CPC MEDICAL CODING EXAM 2026/2027 – EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
1. A physician documents that a patient has inflammation of the liver. Which medical term
most directly describes this condition?
A. Nephritis
B. Hepatitis
C. Gastritis
D. Pancreatitis
Rationale: Hepatitis means inflammation of the liver. Nephritis refers to kidney inflammation,
gastritis to stomach inflammation, and pancreatitis to inflammation of the pancreas.
2. During a chart review, the coder encounters the term “bradycardia.” What does this term
describe?
A. Abnormally rapid breathing
B. Elevated blood pressure
C. Abnormally rapid heart rate
D. Abnormally slow heart rate
Rationale: Bradycardia refers to a heart rate that is slower than expected. The prefix “brady-”
means slow, while “tachy-” means fast.
3. A patient presents with pain in the right lower quadrant of the abdomen. Which
anatomical plane divides the body into anterior and posterior portions?
A. Sagittal plane
B. Frontal plane
C. Transverse plane
D. Oblique plane
,Rationale: The frontal, or coronal, plane divides the body into anterior and posterior portions.
The sagittal plane separates right and left portions, while the transverse plane separates
superior and inferior portions.
4. A provider documents a condition as “idiopathic.” What does this terminology indicate?
A. The condition was caused by trauma
B. The condition is known to be hereditary
C. The cause of the condition is unknown
D. The condition resulted from medication use
Rationale: Idiopathic describes a disease or condition for which the underlying cause is
unknown. It does not establish a hereditary, traumatic, or medication-related cause.
5. Which code set is primarily used to report physician and other professional services and
procedures?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. NDC
Rationale: CPT is used to report many professional medical procedures and services. ICD-10-
CM primarily identifies diagnoses, while ICD-10-PCS is used for inpatient hospital procedures.
6. A coder is assigning a diagnosis code from ICD-10-CM. What is the primary purpose of
an ICD-10-CM code?
A. To identify the physician's reimbursement rate
B. To identify the patient's insurance plan
C. To identify the procedure performed
D. To identify the patient's diagnosis, condition, or reason for encounter
Rationale: ICD-10-CM is the diagnosis classification system used to report diseases, conditions,
symptoms, and other reasons for healthcare encounters.
, 7. When using the ICD-10-CM Alphabetic Index, the coder locates a main term and is
directed to another term that provides additional information. What should the coder do
next?
A. Assign the first code displayed
B. Follow the applicable cross-reference and review the Tabular List
C. Use a CPT code instead
D. Ignore the cross-reference if the diagnosis appears obvious
Rationale: ICD-10-CM coding requires use of the Alphabetic Index followed by verification in
the Tabular List. Cross-references such as “see” and “see also” guide the coder to the
appropriate terminology.
8. Which ICD-10-CM convention indicates that a coder should refer to another term rather
than assigning a code from the current term?
A. NEC
B. NOS
C. See
D. Code first
Rationale: “See” is a mandatory cross-reference directing the coder to another term. “See also”
provides an optional additional reference, while NEC and NOS have different meanings.
9. A diagnosis is documented as “pneumonia, unspecified.” Which abbreviation commonly
corresponds to “unspecified” in coding terminology?
A. NOS
B. NEC
C. CC
D. POA
Rationale: NOS means “not otherwise specified” and is used when the documentation does not
provide enough detail for a more specific classification. NEC means “not elsewhere classified.”
10. A coder sees the abbreviation “NEC” in an ICD-10-CM index entry. What does NEC
mean?
, A. No encounter confirmed
B. New evaluation required
C. Not otherwise specified
D. Not elsewhere classified
Rationale: NEC means “not elsewhere classified.” It indicates that the documented condition
has sufficient specificity but does not have a separate, more specific classification elsewhere.
11. A physician documents type 2 diabetes mellitus with diabetic chronic kidney disease.
Which coding approach is generally appropriate?
A. Report only the chronic kidney disease
B. Assign the diabetes code with the appropriate kidney complication and also code the
chronic kidney disease when required
C. Report only the diabetes code without the complication
D. Report only a symptom code for reduced kidney function
Rationale: ICD-10-CM contains combination codes for diabetes with specified complications.
The applicable diabetes code is assigned along with an additional code identifying the stage or
type of chronic kidney disease when instructed by the classification.
12. A patient has hypertension and chronic kidney disease documented by the provider. What
coding principle is important when these conditions coexist?
A. Hypertension should always be coded as a symptom
B. Chronic kidney disease should never be coded separately
C. ICD-10-CM presumes a causal relationship between hypertension and certain chronic
kidney disease categories unless documentation indicates otherwise
D. The coder should assign only an unspecified hypertension code
Rationale: ICD-10-CM provides specific combination coding guidance for hypertension and
chronic kidney disease. When the applicable combination relationship is present, the
hypertension code and the appropriate CKD code are reported according to the classification
instructions.
