Exam (elaborations)

Certified Professional Coder Coding Test 2025/2026| Verified Q&A

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CPC certified professional coder

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CPC Certified Professional Coder

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Uploaded on November 13, 2024
Number of pages 54
Written in 2024/2025
Type Exam (elaborations)
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Institution CPC certified professional coder
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Certified Professional Coder Coding Test
2025/2026| Verified Q&A
Which entity is responsible for developing and updating the ICD-10-PCS code set?

Centers for Medicare and Medicaid Services (CMS)

In the Medicare Physician Fee Schedule, what is the purpose of the Relative Value Unit (RVU)?

To determine the value of services provided by physicians

Which ICD-10-CM chapter covers diseases of the digestive system?

Chapter 11

What is the primary purpose of the ICD-10-CM code set?

To classify diagnoses and reasons for patient visits

In CPT coding, what does a modifier 59 indicate?

Distinct procedural service

When should CPT modifier 25 be appended?

When a significant, separately identifiable E/M service is provided on the same day as

another service or procedure

Which ICD-10-CM code set character indicates laterality?
1

, The sixth character

What does the term "upcoding" refer to?

Assigning a code for a higher level of service than was actually provided

In the CPT coding manual, Category II codes are primarily used for what purpose?

Tracking performance measurements

What is the function of an E/M code?

To describe the evaluation and management of a patient's condition

Which modifier should be used when a bilateral procedure is performed?

Modifier 50

If a diagnostic test is performed to confirm a physician's suspicion of a condition, how should it

be coded?

Code the sign or symptom prompting the test unless the condition is confirmed

What does the CPT symbol of a circle with a line through it indicate?

A code exempt from modifier 51

When reporting anesthesia services, what additional information is often required?

2

, Physical status modifiers

In CPT coding, how are add-on codes identified?

By a plus sign (+) before the code

What does the term “bundling” in coding mean?

Combining multiple procedures into a single code

What is a “code linkage” and why is it important in coding?

Linking diagnosis codes to procedure codes to support medical necessity

When is modifier 24 appropriate for use?

When an unrelated E/M service is provided by the same physician during a postoperative

period

Which document is essential for coding the diagnosis from an operative procedure?

Operative report

What is the purpose of an advance beneficiary notice (ABN)?

To inform Medicare beneficiaries of potential out-of-pocket costs for a service not covered

by Medicare

3

, What is the CPT code range for anesthesia services?

00100-01999

When using an unlisted procedure code, what documentation is crucial to include?

Detailed explanation of the procedure performed

What does CPT code 99080 cover?

Special reports such as insurance forms and documentation preparation

Which modifier is used to report an assistant surgeon's participation?

Modifier 80

For CPT coding, what does “global period” refer to?

The time period during which related follow-up care is included in the surgical package

Which CPT code symbol signifies a telemedicine service?

A star symbol (*)

What is the CPT code range for pathology and laboratory procedures?

80047-89398

What should you code if the final diagnosis is documented as “probable” in an inpatient setting?

4

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