ICD-10 CODING PRACTICE EXAM — 100 Questions
& Answers (2026)
Correct answers are clearly marked with ✓
SECTION A — ICD-10-CM GUIDELINES (1–25)
1. Which placeholder is used in ICD-10 when a 7th character is required but a character is
absent?
A. Z
B. Y
C. X ✓
D. 0
2. Which type of code describes a residual condition after the acute phase?
A. Sequela code ✓
B. Acute code
C. External cause code
D. Placeholder code
3. Which of the following statements is TRUE about “Excludes1”?
A. Means “Not coded here” ✓
B. Codes may be reported together
C. Codes must always be sequenced first
D. Used for external causes only
4. What is the correct term for the cause of an injury?
A. Manifestation
B. Etiology
C. External cause ✓
D. Sequela
5. When both acute and chronic conditions exist, how are they coded?
A. Only acute
B. Only chronic
,C. Chronic first
D. Acute first, then chronic ✓
6. A “Z” code represents what category?
A. Injury
B. External cause
C. Factors influencing health status ✓
D. Drug poisoning
7. Which codes require a 7th character extension?
A. Respiratory codes
B. Pregnancy codes
C. Injury codes ✓
D. Infectious disease codes
8. The term “NOS” means—
A. Code also
B. Not otherwise specified ✓
C. Excludes2
D. Manifestation only
9. The term “NEC” means—
A. Not elsewhere classified ✓
B. Not elsewhere coded
C. Not expected condition
D. External cause not needed
10. If a condition is documented as “rule out,” what should the coder code?
A. Code the suspected condition
B. Code all related symptoms ✓
C. Code nothing
D. Use Z02.89
11. Which guideline applies to combination codes?
A. Code first
B. Code also
,C. One code covers both condition + manifestation ✓
D. Use two codes
12. If a patient has Type 2 diabetes with neuropathy, which takes precedence?
A. Neuropathy
B. Type 2 diabetes with neuropathy ✓
C. Type 2 diabetes unspecified
D. Neuropathy unspecified
13. Which is a manifestation code (requires etiology first)?
A. A00.0
B. I10
C. G81.91
D. M32.0 ✓
14. Z79.4 indicates—
A. Type 1 diabetes
B. Long-term insulin use ✓
C. Steroid use
D. Vaccine encounter
15. A sign or symptom should be coded when—
A. A definitive diagnosis is present
B. No definitive diagnosis exists ✓
C. Patient refuses treatment
D. Physician is unsure
16. External cause codes (V00–Y99) are—
A. Mandatory
B. Required only for deaths
C. Helpful but never required ✓
D. Used only for children
17. Which of the following is a principal diagnosis?
A. First listed reason after study ✓
B. Always the first documented
, C. Always chronic condition
D. Always acute condition
18. A late effect/sequela code is—
A. Only used in cancer
B. First listed when treating sequela ✓
C. Never used with injuries
D. Used for pregnancy only
19. Which type of code begins with “S”?
A. External cause
B. Injury code ✓
C. Drug code
D. Z factor code
20. Which of the following requires two codes: one for poisoning + one for intent?
A. Diabetes
B. Pregnancy
C. Drug overdose ✓
D. Burns
21. Fracture healing stage "delayed" uses which 7th character?
A. A
B. D
C. G ✓
D. S
22. Burns and corrosions are coded by—
A. Cause only
B. Body surface only
C. Depth, extent, and agent ✓
D. Age
23. Late effect of stroke with hemiparesis— which is coded first?
A. Stroke
B. Hemiparesis sequela ✓
C. Vascular disease
D. Screening code
& Answers (2026)
Correct answers are clearly marked with ✓
SECTION A — ICD-10-CM GUIDELINES (1–25)
1. Which placeholder is used in ICD-10 when a 7th character is required but a character is
absent?
A. Z
B. Y
C. X ✓
D. 0
2. Which type of code describes a residual condition after the acute phase?
A. Sequela code ✓
B. Acute code
C. External cause code
D. Placeholder code
3. Which of the following statements is TRUE about “Excludes1”?
A. Means “Not coded here” ✓
B. Codes may be reported together
C. Codes must always be sequenced first
D. Used for external causes only
4. What is the correct term for the cause of an injury?
A. Manifestation
B. Etiology
C. External cause ✓
D. Sequela
5. When both acute and chronic conditions exist, how are they coded?
A. Only acute
B. Only chronic
,C. Chronic first
D. Acute first, then chronic ✓
6. A “Z” code represents what category?
A. Injury
B. External cause
C. Factors influencing health status ✓
D. Drug poisoning
7. Which codes require a 7th character extension?
A. Respiratory codes
B. Pregnancy codes
C. Injury codes ✓
D. Infectious disease codes
8. The term “NOS” means—
A. Code also
B. Not otherwise specified ✓
C. Excludes2
D. Manifestation only
9. The term “NEC” means—
A. Not elsewhere classified ✓
B. Not elsewhere coded
C. Not expected condition
D. External cause not needed
10. If a condition is documented as “rule out,” what should the coder code?
A. Code the suspected condition
B. Code all related symptoms ✓
C. Code nothing
D. Use Z02.89
11. Which guideline applies to combination codes?
A. Code first
B. Code also
,C. One code covers both condition + manifestation ✓
D. Use two codes
12. If a patient has Type 2 diabetes with neuropathy, which takes precedence?
A. Neuropathy
B. Type 2 diabetes with neuropathy ✓
C. Type 2 diabetes unspecified
D. Neuropathy unspecified
13. Which is a manifestation code (requires etiology first)?
A. A00.0
B. I10
C. G81.91
D. M32.0 ✓
14. Z79.4 indicates—
A. Type 1 diabetes
B. Long-term insulin use ✓
C. Steroid use
D. Vaccine encounter
15. A sign or symptom should be coded when—
A. A definitive diagnosis is present
B. No definitive diagnosis exists ✓
C. Patient refuses treatment
D. Physician is unsure
16. External cause codes (V00–Y99) are—
A. Mandatory
B. Required only for deaths
C. Helpful but never required ✓
D. Used only for children
17. Which of the following is a principal diagnosis?
A. First listed reason after study ✓
B. Always the first documented
, C. Always chronic condition
D. Always acute condition
18. A late effect/sequela code is—
A. Only used in cancer
B. First listed when treating sequela ✓
C. Never used with injuries
D. Used for pregnancy only
19. Which type of code begins with “S”?
A. External cause
B. Injury code ✓
C. Drug code
D. Z factor code
20. Which of the following requires two codes: one for poisoning + one for intent?
A. Diabetes
B. Pregnancy
C. Drug overdose ✓
D. Burns
21. Fracture healing stage "delayed" uses which 7th character?
A. A
B. D
C. G ✓
D. S
22. Burns and corrosions are coded by—
A. Cause only
B. Body surface only
C. Depth, extent, and agent ✓
D. Age
23. Late effect of stroke with hemiparesis— which is coded first?
A. Stroke
B. Hemiparesis sequela ✓
C. Vascular disease
D. Screening code