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
1. A physician documents that a patient has inflammation of the liver. Which medical term
most directly describes this condition?
A. Nephritis
B. Hepatitis
C. Gastritis
D. Pancreatitis
Rationale: Hepatitis means inflammation of the liver. Nephritis refers to kidney inflammation,
gastritis to stomach inflammation, and pancreatitis to inflammation of the pancreas.
2. During a chart review, the coder encounters the term “bradycardia.” What does this term
describe?
A. Abnormally rapid breathing
B. Elevated blood pressure
C. Abnormally rapid heart rate
D. Abnormally slow heart rate
Rationale: Bradycardia refers to a heart rate that is slower than expected. The prefix “brady-”
means slow, while “tachy-” means fast.
3. A patient presents with pain in the right lower quadrant of the abdomen. Which
anatomical plane divides the body into anterior and posterior portions?
A. Sagittal plane
B. Frontal plane
C. Transverse plane
D. Oblique plane
,Rationale: The frontal, or coronal, plane divides the body into anterior and posterior portions.
The sagittal plane separates right and left portions, while the transverse plane separates
superior and inferior portions.
4. A provider documents a condition as “idiopathic.” What does this terminology indicate?
A. The condition was caused by trauma
B. The condition is known to be hereditary
C. The cause of the condition is unknown
D. The condition resulted from medication use
Rationale: Idiopathic describes a disease or condition for which the underlying cause is
unknown. It does not establish a hereditary, traumatic, or medication-related cause.
5. Which code set is primarily used to report physician and other professional services and
procedures?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. NDC
Rationale: CPT is used to report many professional medical procedures and services. ICD-10-
CM primarily identifies diagnoses, while ICD-10-PCS is used for inpatient hospital procedures.
6. A coder is assigning a diagnosis code from ICD-10-CM. What is the primary purpose of
an ICD-10-CM code?
A. To identify the physician's reimbursement rate
B. To identify the patient's insurance plan
C. To identify the procedure performed
D. To identify the patient's diagnosis, condition, or reason for encounter
Rationale: ICD-10-CM is the diagnosis classification system used to report diseases, conditions,
symptoms, and other reasons for healthcare encounters.
, 7. When using the ICD-10-CM Alphabetic Index, the coder locates a main term and is
directed to another term that provides additional information. What should the coder do
next?
A. Assign the first code displayed
B. Follow the applicable cross-reference and review the Tabular List
C. Use a CPT code instead
D. Ignore the cross-reference if the diagnosis appears obvious
Rationale: ICD-10-CM coding requires use of the Alphabetic Index followed by verification in
the Tabular List. Cross-references such as “see” and “see also” guide the coder to the
appropriate terminology.
8. Which ICD-10-CM convention indicates that a coder should refer to another term rather
than assigning a code from the current term?
A. NEC
B. NOS
C. See
D. Code first
Rationale: “See” is a mandatory cross-reference directing the coder to another term. “See also”
provides an optional additional reference, while NEC and NOS have different meanings.
9. A diagnosis is documented as “pneumonia, unspecified.” Which abbreviation commonly
corresponds to “unspecified” in coding terminology?
A. NOS
B. NEC
C. CC
D. POA
Rationale: NOS means “not otherwise specified” and is used when the documentation does not
provide enough detail for a more specific classification. NEC means “not elsewhere classified.”
10. A coder sees the abbreviation “NEC” in an ICD-10-CM index entry. What does NEC
mean?
, A. No encounter confirmed
B. New evaluation required
C. Not otherwise specified
D. Not elsewhere classified
Rationale: NEC means “not elsewhere classified.” It indicates that the documented condition
has sufficient specificity but does not have a separate, more specific classification elsewhere.
11. A physician documents type 2 diabetes mellitus with diabetic chronic kidney disease.
Which coding approach is generally appropriate?
A. Report only the chronic kidney disease
B. Assign the diabetes code with the appropriate kidney complication and also code the
chronic kidney disease when required
C. Report only the diabetes code without the complication
D. Report only a symptom code for reduced kidney function
Rationale: ICD-10-CM contains combination codes for diabetes with specified complications.
The applicable diabetes code is assigned along with an additional code identifying the stage or
type of chronic kidney disease when instructed by the classification.
12. A patient has hypertension and chronic kidney disease documented by the provider. What
coding principle is important when these conditions coexist?
A. Hypertension should always be coded as a symptom
B. Chronic kidney disease should never be coded separately
C. ICD-10-CM presumes a causal relationship between hypertension and certain chronic
kidney disease categories unless documentation indicates otherwise
D. The coder should assign only an unspecified hypertension code
Rationale: ICD-10-CM provides specific combination coding guidance for hypertension and
chronic kidney disease. When the applicable combination relationship is present, the
hypertension code and the appropriate CKD code are reported according to the classification
instructions.
