Solution and Answer Guide
GREEN, 3-2-1 CODE IT! 2025, 979821411098; CHAPTER 1: OVERVIEW OF CODING
Table of Contents
Exercises 1
Exercise 1.1: Career as a Coder 1
Exercise 1.2: Professional Associations 2
Exercise 1.3: Coding Systems and Processes 3
Exercise 1.4: Other Classification Systems and Databases 4
Exercise 1.5: Documentation as Basis for Coding 6
Exercise 1.6: Health Data Collection 8
Review 9
Multiple Choice 9
Exercises
Exercise 1.1: Career as a Coder
1. A coder is required to have a working knowledge of the CPT, HCPCS Level II, ICD-10-
CM, and __________ coding systems.
Answer: ICD-10-PCS
Analysis: A coder must have a working knowledge of the CPT, HCPCS Level II,
ICD-10-CM, and ICD-10-PCS coding systems.
2. The complexity and intensity of procedures performed and services provided during
an outpatient or physician office encounter are captured as part of __________
coding.
Answer: professional
Analysis: The complexity and intensity of procedures performed and services
provided during an outpatient or physician office encounter are captured as part
of professional coding.
3. The intensity of services and severity of illness associated with inpatient care are
captured as part of __________ (or facility) coding.
, Answer: institutional
Analysis: The intensity of services and severity of illness associated with inpatient
care are captured as part of institutional (or facility) coding.
4. When a multi-hospital system provides physician office services along with
traditional inpatient, outpatient, and emergency department hospital care, the
concept of __________ coding is adopted to facilitate professional and institutional
billing.
Answer: single-path
Analysis: When a multi-hospital system provides physician office services along
with traditional inpatient, outpatient, and emergency department hospital care,
the concept of single-path coding is adopted to facilitate professional and
institutional billing.
5. A profession that is closely related to that of a coder is a health __________
specialist (or claims examiner). This role involves reviewing health-related claims to
determine whether the costs are reasonable and medically necessary based on the
patient’s diagnosis reported for procedures performed and services provided.
Answer: insurance
Analysis: A profession that is closely related to that of a coder is a health
insurance specialist (or claims examiner). This role involves reviewing health-
related claims to determine whether the costs are reasonable and medically
necessary based on the patient’s diagnosis reported for procedures performed
and services provided.
Exercise 1.2: Professional Associations
1. Students who become members of __________ associations usually pay a reduced
membership fee.
Answer: professional
Analysis: Students who become members of professional associations usually
pay a reduced membership fee.
2. Attending professional association conferences and meetings provides
opportunities to __________ (or interact) with other professionals, which can
facilitate internship or job placement.
Answer: network
Analysis: Attending professional association conferences and meetings provides
opportunities to network (or interact) with other professionals, which can
facilitate internship or job placement.
3. A medical assistant usually joins the American Medical Technologists (AMT) or the
__________.
, Answer: American Association of Medical Assistants (AAMA)
Analysis: A medical assistant usually joins the American Medical Technologists
(AMT) or the American Association of Medical Assistants (AAMA).
4. An Internet-based discussion forum that covers a variety of professional topics and
issues is called an online __________ board.
Answer: discussion
Analysis: An Internet-based discussion forum that covers a variety of professional
topics and issues is called an online discussion board.
5. A coder usually joins either the American Health Information Management
Association (AHIMA) or the __________.
Answer: AAPC
Analysis: A coder usually joins either the American Health Information
Management Association (AHIMA) or the AAPC. (The AAPC was founded as the
American Academy of Professional Coders and uses just the abbreviation today.)
Exercise 1.3: Coding Systems and Processes
1. A medical nomenclature that is organized according to similar conditions, diseases,
procedures, and services, and contains codes for each, is called a __________ (or
classification) system.
Answer: coding
Analysis: A medical nomenclature that is organized according to similar
conditions, diseases, procedures, and services, and contains codes for each, is
called a coding (or classification) system.
2. All diseases, injuries, and reasons for an encounter, whether patients are treated as
inpatients or outpatients, are coded using the __________ classification system.
