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19 multiple-choice questions and 8 flashcards on ICD-10-CM Coding Guidelines and Concepts, about 11% of the Medical Coder bank. Every one carries a written rationale.
ICD-10-CM Coding Guidelines and Concepts is one of 6 chapters in CoStudy's Medical Coder (CPC/AAPC) bank, and it holds 19 of the bank's 173 multiple-choice questions — roughly 11% of the total. That proportion is not arbitrary: chapters follow the certifying body's published exam outline, and the number of questions in each is set by that domain's published weight, so the share of your practice time this chapter takes matches the share of the real exam it accounts for.
Studying by chapter is worth doing once you have a diagnostic score. A single overall percentage tells you whether you are close; it does not tell you which domain is dragging. Working a weak chapter in isolation, and re-testing it in isolation, is the fastest way to move a score that has stalled — and it is why the mock exams in CoStudy report by domain rather than as one number.
10 questions drawn from this chapter, with the full rationale shown — the controlling principle behind the right answer, and why each wrong option tempts and fails.
NOS in ICD-10-CM means:
Answer: A — Not Otherwise Specified — equivalent to 'unspecified'
NOS = Not Otherwise Specified = unspecified. NEC = Not Elsewhere Classifiable = 'other specified.' Use specific codes when documentation supports.
Initial encounter for a closed fracture of the left distal radius — what 7th character?
Answer: A — A
7th character A = initial encounter for closed fracture. B = initial open. D = subsequent routine healing. S = sequela. Open vs closed determined by clinician documentation.
For an Excludes2 note, the coder may:
Answer: B — Code both if both conditions are present
Excludes2 = 'not included here' but both conditions CAN be coded together if both are documented. Excludes1 is the absolute mutual-exclusion note.
Z codes describe:
Answer: B — Factors influencing health status + contact with health services
A/C/D) Wrong. B) Correct — routine exam, screening, status codes.
ICD-10-CM is used for:
Answer: B — Diagnoses
A) CPT. B) Correct. C/D) HCPCS Level II.
Z79.4 represents:
Answer: A — Long-term (current) use of insulin
Z79.4 = long-term (current) use of insulin. Status code. Frequently used adjunct to E11.x for type 2 DM on insulin.
A patient is documented with an adverse effect from a drug taken correctly as prescribed. This is coded using:
Answer: B — The code for the nature of the adverse effect (e.g., the reaction) plus the drug code from Table of Drugs and Chemicals with an 'adverse effect' 5th/6th character
A) Poisoning codes apply when the drug was taken incorrectly, in excess, or was not prescribed for the patient — not when taken correctly. B) Correct — code the nature of the reaction first, then the drug code with the adverse-effect character from the Table of Drugs and Chemicals. C) Underdosing applies when LESS medication than prescribed was taken. D) A drug code is required, not omitted.
Excludes1 note means:
Answer: B — Conditions never coded together
A) Includes. B) Correct — 'not coded here.' C) Excludes2.
When a patient is admitted for treatment of a primary malignancy and, during that same encounter, a secondary (metastatic) site is also treated, which is sequenced first?
Answer: C — The code for the neoplasm responsible for the treatment provided during the encounter is sequenced first
A) Not a universal rule — depends on which site the encounter's treatment targets. B) ICD-10-CM sequencing is guideline-driven, not alphabetical. C) Correct — sequencing follows which neoplasm (primary or secondary) the encounter's treatment is directed at; that code is listed first. D) Metastatic sites get their own codes (C77-C79) when documented.
A combination code in ICD-10-CM is:
Answer: B — A single code that classifies two diagnoses, a diagnosis with an associated secondary process, or a diagnosis with an associated complication
A) Combination codes replace the need for two codes with one — the opposite of what's stated. B) Correct — e.g., E11.21 combines type 2 diabetes with diabetic nephropathy into a single code. C) Not limited to external causes. D) Combination codes are typically specific, not unspecified.
1 cards from the 8 in this chapter.
ICD-10-CM?
International Classification of Diseases, 10th edition, Clinical Modification. Used in US for diagnoses. 3-7 character alphanumeric codes. Replaced ICD-9 in October 2015.
These are a sample. The full ICD-10-CM Coding Guidelines and Concepts chapter runs 27 items with per-chapter progress tracking, on the web and in the iOS app.
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