CERTIFIED PROFESSIONAL PROPERTY
SPECIALIST FINAL PAPER 2026 EXAM Q&A
STUDY GUIDE COMPLETE SOLUTIONS
◉ Proper code assignment is determined by. Answer: content of the
medical record and by the unique rules that governs each code set
◉ what are 3 things that Coder must master. Answer: 1. anatomy
2. medical terminology
3. must be detail-oriented
◉ Medical coders assign a code to what. Answer: 1. Each diagnosis
2. service/procedure
3. Supply, using the classification system when applicable
◉ The classification system determines what. Answer: the amount
health care providers will be reimbursed if the patient is covered by
Medicare, Medicaid, or other insurance programs using the system
◉ A coder must evaluate the medical record for. Answer: 1.
completeness and accuracy
,2. communicate regularly with physicians and othe health care
professional to clarify DX or obtain additonal PT info.
◉ Techicians who speciallize in coding inpatient hospital services are
referred as. Answer: 1. Health information coders
2. medical record coders
3. Coder/abstractors
4. Coding Specialist
◉ What is MS-DRGs and what is it. Answer: 1. Medicare Severity-
Diagnosis Related Groups
2. Determines the amt the hospital will be reimbursed if the PT is
covered by Medicare or other insurance programs
◉ What is EHR. Answer: Electronic health record
◉ Skill coders may become. Answer: consulatants, educators or medical
auditors
◉ What is the difference between Hospital and Physican Services.
Answer: 1. Outpatient coding (physician services)- learning CPT,
HCPCS, LEVEL II, ICD-9 CM codes Volume 1 and 2
2. Inpatient coding (Hospital services)- Learning CPT, ICD-9 CM codes
Volumes 1,2,3 and MS-DRGS
,◉ What is APC and who uses it. Answer: Ambulatory Payment
Classification- outpatient facility coders (physician services
◉ What is the coder role in a physician's office. Answer: Extremely
important to proper reimbursement and the livelihood of the physican
◉ What is a physican degree of education. Answer: 4 years of college, 4
years of medical school plus 3 to 5 years of residency.
◉ What is a mid-level providers and who. Answer: 1. Mid-level
providers are know as physician extenders
2. Physician assistants (PA) and Nurse Practitioners (NP)
◉ What are the requirement for a PA and what. Answer: 1. 26 1/2 month
to complete
2. Lincense to practice medicine with physician supervision
◉ NP must have. Answer: A Master Degree in Nursing
◉ How many payers in the most simplest form?. Answer: 2
Private insurance plans and government insurance plans
, ◉ Commerical carriers are considered what. Answer: Private payers that
offer both group and individual plans.
◉ Private Payers contracts may. Answer: Vary but may include
hospitalization, basic and major medical coverage.
◉ What is the most significant government insurer. Answer: Medicare
◉ What is Medicare. Answer: Federal health insurance program-
Administerd by the Center for Medicare &Medicaid Services (CMS)
◉ What is CMS and what does it provide. Answer: Center for Medicare
& Medicaid Services (CMS) provides coverage for people over the age
of 65, blind, or disabled individuals, people with end -stage renal disease
◉ CMS regulations often serves as ____ word in coding requirement for
Medicare and Non-Medicare payers alike. Answer: Last
◉ What are the parts of Medicare. Answer: Medicare A
Medicare B
Medicare C
Medicare D
SPECIALIST FINAL PAPER 2026 EXAM Q&A
STUDY GUIDE COMPLETE SOLUTIONS
◉ Proper code assignment is determined by. Answer: content of the
medical record and by the unique rules that governs each code set
◉ what are 3 things that Coder must master. Answer: 1. anatomy
2. medical terminology
3. must be detail-oriented
◉ Medical coders assign a code to what. Answer: 1. Each diagnosis
2. service/procedure
3. Supply, using the classification system when applicable
◉ The classification system determines what. Answer: the amount
health care providers will be reimbursed if the patient is covered by
Medicare, Medicaid, or other insurance programs using the system
◉ A coder must evaluate the medical record for. Answer: 1.
completeness and accuracy
,2. communicate regularly with physicians and othe health care
professional to clarify DX or obtain additonal PT info.
◉ Techicians who speciallize in coding inpatient hospital services are
referred as. Answer: 1. Health information coders
2. medical record coders
3. Coder/abstractors
4. Coding Specialist
◉ What is MS-DRGs and what is it. Answer: 1. Medicare Severity-
Diagnosis Related Groups
2. Determines the amt the hospital will be reimbursed if the PT is
covered by Medicare or other insurance programs
◉ What is EHR. Answer: Electronic health record
◉ Skill coders may become. Answer: consulatants, educators or medical
auditors
◉ What is the difference between Hospital and Physican Services.
Answer: 1. Outpatient coding (physician services)- learning CPT,
HCPCS, LEVEL II, ICD-9 CM codes Volume 1 and 2
2. Inpatient coding (Hospital services)- Learning CPT, ICD-9 CM codes
Volumes 1,2,3 and MS-DRGS
,◉ What is APC and who uses it. Answer: Ambulatory Payment
Classification- outpatient facility coders (physician services
◉ What is the coder role in a physician's office. Answer: Extremely
important to proper reimbursement and the livelihood of the physican
◉ What is a physican degree of education. Answer: 4 years of college, 4
years of medical school plus 3 to 5 years of residency.
◉ What is a mid-level providers and who. Answer: 1. Mid-level
providers are know as physician extenders
2. Physician assistants (PA) and Nurse Practitioners (NP)
◉ What are the requirement for a PA and what. Answer: 1. 26 1/2 month
to complete
2. Lincense to practice medicine with physician supervision
◉ NP must have. Answer: A Master Degree in Nursing
◉ How many payers in the most simplest form?. Answer: 2
Private insurance plans and government insurance plans
, ◉ Commerical carriers are considered what. Answer: Private payers that
offer both group and individual plans.
◉ Private Payers contracts may. Answer: Vary but may include
hospitalization, basic and major medical coverage.
◉ What is the most significant government insurer. Answer: Medicare
◉ What is Medicare. Answer: Federal health insurance program-
Administerd by the Center for Medicare &Medicaid Services (CMS)
◉ What is CMS and what does it provide. Answer: Center for Medicare
& Medicaid Services (CMS) provides coverage for people over the age
of 65, blind, or disabled individuals, people with end -stage renal disease
◉ CMS regulations often serves as ____ word in coding requirement for
Medicare and Non-Medicare payers alike. Answer: Last
◉ What are the parts of Medicare. Answer: Medicare A
Medicare B
Medicare C
Medicare D