Answer: ICD-10-CM
Analysis: All diseases, injuries, and reasons for an encounter, whether patients
are treated as inpatients or outpatients, are coded using the ICD-10-CM
classification system.
3. Inpatient hospital procedures and services are coded using the __________
classification system.
Answer: ICD-10-PCS
Analysis: Inpatient hospital procedures and services are coded using the ICD-10-
PCS classification system.
, 4. A public or private entity that processes or facilitates the processing of health
information and claims from a nonstandard to a standard format is called a health
care __________.
Answer: clearinghouse
Analysis: A public or private entity that processes or facilitates the processing of
health information and claims from a nonstandard to a standard format is called
a health care clearinghouse.
5. Routinely assigning lower-level CPT codes for convenience instead of reviewing
patient record documentation and the coding manual to determine the proper code
to be reported is called __________.
Answer: downcoding
Analysis: Routinely assigning lower-level CPT codes as a convenience instead of
reviewing patient record documentation and the coding manual to determine the
proper code to be reported is called downcoding.
6. Reporting codes that are not supported by documentation in the patient record for
the purpose of increasing reimbursement is called __________.
Answer: upcoding
Analysis: Reporting codes that are not supported by documentation in the patient
record for the purpose of increasing reimbursement is called upcoding.
7. Reporting codes for signs and symptoms in addition to the established diagnosis
code is called __________.
Answer: overcoding
Analysis: Reporting codes for signs and symptoms in addition to the established
diagnosis code is called overcoding.
8. Reporting multiple codes to increase reimbursement when a single combination
code should be reported is called __________.
Answer: unbundling
Analysis: Reporting multiple codes to increase reimbursement when a single
combination code should be reported is called unbundling.
9. Coders should always avoid assumption coding, and can do so by generating a
physician __________ when documentation needs clarification prior to the
assignment of codes.
Answer: query
Analysis: Coders should always avoid assumption coding, and can do so by
generating a physician query when documentation needs clarification prior to the
assignment of codes.
GREEN, 3-2-1 CODE IT! 2025, 979821411098; CHAPTER 1: OVERVIEW OF CODING
Table of Contents
Exercises 1
Exercise 1.1: Career as a Coder 1
Exercise 1.2: Professional Associations 2
Exercise 1.3: Coding Systems and Processes 3
Exercise 1.4: Other Classification Systems and Databases 4
Exercise 1.5: Documentation as Basis for Coding 6
Exercise 1.6: Health Data Collection 8
Review 9
Multiple Choice 9
Exercises
Exercise 1.1: Career as a Coder
1. A coder is required to have a working knowledge of the CPT, HCPCS Level II, ICD-10-
CM, and __________ coding systems.
Answer: ICD-10-PCS
Analysis: A coder must have a working knowledge of the CPT, HCPCS Level II,
ICD-10-CM, and ICD-10-PCS coding systems.
2. The complexity and intensity of procedures performed and services provided during
an outpatient or physician office encounter are captured as part of __________
coding.
Answer: professional
Analysis: The complexity and intensity of procedures performed and services
provided during an outpatient or physician office encounter are captured as part
of professional coding.
3. The intensity of services and severity of illness associated with inpatient care are
captured as part of __________ (or facility) coding.
, Answer: institutional
Analysis: The intensity of services and severity of illness associated with inpatient
care are captured as part of institutional (or facility) coding.
4. When a multi-hospital system provides physician office services along with
traditional inpatient, outpatient, and emergency department hospital care, the
concept of __________ coding is adopted to facilitate professional and institutional
billing.
Answer: single-path
Analysis: When a multi-hospital system provides physician office services along
with traditional inpatient, outpatient, and emergency department hospital care,
the concept of single-path coding is adopted to facilitate professional and
institutional billing.
5. A profession that is closely related to that of a coder is a health __________
specialist (or claims examiner). This role involves reviewing health-related claims to
determine whether the costs are reasonable and medically necessary based on the
patient’s diagnosis reported for procedures performed and services provided.
