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Medical Coding · CIC-I

AAPC CIC Instructor (CIC-I) Examination Practice Test

The AAPC CIC Instructor (CIC-I) Examination practice page addresses inpatient diagnosis and procedure coding. Sample scenarios involve principal-diagnosis selection, secondary diagnoses, uncertain or incomplete documentation, and translating operative reports into ICD-10-PCS codes. The questions also touch on malignancy, injury, and acute kidney injury coding decisions.

Exam overview

Exam providerAAPC
Exam codeCIC-I
CategoryMedical Coding

About the AAPC CIC Instructor (CIC-I) Examination Exam

Inpatient coding requires sequencing diagnoses based on the circumstances of admission and findings after study, while applying applicable ICD-10-CM guidelines. Scenarios in this practice bank ask you to distinguish the condition chiefly responsible for admission from reportable secondary conditions, handle equally qualifying diagnoses, and recognize when the record does not establish a cause or greater specificity. Procedure questions focus on selecting ICD-10-PCS root operations that reflect the documented objective and using operative documentation to identify what was performed. These tasks call for careful reading across the inpatient record, including discharge summaries and operative reports, and for separating documented facts from assumptions. The examples also involve malignancy sequencing, fracture and fall documentation, and whether a resolved condition belongs in current reporting. For an instructor-focused examination, explaining why a coding choice follows documentation and coding principles is useful practice alongside making the choice itself.

Sample Practice Questions

Review a selection from this exam's published US Practice Tests practice bank.

Question 1

A patient develops acute kidney injury during an inpatient stay. The attending documents the diagnosis but does not state its cause. Which approach is appropriate?

  1. AAssume it is due to dehydration if the patient received IV fluids
  2. BReport a specific cause based only on laboratory trends
  3. CCode the documented acute kidney injury and query if clarification of cause is clinically relevant
  4. DOmit the diagnosis because a cause was not documented
Show answerCorrect answer: C

Code the condition documented by the responsible provider. A coder should not infer a specific etiology from treatment, laboratory data, or clinical indicators alone. A query may be appropriate when clarification is needed for accurate code assignment or other reporting purposes.

Question 2

An inpatient operative report describes a procedure, while the discharge summary contains no procedure details. For ICD-10-PCS code assignment, which documentation is generally the most useful source for the procedure's operative details?

  1. AThe operative report
  2. BThe admission order
  3. CThe nursing discharge checklist
  4. DThe patient's medication reconciliation
Show answerCorrect answer: A

The operative report typically provides the detailed description of what was performed, including the objective and technique needed for ICD-10-PCS code construction. Other records may provide context but generally do not replace the operative documentation.

Question 3

A patient is admitted for treatment of a malignancy that has spread to the liver. The primary tumor remains active and is also treated during the stay. Which general coding principle should guide selection of the principal diagnosis?

  1. AAlways sequence the metastatic site first
  2. BAlways sequence the primary malignancy first
  3. CSelect the condition chiefly responsible for the admission after study, following applicable neoplasm guidelines
  4. DSequence the malignancy with the highest stage first
Show answerCorrect answer: C

For inpatient coding, the principal diagnosis is the condition established after study to be chiefly responsible for the admission, subject to applicable chapter-specific instructions. Neoplasm sequencing depends on the reason for admission and the treatment provided; it is not determined solely by which site is metastatic or by stage.

Question 4

In ICD-10-PCS, a surgeon uses a laparoscope to inspect the peritoneal cavity without performing a biopsy or other treatment. Which root operation best represents this objective?

  1. ADrainage
  2. BInspection
  3. CExcision
  4. DResection
Show answerCorrect answer: B

Inspection represents visually and/or manually exploring a body part. Because the documented objective is examination without removal or other treatment, Inspection is the appropriate root-operation concept.

Question 5

A patient undergoes an inpatient procedure that is documented as completed without complications. Which source should generally be used to identify the specific procedure performed for ICD-10-PCS coding?

  1. AThe procedure title alone, without reviewing the operative report.
  2. BThe operative report and other relevant procedural documentation describing what was actually performed.
  3. CThe preoperative plan, even if the procedure changed during surgery.
  4. DThe diagnosis code that best explains why the procedure was needed.
Show answerCorrect answer: B

ICD-10-PCS code assignment is based on the procedure actually performed, as documented in the operative report and supporting record. A planned procedure or diagnosis does not substitute for the details needed to identify the performed procedure's PCS characteristics.

Question 6

A patient is admitted for treatment of a fracture caused by a fall. The provider documents the fracture and the fall, but the record does not establish whether the fall was accidental or intentional. What should the coder do?

  1. AClassify the event as intentional because the patient has a psychiatric history
  2. BAssign an external-cause intent based on the most common pattern
  3. CUse available documentation and seek clarification when intent is necessary and remains unclear
  4. DOmit the fracture code until intent is known
Show answerCorrect answer: C

External-cause coding should be based on documentation and applicable classification rules. Intent should not be inferred from demographics, history, or statistical likelihood. The fracture can be coded from its documented details; clarification may be sought for unresolved event details when relevant.

Question 7

An inpatient discharge summary documents two diagnoses as equally responsible for the admission after study, and no circumstance or guideline requires one to be sequenced first. What is the general principal-diagnosis approach?

  1. AChoose the diagnosis with the higher relative weight in the MS-DRG.
  2. BChoose the diagnosis documented first in the chart.
  3. CEither diagnosis may be sequenced as principal, subject to applicable instructions and circumstances.
  4. DReport both diagnoses as principal diagnoses.
Show answerCorrect answer: C

When two or more diagnoses equally meet the definition of principal diagnosis, and no sequencing instruction or other circumstance determines priority, either may be selected as principal. Only one principal diagnosis is ordinarily reported for an inpatient admission.

How to use this practice test

Access the free question bank for the CIC-I examination and complete a session of up to 20 randomly selected questions from its 50 published practice questions. Review the results shown after the session to identify coding decisions that need more work, such as diagnosis sequencing, documentation interpretation, or ICD-10-PCS procedure selection.

Preparation tips

  • For principal-diagnosis scenarios, identify the admission circumstances and diagnoses established after study before deciding sequencing.
  • Practice distinguishing reportable secondary diagnoses from resolved history conditions that do not affect current care.
  • When a record omits a cause, intent, site detail, or other coding fact, identify what is documented and avoid supplying missing information; consider when clarification is needed.
  • For ICD-10-PCS cases, compare the procedure's documented objective with root-operation definitions, and use the operative report for procedural details.
  • Explain each answer aloud as if teaching a coding learner: cite the relevant documentation and the coding decision it supports.
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