1. In which scenario would you use an unlisted CPT code?
A. The procedure is experimental
B. The procedure is commonly performed
C. The procedure has a designated code
D. The procedure is not documented
Answer: a) The procedure is experimental
Rationale: Unlisted CPT codes are used when a procedure or
service is not specifically described by any other code.
2. Which of the following conditions would require the use of a
combination code in ICD-10-CM?
A. Osteoarthritis with obesity
B. Asthma with pneumonia
C. Hypertension and heart disease
D. Diabetes with hypertension
Answer: b) Asthma with pneumonia
Rationale: Combination codes in ICD-10-CM are used when two
diagnoses are combined into one code, as seen with asthma and
pneumonia.
,3. What is the primary purpose of a modifier in medical coding?
A. To reduce insurance payments
B. To indicate special circumstances about a procedure or service
C. To change the primary diagnosis
D. To indicate a different physician performing the service
Answer: b) To indicate special circumstances about a procedure or
service
Rationale: Modifiers are used to provide additional information
about a procedure, such as whether it was performed under
unusual circumstances or in a modified form.
4. When would you use an ICD-10-PCS code?
A. For coding outpatient diagnostic procedures
B. For coding inpatient procedures performed in a hospital setting
C. For coding physician office visits
D. For coding laboratory tests in an outpatient clinic
Answer: b) For coding inpatient procedures performed in a
hospital setting
Rationale: ICD-10-PCS codes are used specifically for inpatient
hospital procedures, distinguishing them from ICD-10-CM codes
used for diagnoses.
5. What is the purpose of the ICD-10-CM code system?
, A. To classify diseases and other health-related problems
B. To determine insurance reimbursement
C. To track patients' vital signs
D. To document physician consultations
Answer: a) To classify diseases and other health-related problems
Rationale: ICD-10-CM is used for the classification of diseases,
injuries, and other health-related problems, as well as to facilitate
statistical analysis, reimbursement, and billing.
6. Which of the following describes a "global period" in medical
billing?
A. The time between the initial consultation and the final payment
B. The period of time in which follow-up visits for a specific
procedure are covered
C. The time needed to perform a procedure
D. The length of time before a diagnosis code becomes effective
Answer: b) The period of time in which follow-up visits for a
specific procedure are covered
Rationale: A global period refers to the time frame during which
all services related to a specific procedure, including follow-up
visits, are considered part of the same procedure and not
reimbursed separately.
7. Which of the following is a valid use for a Z code?
A. The procedure is experimental
B. The procedure is commonly performed
C. The procedure has a designated code
D. The procedure is not documented
Answer: a) The procedure is experimental
Rationale: Unlisted CPT codes are used when a procedure or
service is not specifically described by any other code.
2. Which of the following conditions would require the use of a
combination code in ICD-10-CM?
A. Osteoarthritis with obesity
B. Asthma with pneumonia
C. Hypertension and heart disease
D. Diabetes with hypertension
Answer: b) Asthma with pneumonia
Rationale: Combination codes in ICD-10-CM are used when two
diagnoses are combined into one code, as seen with asthma and
pneumonia.
,3. What is the primary purpose of a modifier in medical coding?
A. To reduce insurance payments
B. To indicate special circumstances about a procedure or service
C. To change the primary diagnosis
D. To indicate a different physician performing the service
Answer: b) To indicate special circumstances about a procedure or
service
Rationale: Modifiers are used to provide additional information
about a procedure, such as whether it was performed under
unusual circumstances or in a modified form.
4. When would you use an ICD-10-PCS code?
A. For coding outpatient diagnostic procedures
B. For coding inpatient procedures performed in a hospital setting
C. For coding physician office visits
D. For coding laboratory tests in an outpatient clinic
Answer: b) For coding inpatient procedures performed in a
hospital setting
Rationale: ICD-10-PCS codes are used specifically for inpatient
hospital procedures, distinguishing them from ICD-10-CM codes
used for diagnoses.
5. What is the purpose of the ICD-10-CM code system?
, A. To classify diseases and other health-related problems
B. To determine insurance reimbursement
C. To track patients' vital signs
D. To document physician consultations
Answer: a) To classify diseases and other health-related problems
Rationale: ICD-10-CM is used for the classification of diseases,
injuries, and other health-related problems, as well as to facilitate
statistical analysis, reimbursement, and billing.
6. Which of the following describes a "global period" in medical
billing?
A. The time between the initial consultation and the final payment
B. The period of time in which follow-up visits for a specific
procedure are covered
C. The time needed to perform a procedure
D. The length of time before a diagnosis code becomes effective
Answer: b) The period of time in which follow-up visits for a
specific procedure are covered
Rationale: A global period refers to the time frame during which
all services related to a specific procedure, including follow-up
visits, are considered part of the same procedure and not
reimbursed separately.
7. Which of the following is a valid use for a Z code?
