Massachusetts Medical Coding Certification
Exam question with correct answers (100%
verified answers) plus rationales Q &A
2026 INSTANT DOWNLOAD PDF
1. Which coding system is primarily used for reporting diagnoses in outpatient
settings?
A. CPT
B. ICD-10-CM
C. HCPCS Level II
D. DRG
Answer: B
ICD-10-CM is used to classify and code diagnoses in all healthcare settings,
especially outpatient care.
2. What does CPT stand for?
A. Current Procedure Terminology
B. Clinical Procedure Tracking
C. Current Procedural Terminology
D. Certified Practice Technique
Answer: C
Current Procedural Terminology (CPT) is used to report medical procedures and
services.
,3. What is the main purpose of HCPCS Level II codes?
A. Inpatient diagnosis coding
B. Laboratory test classification
C. Reporting medical supplies and non-physician services
D. Surgical procedure coding
Answer: C
HCPCS Level II codes cover durable medical equipment, supplies, and non-
physician services.
4. Which organization maintains CPT codes?
A. WHO
B. AMA
C. CMS
D. CDC
Answer: B
The American Medical Association (AMA) is responsible for CPT code maintenance.
5. What does ICD-10-PCS primarily code?
A. Outpatient procedures
B. Inpatient hospital procedures
C. Physician services
D. Laboratory tests
Answer: B
ICD-10-PCS is used for inpatient hospital procedure coding.
6. What is a modifier in CPT coding used for?
,A. To replace a code
B. To describe diagnosis severity
C. To indicate service alteration without changing definition
D. To classify diseases
Answer: C
Modifiers provide additional information about a procedure without changing its
core definition.
7. Which code set is used for hospital inpatient reimbursement classification?
A. CPT
B. DRG
C. HCPCS
D. ICD-10-CM
Answer: B
Diagnosis-Related Groups (DRGs) determine inpatient hospital payment.
8. What does ICD-10-CM primarily classify?
A. Medical devices
B. Diagnoses
C. Hospital payments
D. Surgical instruments
Answer: B
ICD-10-CM is used for diagnosis coding.
9. Which of the following is an example of a Level I HCPCS code?
A. A0429
B. 99213
, C. J1885
D. E1399
Answer: B
Level I HCPCS codes are CPT codes (e.g., 99213 for office visits).
10. What does the term “upcoding” mean?
A. Coding lower severity
B. Reporting duplicate codes
C. Coding higher level of service than provided
D. Removing diagnosis codes
Answer: C
Upcoding is billing for a more severe or complex service than was performed.
11. What is the first step in medical coding?
A. Assign CPT codes
B. Assign ICD codes
C. Review documentation
D. Submit claim
Answer: C
Accurate coding begins with reviewing clinical documentation.
12. Which section of CPT codes covers anesthesia?
A. 00100–01999
B. 10021–69990
C. 70010–79999
D. 80000–89999
Exam question with correct answers (100%
verified answers) plus rationales Q &A
2026 INSTANT DOWNLOAD PDF
1. Which coding system is primarily used for reporting diagnoses in outpatient
settings?
A. CPT
B. ICD-10-CM
C. HCPCS Level II
D. DRG
Answer: B
ICD-10-CM is used to classify and code diagnoses in all healthcare settings,
especially outpatient care.
2. What does CPT stand for?
A. Current Procedure Terminology
B. Clinical Procedure Tracking
C. Current Procedural Terminology
D. Certified Practice Technique
Answer: C
Current Procedural Terminology (CPT) is used to report medical procedures and
services.
,3. What is the main purpose of HCPCS Level II codes?
A. Inpatient diagnosis coding
B. Laboratory test classification
C. Reporting medical supplies and non-physician services
D. Surgical procedure coding
Answer: C
HCPCS Level II codes cover durable medical equipment, supplies, and non-
physician services.
4. Which organization maintains CPT codes?
A. WHO
B. AMA
C. CMS
D. CDC
Answer: B
The American Medical Association (AMA) is responsible for CPT code maintenance.
5. What does ICD-10-PCS primarily code?
A. Outpatient procedures
B. Inpatient hospital procedures
C. Physician services
D. Laboratory tests
Answer: B
ICD-10-PCS is used for inpatient hospital procedure coding.
6. What is a modifier in CPT coding used for?
,A. To replace a code
B. To describe diagnosis severity
C. To indicate service alteration without changing definition
D. To classify diseases
Answer: C
Modifiers provide additional information about a procedure without changing its
core definition.
7. Which code set is used for hospital inpatient reimbursement classification?
A. CPT
B. DRG
C. HCPCS
D. ICD-10-CM
Answer: B
Diagnosis-Related Groups (DRGs) determine inpatient hospital payment.
8. What does ICD-10-CM primarily classify?
A. Medical devices
B. Diagnoses
C. Hospital payments
D. Surgical instruments
Answer: B
ICD-10-CM is used for diagnosis coding.
9. Which of the following is an example of a Level I HCPCS code?
A. A0429
B. 99213
, C. J1885
D. E1399
Answer: B
Level I HCPCS codes are CPT codes (e.g., 99213 for office visits).
10. What does the term “upcoding” mean?
A. Coding lower severity
B. Reporting duplicate codes
C. Coding higher level of service than provided
D. Removing diagnosis codes
Answer: C
Upcoding is billing for a more severe or complex service than was performed.
11. What is the first step in medical coding?
A. Assign CPT codes
B. Assign ICD codes
C. Review documentation
D. Submit claim
Answer: C
Accurate coding begins with reviewing clinical documentation.
12. Which section of CPT codes covers anesthesia?
A. 00100–01999
B. 10021–69990
C. 70010–79999
D. 80000–89999
