MO Metrix CCS Exam Practice Test 2026
a. The Centers for Disease Control and Prevention - correct answersWhich of the following is not a
covered entity in the HIPAA Privacy rule?
a. The Centers for Disease Control and Prevention
b. Employer-sponsored health plan
c. Third-party billing agency
d. Healthcare provider
d. Hierarchical condition category (HCC) coding - correct answersWhich of the following is a risk
adjustment model used by Medicare to predict health care costs and resource consumption of specific
patient populations over time?
a. Risk adjustment factor (RAF)
b. Diagnosis-related groups
c. Outcome and Assessment information set
d. Hierarchical condition category (HCC) coding
d. The two codes can be billed together with an appropriate modifier - correct answersCPT cod 20650 is
a column 2 code that has a National Correct Coding Initiative (NCCI) edit of 1 when paired with CPT code
21813. How would this be interpreted?
a. The two codes are inclusive of each other and can never be billed together.
b. If being billed together, only report one unit of each
c. The two codes are exclusive of each other and can never be billed together
d. The two codes can be billed together with an appropriate modifier
c. Moderate complexity - correct answersBased on the following documentation, what would the overall
medical decision-making be?
Numbered of diagnosis or management options: Minimal
Amount and complexity of data: Moderate
Level of risk: Moderate
a. Straightforward
b. Low complexity
c. Moderate complexity
d. High complexity
a. 58301-53 - correct answersA patient was seen by her gynecologist to remove her intrauterine device.
The removal was attempted but terminated due to excessive bleeding. How should the gynecologist
report the encounter?
a. 58301-53
b. 58301-52
c. 99212-25, 58301
,d. 99212, 58301-59
c. 76536
no modifier - correct answersA technician performs an ultrasound of a patient's thyroid at a privately
owned family practice immediately following her annual health screening. The primary care physician
determines that the images are normal and advises the patient to return in one year. How should the
primary care physician report the ultrasound?
a. 76536-26
b. 76536-TC
c. 76536
d. 76536-TC, 26
a. Medically unlikely edits - correct answersWhich type of edit identifies the maximum number of units
that may be reported for a CPT/HCPCS code that relates to an individual patient?
a. Medically unlikely edits
b. Add-on-code edits
c. Correspondence edits
d. Procedure-to-procedure coding edits
d. Two or more unrelated diseases occurring at the same time. - correct answersWhich statement best
describes a comorbidity?
a. Two or more life-threatening illnesses occurring at the same time
b. Three or more minor injuries occurring at the same time
c. Three or more chronic illness occurring at the same time
d. Two or more unrelated diseases occurring at the same time.
a. Protect privacy and confidentiality; protect personal health information; and use technology, data,
and information resources in the way they are intended. - correct answersA healthcare employee
happens to meet a well-known actor during a lunch break. Unknown to the employee, the actor is
currently admitted in the hospital and has chosen to eat in the cafeteria to not feel cooped up any
longer. The employee takes a photo and shares it with his co-workers and social media. Which AHIMA
standard(s) of Ethical Coding has been violated?
a. Protect privacy and confidentiality; protect personal health information; and use technology, data,
and information resources in the way they are intended.
b. Respect the dignity of every person, put the welfare of persons before self-interest.
c. Refuse to participate in unethical practices, privacy and confidentiality, respect the dignity of every
person
d. None, the act was unintentional
d. Social history - correct answersThe smoking status of a patient should generally be found in which
section of a medical record?
a. Chief complaint
, b. Plan
c. Examination
d. Social history
c. Family history - correct answersWhich of the following is not a data element required by the uniform
Hospital Discharge Data set (UHDDS)
a. Location of residence
b. Provider name
c. Family history
d. Total charges for services rendered.
b. Mentor colleagues to strengthen the professional workforce - correct answersA hospital director
repeatedly refuses to accept residents due to a tight budget that limits training time for students. Which
AHIMA Standard(s) of ethical Coding has been violated?
a. Put the welfare of persons before self-interest
b. Mentor colleagues to strengthen the professional workforce
c. Respect the worth of every person.
d. Represent the profession to the public in a positive manner.
