Certified Coding Specialist
Exam Prep
(2026–2027)
Exam Questions With Verified Correct
Solutions |100% Guaranteed Pass |
Latest Version | Grade A+
,How many units of service may be billed when one unit
reporting the -50 modifier (bilateral) to Medicare?
For medicare, just submit 27447-50 for procedure done left and right; other
payers may code it differently.
When reporting -51 modifier to indicate multiple Primary Procedure (most expensive)
procedure performed, which procedure should be
reported first on the claim?
Medicare considers what service to be part of the preoperative
surgery and bundled payment not allowing the -56
modifier?
E&M services provided the day before or the day of a Global Day
major surgery are included in what package?
Modifier -63 indicates procedure provided to a 4 kg or 8.8 lbs
neonate or infant up to what weight?
A surgical team consists of how many physicians? More than two
How many modifier areas are available on a CMS-1500 four
(physician) insurance claim form for one-line item
charge?
Describing a physician's services in radiology or Professional component (use modifier -26)
pathology.
Technical Component (use modifier -TC)
Describing the services provided by the facility.
Bundling together of time effort and services for a Surgical Package
specific procedure into one code instead of reporting
each component separately
Code assignments in the E/M section varies according 1. place of service
to three factors: 2. type of service
3. patient status
Six sections of the CPT manual Evaluation and Management
Anesthesia
Surgery
Radiology
Pathology and Laboratory
Medicine
,Patient status (for E/M) new, established, outpatient, inpatient
The key component of E/M service is _____. medical decision-making
The four levels of medical decision-making complexity 1.straightforward
are: 2.low
3.moderate
4.high
The complexity of medical decision-making (for E/M) is 1. number of diagnoses
based on: 2. amount or complexity of data to review
3. risk of complication or death if the condition is left untreated
UHDDS Uniform Hospital Discharge Data. UHDDS is the core data set for inpatient
admissions. The data is collected on inpatient hospital discharges for Medicare
and Medicaid program.
UHDDS includes elements such as patient demographics (name, age, gender,
race), medical history (previous illnesses, surgeries), admission and discharge
dates, diagnosis codes (ICD-10 codes), procedures performed, and discharge
disposition (home, another facility).
The definition of a ____ ______ is one that is performed for Principal procedure
definitive tx rather than for diagnostic or exploratory
purposes or when it is necessary to take care of a
complication
What identifies where the patient is at conclusion of Discharge disposition
healthcare or the end time of billing cycle
UB-04 is maintained by the national U niform B illing committee
What was created for hospital inpatient prospective MS- DRG, Medical severity Diagnostic related group
payment to better to reflect the patients severity of
illness and expected risk of mortality
Conditions that develop during an outpatient Present on admission POA
encounter, including ER, observation or outpatient
surgery are considered ______
Where are POA guidelines found in ICD-10-CM Appendix 1
Under the _____ each case is categorized into a DRG Inpatient prospective payment system IPPS
One _____ group per inpatient admission DRG
, MS-DRG variables -principal diagnosis
-secondary diagnosis
(UHDDS items that can affect ms-drg assignment) -principal or significant procedure
-age/sex
- discharge disposition
modifier -51 Multiple procedures
Can't be used with add-on codes.
Is used by physicians not hospitals!
To code lesion procedures you need ..........., .............., size the site, number, size of the excised lesion, and whether the lesion is malignant
of ............., and whether the lesion is ...................... or benign.
When coding the excision of a lesion, the size of the lesion and narrowest width of margin
lesion is based on the following measurement:
..................... requires no closure because no incision is Shaving of lesions
made
Excision
....................includes simple closure but may require more
complex closure Destruction
.................. may be by any method including freezing,
burning, chemicals, etc.
Don't report BOTH ................ performed at the same time a biopsy and an excision
as the biopsy is ....................into the excision service. bundled
This is a graft from patient's body: autograph
This is a graft from a human donor: allograph
This is a graft from another species: xenograph
.................and ...........is included in skin tag codes as simple closure
bundled. local anesthesia
Excision codes also include _________ and ____________ simple closure and anesthesia
If the closure is reported as more than simple__________ you would code the more complicated closure using a separate code from
12031-13160
Exam Prep
(2026–2027)
Exam Questions With Verified Correct
Solutions |100% Guaranteed Pass |
Latest Version | Grade A+
,How many units of service may be billed when one unit
reporting the -50 modifier (bilateral) to Medicare?
