Medical Coding Guidelines Practice Test

A set of Q&A flashcards covering ICD-10-CM, CPT, and HCPCS coding concepts from the practice test notes.

What is the main purpose of ICD-10-CM codes?

To classify diagnoses, symptoms, and conditions.

In ICD-10-CM, the first three characters of a code represent:

Category of disease or condition

The 7th character in an ICD-10-CM code is used to

The episode of care. initial encounter, subsequent encounter, sequela

In an outpatient setting, a diagnosis documented as 'probable' should be coded as

The signs and symptoms only

Chronic conditions should be coded:

Every time the patient receives care for the condition.

What is the main purpose of CPT codes?

To report medical, surgical, and diagnostic services.

Who maintains CPT codes?

American Medical Association (AMA).

How many digits are in a CPT code?

5 digits.

A CPT modifier is used to:

Indicate that a service or procedure was altered without changing its definition.

Category III CPT codes are:

Temporary codes for emerging technologies and procedures.

HCPCS Level II codes are used for:

Non-physician services, supplies, and equipment.

Who maintains HCPCS Level II codes?

The Centers for Medicare and Medicaid Services (CMS).

The letter at the beginning of a Level II HCPCS code indicates:

Code category.

Before coding a medical record, the first step is to:

A. Check payer rules

B. Review documentation for accuracy and completeness

C. Look up similar patient records

D. Assign CPT codes first

B. Review documentation for accuracy and completeness.

'Upcoding' refers to

Assigning a higher level code than supported by documentation.

'Unbundling' means:

Separating services that should be reported under one code.

ICD-10-CM, CPT, and HCPCS codes are updated:

Annually.

The False Claims Act enforces penalties for:

Submitting inaccurate or fraudulent claims.