy was seen in an ambulatory surgical center for pain in his right arm.
The x-ray showed fracture of ulna. Patient underwent closed reduction of fracture
right proximal ulna. What diagnostic and procedure codes should be assigned?
● S52.101A Unspecified fracture of upper end of right radius, initial encounter
for closed fracture
● S52.101B Unspecified fracture of upper end of right radius, initial encounter
for open fracture
● S52.001A Unspecified fracture of upper end of right ulna, initial encounter for
closed fracture
● S52.001B Unspecified fracture of upper end of right ulna, initial encounter for
open fracture
● 0PSH0ZZ Reposition right radius, open approach
● 0PSK0ZZ Reposition right ulna, open approach
● 24670 Closed treatment of ulnar fracture, proximal end (eg, olecranon or
coronoid process(es)); without manipulation
● 24675 Closed treatment of ulnar fracture, proximal end (eg, olecranon or
coronoid process(es)); with manipulation
A. S52.101A, 24670
B. S52.001A, 24670
C. S52.101A, 24675
D. S52.001A, 24675
Answer: D
,Explanation: The patient has a fracture of the right proximal ulna and closed
reduction (manipulation) was performed. The term "manipulation" indicates reduction
in CPT. Since this is an ambulatory surgery center case, CPT codes are assigned
rather than ICD-10-PCS codes.
Question 4: Hypertension with Acute Renal Failure and
Stage 3 CKD
A 35-year-old woman has hypertension with acute renal failure and stage 3 chronic
kidney disease. What code would be assigned?
A. N17.9, Acute kidney failure, unspecified
B. I13.2, Hypertensive heart and chronic kidney disease with heart failure and with
stage 5 chronic kidney disease, or end stage renal disease
C. I50.9, Heart failure, unspecified
D. N17.9, Acute kidney failure, unspecified and I12.9, Hypertensive chronic kidney
disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic
kidney disease and N18.3, Chronic kidney disease, stage 3 (moderate)
Answer: D
Explanation: Code the hypertension with stage 3 chronic kidney disease using a
combination code. The code for stage 3 CKD must also be assigned due to the
"code also" note. The acute renal failure is identified with a separate code.
Question 5: Chronic Ulcerative Enterocolitis with
Steroid-Induced Osteoporosis
A 45-year-old female with chronic ulcerative enterocolitis and steroid induced
osteoporosis due to long-term steroid therapy. What codes should be assigned?
● K50.00 Crohn's disease of small intestine without complications
● K51.00 Ulcerative pancolitis without complications
● M81.0 Age-related osteoporosis without current pathological fracture
● M81.8 Other osteoporosis without current pathological fracture
● T38.0X5A Adverse effects of glucocorticoids and synthetic analogues, initial
encounter
, ● Z79.52 Long term (current) use of systemic steroids
● Z79.899 Other long term (current) drug therapy
A. K51.00, M81.8, T38.0X5A, Z79.52
B. K50.00, M81.0, T38.0X5A, Z79.52
C. K51.00, M81.0, T38.0X5A, Z79.899
D. K50.00, M81.8, T38.0X5A, Z79.52
Answer: A
Explanation: The ulcerative colitis (K51.00) and osteoporosis (M81.8) should be
coded as well as the adverse effect (T38.0X5A) and long term use of the steroid
(Z79.52).
Question 6: Hypertensive Heart Disease with CHF
A 55-year-old patient has hypertensive heart disease with congestive heart failure.
What code would be assigned?
A. I15.8, Other secondary hypertension
B. I11.0, Hypertensive heart disease with heart failure and I50.9, Heart failure,
unspecified
C. I50.9, Heart failure, unspecified and I15.0, Renovascular hypertension
D. N18.6, End stage renal disease
Answer: B
Explanation: There is a cause and effect relationship established between the
hypertension and the congestive heart failure. A separate code for the congestive
heart failure is assigned based on the "code also" note.
Question 7: CHF, Hypertension, and End-Stage Renal
Disease
A 70-year-old patient has congestive heart failure and hypertension with end-stage
renal disease. What codes would be assigned?
Exam Preparation
Medical Coding Practice Questions
Question 1: Cardiac Catheterization Coding
In order to accurately code a cardiac catheterization, what needs to be determined
based on a review of the documentation?
A. The approach and the side of the heart (chambers) into which the catheter was
inserted
B. The approach, the side of the heart (chambers) into which the catheter was
inserted, as well as any additional procedures performed
C. The duration of the procedure
D. If there is documentation of the procedure in the medical record that stents are
considered
Answer: B
Question 2: Bronchoscopy with Bilateral
Transbronchial Biopsy
Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for each
lobe of each lung.
