Medical Coding Practice Exam
Course Introduction
Medical Coding covers the principles, guidelines, and practical applications of translating healthcare diagnoses, procedures, and services into universally recognized alphanumeric codes. The course introduces students to major coding systems, including ICD-10-CM, CPT, and HCPCS, and emphasizes accuracy, ethical practices, and compliance with healthcare regulations. Learners develop skills in interpreting medical documentation, applying coding conventions, and understanding the role of coding in medical billing and reimbursement processes. This foundational knowledge prepares students for entry-level positions in healthcare administration and helps pave the way for certification in medical coding.
Recommended Textbook
Step by Step Medical Coding 2016 1st Edition by Carol J. Buck
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1233 Flashcards
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Chapter 1: Reimbursement, Hipaa, and Compliance
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Sample Questions
Q1) A major change took place in Medicare in ____ with the enactment of the Omnibus Budget Reconciliation Act.
A)1989
B)1992
C)1997
D)2000
Answer: A
Q2) The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 established these new benefits available under the Medicare program.
A)Part A
B)Part B
C)Part C
D)Part D
Answer: D
Q3) In the role as a medical coder, it is your responsibility to ensure that you code ____________________ and ____________________ to optimize reimbursement for services provided. (Separate your answers with a comma and a space.)
Answer: accurately, completely completely, accurately
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Chapter 2: An Overview of ICD-10-CM
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Sample Questions
Q1) Which organization has been responsible for the development of ICD-10-CM?
A)NCHS
B)AHIMA
C)AMA
D)AHA
Answer: A
Q2) Which of the following is true about the ICD-10-CM:
A)There is a limitation of injury codes.
B)There is additional information that is relevant to inpatient encounters.
C)There are combination diagnosis/symptom codes.
D)There was an addition of an eighth character.
Answer: C
Q3) ICD-10-CM codes have a maximum of five characters.
A)True
B)False
Answer: False
Q4) All ICD-10-CM codes have seven characters.
A)True
B)False
Answer: False
Page 4
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Chapter 3: ICD-10-CM Outpatient Coding and Reporting
Guidelines
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Sample Questions
Q1) Z codes cannot be used in the outpatient setting.
A)True
B)False Answer: False
Q2) Section IV of the Official Guidelines for Coding and Reporting applies to both the inpatient and outpatient settings.
A)True
B)False Answer: False
Q3) A patient is admitted to an observation unit for a medical condition that has worsened and is then admitted as an inpatient to the same hospital for the same medical condition. The primary diagnosis would be the medical condition that led to the admission.
A)True
B)False Answer: True
Q4) Z codes may be assigned as first-listed or a secondary diagnosis. A)True
B)False Answer: True
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Chapter 4: Using ICD-10-CM
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Sample Questions
Q1) Chronic osteomyelitis with draining sinuses of right first toe due to Staphylococcus aureus.
ICD-10-CM Codes:____________________, _____________________
Q2) Subsequent encounter for a joint injection for a patient with acute pain due to a sprained right acromioclavicular joint.
ICD-10-CM Codes:____________________, _____________________
Q3) It is important to follow any cross-reference instructions in the Index of the I-10, such as see also.
A)True B)False
Q4) The correct reporting for Staphylococcus pneumonia:
A)E86.0, J41.0
B)J18.9, E86.0
C)J18.9, E86.9
D)J15.20
Q5) Osteoarthritis of both knees with pain and swelling.
ICD-10-CM Code:____________________
Q6) Each unique I-10 diagnosis code may be reported more than once for an encounter. A)True B)False
Page 6
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Chapter 5: Introduction to CPT
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Sample Questions
Q1) Which of the following is NOT a reason for the CPT coding system?
A)increased reimbursement
B)comparative analysis
C)data for research
D)improved communication
Q2) Which punctuation mark between codes in the index of the CPT manual indicates two codes are available?
A)period
B)ampersand
C)comma
D)semicolon
Q3) According to the CPT Surgery Guidelines, what is the code for the following unlisted procedures: Unlisted procedure, arthroscopy?
Code: ____________________
Q4) CPT stands for:
A)Current Physician's Terminology
B)Current Procedure Terminology
C)Current Procedural Terminology
D)Current Procedural Terms
Q5) Appendix C of the CPT manual contains examples of ____________________ codes.
