NURS 5337 BILLING AND CODING QUIZ | COMPLETE
QUESTIONS AND ANSWERS
2026 UPDATE | GRADED A+ | UNIVERSITY OF TEXAS AT
ARLINGTON
TABLE OF CONTENTS
1. EXAM INFORMATION...................................... PAGE 1
2. SECTION 1: ICD-10-CM CODING............................ PAGE 2
3. SECTION 2: CPT CODING AND EVALUATION/MANAGEMENT........ PAGE 4
4. SECTION 3: MEDICARE AND PAYMENT SYSTEMS................ PAGE 7
5. SECTION 4: COMPLIANCE AND DOCUMENTATION................ PAGE 9
6. SECTION 5: MODIFIERS AND BILLING RULES................. PAGE 11
7. COMPLETE ANSWER KEY WITH RATIONALES.................... PAGE 14
8. QUICK REFERENCE ANSWER KEY............................. PAGE 18
EXAM INFORMATION
Institution: University of Texas at Arlington
Course: NURS 5337 – Advanced Practice Nursing Role
Document Type: Complete Billing and Coding Quiz Questions and Answers with Rationales
Latest Update: 2026
Grade: A+ Verified
Total Questions: 50
This comprehensive study guide covers all major billing and coding concepts tested in NURS
5337, including ICD-10-CM coding guidelines, CPT Evaluation and Management (E/M) coding,
Medicare payment systems, compliance requirements, and modifier usage .
SECTION 1: ICD-10-CM CODING
Question 1
What is the purpose of ICD-10-CM coding in healthcare?
, Answer: ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical
Modification) is used to classify and code diagnoses, symptoms, and procedures recorded in
conjunction with hospital care. It provides a standardized system for tracking health statistics
and serves as the basis for reimbursement .
Rationale: ICD-10-CM codes translate written descriptions of diseases, injuries, and other
health conditions into alphanumeric codes that are used for billing, research, and
epidemiological tracking .
Question 2
How many characters can an ICD-10-CM code have?
Answer: ICD-10-CM codes can have from 3 to 7 characters.
Rationale: The first character is always alphabetic. The second character is always numeric.
Characters 3 through 7 may be alphabetic or numeric. The seventh character is used for
specific clinical details such as encounter type (initial, subsequent, sequela) .
Question 3
What is the significance of the "placeholder X" in an ICD-10-CM code?
Answer: The placeholder "X" is used to fill empty characters when a code requires a 7th
character extension but has fewer than 6 characters. It ensures proper code formatting for
specific clinical details.
Rationale: For example, a code like S01.001A (laceration of scalp, initial encounter) uses the
structure properly. If a code has only 5 characters but requires a 7th character extension, an "X"
is added to maintain the required format .
Question 4
What is the difference between a diagnosis code and a procedure code?
Answer: Diagnosis codes (ICD-10-CM) describe the patient's condition or reason for encounter.
Procedure codes (CPT/HCPCS) describe the services and procedures performed by healthcare
providers.
Rationale: Both code sets are required for complete billing. The diagnosis code justifies medical
necessity for the procedures performed .
Question 5
QUESTIONS AND ANSWERS
2026 UPDATE | GRADED A+ | UNIVERSITY OF TEXAS AT
ARLINGTON
TABLE OF CONTENTS
1. EXAM INFORMATION...................................... PAGE 1
2. SECTION 1: ICD-10-CM CODING............................ PAGE 2
3. SECTION 2: CPT CODING AND EVALUATION/MANAGEMENT........ PAGE 4
4. SECTION 3: MEDICARE AND PAYMENT SYSTEMS................ PAGE 7
5. SECTION 4: COMPLIANCE AND DOCUMENTATION................ PAGE 9
6. SECTION 5: MODIFIERS AND BILLING RULES................. PAGE 11
7. COMPLETE ANSWER KEY WITH RATIONALES.................... PAGE 14
8. QUICK REFERENCE ANSWER KEY............................. PAGE 18
EXAM INFORMATION
Institution: University of Texas at Arlington
Course: NURS 5337 – Advanced Practice Nursing Role
Document Type: Complete Billing and Coding Quiz Questions and Answers with Rationales
Latest Update: 2026
Grade: A+ Verified
Total Questions: 50
This comprehensive study guide covers all major billing and coding concepts tested in NURS
5337, including ICD-10-CM coding guidelines, CPT Evaluation and Management (E/M) coding,
Medicare payment systems, compliance requirements, and modifier usage .
SECTION 1: ICD-10-CM CODING
Question 1
What is the purpose of ICD-10-CM coding in healthcare?
, Answer: ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical
Modification) is used to classify and code diagnoses, symptoms, and procedures recorded in
conjunction with hospital care. It provides a standardized system for tracking health statistics
and serves as the basis for reimbursement .
Rationale: ICD-10-CM codes translate written descriptions of diseases, injuries, and other
health conditions into alphanumeric codes that are used for billing, research, and
epidemiological tracking .
Question 2
How many characters can an ICD-10-CM code have?
Answer: ICD-10-CM codes can have from 3 to 7 characters.
Rationale: The first character is always alphabetic. The second character is always numeric.
Characters 3 through 7 may be alphabetic or numeric. The seventh character is used for
specific clinical details such as encounter type (initial, subsequent, sequela) .
Question 3
What is the significance of the "placeholder X" in an ICD-10-CM code?
Answer: The placeholder "X" is used to fill empty characters when a code requires a 7th
character extension but has fewer than 6 characters. It ensures proper code formatting for
specific clinical details.
Rationale: For example, a code like S01.001A (laceration of scalp, initial encounter) uses the
structure properly. If a code has only 5 characters but requires a 7th character extension, an "X"
is added to maintain the required format .
Question 4
What is the difference between a diagnosis code and a procedure code?
Answer: Diagnosis codes (ICD-10-CM) describe the patient's condition or reason for encounter.
Procedure codes (CPT/HCPCS) describe the services and procedures performed by healthcare
providers.
Rationale: Both code sets are required for complete billing. The diagnosis code justifies medical
necessity for the procedures performed .
Question 5
