Chapter 8 — Quiz

Twenty-four questions.


Multiple choice

1. The correct coding sequence is:

  • A. Tabular List, then Alphabetic Index
  • B. Alphabetic Index, then Tabular List
  • C. either, as long as the code is verified
  • D. Alphabetic Index only, for outpatient coding

2. Main terms in the Alphabetic Index are:

  • A. body parts
  • B. conditions
  • C. procedures
  • D. alphabetized by code

3. Knee — see condition means:

  • A. no code exists
  • B. you have looked up a body part instead of a condition
  • C. see the Tabular List
  • D. use an unspecified code

4. A word in parentheses after a main term is:

  • A. essential and must be documented
  • B. nonessential and need not be documented
  • C. a manifestation code
  • D. an Excludes note

5. An indented subterm is:

  • A. optional
  • B. an essential modifier that must be documented
  • C. a nonessential modifier
  • D. always a complete code

6. A trailing dash on an index entry means:

  • A. the code is invalid
  • B. more characters are required and only the Tabular can supply them
  • C. the code has been deleted
  • D. the condition is unspecified

7. Excludes1 means:

  • A. the excluded condition may be reported with this code
  • B. the two conditions cannot occur together and must not both be reported
  • C. an additional code is required
  • D. the code has been replaced

8. Excludes2 means:

  • A. never report the excluded condition
  • B. the excluded condition is not part of this code, and both may be reported if both are documented
  • C. the code requires a seventh character
  • D. see the Alphabetic Index

9. "Code first" appears on:

  • A. the etiology code
  • B. the manifestation code
  • C. any code requiring a companion
  • D. external cause codes only

10. "Code also" indicates:

  • A. an optional additional code
  • B. that two codes are needed, without dictating sequence
  • C. that the underlying condition is sequenced first
  • D. a nonessential modifier

11. NOS indicates:

  • A. the documentation lacks the detail for a more specific code
  • B. the classification has no code for a specifically documented condition
  • C. an additional code is required
  • D. an excluded condition

12. NEC indicates:

  • A. the documentation is insufficient
  • B. the documentation is specific and the classification has no category for it
  • C. an unspecified condition
  • D. a manifestation

13. In the Alphabetic Index, brackets enclose:

  • A. nonessential modifiers
  • B. manifestation codes
  • C. inclusion terms
  • D. Excludes notes

14. The convention "and" in a category title means:

  • A. both must be present
  • B. and/or
  • C. sequenced together
  • D. mutually exclusive

15. "See also" in the index is:

  • A. mandatory
  • B. advisory
  • C. applicable only to procedures
  • D. an Excludes1 instruction

16. Before using the Table of Neoplasms you must know:

  • A. the treatment
  • B. the behavior
  • C. the stage
  • D. the payer

17. A patient took a prescribed drug as directed and had a reaction. The correct column of the Table of Drugs and Chemicals is:

  • A. poisoning, accidental
  • B. adverse effect
  • C. underdosing
  • D. poisoning, undetermined

Short answer

18. State the two-step rule and name four things that live only in the Tabular.

19. Explain why the index alone cannot tell you that a code requires a seventh character.

20. Give the Excludes1/Excludes2 memory aid and explain it.

21. A code carries "code first" and the underlying condition is not documented. What kind of problem is this, and what is the tool?

22. Explain the difference between NEC and NOS in terms of what is limiting you.

23. (Chapter 7) Perform the full lookup for right knee pain, naming both common wrong turns.

24. (Chapter 4) Each of the three specialty tables requires a clinical fact before it can be used. Name all three facts, and say who may supply them.


Answer key **1.** B. **2.** B. **3.** B. **4.** B. **5.** B. **6.** B. **7.** B. **8.** B. **9.** B — "code first" appears on the *manifestation* code, pointing back to the etiology. **10.** B. **11.** A. **12.** B. **13.** B. **14.** B. **15.** B. **16.** B. **17.** B. **18.** Alphabetic Index first, Tabular List second, always. **Only in the Tabular:** the complete code; seventh-character requirements (stated at category level); Excludes1 and Excludes2 notes; "code first" / "use additional code" / "code also" instructions; laterality options; inclusion terms; and block- and chapter-level notes. (Any four.) **19.** Because the requirement is printed **once, at the category level**, not on the individual code. The index points at a code, not at the category heading several lines above it, so a coder who stops at the index has not seen the instruction and has no way of knowing it exists. **20.** **Excludes1 — "one" means only ONE of them.** Excludes**2** — "two" means you may need **two** codes. Excludes1 is a prohibition; Excludes2 is permission. **21.** A **documentation** problem, not a coding problem. The code cannot be reported without its required companion, and the companion is a clinical fact the record does not contain. **The tool is a query** (Chapter 4 §4.9) — non-leading, presenting the clinical evidence, offering reasonable options. **22.** **NOS: the record is limiting you.** The documentation lacks detail; a more specific code exists and the note does not support it. **NEC: the code set is limiting you.** The documentation is precise and the classification has no category for that particular thing. **Only NOS is fixable by a query** — asking a provider a better question cannot create a code that does not exist. **23.** **Wrong turn 1:** look up *Knee*; the index answers `Knee — see condition`. **Wrong turn 2:** look up *Pain* and take the main term's own code, `R52`, which is generalized pain and is not what the patient has. **The path:** main term **Pain(s)** → subterm **joint** → subterm **knee** → `M25.56-`; the dash sends you to the Tabular, where the laterality character gives **M25.561** for the right knee, with no seventh character required. **24.** **Neoplasms → the behavior.** **Drugs and Chemicals → whether this was poisoning, adverse effect, or underdosing.** **External Causes → what the event was.** All three are **clinical facts the record must supply** — the pathology report or provider documentation, the provider's account of the circumstance, and the record's account of how the injury happened. **A coder may not supply any of them** (Chapter 4 §4.7). Where the record does not answer, the options are the unspecified column, a query, or omission.