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NWCA Medical Billing And Coding Practice Exam

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In a patient with chronic kidney disease and hypertensive heart disease, if the visit's main focus is kidney disease management, which code is typically listed first?
Correct Answer:
CKD first
Explanation:
When the visit is focused on a specific condition, that condition’s code is listed first as the main reason for the encounter. If the patient’s main focus is kidney disease management, the CKD code (N18.x) should be the first-listed diagnosis. Hypertensive heart disease would then appear as a secondary code if it’s relevant to the visit but not the primary focus. The presence of heart disease does not remove CKD coding, and it wouldn’t be correct to code diabetes first unless diabetes was the reason for the visit.

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