CERTIFIED CODING SPECIALIST 3 PRACTICE
QUESTIONS AND CODING RATIONALE GUIDE
2026
◉ A patient is treated for esophageal varices with hemorrhage due
to cirrhosis. The diagnostic codes that would be assigned are:
I85.01 Esophageal varices with bleeding
I85.11 Secondary esophageal varices with bleeding
K74.60 Unspecified cirrhosis of liver. Answer: d. K74.60, I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
**The patient has cirrhosis of the liver with resulting bleeding
esophageal varices. Cirrhosis of liver is sequenced first followed by
the code for the bleeding esophageal varices (HHS 2017, Section
I.A.13, 11).
◉ 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. Answer:
◉ Assign the code(s) for endoscopic sinusotomy with bilateral
anterior ethmoidectomy.
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate
procedure)
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial
(anterior)
−50 Bilateral procedurea.
a. 31254
b. 31254-50
c. 31254, 31254
d. 31231. Answer: b. 31254-50
,31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial
(anterior)
−50 Bilateral procedurea.
** A code for the anterior ethmoidectomy is assigned and to denote
the bilateral procedure, a modifier of -50 is added (CPT Assistant
Winter 1993, 23; Jan. 1997, 4; Sept. 1997, 10; Oct. 1997, 5; Dec.
2001, 6; May 2003, 5). The sinusotomy is not coded separately, as it
is a diagnostic procedure.
◉ The most common language used for both data definition
language and data manipulation language is:
a. Unified modeling language
b. JAVA
c. Perl
d. Structured query language. Answer: d. Structured query language
** Structured query language (SQL) is used commonly for data
language and data definitions (Sharp 2016, 184).
◉ An ethmoidectomy removes infected tissue and bone in the
ethmoid sinuses that blocks natural drainage. The surgeon views
your ethmoid sinuses with an endoscope, a thin flexible tube with a
very small camera and light at the end of it.. Answer:
, ◉ Documentation from the nursing or other allied health
professionals' notes can be used to establish which of the following
diagnoses:
a. Body mass index (BMI)
b. Malnutrition
c. Aspiration pneumonia
d. Fatigue. Answer: a. Body mass index (BMI)
** The physician must establish the diagnosis—obesity or morbid
obesity—and the additional information can be pulled from
ancillary documentation to establish the correct code assignment for
body mass index (BMI) (Leon-Chisen 2017, 168).
◉ 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
QUESTIONS AND CODING RATIONALE GUIDE
2026
◉ A patient is treated for esophageal varices with hemorrhage due
to cirrhosis. The diagnostic codes that would be assigned are:
I85.01 Esophageal varices with bleeding
I85.11 Secondary esophageal varices with bleeding
K74.60 Unspecified cirrhosis of liver. Answer: d. K74.60, I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
**The patient has cirrhosis of the liver with resulting bleeding
esophageal varices. Cirrhosis of liver is sequenced first followed by
the code for the bleeding esophageal varices (HHS 2017, Section
I.A.13, 11).
◉ 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. Answer:
◉ Assign the code(s) for endoscopic sinusotomy with bilateral
anterior ethmoidectomy.
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate
procedure)
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial
(anterior)
−50 Bilateral procedurea.
a. 31254
b. 31254-50
c. 31254, 31254
d. 31231. Answer: b. 31254-50
,31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial
(anterior)
−50 Bilateral procedurea.
** A code for the anterior ethmoidectomy is assigned and to denote
the bilateral procedure, a modifier of -50 is added (CPT Assistant
Winter 1993, 23; Jan. 1997, 4; Sept. 1997, 10; Oct. 1997, 5; Dec.
2001, 6; May 2003, 5). The sinusotomy is not coded separately, as it
is a diagnostic procedure.
◉ The most common language used for both data definition
language and data manipulation language is:
a. Unified modeling language
b. JAVA
c. Perl
d. Structured query language. Answer: d. Structured query language
** Structured query language (SQL) is used commonly for data
language and data definitions (Sharp 2016, 184).
◉ An ethmoidectomy removes infected tissue and bone in the
ethmoid sinuses that blocks natural drainage. The surgeon views
your ethmoid sinuses with an endoscope, a thin flexible tube with a
very small camera and light at the end of it.. Answer:
, ◉ Documentation from the nursing or other allied health
professionals' notes can be used to establish which of the following
diagnoses:
a. Body mass index (BMI)
b. Malnutrition
c. Aspiration pneumonia
d. Fatigue. Answer: a. Body mass index (BMI)
** The physician must establish the diagnosis—obesity or morbid
obesity—and the additional information can be pulled from
ancillary documentation to establish the correct code assignment for
body mass index (BMI) (Leon-Chisen 2017, 168).
◉ 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