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Chapter 6: Introduction to Level II National Codes HCPSC
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Sample Questions
Q1) A modifier:
A)subtracts from the definition of the code
B)adds to the HCPCS code number
C)provides additional information to the third-party payer
D)increases third-party payer reimbursement
Q2) HCPCS codes have how many digits?
A)4
B)3
C)5
D)6
Q3) HCPCS stands for:
A)Healthcare Coding Procedure Charge System
B)Health Coding Procedures Creating Standards
C)Healthcare Current Procedure Coding System
D)Healthcare Common Procedure Coding System
Q4) What is the HCPCS Level II code for home blood glucose monitor?
Q5) What is the HCPCS Level II code for Injection, gadoterate meglumine, 0.1 ml?
Q6) The entries in the index of the National Codes are listed under one main term.
A)True
B)False
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Chapter 7: Modifiers
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Sample Questions
Q1) Mrs. Smith presented to her physician's office for an office visit for an upper respiratory infection. The physician examines the patient and prescribes antibiotics. The physician notices the patient has a suspicious-looking mole. The physician examined the mole and determined that it should be removed. The mole was removed during the same office visit. The physician bills both an E/M code and a procedure code. Which modifier would you use on the E/M code? ____________________
Q2) Multiple modifiers are indicated with which modifier?
A)-47
B)-50
C)-22
D)-99
Q3) Modifier -59, distinct procedure service, is used to indicate that:
A)services that are usually bundled into one payment were provided as separate services
B)a subsequent surgery was planned or staged
C)a service was repeated
D)a patient is taken back to the operating room for surgical treatment of a complication resulting from a previous surgery
Q4) ____________________ lists some HCPCS modifiers in the CPT book.
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Chapter 8: Evaluation and Management EM Services
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Sample Questions
Q1) Location: Emergency Room
SUBJECTIVE: This is a 38-year-old female who presents to the emergency room with a history of currently being under treatment for a right corneal abrasion that occurred on Sunday. She states she was seen by the "eye doctor earlier today" and now has a bandage over her eye. Apparently her eye is opened underneath the bandage and she is unable to close her eyelid. She feels her eyelid is stuck to the bandage.
OBJECTIVE: She is afebrile with stable vital signs. The patch was removed and there was a folded piece of Telfa that had slipped down and her upper eyelid was unable to close over the top of this. The Telfa was removed and a wet patch was placed. This did provide significant comfort. Her eye patch was reinforced.
ASSESSMENT: 1. Right corneal abrasion under treatment. 2. Eye patch replaced as described above.
PLAN: She has a follow up visit tomorrow morning with ophthalmology. I told her she needs to keep that appointment. She is to return here sooner if she is having increasing problems.
CPT Code: ____________________
Q2) What are the four elements of history?
Q3) What are the four levels of medical decision making complexity?
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Chapter 9: Anesthesia
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Sample Questions
Q1) Assign a CPT anesthesia code and applicable modifiers for anesthesia services for a 9-month-old normal child who received anesthesia for hernia repair in the lower abdomen.
CPT Code: ____________________
Q2) In the Anesthesia section of the CPT manual, the codes are usually divided first by which of the following?
A)specific procedure
B)anatomic site
C)degree of difficulty
D)amount of time
Q3) Anesthesia for burr holes.
CPT Code: ____________________
Q4) There are various types of anesthesia, and these include general, regional, or local sedation.
A)True
B)False
Q5) Anesthesia code for a biopsy of the clavicle.
CPT Code: _____________
Q6) Assign a CPT anesthesia code for Strayer procedure. CPT Code: ____________________
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Chapter 10: Surgery Guidelines and General Surgery
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Sample Questions
Q1) The global surgery period includes:
A)all routine preoperative and postoperative care
B)serious complications requiring a return to the operating room
C)staged procedures
D)all of the above
Q2) Third-party payers determine the contents of a surgical package.
A)True
B)False
Q3) Excision including simple closure of benign lesions of the skin includes this type of anesthesia:
A)local
B)general
C)spinal
D)none of the above
Q4) When using an unlisted code a(n) ____ must accompany the claim.
A)modifier
B)operative report
C)special report
D)all of the above
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Chapter 11: Extension 1: Chapter-Specific Guidelines:
ICD-10-CM Chapters 1-10
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Sample Questions
Q1) I-10 presumes a cause-and-effect relationship between hypertension and acute kidney disease.
A)True
B)False
Q2) Cataract due to type 2 diabetes mellitus.
