Certified Inpatient Coding (CIC) Practice Exam 2025 – The All-in-One Guide to Master Your Certification!

When a procedure performed is not specifically captured in the ICD-10-PCS code set, the appropriate course of action is to select the closest matching code based on its definition and guidelines. This approach is supported by coding principles, which emphasize the importance of accurate representation of the procedure performed for the sake of proper documentation, communication, and reimbursement. Using the closest matching code allows for the coding to reflect the clinical scenario as faithfully as possible, thus ensuring that claim submissions are justified and comply with regulatory standards.

Additionally, selecting a closely associated code aligns with coding guidelines that encourage coders to seek the best fit available when a precise code is not found. This reflects an understanding of the procedure's clinical intent, which is crucial in medical coding, particularly because variations in procedures can exist in practice.

Other options do not provide a solution that meets coding standards. Documenting the procedure without coding it ignores the need for accurate data submission, while using previous ICD versions is not compliant with current coding practices. Ignoring the procedure altogether in the billing process could lead to revenue loss and compliance issues. Therefore, choosing the closest matching code is the most effective and ethical approach in this scenario.