NHA CBCS – ICD-10-CM Coding Practice Exam Questions and
Answers with Rationales 2026/2027 Update
1.
Which classification system is used in the United States to report diagnoses and
conditions?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. HCPCS Level II
Answer: B
Rationale: ICD-10-CM is the U.S. clinical modification used to report diagnoses,
diseases, conditions, symptoms, and reasons for encounters.
2.
Which resource should be consulted after locating a diagnosis in the Alphabetic
Index?
A. CPT codebook
B. Tabular List
C. HCPCS manual
D. NCCI edits
Answer: B
Rationale: The coder must verify the code in the Tabular List and review
applicable instructional notes.
3.
What does an Excludes1 note generally indicate?
A. The two conditions should not be coded together
B. The condition must always be coded second
,C. The condition is optional
D. The code requires a seventh character
Answer: A
Rationale: Excludes1 indicates that the excluded condition is not coded with the
listed code under the circumstances described.
4.
What does an Excludes2 note mean?
A. The excluded condition can never be reported
B. The excluded condition may be coded separately when appropriate
C. The condition must be sequenced first
D. The code is invalid
Answer: B
Rationale: Excludes2 means the excluded condition is not part of the code but
may coexist and be reported separately when appropriate.
5.
A "code first" note generally instructs the coder to:
A. Code the underlying condition first
B. Code the manifestation first
C. Use a CPT code first
D. Omit the underlying disease
Answer: A
Rationale: A code-first instruction directs the underlying condition to be
sequenced before the associated manifestation when applicable.
6.
,A "use additional code" note indicates that:
A. The current code must be deleted
B. Another code may be required to provide additional information
C. Only a procedure code may be assigned
D. The diagnosis is uncertain
Answer: B
Rationale: The instruction indicates that another code may be needed to fully
describe the patient's condition.
7.
What does laterality identify?
A. Severity
B. Encounter type
C. Body side
D. Disease duration
Answer: C
Rationale: Laterality identifies whether a condition affects the right side, left side,
or both sides when the classification provides those distinctions.
8.
A patient is documented as having a disorder of the left shoulder. If a left-sided
code is available, the coder should:
A. Use right-sided coding
B. Use bilateral coding
C. Use the left-sided code
D. Use unspecified laterality
Answer: C
, Rationale: Coding should reflect the highest level of specificity supported by
documentation.
9.
What is a combination code?
A. Two unrelated codes assigned together
B. A single code representing multiple related diagnostic elements
C. A procedure code with a modifier
D. An external cause code
Answer: B
Rationale: A combination code represents two diagnoses, a diagnosis with a
manifestation, or a diagnosis with an associated complication in one code.
10.
In outpatient coding, a diagnosis documented as "probable pneumonia" should
generally be reported as:
A. Confirmed pneumonia
B. The documented signs, symptoms, or confirmed conditions
C. Sepsis
D. No diagnosis
Answer: B
Rationale: Outpatient coding generally does not code uncertain diagnoses as
established. Signs, symptoms, or confirmed conditions are reported instead.
11.
For a qualifying inpatient discharge, an uncertain diagnosis documented as
"probable" may generally be coded as:
Answers with Rationales 2026/2027 Update
1.
Which classification system is used in the United States to report diagnoses and
conditions?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. HCPCS Level II
Answer: B
Rationale: ICD-10-CM is the U.S. clinical modification used to report diagnoses,
diseases, conditions, symptoms, and reasons for encounters.
2.
Which resource should be consulted after locating a diagnosis in the Alphabetic
Index?
A. CPT codebook
B. Tabular List
C. HCPCS manual
D. NCCI edits
Answer: B
Rationale: The coder must verify the code in the Tabular List and review
applicable instructional notes.
3.
What does an Excludes1 note generally indicate?
A. The two conditions should not be coded together
B. The condition must always be coded second
,C. The condition is optional
D. The code requires a seventh character
Answer: A
Rationale: Excludes1 indicates that the excluded condition is not coded with the
listed code under the circumstances described.
4.
What does an Excludes2 note mean?
A. The excluded condition can never be reported
B. The excluded condition may be coded separately when appropriate
C. The condition must be sequenced first
D. The code is invalid
Answer: B
Rationale: Excludes2 means the excluded condition is not part of the code but
may coexist and be reported separately when appropriate.
5.
A "code first" note generally instructs the coder to:
A. Code the underlying condition first
B. Code the manifestation first
C. Use a CPT code first
D. Omit the underlying disease
Answer: A
Rationale: A code-first instruction directs the underlying condition to be
sequenced before the associated manifestation when applicable.
6.
,A "use additional code" note indicates that:
A. The current code must be deleted
B. Another code may be required to provide additional information
C. Only a procedure code may be assigned
D. The diagnosis is uncertain
Answer: B
Rationale: The instruction indicates that another code may be needed to fully
describe the patient's condition.
7.
What does laterality identify?
A. Severity
B. Encounter type
C. Body side
D. Disease duration
Answer: C
Rationale: Laterality identifies whether a condition affects the right side, left side,
or both sides when the classification provides those distinctions.
8.
A patient is documented as having a disorder of the left shoulder. If a left-sided
code is available, the coder should:
A. Use right-sided coding
B. Use bilateral coding
C. Use the left-sided code
D. Use unspecified laterality
Answer: C
, Rationale: Coding should reflect the highest level of specificity supported by
documentation.
9.
What is a combination code?
A. Two unrelated codes assigned together
B. A single code representing multiple related diagnostic elements
C. A procedure code with a modifier
D. An external cause code
Answer: B
Rationale: A combination code represents two diagnoses, a diagnosis with a
manifestation, or a diagnosis with an associated complication in one code.
10.
In outpatient coding, a diagnosis documented as "probable pneumonia" should
generally be reported as:
A. Confirmed pneumonia
B. The documented signs, symptoms, or confirmed conditions
C. Sepsis
D. No diagnosis
Answer: B
Rationale: Outpatient coding generally does not code uncertain diagnoses as
established. Signs, symptoms, or confirmed conditions are reported instead.
11.
For a qualifying inpatient discharge, an uncertain diagnosis documented as
"probable" may generally be coded as:
