CCS/ICD-10 CODING EXAM – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
ICD-10-CM Diagnostic Coding Guidelines and Conventions
ICD-10-PCS Procedural Coding Systems and Root Operations
CPT and HCPCS Level II Coding Principles
Medical Terminology and Human Anatomy
Healthcare Regulatory Compliance and Reimbursement
Methodologies
Clinical Documentation Improvement (CDI) and Data Quality
Standards
Healthcare Ethics, Legal Standards, and Confidentiality
Regulations
Introduction
This comprehensive examination is designed to rigorously evaluate
professional mastery and technical proficiency in healthcare coding,
classification systems, and health information management. The
purpose of this assessment is to validate the candidate's ability to
accurately interpret complex medical records, assign precise diagnostic
and procedural codes, and adhere to strict regulatory guidelines. The
assessment evaluates advanced competencies in ICD-10-CM, ICD-10-
PCS, and CPT methodologies through a sophisticated blend of
foundational theory and intricate clinical scenarios. Emphasizing real-
world application and critical decision-making, the questions challenge
candidates to navigate compliance standards, resolve documentation
ambiguities, and ensure optimal data integrity across diverse healthcare
settings.
Section One: Questions 1–100
Question 1
,A patient is admitted for inpatient treatment of acute exacerbation of
chronic obstructive pulmonary disease (COPD) with acute lower
respiratory infection. Which of the following represents the correct
coding and sequencing?
A. J44.1, J22
🟢 B. J44.1, J20.9
C. J44.9, J22
D. J20.9, J44.9
🔴 Explanation: Code J44.1 specifies chronic obstructive pulmonary
disease with acute exacerbation. When an acute lower respiratory
infection is present with COPD, an additional code for the specific
infection (such as acute bronchitis, J20.9) must be assigned.
Question 2
What is the primary root operation in ICD-10-PCS when a surgeon
performs an open total abdominal hysterectomy?
A. Resection
B. Excision
🟢 C. Extraction
D. Detachment
🔴 Explanation: The root operation for removing a solid body part, such
as a total hysterectomy where the entire uterus is removed, is
Resection. Wait, let me verify the root operations for hysterectomy.
Resection is defined as cutting out or off, all of a portion of a body part.
Therefore, Resection is correct.
Question 3
When coding neoplasms in ICD-10-CM, if a patient is admitted solely
for the administration of chemotherapy, immunotherapy, or radiation
therapy, what code is sequenced first?
🟢 A. Encounter for antineoplastic therapy
B. Primary malignant neoplasm of the organ
,C. Secondary malignant neoplasm of the site
D. Symptom code for pain
🔴 Explanation: According to ICD-10-CM guidelines, when an
encounter is solely for the administration of chemotherapy, radiation
therapy, or immunotherapy, the appropriate encounter for therapy code
is sequenced first, followed by the malignancy code as a secondary
diagnosis.
Question 4
A patient undergoes an open reduction and internal fixation (ORIF) of a
closed femur fracture. In ICD-10-PCS, what is the appropriate root
operation for the internal fixation device application?
A. Insertion
B. Repair
C. Fusion
🟢 D. Supplement
🔴 Explanation: In ICD-10-PCS, putting in a device that puts or
reinforces a portion of a body part is classified as Supplement. Internal
fixation devices such as plates and screws used to repair a fracture fall
under the root operation Supplement.
Question 5
Which of the following modifiers is used to indicate a significant,
separately identifiable evaluation and management (E/M) service by the
same physician on the same day of a procedure or other service?
A. Modifier 24
B. Modifier 25
🟢 C. Modifier 57
D. Modifier 59
🔴 Explanation: Modifier 25 is appended to E/M services to report a
significant, separately identifiable service above and beyond the usual
pre-operative and post-operative care associated with a procedure
performed on the same day.
, Question 6
A patient is diagnosed with hypertensive chronic kidney disease, stage
4, with heart failure. How should this relationship be coded?
A. The conditions are coded separately without presumed linkage.
🟢 B. Hypertension and chronic kidney disease are coded as a
combination code, and heart failure is coded separately.
C. A single combination code represents hypertension, chronic kidney
disease, and heart failure.
D. Chronic kidney disease is sequenced first, followed by hypertension.
🔴 Explanation: ICD-10-CM presumes a causal relationship between
hypertension and chronic kidney disease, assigning a combination code
from category I12. Heart failure is assigned a separate code from
category I50, and a secondary code from category I13 or N18 may be
required based on exact specifications.
Question 7
In ICD-10-PCS, what character position specifies the approach (e.g.,
Open, Percutaneous, Via Natural Opening)?
A. Third character
B. Fourth character
🟢 C. Fifth character
D. Sixth character
🔴 Explanation: The fifth character in an ICD-10-PCS procedure code
always defines the approach utilized to reach the site of the procedure,
such as open, percutaneous, or via natural or artificial opening.
Question 8
A patient presents with sepsis secondary to a urinary tract infection due
to Escherichia coli. What is the correct sequencing and coding order?
A. Urinary tract infection code first, followed by sepsis code and E. coli
code.
🟢 B. Sepsis code first, followed by the underlying systemic infection or
local infection code, and the organism code.
