RHIT Medical Coding Principles 3 — Questions and Answers
Question 1: In HCPCS Level II coding, which category of codes is used for durable medical equipment (DME)?
- A codes
- E codes (Correct answer)
- L codes
- K codes
Correct answer: E codes
HCPCS Level II 'E' codes (E0100–E8002) are designated for durable medical equipment.
Question 2: What is the correct action when ICD-10-CM instructs 'Code first the underlying condition' beneath a manifestation code?
- Sequence the manifestation code first
- Sequence the underlying condition code first, then the manifestation (Correct answer)
- Use only the manifestation code
- Assign both codes in any order
Correct answer: Sequence the underlying condition code first, then the manifestation
The etiology/manifestation convention requires the underlying disease to be sequenced first, followed by the manifestation.
Question 3: A coder finds a diagnosis documented as 'probable pneumonia' in an outpatient record. What is the correct coding approach?
- Code pneumonia as confirmed
- Code the sign or symptom (e.g., cough, fever) that prompted the visit (Correct answer)
- Use an uncertain diagnosis code from ICD-10-CM
- Leave the diagnosis uncoded and query the physician
Correct answer: Code the sign or symptom (e.g., cough, fever) that prompted the visit
Outpatient coding guidelines prohibit coding uncertain diagnoses; the coder should report the sign/symptom instead.
Question 4: Which modifier is appended to a CPT code to indicate that a procedure was performed bilaterally?
- -50 (Correct answer)
- -51
- -59
- -80
Correct answer: -50
CPT modifier -50 indicates a bilateral procedure performed at the same operative session.
Question 5: In ICD-10-CM, what is the significance of a 7th character 'A' in injury codes?
- Subsequent encounter
- Initial encounter — active treatment phase (Correct answer)
- Sequela
- Accidental cause
Correct answer: Initial encounter — active treatment phase
The 7th character 'A' denotes the initial encounter when the patient is receiving active treatment for the injury.
Question 6: Which CPT code range covers Evaluation and Management (E/M) services for hospital inpatient initial care?
- 99201–99215
- 99221–99223 (Correct answer)
- 99231–99233
- 99241–99245
Correct answer: 99221–99223
CPT codes 99221–99223 are used for initial hospital inpatient care, with varying levels of complexity.
Question 7: What does the ICD-10-CM Excludes1 note mean?
- The excluded code may be used together with this code if both are documented
- The two conditions cannot occur together and the excluded code should never be used with this code (Correct answer)
- The excluded code is a different condition but may coexist
- The excluded code is an alternative code for the same condition
Correct answer: The two conditions cannot occur together and the excluded code should never be used with this code
Excludes1 means the excluded condition cannot coexist with the code and should not be coded together.
RHIT Medical Coding Principles 3
In HCPCS Level II coding, which category of codes is used for durable medical equipment (DME)?