AAPC Certified Professional Coder (CPC) — All Questions
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In ICD-10-CM inpatient coding, the principal diagnosis is defined as:
- a.The condition established after study to be chiefly responsible for occasioning the admission✓
- b.Any chronic condition the patient carries
- c.Whichever diagnosis is easiest to assign a code to
- d.The comorbidity with the highest severity of illness
The principal diagnosis is the condition determined, after study, to be chiefly responsible for the admission. In the outpatient setting the parallel concept is the 'first-listed' diagnosis — the reason chiefly responsible for the visit. Accurate sequencing drives reimbursement and data integrity, so this definition is foundational to ICD-10-CM.
When is the placeholder character 'X' required in an ICD-10-CM code?
- a.When a code requires a 7th character but has fewer than 6 characters, 'X' fills the empty positions so the 7th character lands in the correct place✓
- b.It is never used in ICD-10-CM
- c.It is added to the end of every injury code
- d.It is used to indicate a bilateral condition
ICD-10-CM uses 'X' as a placeholder to hold empty character positions so that a required 7th character (for example A, D, or S on injury/external-cause codes) occupies the seventh slot. Omitting the placeholder makes the code invalid. The placeholder has no clinical meaning of its own — it is purely structural.
Which federal law makes it illegal to knowingly submit, or cause the submission of, false or fraudulent claims to Medicare or Medicaid?
- a.The HIPAA Privacy Rule
- b.The False Claims Act✓
- c.The Emergency Medical Treatment and Labor Act (EMTALA)
- d.The Clinical Laboratory Improvement Amendments (CLIA)
The False Claims Act imposes civil liability (and treble damages/penalties) for knowingly presenting false claims to the government, and it underpins much of coding compliance. The HIPAA Privacy Rule governs protected health information, EMTALA governs emergency screening/stabilization, and CLIA governs laboratory quality — none of which is the anti-false-claims statute.