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
ICD-10-CM Diagnostic Coding Guidelines and Conventions
ICD-10-PCS Procedural Coding Systems and Root Operations
CPT and HCPCS Level II Coding Principles
Medical Terminology and Human Anatomy
Healthcare Regulatory Compliance and Reimbursement
Methodologies
Clinical Documentation Improvement (CDI) and Data Quality
Standards
Healthcare Ethics, Legal Standards, and Confidentiality
Regulations
Introduction
This comprehensive examination is designed to rigorously evaluate
professional mastery and technical proficiency in healthcare coding,
classification systems, and health information management. The
purpose of this assessment is to validate the candidate's ability to
accurately interpret complex medical records, assign precise diagnostic
and procedural codes, and adhere to strict regulatory guidelines. The
assessment evaluates advanced competencies in ICD-10-CM, ICD-10-
PCS, and CPT methodologies through a sophisticated blend of
foundational theory and intricate clinical scenarios. Emphasizing real-
world application and critical decision-making, the questions challenge
candidates to navigate compliance standards, resolve documentation
ambiguities, and ensure optimal data integrity across diverse healthcare
settings.
Section One: Questions 1–100
Question 1
,A patient is admitted for inpatient treatment of acute exacerbation of
chronic obstructive pulmonary disease (COPD) with acute lower
respiratory infection. Which of the following represents the correct
coding and sequencing?
A. J44.1, J22
🟢 B. J44.1, J20.9
C. J44.9, J22
D. J20.9, J44.9
🔴 Explanation: Code J44.1 specifies chronic obstructive pulmonary
disease with acute exacerbation. When an acute lower respiratory
infection is present with COPD, an additional code for the specific
infection (such as acute bronchitis, J20.9) must be assigned.
Question 2
What is the primary root operation in ICD-10-PCS when a surgeon
performs an open total abdominal hysterectomy?
A. Resection
B. Excision
🟢 C. Extraction
D. Detachment
🔴 Explanation: The root operation for removing a solid body part, such
as a total hysterectomy where the entire uterus is removed, is
Resection. Wait, let me verify the root operations for hysterectomy.
Resection is defined as cutting out or off, all of a portion of a body part.
Therefore, Resection is correct.
Question 3
When coding neoplasms in ICD-10-CM, if a patient is admitted solely
for the administration of chemotherapy, immunotherapy, or radiation
therapy, what code is sequenced first?
🟢 A. Encounter for antineoplastic therapy
B. Primary malignant neoplasm of the organ
,C. Secondary malignant neoplasm of the site
D. Symptom code for pain
🔴 Explanation: According to ICD-10-CM guidelines, when an
encounter is solely for the administration of chemotherapy, radiation
therapy, or immunotherapy, the appropriate encounter for therapy code
is sequenced first, followed by the malignancy code as a secondary
diagnosis.
Question 4
A patient undergoes an open reduction and internal fixation (ORIF) of a
closed femur fracture. In ICD-10-PCS, what is the appropriate root
operation for the internal fixation device application?
A. Insertion
B. Repair
C. Fusion
🟢 D. Supplement
🔴 Explanation: In ICD-10-PCS, putting in a device that puts or
reinforces a portion of a body part is classified as Supplement. Internal
fixation devices such as plates and screws used to repair a fracture fall
under the root operation Supplement.
Question 5
Which of the following modifiers is used to indicate a significant,
separately identifiable evaluation and management (E/M) service by the
same physician on the same day of a procedure or other service?
A. Modifier 24
B. Modifier 25
🟢 C. Modifier 57
D. Modifier 59
🔴 Explanation: Modifier 25 is appended to E/M services to report a
significant, separately identifiable service above and beyond the usual
pre-operative and post-operative care associated with a procedure
performed on the same day.
, Question 6
A patient is diagnosed with hypertensive chronic kidney disease, stage
4, with heart failure. How should this relationship be coded?
A. The conditions are coded separately without presumed linkage.
🟢 B. Hypertension and chronic kidney disease are coded as a
combination code, and heart failure is coded separately.
C. A single combination code represents hypertension, chronic kidney
disease, and heart failure.
D. Chronic kidney disease is sequenced first, followed by hypertension.
🔴 Explanation: ICD-10-CM presumes a causal relationship between
hypertension and chronic kidney disease, assigning a combination code
from category I12. Heart failure is assigned a separate code from
category I50, and a secondary code from category I13 or N18 may be
required based on exact specifications.
Question 7
In ICD-10-PCS, what character position specifies the approach (e.g.,
Open, Percutaneous, Via Natural Opening)?
A. Third character
B. Fourth character
🟢 C. Fifth character
D. Sixth character
🔴 Explanation: The fifth character in an ICD-10-PCS procedure code
always defines the approach utilized to reach the site of the procedure,
such as open, percutaneous, or via natural or artificial opening.
Question 8
A patient presents with sepsis secondary to a urinary tract infection due
to Escherichia coli. What is the correct sequencing and coding order?
A. Urinary tract infection code first, followed by sepsis code and E. coli
code.
🟢 B. Sepsis code first, followed by the underlying systemic infection or
local infection code, and the organism code.
