RHIT Medical Coding – ICD-10-CM, CPT, and HCPCS EXAM 2026/2027
ACTUAL QUESTIONS AND 100% CORRECT ANSWERS WITH RATIONS
ICD-10-CM: Questions 1–80
1. What is the primary purpose of ICD-10-CM?
A. Reporting inpatient procedures
B. Reporting diagnoses and conditions
C. Reporting physician fees
D. Reporting medical supplies
Answer: B
Rationale: ICD-10-CM is the U.S. clinical modification of ICD-10 used
primarily to classify diagnoses, conditions, symptoms, and reasons for
healthcare encounters.
2. What does the “CM” in ICD-10-CM stand for?
A. Clinical Management
B. Clinical Modification
C. Coding Manual
D. Clinical Measurement
Answer: B
Rationale: CM means Clinical Modification, reflecting the U.S.
adaptation of ICD-10.
3. Which publication contains the official ICD-10-CM coding
guidelines?
A. CPT codebook only
B. ICD-10-CM Official Guidelines for Coding and Reporting
C. HCPCS manual only
D. NCCI Policy Manual only
,Answer: B
Rationale: The Official Guidelines provide authoritative instructions for
ICD-10-CM code assignment.
4. What is the Alphabetic Index used for?
A. Finalizing every code without verification
B. Locating terms and potential code categories
C. Reporting CPT services
D. Calculating reimbursement
Answer: B
Rationale: The Index is a starting point for locating diagnoses and
conditions; the Tabular List must then be reviewed.
5. Why must the Tabular List be consulted after locating a code in the
Index?
A. To verify the complete code and applicable instructions
B. To determine the physician's salary
C. To find CPT modifiers
D. To determine the patient's insurance
Answer: A
Rationale: The Tabular List contains the full code, inclusion terms,
exclusions, instructional notes, and other requirements.
6. What does an “Excludes1” note generally indicate?
A. The two conditions may always be coded together
B. The excluded condition should not be coded with the code
containing the note
C. The code is optional
D. A modifier is required
Answer: B
Rationale: An Excludes1 note generally means the excluded condition is
,not coded with the listed code, subject to the applicable official
guidance.
7. What does an “Excludes2” note generally indicate?
A. The excluded condition is not part of the code but may be coded
separately when appropriate
B. The code must never be used
C. The code is invalid
D. The condition is automatically principal
Answer: A
Rationale: Excludes2 means the excluded condition is not included in
the code and may be reported separately when clinically appropriate.
8. What does “code also” indicate?
A. Another code may be needed to fully describe the condition
B. The code must be deleted
C. A CPT code must be assigned
D. The code is prohibited
Answer: A
Rationale: A “code also” instruction signals that an additional code may
be necessary.
9. What does “use additional code” indicate?
A. An additional code should be assigned when applicable
B. The code is optional in all cases
C. The diagnosis is uncertain
D. The code is obsolete
Answer: A
Rationale: The instruction directs the coder to assign another code to
provide additional information.
, 10. What is the purpose of a placeholder character?
A. To fill an empty position so a required seventh character can be
placed correctly
B. To identify a CPT modifier
C. To indicate a diagnosis is uncertain
D. To replace a missing diagnosis
Answer: A
Rationale: Placeholder “X” maintains the required character position in
certain ICD-10-CM codes.
11. Which character is commonly used as an ICD-10-CM placeholder?
A. P
B. X
C. Z
D. Q
Answer: B
Rationale: “X” is used as a placeholder in specified ICD-10-CM codes.
12. What is the purpose of a seventh character in certain ICD-10-CM
categories?
A. It can provide required information such as encounter or healing
status
B. It identifies the payer
C. It replaces the diagnosis
D. It identifies a CPT procedure
Answer: A
Rationale: Certain categories require a seventh character to convey
additional clinical information.
13. In injury coding, what can the seventh character “A” represent?
A. Initial encounter
ACTUAL QUESTIONS AND 100% CORRECT ANSWERS WITH RATIONS
ICD-10-CM: Questions 1–80
1. What is the primary purpose of ICD-10-CM?
A. Reporting inpatient procedures
B. Reporting diagnoses and conditions
C. Reporting physician fees
D. Reporting medical supplies
Answer: B
Rationale: ICD-10-CM is the U.S. clinical modification of ICD-10 used
primarily to classify diagnoses, conditions, symptoms, and reasons for
healthcare encounters.
2. What does the “CM” in ICD-10-CM stand for?
A. Clinical Management
B. Clinical Modification
C. Coding Manual
D. Clinical Measurement
Answer: B
Rationale: CM means Clinical Modification, reflecting the U.S.
adaptation of ICD-10.
3. Which publication contains the official ICD-10-CM coding
guidelines?
A. CPT codebook only
B. ICD-10-CM Official Guidelines for Coding and Reporting
C. HCPCS manual only
D. NCCI Policy Manual only
,Answer: B
Rationale: The Official Guidelines provide authoritative instructions for
ICD-10-CM code assignment.
4. What is the Alphabetic Index used for?
A. Finalizing every code without verification
B. Locating terms and potential code categories
C. Reporting CPT services
D. Calculating reimbursement
Answer: B
Rationale: The Index is a starting point for locating diagnoses and
conditions; the Tabular List must then be reviewed.
5. Why must the Tabular List be consulted after locating a code in the
Index?
A. To verify the complete code and applicable instructions
B. To determine the physician's salary
C. To find CPT modifiers
D. To determine the patient's insurance
Answer: A
Rationale: The Tabular List contains the full code, inclusion terms,
exclusions, instructional notes, and other requirements.
6. What does an “Excludes1” note generally indicate?
A. The two conditions may always be coded together
B. The excluded condition should not be coded with the code
containing the note
C. The code is optional
D. A modifier is required
Answer: B
Rationale: An Excludes1 note generally means the excluded condition is
,not coded with the listed code, subject to the applicable official
guidance.
7. What does an “Excludes2” note generally indicate?
A. The excluded condition is not part of the code but may be coded
separately when appropriate
B. The code must never be used
C. The code is invalid
D. The condition is automatically principal
Answer: A
Rationale: Excludes2 means the excluded condition is not included in
the code and may be reported separately when clinically appropriate.
8. What does “code also” indicate?
A. Another code may be needed to fully describe the condition
B. The code must be deleted
C. A CPT code must be assigned
D. The code is prohibited
Answer: A
Rationale: A “code also” instruction signals that an additional code may
be necessary.
9. What does “use additional code” indicate?
A. An additional code should be assigned when applicable
B. The code is optional in all cases
C. The diagnosis is uncertain
D. The code is obsolete
Answer: A
Rationale: The instruction directs the coder to assign another code to
provide additional information.
, 10. What is the purpose of a placeholder character?
A. To fill an empty position so a required seventh character can be
placed correctly
B. To identify a CPT modifier
C. To indicate a diagnosis is uncertain
D. To replace a missing diagnosis
Answer: A
Rationale: Placeholder “X” maintains the required character position in
certain ICD-10-CM codes.
11. Which character is commonly used as an ICD-10-CM placeholder?
A. P
B. X
C. Z
D. Q
Answer: B
Rationale: “X” is used as a placeholder in specified ICD-10-CM codes.
12. What is the purpose of a seventh character in certain ICD-10-CM
categories?
A. It can provide required information such as encounter or healing
status
B. It identifies the payer
C. It replaces the diagnosis
D. It identifies a CPT procedure
Answer: A
Rationale: Certain categories require a seventh character to convey
additional clinical information.
13. In injury coding, what can the seventh character “A” represent?
A. Initial encounter
