Free CEMC exam Practice Questions

Sample Practice Questions

Try these 10 sample questions from the CEMC exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1When selecting an ICD-10-CM diagnosis code for an E/M encounter, how should a coder use the Alphabetic Index and Tabular List?

   1. A. Select the code directly from the Index without further review.
   2. B. Find the term in the Index, then verify the code and instructions in the Tabular List.
   3. C. Use the Tabular List only if the Index entry ends in a dash.
   4. D. Choose the shortest valid code appearing in either resource.

   Answer: B

   Explanation: The guidelines state, "first locate the term in the Alphabetic Index, and then verify the code in the Tabular List." Both resources and their instructions are needed.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — General Coding Guidelines, Locating a code in the ICD-10-CM, printed p. 12

2. 2The record supports a specific diagnosis and the ICD-10-CM category has further subdivisions. Which coding approach is appropriate?

   1. A. Report the three-character category because it names the condition.
   2. B. Report the most specific complete code supported by the record.
   3. C. Report a broader code to avoid interpreting the documentation.
   4. D. Report both the category and its more specific child code.

   Answer: B

   Explanation: The rule is to use codes "at their highest number of characters available and to the highest level of specificity documented in the medical record." A subdivided category alone is incomplete.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — General Coding Guidelines, Level of Detail in Coding, printed p. 12

3. 3At an office E/M visit, a patient has a documented symptom but the provider has not established a related definitive diagnosis. What may be reported?

   1. A. The symptom code, when supported by the encounter documentation.
   2. B. A presumed definitive diagnosis based on the symptom pattern.
   3. C. Both a presumed diagnosis and the symptom code in all cases.
   4. D. No diagnosis code until a definitive disease is confirmed.

   Answer: A

   Explanation: The guidelines permit symptom codes "when a related definitive diagnosis has not been established (confirmed) by the provider." The coder should not infer a disease.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — General Coding Guidelines, Signs and symptoms, printed p. 13

4. 4An E/M note documents a confirmed disease and a symptom routinely associated with that disease. No classification instruction calls for an additional symptom code. How should the symptom be handled?

   1. A. Assign the symptom code before the disease code.
   2. B. Assign it as a secondary code to show disease severity.
   3. C. Do not assign an additional code for that routine symptom.
   4. D. Replace the disease code with the symptom code.

   Answer: C

   Explanation: The guidelines say, "Signs and symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification." The stated exception is absent.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — General Coding Guidelines, Conditions that are an integral part of a disease process, printed p. 13

5. 5The provider describes the same condition as both acute and chronic, and separate Index subentries exist at the same level. How are the diagnoses sequenced?

   1. A. Code only the acute form.
   2. B. Code both, with the chronic form first.
   3. C. Code only the chronic form.
   4. D. Code both, with the acute form first.

   Answer: D

   Explanation: The guideline directs coders to "code both and sequence the acute (subacute) code first" when the specified Index subentries exist.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — General Coding Guidelines, Acute and Chronic Conditions, printed p. 14

6. 6A documented diagnosis and complication are fully identified by a single ICD-10-CM combination code. What is the coding approach?

   1. A. Assign only the combination code.
   2. B. Assign separate codes for the diagnosis and complication.
   3. C. Assign the combination code and duplicate its components.
   4. D. Assign only the unspecified diagnosis code.

   Answer: A

   Explanation: The guidelines state, "Assign only the combination code when that code fully identifies the diagnostic conditions involved"; the question specifies full identification.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — General Coding Guidelines, Combination Code, printed p. 14

7. 7An E/M encounter addresses a residual condition from a past injury after its acute phase ended. Under the general sequela rule, which sequence applies?

   1. A. Acute injury code first, followed by the residual.
   2. B. Residual condition first, followed by the sequela code.
   3. C. Sequela code first, followed by the residual condition.
   4. D. Only the original acute injury code is assigned.

   Answer: B

   Explanation: The guideline says, "the condition or nature of the sequela is sequenced first. The sequela code is sequenced second." This is the general rule requested; the original acute injury code is not reused.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — General Coding Guidelines, Sequela (Late Effects), printed p. 14

8. 8At an outpatient E/M visit, the provider documents a diagnosis as 'probable' without confirming it. What should the coder report for that visit?

   1. A. The probable disease as a confirmed diagnosis.
   2. B. The highest-certainty findings or reason for the visit.
   3. C. The probable disease as the principal diagnosis.
   4. D. No code until the provider confirms a disease.

   Answer: B

   Explanation: Section IV.H directs coders to avoid coding an unconfirmed probable diagnosis. The guidelines instead say to "code the condition(s) to the highest degree of certainty for that encounter/visit"; the documented findings or reason for the visit meet that outpatient rule.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — Outpatient Coding and Reporting, Uncertain diagnosis, printed p. 114

9. 9In an ICD-10-CM code that requires a placeholder to position a seventh character, which character fills the empty position?

   1. A. The letter Z
   2. B. The letter X
   3. C. The digit 0
   4. D. The digit 9

   Answer: B

   Explanation: The FY 2027 ICD-10-CM guidelines state, "The ICD-10-CM utilizes a placeholder character “X”." It fills required positions; it is not an unspecified-code marker.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — Section I.A.4, p. 7

10. 10An ICD-10-CM category requires a seventh character. What happens if a reported code omits it?

    1. A. The code remains valid if its category is specific.
    2. B. The code is valid only for outpatient claims.
    3. C. The code is invalid without the required character.
    4. D. The code becomes an unspecified diagnosis.

    Answer: C

    Explanation: The FY 2027 ICD-10-CM guidelines state, "A code that has an applicable 7th character is considered invalid without the 7th character." The requirement applies even when the preceding characters identify a condition.

    Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — Conventions for the ICD-10-CM, Format and Structure, printed p. 7