NCCT Insurance and Coding Specialist
Certification Exam (NCICS) Practice
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. Which of the following is the primary purpose of medical coding?
A. Scheduling patient appointments
B. Translating medical diagnoses and procedures into standardized
codes
C. Filing insurance claims
D. Collecting patient payments
Rationale: Medical coding ensures that diagnoses, procedures, and services
are consistently documented for billing, insurance, and statistical purposes.
, 2. Which coding system is used to report diagnoses in the United States?
A. CPT
B. HCPCS
C. ICD-10-CM
D. DSM-5
Rationale: ICD-10-CM (International Classification of Diseases, 10th Revision,
Clinical Modification) is used for coding diagnoses.
3. What does CPT stand for in medical coding?
A. Clinical Procedure Table
B. Current Procedural Terminology
C. Certified Procedure Test
D. Clinical Practice Technique
Rationale: CPT codes are used to describe medical, surgical, and diagnostic
procedures.
4. A patient presents with chest pain, and the provider documents
angina pectoris. Which code set is used to report this diagnosis?
A. CPT
B. ICD-10-CM
C. HCPCS Level II
D. DRG
,Rationale: ICD-10-CM codes report medical diagnoses such as angina
pectoris.
5. Which type of insurance requires patients to choose a primary care
provider and obtain referrals for specialist care?
A. PPO
B. HMO
C. POS
D. Indemnity
Rationale: Health Maintenance Organizations (HMOs) require PCPs and
referrals to control costs and coordinate care.
6. When a patient has both Medicare and a secondary insurance, the
secondary insurance is called:
A. Primary payer
B. Self-pay
C. Secondary payer
D. Co-insurance
Rationale: Secondary insurance covers amounts not paid by the primary
insurer.
, 7. Which of the following is considered fraud in medical billing?
A. Submitting a claim for services rendered
B. Correcting a coding error
C. Billing for services not provided
D. Verifying patient insurance
Rationale: Fraud involves intentional deception for financial gain, such as
billing for services that were never performed.
8. What is the purpose of a CPT modifier?
A. To identify the diagnosis
B. To provide additional information about a procedure
C. To report lab results
D. To submit claims electronically
Rationale: Modifiers indicate special circumstances of a service, such as
multiple procedures or altered service.
9. Which of the following is a characteristic of a PPO insurance plan?
A. Requires referrals for specialists
B. Allows patients to see providers outside the network
C. Only covers emergency care
D. Requires monthly premiums only
Certification Exam (NCICS) Practice
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. Which of the following is the primary purpose of medical coding?
A. Scheduling patient appointments
B. Translating medical diagnoses and procedures into standardized
codes
C. Filing insurance claims
D. Collecting patient payments
Rationale: Medical coding ensures that diagnoses, procedures, and services
are consistently documented for billing, insurance, and statistical purposes.
, 2. Which coding system is used to report diagnoses in the United States?
A. CPT
B. HCPCS
C. ICD-10-CM
D. DSM-5
Rationale: ICD-10-CM (International Classification of Diseases, 10th Revision,
Clinical Modification) is used for coding diagnoses.
3. What does CPT stand for in medical coding?
A. Clinical Procedure Table
B. Current Procedural Terminology
C. Certified Procedure Test
D. Clinical Practice Technique
Rationale: CPT codes are used to describe medical, surgical, and diagnostic
procedures.
4. A patient presents with chest pain, and the provider documents
angina pectoris. Which code set is used to report this diagnosis?
A. CPT
B. ICD-10-CM
C. HCPCS Level II
D. DRG
,Rationale: ICD-10-CM codes report medical diagnoses such as angina
pectoris.
5. Which type of insurance requires patients to choose a primary care
provider and obtain referrals for specialist care?
A. PPO
B. HMO
C. POS
D. Indemnity
Rationale: Health Maintenance Organizations (HMOs) require PCPs and
referrals to control costs and coordinate care.
6. When a patient has both Medicare and a secondary insurance, the
secondary insurance is called:
A. Primary payer
B. Self-pay
C. Secondary payer
D. Co-insurance
Rationale: Secondary insurance covers amounts not paid by the primary
insurer.
, 7. Which of the following is considered fraud in medical billing?
A. Submitting a claim for services rendered
B. Correcting a coding error
C. Billing for services not provided
D. Verifying patient insurance
Rationale: Fraud involves intentional deception for financial gain, such as
billing for services that were never performed.
8. What is the purpose of a CPT modifier?
A. To identify the diagnosis
B. To provide additional information about a procedure
C. To report lab results
D. To submit claims electronically
Rationale: Modifiers indicate special circumstances of a service, such as
multiple procedures or altered service.
9. Which of the following is a characteristic of a PPO insurance plan?
A. Requires referrals for specialists
B. Allows patients to see providers outside the network
C. Only covers emergency care
D. Requires monthly premiums only