For medicare, just submit 27447-50 for procedure done left and right; other
payers may code it differently.
When reporting -51 modifier to indicate multiple Primary Procedure (most expensive)
procedure performed, which procedure should be
reported first on the claim?
Medicare considers what service to be part of the preoperative
surgery and bundled payment not allowing the -56
modifier?
E&M services provided the day before or the day of a Global Day
major surgery are included in what package?
Modifier -63 indicates procedure provided to a 4 kg or 8.8 lbs
neonate or infant up to what weight?
A surgical team consists of how many physicians? More than two
How many modifier areas are available on a CMS-1500 four
(physician) insurance claim form for one-line item
charge?
Describing a physician's services in radiology or Professional component (use modifier -26)
pathology.
Technical Component (use modifier -TC)
Describing the services provided by the facility.
Bundling together of time effort and services for a Surgical Package
specific procedure into one code instead of reporting
each component separately
Code assignments in the E/M section varies according 1. place of service
to three factors: 2. type of service
3. patient status
Six sections of the CPT manual Evaluation and Management
Anesthesia
Surgery
Radiology
Pathology and Laboratory
Medicine
,Patient status (for E/M) new, established, outpatient, inpatient
The key component of E/M service is _____. medical decision-making
The four levels of medical decision-making complexity 1.straightforward
are: 2.low
3.moderate
4.high
The complexity of medical decision-making (for E/M) is 1. number of diagnoses
based on: 2. amount or complexity of data to review
3. risk of complication or death if the condition is left untreated
UHDDS Uniform Hospital Discharge Data. UHDDS is the core data set for inpatient
admissions. The data is collected on inpatient hospital discharges for Medicare
and Medicaid program.
UHDDS includes elements such as patient demographics (name, age, gender,
race), medical history (previous illnesses, surgeries), admission and discharge
dates, diagnosis codes (ICD-10 codes), procedures performed, and discharge
disposition (home, another facility).
The definition of a ____ ______ is one that is performed for Principal procedure
definitive tx rather than for diagnostic or exploratory
purposes or when it is necessary to take care of a
complication
What identifies where the patient is at conclusion of Discharge disposition
healthcare or the end time of billing cycle
UB-04 is maintained by the national U niform B illing committee
What was created for hospital inpatient prospective MS- DRG, Medical severity Diagnostic related group
payment to better to reflect the patients severity of
illness and expected risk of mortality
Conditions that develop during an outpatient Present on admission POA
encounter, including ER, observation or outpatient
surgery are considered ______
Where are POA guidelines found in ICD-10-CM Appendix 1
Under the _____ each case is categorized into a DRG Inpatient prospective payment system IPPS
One _____ group per inpatient admission DRG
, MS-DRG variables -principal diagnosis
-secondary diagnosis
(UHDDS items that can affect ms-drg assignment) -principal or significant procedure
-age/sex
- discharge disposition
modifier -51 Multiple procedures
Can't be used with add-on codes.
Is used by physicians not hospitals!
To code lesion procedures you need ..........., .............., size the site, number, size of the excised lesion, and whether the lesion is malignant
of ............., and whether the lesion is ...................... or benign.
When coding the excision of a lesion, the size of the lesion and narrowest width of margin
lesion is based on the following measurement:
..................... requires no closure because no incision is Shaving of lesions
made
Excision
....................includes simple closure but may require more
complex closure Destruction
.................. may be by any method including freezing,
burning, chemicals, etc.
Don't report BOTH ................ performed at the same time a biopsy and an excision
as the biopsy is ....................into the excision service. bundled
This is a graft from patient's body: autograph
This is a graft from a human donor: allograph
This is a graft from another species: xenograph
.................and ...........is included in skin tag codes as simple closure
bundled. local anesthesia
Excision codes also include _________ and ____________ simple closure and anesthesia
If the closure is reported as more than simple__________ you would code the more complicated closure using a separate code from
12031-13160