● 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial lung biopsy(s), single lobe
● 31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial needle aspiration biopsy(s), trachea, main
stem and/or lobar bronchus(i)
● 31632 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial lung biopsy(s), each additional lobe
● −50 Bilateral procedure
A. 31628
,B. 31628-50
C. 31628, 31632
D. 31629
Answer: C
Explanation: 31628 is for single lobe biopsy and 31632 is the add-on code for each
additional lobe. The code description specifies "single lobe" so an additional code is
needed rather than a modifier to denote bilateral biopsy.
Question 3: Closed Reduction of Fracture Right
Proximal Ulna
A 12-year-old boy was seen in an ambulatory surgical center for pain in his right arm.
The x-ray showed fracture of ulna. Patient underwent closed reduction of fracture
right proximal ulna. What diagnostic and procedure codes should be assigned?
● S52.101A Unspecified fracture of upper end of right radius, initial encounter
for closed fracture
● S52.101B Unspecified fracture of upper end of right radius, initial encounter
for open fracture
● S52.001A Unspecified fracture of upper end of right ulna, initial encounter for
closed fracture
● S52.001B Unspecified fracture of upper end of right ulna, initial encounter for
open fracture
● 0PSH0ZZ Reposition right radius, open approach
● 0PSK0ZZ Reposition right ulna, open approach
● 24670 Closed treatment of ulnar fracture, proximal end (eg, olecranon or
coronoid process(es)); without manipulation
● 24675 Closed treatment of ulnar fracture, proximal end (eg, olecranon or
coronoid process(es)); with manipulation
A. S52.101A, 24670
B. S52.001A, 24670
C. S52.101A, 24675
D. S52.001A, 24675
Answer: D
,Explanation: The patient has a fracture of the right proximal ulna and closed
reduction (manipulation) was performed. The term "manipulation" indicates reduction
in CPT. Since this is an ambulatory surgery center case, CPT codes are assigned
rather than ICD-10-PCS codes.
Question 4: Hypertension with Acute Renal Failure and
Stage 3 CKD
A 35-year-old woman has hypertension with acute renal failure and stage 3 chronic
kidney disease. What code would be assigned?
A. N17.9, Acute kidney failure, unspecified
B. I13.2, Hypertensive heart and chronic kidney disease with heart failure and with
stage 5 chronic kidney disease, or end stage renal disease
C. I50.9, Heart failure, unspecified
D. N17.9, Acute kidney failure, unspecified and I12.9, Hypertensive chronic kidney
disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic
kidney disease and N18.3, Chronic kidney disease, stage 3 (moderate)
Answer: D
Explanation: Code the hypertension with stage 3 chronic kidney disease using a
combination code. The code for stage 3 CKD must also be assigned due to the
"code also" note. The acute renal failure is identified with a separate code.
Question 5: Chronic Ulcerative Enterocolitis with
Steroid-Induced Osteoporosis
A 45-year-old female with chronic ulcerative enterocolitis and steroid induced
osteoporosis due to long-term steroid therapy. What codes should be assigned?
● K50.00 Crohn's disease of small intestine without complications
● K51.00 Ulcerative pancolitis without complications
● M81.0 Age-related osteoporosis without current pathological fracture
● M81.8 Other osteoporosis without current pathological fracture
● T38.0X5A Adverse effects of glucocorticoids and synthetic analogues, initial
encounter
, ● Z79.52 Long term (current) use of systemic steroids
● Z79.899 Other long term (current) drug therapy
A. K51.00, M81.8, T38.0X5A, Z79.52
B. K50.00, M81.0, T38.0X5A, Z79.52
C. K51.00, M81.0, T38.0X5A, Z79.899
D. K50.00, M81.8, T38.0X5A, Z79.52
Answer: A
Explanation: The ulcerative colitis (K51.00) and osteoporosis (M81.8) should be
coded as well as the adverse effect (T38.0X5A) and long term use of the steroid
(Z79.52).
Question 6: Hypertensive Heart Disease with CHF
A 55-year-old patient has hypertensive heart disease with congestive heart failure.
What code would be assigned?
A. I15.8, Other secondary hypertension
B. I11.0, Hypertensive heart disease with heart failure and I50.9, Heart failure,
unspecified
C. I50.9, Heart failure, unspecified and I15.0, Renovascular hypertension
D. N18.6, End stage renal disease
Answer: B
Explanation: There is a cause and effect relationship established between the
hypertension and the congestive heart failure. A separate code for the congestive
heart failure is assigned based on the "code also" note.
Question 7: CHF, Hypertension, and End-Stage Renal
Disease
A 70-year-old patient has congestive heart failure and hypertension with end-stage
renal disease. What codes would be assigned?