Answer: insurance
Analysis: A profession that is closely related to that of a coder is a health
insurance specialist (or claims examiner). This role involves reviewing health-
related claims to determine whether the costs are reasonable and medically
necessary based on the patient’s diagnosis reported for procedures performed
and services provided.
Exercise 1.2: Professional Associations
1. Students who become members of __________ associations usually pay a reduced
membership fee.
Answer: professional
Analysis: Students who become members of professional associations usually
pay a reduced membership fee.
2. Attending professional association conferences and meetings provides
opportunities to __________ (or interact) with other professionals, which can
facilitate internship or job placement.
Answer: network
Analysis: Attending professional association conferences and meetings provides
opportunities to network (or interact) with other professionals, which can
facilitate internship or job placement.
3. A medical assistant usually joins the American Medical Technologists (AMT) or the
__________.
, Answer: American Association of Medical Assistants (AAMA)
Analysis: A medical assistant usually joins the American Medical Technologists
(AMT) or the American Association of Medical Assistants (AAMA).
4. An Internet-based discussion forum that covers a variety of professional topics and
issues is called an online __________ board.
Answer: discussion
Analysis: An Internet-based discussion forum that covers a variety of professional
topics and issues is called an online discussion board.
5. A coder usually joins either the American Health Information Management
Association (AHIMA) or the __________.
Answer: AAPC
Analysis: A coder usually joins either the American Health Information
Management Association (AHIMA) or the AAPC. (The AAPC was founded as the
American Academy of Professional Coders and uses just the abbreviation today.)
Exercise 1.3: Coding Systems and Processes
1. A medical nomenclature that is organized according to similar conditions, diseases,
procedures, and services, and contains codes for each, is called a __________ (or
classification) system.
Answer: coding
Analysis: A medical nomenclature that is organized according to similar
conditions, diseases, procedures, and services, and contains codes for each, is
called a coding (or classification) system.
2. All diseases, injuries, and reasons for an encounter, whether patients are treated as
inpatients or outpatients, are coded using the __________ classification system.
Answer: ICD-10-CM
Analysis: All diseases, injuries, and reasons for an encounter, whether patients
are treated as inpatients or outpatients, are coded using the ICD-10-CM
classification system.
3. Inpatient hospital procedures and services are coded using the __________
classification system.
Answer: ICD-10-PCS
Analysis: Inpatient hospital procedures and services are coded using the ICD-10-
PCS classification system.
, 4. A public or private entity that processes or facilitates the processing of health
information and claims from a nonstandard to a standard format is called a health
care __________.
Answer: clearinghouse
Analysis: A public or private entity that processes or facilitates the processing of
health information and claims from a nonstandard to a standard format is called
a health care clearinghouse.
5. Routinely assigning lower-level CPT codes for convenience instead of reviewing
patient record documentation and the coding manual to determine the proper code
to be reported is called __________.
Answer: downcoding
Analysis: Routinely assigning lower-level CPT codes as a convenience instead of
reviewing patient record documentation and the coding manual to determine the
proper code to be reported is called downcoding.
6. Reporting codes that are not supported by documentation in the patient record for
the purpose of increasing reimbursement is called __________.
Answer: upcoding
Analysis: Reporting codes that are not supported by documentation in the patient
record for the purpose of increasing reimbursement is called upcoding.
7. Reporting codes for signs and symptoms in addition to the established diagnosis
code is called __________.
Answer: overcoding
Analysis: Reporting codes for signs and symptoms in addition to the established
diagnosis code is called overcoding.
8. Reporting multiple codes to increase reimbursement when a single combination
code should be reported is called __________.
Answer: unbundling
Analysis: Reporting multiple codes to increase reimbursement when a single
combination code should be reported is called unbundling.
9. Coders should always avoid assumption coding, and can do so by generating a
physician __________ when documentation needs clarification prior to the
assignment of codes.
Answer: query
Analysis: Coders should always avoid assumption coding, and can do so by
generating a physician query when documentation needs clarification prior to the
assignment of codes.