ICD-10-CM Code: ____________________
Q3) Unspecified thyrotoxicosis with thyrotoxic storm.
ICD-10-CM Code: _____________________
Q4) If a patient is seen for a pathological fracture due to a neoplasm, the neoplasm should be the first-listed diagnosis.
A)True
B)False
Q5) Mitral valve prolapse, nonrheumatic.
ICD-10-CM Code: ____________________
Q6) Sickle-cell crisis with acute chest syndrome.
ICD-10-CM Code: _____________________
Q7) Hypertensive congestive heart failure with hypertension and chronic kidney disease, stage 4.
ICD-10-CM Codes: ____________________, ___________________, Page 13
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Page 14
Chapter 13: Musculoskeletal System
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Sample Questions
Q1) ____________________ is the application of pulling force to hold a bone in correct alignment.
Q2) Surgical arthroscopy of the shoulder, rotator cuff repair.
CPT Code: ____________________
Q3) The codes for wound exploration can be reported for exploration of any type of wound.
A)True
B)False
Q4) Codes for arthrodesis include the bone graft and instrumentation, and these cannot be coded separately.
A)True
B)False
Q5) Arthroscopy is a desirable treatment choice by physicians and patients because the:
A)incisions are smaller
B)risk of infection is decreased
C)recovery time is quicker
D)all of the above
Q6) Trigger finger release.
CPT Code: ____________________
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Chapter 14: Integumentary System
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Sample Questions
Q1) -plasty
A) to remedy, replace, or heal
B) suffix for molding or surgically forming
C) free flow or withdrawal of fluids from a wound or cavity
D) cutting or taking away
E) to unite parts by stitching them together
F) inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
G) scraping of a cavity using a spoon-shaped instrument
H) forcing a fluid into a vessel or cavity
I) suffix for suturing
J) suffix for puncture of a cavity
K) suffix for removal of part or all of an organ of the body
L) removal of a small piece of living tissue for diagnostic examination
M) surgically cutting into
N) binding or tying off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
O) suffix for incision into
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Chapter 14: Respiratory System
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Sample Questions
Q1) ____________________ is a procedure in which the nose is reshaped internally or externally.
Q2) A diagnostic endoscopic procedure is reported only when:
A)no surgical procedure is performed during the same operative session
B)a surgical procedure is performed during the same operative session
C)multiple surgical procedures are performed during the same operative session
D)no other code in that section applies
Q3) The physician uses an endoscope for surgical access to decompress the optic nerve in the posterior orbit.
CPT Code: ____________________
Q4) Select the term that describes a procedure in which a scope is placed into a body cavity.
A)indirect
B)open procedure
C)endoscopy
D)direct
Q5) Excision of tracheal tumor using cervical approach.
CPT Code: ____________________
Q6) Simple excision of a nasal polyp.
CPT Code: ____________________
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Chapter 15: Extension 2: Chapter-Specific Guidelines:
ICD-10-CM Chapters 11-14
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Sample Questions
Q1) Initial encounter for a pathologic fracture left metatarsal due to age-related postmenopausal osteoporosis. This patient had a previous pathologic fracture of the hip due to osteoporosis.
ICD-10-CM Codes:____________________, ____________________
Q2) Chapter 11, Diseases of the Digestive System (K00-K94), contains many combination codes that require careful reading.
A)True
B)False
Q3) Osteopathy of right lower leg following poliomyelitis.
ICD-10-CM Codes:____________________, ____________________
Q4) Patient who habitually chews tobacco is diagnosed with leukoplakia of the tongue, nicotine induced.
ICD-10-CM Codes: ___________________, __________________
Q5) Pressure ulcers develop when the circulation to an area is decreased by the application of pressure to the area.
A)True
B)False
Q6) Obstructed intestinal hernia with gangrene.
ICD-10-CM Code:____________________
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Chapter 16: Cardiovascular System
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Sample Questions
Q1) A(n) ____ is a mass of undissolved matter that is present in blood and is transported by the blood.
A)thrombus
B)aneurysm
C)false aneurysm
D)embolus
Q2) Arrhythmia ablation is a treatment for:
A)bradycardia/tachycardia
B)atrial fibrillation
C)complete heart block
D)all of the above
Q3) Which item is NOT considered to be bundled in with a vascular injection?
A)local anesthesia
B)contrast media
C)introduction of needle or catheter
D)preinjection and postinjection care related to procedure
Q4) Direct repair of aneurysm associated with occlusion of the vertebral artery.
