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Medical Coding Exam Guide (100+ Expert Q&A) – ICD-10-CM/PCS, CPT, HCPCS, Modifiers, Ethics | 2025/2026

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This detailed exam guide features over 100 expert-verified questions and answers, covering all major areas of medical coding for students and professionals preparing for certification exams in 2025/2026. Designed for real-world relevance, this resource spans both outpatient and inpatient coding, with special attention to diagnostic and procedural coding systems, compliance, and reimbursement documentation. Topics comprehensively addressed include: ICD-10-CM and ICD-10-PCS: Code structure, chapter hierarchy, main terms, specificity, laterality, excludes notes, Z-codes, sequelae, and root operations for inpatient procedures CPT coding: Evaluation & Management (E/M), surgery sections, anesthesia modifiers (P1–P6), code symbols (triangle, bullet), panel reporting, and use of unlisted codes HCPCS Level II: J-codes for non-orally administered drugs, supply/equipment reporting, and services outside the CPT code range Modifiers and surgical packages: Correct modifier use (-24, -51, -52, -81), global periods, bundled services, and surgical follow-up Medical necessity & documentation: SOAP notes, appropriate diagnosis-procedure linkage, and accurate code sequencing Regulatory compliance: HIPAA Privacy Rule, coding fraud vs. abuse, the role of CMS, AAPC, and AHIMA in industry ethics and oversight Specialty coding: Obstetrics, dermatology, neurology, psychiatry, ENT, endocrine, and GI procedures with appropriate CPT codes Diagnostic and procedural tools: Use of Alphabetic Index, Tabular List, CPT appendices, ICD-10-PCS Tables and Index, and coding based on site, service, and condition This resource is perfect for: Students in medical coding, billing, HIT, and HIM programs Candidates preparing for CPC, CCS, CBCS, or CCA exams Instructors developing assessments or training material Coders seeking a refresher on ethics, compliance, or multi-setting procedure coding Its well-organized Q&A structure ensures fast recall, deep understanding, and practical application across all domains of professional medical coding. Keywords: ICD-10-CM, ICD-10-PCS, CPT, HCPCS, coding exam, medical necessity, surgical modifiers, SOAP format, reimbursement, inpatient coding, outpatient coding, compliance, Z codes, sequencing rules, anesthesia coding, CMS, AAPC, AHIMA, medical ethics, procedural coding

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Medical Coding
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Uploaded on
January 16, 2026
Number of pages
34
Written in
2025/2026
Type
Exam (elaborations)
Contains
Questions & answers

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Medical Coding 2025/2026 Exam
Questions and Answers | A+ Score
Assured



Which of the following are characteristics of the index for the ICD-10-CM?




The main term represents the diseases, conditions, nouns, and adjectives

that you might see in the patient record.




The main term is the first place you go to locate the code for the patient's

disease or condition.

,Subterms or essential modifiers are located beneath the main term.




All of the above - 🧠ANSWER ✔✔All the above


Which of the following statements about coding in ICD-10-CM is most

correct?

Coders are not allowed to assign codes directly from the index without

obtaining physician confirmation.




It is an acceptable practice for coders to both reference and code directly

from the index.




It is not acceptable for coders to both reference and code directly from the

index.




None of the above - 🧠ANSWER ✔✔It is not acceptable for coders to both

reference and code directly from the index.

Which of the following statements about coding guidelines is most correct?

,Coding for inpatient and outpatient services uses the same coding

guidelines.




Coding for inpatient and outpatient services uses coding guidelines are

interchangeable, so it's acceptable to only memorize one set of codes.




Coding for inpatient and outpatient services uses different coding

guidelines.




None of the above - 🧠ANSWER ✔✔Coding for inpatient and outpatient

services uses different coding guidelines.

A combination code is a single code used to classify: ____________, or a

diagnosis with an associated secondary process (manifestation), or a

diagnosis with an associated complication.




additional codes



COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
3
STATEMENT. ALL RIGHTS RESERVED

, multiple codes




subterm entries




two diagnoses - 🧠ANSWER ✔✔two diagnoses


To accurately code, it's necessary for you to have in-depth knowledge of

medical terminology, anatomy and physiology, disease conditions, and

pharmacology, along with an understanding of the __________ coding

guidelines format and conventions.




AAPC's Medical Coding Code of Ethics




diagnosis




Medicare Catastrophic Coverage Act

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