2025
Medical Coding Training: CPC®
Practical Application Workbook—Answer Key
,Contents
Chapter 1
The Business of Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 2
Medical Terminology and Anatomy Review. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Chapter 3
Introduction to ICD-10-CM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Chapter 4
ICD-10-CM Coding Chapters 1–11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Chapter 5
ICD-10-CM Coding Chapters 12–21. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Chapter 6
Introduction to CPT®, Surgery Guidelines, HCPCS Level II, and Modifiers . . . . . . . . . . . . . . . . . . 29
Chapter 7
Integumentary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Chapter 8
Musculoskeletal System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
Chapter 9
Respiratory, Hemic, Lymphatic, Mediastinum, and Diaphragm . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Chapter 10
Cardiovascular System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Chapter 11
Digestive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Chapter 12
Urinary System and Male Genital System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
,Contents
Chapter 13
Female Reproductive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Chapter 14
Endocrine and Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Chapter 15
Eye and Ocular Adnexa, Auditory Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Chapter 16
Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Chapter 17
Radiology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Chapter 18
Pathology and Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Chapter 19
Evaluation and Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Chapter 20
Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
, Chapter
1 The Business of Medicine
Exercise 1
1. What type of profession, other than coding, might a skilled coder enter?
Answer: Consultants, educators, medical auditors
2. What is the difference between outpatient and inpatient coding?
Answer: Outpatient coders focus on assigning CPT®, HCPCS Level II, and ICD-10-CM codes. They work in provider offices,
outpatient clinics and facility outpatient departments. Outpatient facility coders also work with ambulatory payment
classifications (APCs). Outpatient coders usually have more interaction throughout the day and must communicate well with
providers.
Inpatient hospital coding focuses on a different subset of skills, where coders work with ICD-10-CM and ICD-10-PCS. These
coders also assign Medicare severity-diagnosis related groups (MS-DRGs) for reimbursement. Inpatient coders tend to have
less interaction throughout the day.
3. What is a mid-level provider?
Answer: Mid-level providers include physician assistants (PA) and nurse practitioners (NP). Mid-level providers are known
also as physician extenders because they extend the work of a physician.
4. Discuss the different parts of Medicare and what each program covers.
Answer:
l Medicare Part A helps to cover inpatient hospital care, as well as care provided in skilled nursing facilities, hospice
care, and home healthcare.
l Medicare Part B covers two types of services: 1) Medically necessary provider services that are needed to diagnose or
treat a medical condition and that meet accepted standards of medical practice; and 2) preventive services to prevent
illness or detect it at an early stage. Medicare Part B is an optional benefit for which the patient pays a premium, an
annual deductible and generally has a 20% co-insurance except for preventive services covered under healthcare law.
Coders working in provider offices code mainly Medicare Part B claims.
l Medicare Part C, also called Medicare Advantage, combines the benefits of Medicare Part A, Part B and sometimes Part
D. The plans are managed by private insurers approved by Medicare and may include preferred provider organizations,
health maintenance organizations, etc.
l Medicare Part D is a prescription drug coverage program available to all Medicare beneficiaries for a fee. Private
companies approved by Medicare provide the coverage.
Medical Coding Training: CPC®
Practical Application Workbook—Answer Key
,Contents
Chapter 1
The Business of Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 2
Medical Terminology and Anatomy Review. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Chapter 3
Introduction to ICD-10-CM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Chapter 4
ICD-10-CM Coding Chapters 1–11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Chapter 5
ICD-10-CM Coding Chapters 12–21. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Chapter 6
Introduction to CPT®, Surgery Guidelines, HCPCS Level II, and Modifiers . . . . . . . . . . . . . . . . . . 29
Chapter 7
Integumentary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Chapter 8
Musculoskeletal System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
Chapter 9
Respiratory, Hemic, Lymphatic, Mediastinum, and Diaphragm . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Chapter 10
Cardiovascular System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Chapter 11
Digestive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Chapter 12
Urinary System and Male Genital System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
,Contents
Chapter 13
Female Reproductive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Chapter 14
Endocrine and Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Chapter 15
Eye and Ocular Adnexa, Auditory Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Chapter 16
Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Chapter 17
Radiology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Chapter 18
Pathology and Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Chapter 19
Evaluation and Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Chapter 20
Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
, Chapter
1 The Business of Medicine
Exercise 1
1. What type of profession, other than coding, might a skilled coder enter?
Answer: Consultants, educators, medical auditors
2. What is the difference between outpatient and inpatient coding?
Answer: Outpatient coders focus on assigning CPT®, HCPCS Level II, and ICD-10-CM codes. They work in provider offices,
outpatient clinics and facility outpatient departments. Outpatient facility coders also work with ambulatory payment
classifications (APCs). Outpatient coders usually have more interaction throughout the day and must communicate well with
providers.
Inpatient hospital coding focuses on a different subset of skills, where coders work with ICD-10-CM and ICD-10-PCS. These
coders also assign Medicare severity-diagnosis related groups (MS-DRGs) for reimbursement. Inpatient coders tend to have
less interaction throughout the day.
3. What is a mid-level provider?
Answer: Mid-level providers include physician assistants (PA) and nurse practitioners (NP). Mid-level providers are known
also as physician extenders because they extend the work of a physician.
4. Discuss the different parts of Medicare and what each program covers.
Answer:
l Medicare Part A helps to cover inpatient hospital care, as well as care provided in skilled nursing facilities, hospice
care, and home healthcare.
l Medicare Part B covers two types of services: 1) Medically necessary provider services that are needed to diagnose or
treat a medical condition and that meet accepted standards of medical practice; and 2) preventive services to prevent
illness or detect it at an early stage. Medicare Part B is an optional benefit for which the patient pays a premium, an
annual deductible and generally has a 20% co-insurance except for preventive services covered under healthcare law.
Coders working in provider offices code mainly Medicare Part B claims.
l Medicare Part C, also called Medicare Advantage, combines the benefits of Medicare Part A, Part B and sometimes Part
D. The plans are managed by private insurers approved by Medicare and may include preferred provider organizations,
health maintenance organizations, etc.
l Medicare Part D is a prescription drug coverage program available to all Medicare beneficiaries for a fee. Private
companies approved by Medicare provide the coverage.