CPT Code: ____________________
Q5) ____________________ is a procedure in which the surgeon withdraws fluid from the pericardial space by means of a needle.
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Chapter 17: Hemic, Lymphatic, Mediastinum, and Diaphragm
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Sample Questions
Q1) This bone marrow is collected from the patient and later transplanted or reinfused back into the patient from whom it came.
A)allogeneic
B)transgenic
C)autologenic
D)biogenic
Q2) Transplantation
A) Overlapping
B) Grafting tissue from one source to another
C) Inflammation of lymph nodes
D) Cutting into the mediastinum
Q3) Suprahyoid lymphadenectomy.
CPT Code: ____________________
Q4) What is it called when the diaphragm is out of normal position and has moved up farther into the thoracic cavity?
A)hernia
B)eventration
C)imbriation
D)laceration
20
Q5) The mediastinum category code range is ____________________.
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Chapter 18: Digestive System
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Q1) Excision, lesion of the palate with a simple primary closure.
CPT Code: ____________________
Q2) When a colectomy is performed, a segment of the stomach is resected and an anastomosis is performed between the remaining ends.
A)True
B)False
Q3) A common abbreviation for procedure code 43260 endoscopic retrograde cholangiopancreatography is ERCP.
A)True
B)False
Q4) With the exception of incisional and ventral hernias, the use of mesh or other prosthesis is not separately reported when performing hernia repairs.
A)True
B)False
Q5) ____________________ is the term that describes the displacement of an organ or tissue that protrudes through the wall or from the cavity that usually contains it.
Q6) A physician is placing a nasogastric tube using fluoroscopic guidance.
CPT Code: ____________________
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Chapter 19: Urinary and Male Genital Systems
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Sample Questions
Q1) A complete transurethral electrosurgical resection of the prostate.
CPT Code: ___________________
Q2) Bilateral vasectomy.
CPT Code: ____________________
Q3) Location: Outpatient Hospital
OPERATIVE REPORT
PREOPERATIVE DIAGNOSIS: Minimal change disease
POSTOPERATIVE DIAGNOSIS: Same.
PROCEDURE PERFORMED: Native kidney biopsy.
PROCEDURE: After providing consent, the patient was taken to ultrasound room. She was put in the prone position. Both kidneys were difficult to visualize. The right kidney was chosen. Skin was prepped in the usual fashion. Lidocaine was used for local anesthesia. Using real-time ultrasound guidance, the right kidney was accessed multiple times. At least six core biopsies were obtained and were sent for light and electromicroscopy in addition to immune fluorescence. Postbiopsy ultrasound showed no evidence of hematoma.
The patient tolerated the procedure well without immediate complication. She was sent back to the procedure area.
CPT Codes: ____________________, ____________________
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Chapter 20: Reproductive, Intersex Surgery, Female Genital
System, and Maternity Care and Delivery
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Sample Questions
Q1) A fetal non-stress test is completed on a 36-week pregnancy. The correct code would be:
A)59050
B)59012
C)59020
D)59025
Q2) Biopsy of the vaginal mucosa code is:
A)56605
B)58900
C)57100
D)57110
Q3) Colpotomy is an incision into the vagina.
A)True
B)False
Q4) Assign a code for a cesarean delivery with postpartum care and a ligation of fallopian tubes performed at the same operative session. (Separate the codes with a comma in your response as follows: XXXXX, XXXXX.)
CPT Codes: ____________________, ____________________
Q5) Patient presents for a laparoscopic salpingostomy.
CPT Code: ____________________
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Chapter 21: Extension 3: Chapter-Specific Guidelines :
ICD-10-CM Chapters 15-21
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Sample Questions
Q1) An adverse effect occurs when a drug has been correctly prescribed and properly administered and the patient develops a reaction.
A)True
B)False
Q2) Left lower quadrant abdominal pain.
ICD-10-CM Code: ____________________
Q3) The outcome of delivery is indicated on the mother's medical record only.
A)True
B)False
Q4) Transitory neonatal hypoglycemia.
ICD-10-CM Code: ____________________
Q5) Superficial injuries such as an abrasion or contusion are reported when associated with more severe injuries of the same site.
A)True
B)False
Q6) Localized swelling of the neck.
ICD-10-CM Code: ____________________
Q7) Lethargy.
