CMC Coding Guidelines & Conventions 3 — Questions and Answers
Question 1: What is the correct action when the ICD-10-CM Tabular List instructs 'Use additional code'?
- Add a CPT code for the related procedure
- Report an additional ICD-10-CM code to fully describe the condition (Correct answer)
- Append a modifier to the primary diagnosis
- Report the code only if a secondary payer exists
Correct answer: Report an additional ICD-10-CM code to fully describe the condition
'Use additional code' instructs the coder to assign a secondary code that provides more specific information about the condition.
Question 2: In ICD-10-CM, the 7th character 'A' in trauma codes signifies:
- Subsequent encounter
- Sequela
- Initial encounter for active treatment (Correct answer)
- Annual follow-up
Correct answer: Initial encounter for active treatment
The 7th character 'A' denotes an initial encounter where active treatment is being provided for the injury.
Question 3: When coding external cause codes in ICD-10-CM, how should they be sequenced?
- As the principal/first-listed diagnosis
- Secondary to the injury or condition they describe (Correct answer)
- Only when required by the payer
- Before any symptom codes
Correct answer: Secondary to the injury or condition they describe
External cause codes are never the principal or first-listed diagnosis; they supplement injury or condition codes.
Question 4: A CPT code description enclosed in parentheses following a main code entry is called:
- A cross-reference note
- A supplementary note
- A parenthetical instruction (Correct answer)
- An exclusionary note
Correct answer: A parenthetical instruction
Parenthetical instructions in CPT provide additional guidance, such as listing related codes or specifying when a code should or should not be used.
Question 5: What does HCPCS Level II coding system primarily cover?
- Physician procedures and services
- Products, supplies, and services not covered by CPT (Correct answer)
- Hospital inpatient diagnoses
- Dental procedures exclusively
Correct answer: Products, supplies, and services not covered by CPT
HCPCS Level II codes cover durable medical equipment, prosthetics, orthotics, supplies, and non-physician services not captured in CPT.
Question 6: In ICD-10-CM, placeholder character 'X' is used to:
- Indicate a deleted code
- Allow for future expansion and maintain the required code structure (Correct answer)
- Mark codes requiring additional digits
- Denote bilateral conditions
Correct answer: Allow for future expansion and maintain the required code structure
The placeholder 'X' is inserted to maintain the required code length and allow future additions without disrupting the existing structure.
Question 7: Which section of the ICD-10-CM code book is used to verify a code found in the Alphabetic Index?
- The Official Guidelines
- The Tabular List (Correct answer)
- The Index to External Causes
- The Table of Drugs and Chemicals
Correct answer: The Tabular List
Always verify every code found in the Alphabetic Index by referencing the Tabular List to ensure correct code assignment and read all instructional notes.
CMC Coding Guidelines & Conventions 3
What is the correct action when the ICD-10-CM Tabular List instructs 'Use additional code'?