AAPC CIC Certified Inpatient Coder

In ICD-10-CM, what is the principal diagnosis for an inpatient admission?

• AThe condition established after study to be chiefly responsible for occasioning the admis…
• BThe most severe condition the patient has at discharge
• CThe first diagnosis documented in the medical record
• DThe condition requiring the most resources during the stay

A patient is admitted with chest pain. After workup, the physician documents the diagnosis as acute STEMI of the left anterior descending artery. Which ICD-10-CM code is the principal diagnosis?

• AI21.02 — ST elevation myocardial infarction involving left anterior descending coronary a…
• BR07.9 — Chest pain, unspecified
• CI25.10 — Atherosclerotic heart disease of native coronary artery
• DI21.9 — Acute myocardial infarction, unspecified

What does the 7th character in an ICD-10-CM injury code represent?

• AThe type of encounter (initial, subsequent, or sequela)
• BThe laterality of the injury
• CThe severity of the injury
• DThe anatomical site of the injury

Which ICD-10-CM guideline applies when two or more diagnoses equally meet the definition of principal diagnosis?

• AEither condition may be sequenced first as the principal diagnosis
• BThe condition requiring the most resources must be sequenced first
• CThe condition diagnosed first must be sequenced first
• DThe condition with the highest DRG reimbursement must be sequenced first

A patient is admitted for chemotherapy and also has metastatic liver cancer from a primary colon malignancy. What is the principal diagnosis?

• AZ51.11 — Encounter for antineoplastic chemotherapy
• BC78.7 — Secondary malignant neoplasm of liver and intrahepatic bile duct
• CC18.9 — Malignant neoplasm of colon, unspecified
• DC80.1 — Malignant (primary) neoplasm, unspecified

In ICD-10-PCS, what does the root operation 'Excision' mean?

• ACutting out or off, without replacement, a portion of a body part
• BCutting out or off, without replacement, all of a body part
• CTaking out or off a device from a body part
• DPhysically taking out or off all or a portion of a body part by use of force

How many characters are in a complete ICD-10-PCS code?

• A7
• B5
• C6
• D8

In ICD-10-PCS, which approach is defined as 'cutting through the skin or mucous membrane and any other body layers necessary to expose the operative site'?

• AOpen
• BPercutaneous
• CPercutaneous Endoscopic
• DVia Natural or Artificial Opening

What is the root operation for a total hip replacement in ICD-10-PCS?

• AReplacement
• BRevision
• CSupplement
• DResection

Which ICD-10-PCS root operation is used when the objective of a procedure is to stop or attempt to stop postprocedural or other acute bleeding?

• AControl
• BRepair
• COcclusion
• DRestriction

What is the MS-DRG system used for?

• AClassifying inpatient hospital stays into groups for Medicare payment purposes
• BDetermining the amount of copayment a patient owes
• CAssigning outpatient procedure codes for billing
• DCalculating physician fee schedules

Which of the following factors does NOT affect MS-DRG assignment?

• AThe patient's insurance carrier
• BThe principal diagnosis
• CSurgical procedures performed
• DPresence of complications or comorbidities (CC/MCC)

What is the difference between a CC and an MCC in the MS-DRG system?

• AAn MCC (Major Complication/Comorbidity) has a greater impact on resource use than a CC (C…
• BA CC applies only to surgical DRGs while an MCC applies only to medical DRGs
• CA CC is a principal diagnosis modifier while an MCC is a secondary diagnosis modifier
• DAn MCC applies only to Medicare patients while a CC applies to all payers

A patient admitted with pneumonia develops sepsis during the hospital stay. How should the sepsis be coded?

• AAs a secondary diagnosis since the pneumonia was the reason for admission
• BAs the principal diagnosis since sepsis is more severe
• COnly the pneumonia is coded since the sepsis developed after admission
• DBoth conditions are coded but in an arbitrary order

Under ICD-10-CM guidelines, when is it appropriate to code a diagnosis documented as 'probable' or 'suspected' for an inpatient encounter?

• ACode the condition as if it exists because uncertain diagnoses are coded as confirmed for…
• BNever code uncertain diagnoses — only code confirmed conditions
• COnly code the signs and symptoms associated with the suspected condition
• DUse a Z code to indicate the condition is uncertain

What is the purpose of a Present on Admission (POA) indicator?

• ATo differentiate conditions present at the time of inpatient admission from those that de…
• BTo identify patients who were admitted through the emergency department
• CTo track the time of day that patients are admitted to the hospital
• DTo indicate whether the admitting physician authorized the admission

Which POA indicator is used when the documentation is insufficient to determine if the condition was present on admission?

• AW — Clinically undetermined
• BY — Yes, present at time of admission
• CN — Not present at time of admission
• DU — Documentation insufficient

What is the ICD-10-PCS root operation for a diagnostic biopsy of the liver performed percutaneously with a needle?

• AExcision with qualifier Diagnostic
• BExtraction with qualifier Diagnostic
• CInspection
• DDrainage with qualifier Diagnostic

In ICD-10-PCS, what is the difference between the root operations Bypass and Transfer?

• ABypass alters the route of passage while Transfer moves a body part to function for a dif…
• BBypass and Transfer are interchangeable terms for the same root operation
• CBypass moves tissue to a new location while Transfer reroutes a body passage
• DBypass is only used for vascular procedures while Transfer is only used for nerve procedu…

What federal law established the Inpatient Prospective Payment System (IPPS)?

• ASocial Security Amendments of 1983 (Tax Equity and Fiscal Responsibility Act)
• BAffordable Care Act of 2010
• CHIPAA of 1996
• DBalanced Budget Act of 1997

Which of the following is considered a Hospital-Acquired Condition (HAC) under CMS guidelines?

• AStage III pressure ulcer not present on admission
• BCommunity-acquired pneumonia present on admission
• CDiabetes mellitus documented as present on admission
• DChronic kidney disease diagnosed before hospital admission

A surgeon performs a laparoscopic cholecystectomy that is converted to an open cholecystectomy. How is this coded in ICD-10-PCS?

• ACode only the open cholecystectomy since the procedure was completed via open approach
• BCode both the laparoscopic and the open procedures separately
• CCode only the laparoscopic procedure since it was attempted first
• DCode the laparoscopic procedure with a modifier indicating conversion