CPCU 552 CP&L FINAL PRACTICE STUDY
GUIDE 2026 SOLVED QUESTIONS
◉ CPT is Answer: current procedural terminology
◉ HCPCS is Answer: healthcare common procedure coding system
◉ Who publishes CPT (Level I HCPCS)?
How often is it updated? When is it updated? Answer: AMA
publishes cpt,
it is updated annually, on Jan. 1 of each year
◉ CPT Category 1 codes consist of: Answer: Anesthesia, Evaluation
and management, surgery, radiology, pathology and laboratory,
medicine
◉ What are Category 2 CPT codes for?
What does the Category 2 code consist of? Answer: Performance
Measures
consist of 4 numbers followed by a capital F, such as 1000F
◉ What are Category 3 CPT codes for?
,What does the Category 3 code consist of? Answer: New & Emerging
Technology
consist of 4 numbers followed by a capital T, such as 2000T
◉ What are modifiers
Why are they used? Answer: Supplementary Codes
to provide additional information to a code
◉ What is a HCPCS level II code used to report?
What does the HCPCS level II code consist of? Answer: Are used for
supplies,
DME, injectable substances, dental and chiropractic as well as
orthotics
Structure: J1885 - capital letter followed by 4 numbers
◉ What are HCPCS level II codes also called? Answer: National codes
◉ Who developed the HCPCS level II codes? How often are they
updated? When are they updated? Answer: Developed by CMS,
they are updated yearly update Jan1
◉ NCCI Answer: National Correct Coding Initiative
, ◉ What does the National Correct Coding Initiative edits do?
Answer: Helps CMS to detect inappropriate codes submitted on
claims
- CPT coding guidelines
- Current standards of medical/surgical coding practice
- Advice from specialty societies
◉ List 3 NCCI edits and the definition of those edits. Answer: 1.
Comprehensive/component edit = edit pertains to HCPCS codes that
should NOT be used together.
2. Mutually exclusive edit = edit applies to improbable or impossible
combinations of codes
3. Medical unlikely edits = for part B claims, CMS has developed
medical unlikely edits to reduce error rates for items on the claim
form that reference units of service
◉ • (bullet) Answer: new code
◉ ; (semi-colon) Answer: main entry applies to & is part of all
indented entries that follow
GUIDE 2026 SOLVED QUESTIONS
◉ CPT is Answer: current procedural terminology
◉ HCPCS is Answer: healthcare common procedure coding system
◉ Who publishes CPT (Level I HCPCS)?
How often is it updated? When is it updated? Answer: AMA
publishes cpt,
it is updated annually, on Jan. 1 of each year
◉ CPT Category 1 codes consist of: Answer: Anesthesia, Evaluation
and management, surgery, radiology, pathology and laboratory,
medicine
◉ What are Category 2 CPT codes for?
What does the Category 2 code consist of? Answer: Performance
Measures
consist of 4 numbers followed by a capital F, such as 1000F
◉ What are Category 3 CPT codes for?
,What does the Category 3 code consist of? Answer: New & Emerging
Technology
consist of 4 numbers followed by a capital T, such as 2000T
◉ What are modifiers
Why are they used? Answer: Supplementary Codes
to provide additional information to a code
◉ What is a HCPCS level II code used to report?
What does the HCPCS level II code consist of? Answer: Are used for
supplies,
DME, injectable substances, dental and chiropractic as well as
orthotics
Structure: J1885 - capital letter followed by 4 numbers
◉ What are HCPCS level II codes also called? Answer: National codes
◉ Who developed the HCPCS level II codes? How often are they
updated? When are they updated? Answer: Developed by CMS,
they are updated yearly update Jan1
◉ NCCI Answer: National Correct Coding Initiative
, ◉ What does the National Correct Coding Initiative edits do?
Answer: Helps CMS to detect inappropriate codes submitted on
claims
- CPT coding guidelines
- Current standards of medical/surgical coding practice
- Advice from specialty societies
◉ List 3 NCCI edits and the definition of those edits. Answer: 1.
Comprehensive/component edit = edit pertains to HCPCS codes that
should NOT be used together.
2. Mutually exclusive edit = edit applies to improbable or impossible
combinations of codes
3. Medical unlikely edits = for part B claims, CMS has developed
medical unlikely edits to reduce error rates for items on the claim
form that reference units of service
◉ • (bullet) Answer: new code
◉ ; (semi-colon) Answer: main entry applies to & is part of all
indented entries that follow
