CCA ICD-10-CM Coding Practice Questions
ICD-10-CM Coding makes up 6 of every 50 questions on a Tigertest CCA practice test. Here are 10 of the 24 questions on it, each with the answer and the reason.
Updated by the Tigertest team. Weighted to the AHIMA CCA Exam Content Outline. Original questions on coding guidelines and concepts; not affiliated with AHIMA.
1. An Excludes1 note may be set aside and both codes reported when:
- A.Both are documented
- B.They are unrelated
- C.One is chronic
- D.Both are acute
Answer: B. An Excludes1 note normally means the conditions cannot occur together. The guidelines allow an exception when the two conditions are unrelated to each other.
2. A "code also" note in the Tabular List tells the coder that:
- A.The codes are mutually exclusive
- B.Only a combination code applies
- C.The second code must be first
- D.A second code may be needed
Answer: D. A code also note warns that two codes may be needed to fully describe a condition. It does not set the sequencing, which depends on the circumstances of the encounter.
3. In the etiology/manifestation convention, the "code first" note appears at the:
- A.Manifestation code
- B.Alphabetic Index entry
- C.Etiology code
- D.Chapter heading
Answer: A. Manifestation codes carry a code first note for the underlying condition, which is sequenced first. The etiology code carries the matching use additional code note.
4. The abbreviation NEC tells the coder that:
- A.The code is not billable
- B.A 7th character is required
- C.No specific code exists
- D.The provider gave no detail
Answer: C. NEC means not elsewhere classifiable: the record specifies the condition, but the classification has no specific code for it. Missing detail in the record is NOS.
5. Under the "with" convention, a causal link is presumed unless:
- A.Conditions are both chronic
- B.The visit is outpatient
- C.Provider says unrelated
- D.Provider writes 'due to'
Answer: C. Conditions linked by with in the Index or Tabular are coded as related even without the provider linking them. Only documentation that they are unrelated, or another guideline, overrides this.
6. In the Alphabetic Index, "see also" means:
- A.Another main term may help
- B.The term cannot be coded
- C.Both terms must be coded
- D.You must go to another term
Answer: A. See also points to another main term that may offer more useful entries, but it is not required. See, by contrast, sends the coder to another term that must be followed.
7. A patient is admitted with sepsis due to pneumonia, both present on admission. The principal diagnosis is:
- A.Bacteremia
- B.Pneumonia
- C.Severe sepsis
- D.Sepsis
Answer: D. When sepsis and a localized infection are both present on admission, the systemic infection is sequenced first and the localized infection follows. Severe sepsis is not coded without organ dysfunction.
8. Severe sepsis codes (R65.2-) are sequenced:
- A.Only with septic shock present
- B.After the infection
- C.As the principal diagnosis
- D.Before the infection code
Answer: B. Severe sepsis can never be principal or first-listed. The underlying systemic infection is coded first, then R65.2-, then codes for the acute organ dysfunction.
9. A patient with colon cancer excised years ago, now untreated, is admitted for liver metastases. The principal diagnosis is:
- A.Liver neoplasm, uncertain behavior
- B.Secondary liver malignancy
- C.Primary colon malignancy
- D.History of colon cancer
Answer: B. When treatment is directed at the secondary site only, the secondary neoplasm is principal. A primary excised with no current treatment or evidence of disease is reported with a history code.
10. A pregnant patient is treated for an ankle sprain, and the provider states the pregnancy is incidental. Report:
- A.Z33.1, then the sprain
- B.The sprain code alone
- C.An obstetric code first
- D.The sprain, then Z33.1
Answer: D. When the provider documents that the pregnancy is incidental to the encounter, Z33.1 is used in place of a chapter 15 code and is reported after the code for the condition treated.
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