Spring SemeSter 2026 | medical Billing & coding
(cpc/ccS) certification exam – complete icd-10-
cm, cpt & HcpcS coding review, medical
documentation, reimBurSement metHodologieS,
compliance & etHicS, caSe-BaSed coding
ScenarioS, practice QueStionS & HigH-Yield
certification preparation
Question 1:
Which of the following coding systems is primarily used for outpatient medical
services?
A) ICD-10-CM
B) CPT
C) HCPCS Level II
D) CPT and HCPCS Level II
Correct Option: D) CPT and HCPCS Level II
Rationale: Both CPT (Current Procedural Terminology) and HCPCS Level II (Healthcare
Common Procedure Coding System) are essential for coding outpatient services. CPT
codes describe medical, surgical, and diagnostic services, while HCPCS Level II codes
cover products, supplies, and non-physician services.
Question 2:
In the context of general insurance reimbursement, what does "co-payment" refer
to?
A) A fee the insurance company pays a provider after a service is rendered
B) A fixed amount a patient pays for a covered healthcare service at the time of service
C) The total amount billed to the insurance company by healthcare providers
D) A percentage of the medical bill that the patient is responsible for after the
deductible
Correct Option: B) A fixed amount a patient pays for a covered healthcare service at
the time of service
Rationale: A co-payment is a fixed dollar amount that a patient pays at the time of
receiving a medical service. It is a form of cost-sharing between the patient and the
insurance company.
, Question 3:
Which of the following statements best defines the term "revenue cycle
management" in healthcare?
A) The process of collecting and maintaining patient records
B) A set of practices that healthcare organizations use to track patient care episodes
from registration to billing
C) The management of healthcare staffing and operations
D) The process of coding and submitting claims for patient reimbursement
Correct Option: B) A set of practices that healthcare organizations use to track
patient care episodes from registration to billing
Rationale: Revenue cycle management involves managing the financial process of
patient care, tracking the lifecycle of a patient encounter from the initial contact through
financial clearance and claim processing to final payment.
Question 4:
What is the significance of 'modifiers' in CPT coding?
A) They are used to denote a complete procedure.
B) They provide additional information about a service or procedure that has been
performed.
C) They ensure that procedures are billed at a higher rate.
D) They serve as an alternative coding system for government reimbursement purposes.
Correct Option: B) They provide additional information about a service or
procedure that has been performed
Rationale: Modifiers are two-digit codes used in conjunction with CPT codes to indicate
that a service or procedure has been altered in some way, providing information
necessary for correct billing and payment.
Question 5:
Which of the following would NOT be considered a HIPAA violation?
A) A healthcare provider discussing a patient’s case in a public area
B) An administrative clerk accessing patient records without a job-related reason
C) A nurse sharing patient information with another healthcare provider for treatment
purposes
D) An employer requesting medical records as part of an employment contract
Correct Option: C) A nurse sharing patient information with another healthcare
provider for treatment purposes
(cpc/ccS) certification exam – complete icd-10-
cm, cpt & HcpcS coding review, medical
documentation, reimBurSement metHodologieS,
compliance & etHicS, caSe-BaSed coding
ScenarioS, practice QueStionS & HigH-Yield
certification preparation
Question 1:
Which of the following coding systems is primarily used for outpatient medical
services?
A) ICD-10-CM
B) CPT
C) HCPCS Level II
D) CPT and HCPCS Level II
Correct Option: D) CPT and HCPCS Level II
Rationale: Both CPT (Current Procedural Terminology) and HCPCS Level II (Healthcare
Common Procedure Coding System) are essential for coding outpatient services. CPT
codes describe medical, surgical, and diagnostic services, while HCPCS Level II codes
cover products, supplies, and non-physician services.
Question 2:
In the context of general insurance reimbursement, what does "co-payment" refer
to?
A) A fee the insurance company pays a provider after a service is rendered
B) A fixed amount a patient pays for a covered healthcare service at the time of service
C) The total amount billed to the insurance company by healthcare providers
D) A percentage of the medical bill that the patient is responsible for after the
deductible
Correct Option: B) A fixed amount a patient pays for a covered healthcare service at
the time of service
Rationale: A co-payment is a fixed dollar amount that a patient pays at the time of
receiving a medical service. It is a form of cost-sharing between the patient and the
insurance company.
, Question 3:
Which of the following statements best defines the term "revenue cycle
management" in healthcare?
A) The process of collecting and maintaining patient records
B) A set of practices that healthcare organizations use to track patient care episodes
from registration to billing
C) The management of healthcare staffing and operations
D) The process of coding and submitting claims for patient reimbursement
Correct Option: B) A set of practices that healthcare organizations use to track
patient care episodes from registration to billing
Rationale: Revenue cycle management involves managing the financial process of
patient care, tracking the lifecycle of a patient encounter from the initial contact through
financial clearance and claim processing to final payment.
Question 4:
What is the significance of 'modifiers' in CPT coding?
A) They are used to denote a complete procedure.
B) They provide additional information about a service or procedure that has been
performed.
C) They ensure that procedures are billed at a higher rate.
D) They serve as an alternative coding system for government reimbursement purposes.
Correct Option: B) They provide additional information about a service or
procedure that has been performed
Rationale: Modifiers are two-digit codes used in conjunction with CPT codes to indicate
that a service or procedure has been altered in some way, providing information
necessary for correct billing and payment.
Question 5:
Which of the following would NOT be considered a HIPAA violation?
A) A healthcare provider discussing a patient’s case in a public area
B) An administrative clerk accessing patient records without a job-related reason
C) A nurse sharing patient information with another healthcare provider for treatment
purposes
D) An employer requesting medical records as part of an employment contract
Correct Option: C) A nurse sharing patient information with another healthcare
provider for treatment purposes