24
ICD-10-CM Code: ____________________
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Chapter 22: Endocrine and Nervous Systems
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Q1) Craniotomy
A) method of identifying a specific area or point in the brain
B) removal of a portion of the skull
C) a small opening in the skull
D) an incision of the skull
Q2) Posterior hemilaminectomy with herniated discectomy L2 thru L4. (Separate the codes with a comma in your response as follows: XXXXX, XXXXX.)
CPT Codes: ____________________, ____________________
Q3) Laminectomy for excision of intraspinal lesion, extradural, lumbar.
CPT Code: ____________________
Q4) This is the most commonly known neuroplastic procedure.
A)surgery of skull base
B)craniectomy
C)cisternal cervical puncture
D)carpal tunnel
Q5) In the Surgery of Skull Base, the ____ procedure is what is done to the lesion.
A)radical
B)definitive
C)approach
D)intubation
Page 25
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Chapter 23: Eye, Ocular Adnexa, Auditory, and Operating Microscope
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Q1) Removal of impacted cerumen from both ears using wax curettes and suction. CPT Code: ____________________
Q2) Removal of a superficial foreign body in the external left eye. CPT Code: ____________________
Q3) Strabismus surgery:
A)corrects the condition in which the refractive surfaces of the eye are unequal
B)removes the opaque covering on or in the lens
C)is a repair of the cornea
D)corrects the muscle misalignment
Q4) Bilateral repair of blepharoptosis with frontalis muscle technique. CPT Code: ____________________
Q5) Otoplasty of the right ear, with size reduction. CPT Code: ____________________
Q6) The transparent part of the eye is the ____________________.
Q7) Sclera lesion excision, left eye. CPT Code: ____________________
Q8) The destruction codes in the Posterior Segment subsection include one or more sessions.
A)True
B)False Page 26
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Chapter 24: Radiology Section
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Q1) Epididymography, supervision and interpretation only.
CPT Code: ____________________
Q2) What is the name of the high-frequency sound waves in an imaging process that is used to diagnose patient illness?
A)ultrasound
B)radionuclide
C)MRI
D)radiography
Q3) Parathyroid imaging.
CPT Code: ____________________
Q4) A needle with a suture attached is passed through an incision into the stomach. The needle is snared and removed via the mouth. A gastrostomy tube is connected to the suture and passed through the mouth into the stomach and out the abdominal wall. What is the correct code for this procedure?
A)74230
B)74340
C)49440
D)none of the above
Q5) ____________________ means lying down.
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Chapter 25: Pathology/Laboratory Section
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Q1) colon, total resection
A) Level II
B) Level III
C) Level IV
D) Level V
E) Level VI
Q2) A Pap smear utilizing the Bethesda system done by manual screening and computer-assisted re-screening under physician supervision.
CPT Code: ____________________
Q3) A stool test for Helicobacter pylori.
CPT Code: ____________________
Q4) In Therapeutic Drug Assays (80150-80299), the examination is quantitative.
A)True
B)False
Q5) An influenza B immunofluorescence antigen detection. CPT Code: ____________________
Q6) Drug assay, acetaminophen.
CPT Code: ____________________
Q7) Blood analysis for HGH.
CPT Code: ____________________
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Chapter 26: The Medicine Section
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Sample Questions
Q1) What is the name of the process that routes the blood including waste products outside the body through filters?
A)purification
B)hemodialysis
C)infiltration
D)none of these
Q2) OTH
A)subcutaneous
B)intrathecal
C)inhalant
D)other routes
E)various routes
F)intramuscular
G)intravenous
Q3) Electrocardiogram with 15 leads including the interpretation and report.
CPT Code: ____________________
Q4) Postoperative follow-up visit 4 weeks after a surgery that has a 90-day global period.
CPT Code: ____________________
Q5) The administration code for an influenza vaccine is ____________________.
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Chapter 27: Inpatient Coding
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Q1) The root operation that is defined as restoring, to the extent possible, a body part to its natural anatomic structure is:
A)map
B)replacement
C)restriction
D)repair
Q2) The root operation that is defined as correcting a portion of a previously performed procedure is:
A)revision of device in
B)replacement
C)reposition
D)transfer
Q3) The American Hospital Association is responsible for the development of ICD-10-PCS.
A)True
B)False
Q4) Patient was admitted with shortness of breath and edema due to decompensation of congestive heart failure.
Q5) Patient is admitted with epigastric pain due to acute pancreatitis.
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