c. 33533, 33517 - correct answersA physician performs a coronary artery bypass grafting using the left
internal mammary artery to the right coronary, and a saphenous vein graft to the circumflex. Which CPT
code(s)
a. 33533, 33510
b. 33534
c. 33533, 33517
d. 35600, 33517
b. 99283-25, 16020, T23.701A, T23.602A, T65.6X1A - correct answersA patient is seen in the emergency
room with second- and third-degree burns on the right hand, and second-degree burns on the left hand
after being exposed to paint thinner. After a comprehensive physical examination reveals that
approximately 4% of the body is affected, the physician begins preventative treatment by debriding the
nonviable tissue, cleansing the areas, and applying gauze. The patient is discharged and advised to
return if experiencing symptoms that indicate an infection. What CPT and ICD-10-CM codes should be
reported for this encounter?
a. 99283-25, 16020, T23.701A, T23.61A, T23.602A, T65.6X4A
b. 99283-25, 16020, T23.701A, T23.602A, T65.6X1A
c. 99283, T23.701A, T23.601A, T23.602A, T65.6X4A
d. 16020, T23.701A, T23.602A T65.6X1A
a. the condition established after study to be the foremost reason for which the patient was admitted -
correct answersThe UHDDS defines a principal diagnosis as___________.
a. the condition established after study to be the foremost reason for which the patient was admitted
b. the condition, sign, and/or symptom with which the patient presented and was admitted
a. The Centers for Disease Control and Prevention - correct answersWhich of the following is not a
covered entity in the HIPAA Privacy rule?
a. The Centers for Disease Control and Prevention
b. Employer-sponsored health plan
c. Third-party billing agency
d. Healthcare provider
d. Hierarchical condition category (HCC) coding - correct answersWhich of the following is a risk
adjustment model used by Medicare to predict health care costs and resource consumption of specific
patient populations over time?
a. Risk adjustment factor (RAF)
b. Diagnosis-related groups
c. Outcome and Assessment information set
d. Hierarchical condition category (HCC) coding
d. The two codes can be billed together with an appropriate modifier - correct answersCPT cod 20650 is
a column 2 code that has a National Correct Coding Initiative (NCCI) edit of 1 when paired with CPT code
21813. How would this be interpreted?
a. The two codes are inclusive of each other and can never be billed together.
b. If being billed together, only report one unit of each
c. The two codes are exclusive of each other and can never be billed together
d. The two codes can be billed together with an appropriate modifier
c. Moderate complexity - correct answersBased on the following documentation, what would the overall
medical decision-making be?
Numbered of diagnosis or management options: Minimal
Amount and complexity of data: Moderate
Level of risk: Moderate
a. Straightforward
b. Low complexity
c. Moderate complexity
d. High complexity
a. 58301-53 - correct answersA patient was seen by her gynecologist to remove her intrauterine device.
The removal was attempted but terminated due to excessive bleeding. How should the gynecologist
report the encounter?
a. 58301-53
b. 58301-52
c. 99212-25, 58301
,d. 99212, 58301-59
c. 76536
no modifier - correct answersA technician performs an ultrasound of a patient's thyroid at a privately
owned family practice immediately following her annual health screening. The primary care physician
determines that the images are normal and advises the patient to return in one year. How should the
primary care physician report the ultrasound?
a. 76536-26
b. 76536-TC
c. 76536
d. 76536-TC, 26
a. Medically unlikely edits - correct answersWhich type of edit identifies the maximum number of units
that may be reported for a CPT/HCPCS code that relates to an individual patient?
a. Medically unlikely edits
b. Add-on-code edits
c. Correspondence edits
d. Procedure-to-procedure coding edits
d. Two or more unrelated diseases occurring at the same time. - correct answersWhich statement best
describes a comorbidity?
a. Two or more life-threatening illnesses occurring at the same time
b. Three or more minor injuries occurring at the same time
c. Three or more chronic illness occurring at the same time
d. Two or more unrelated diseases occurring at the same time.
a. Protect privacy and confidentiality; protect personal health information; and use technology, data,
and information resources in the way they are intended. - correct answersA healthcare employee
happens to meet a well-known actor during a lunch break. Unknown to the employee, the actor is
currently admitted in the hospital and has chosen to eat in the cafeteria to not feel cooped up any
longer. The employee takes a photo and shares it with his co-workers and social media. Which AHIMA
standard(s) of Ethical Coding has been violated?
a. Protect privacy and confidentiality; protect personal health information; and use technology, data,
and information resources in the way they are intended.
b. Respect the dignity of every person, put the welfare of persons before self-interest.
c. Refuse to participate in unethical practices, privacy and confidentiality, respect the dignity of every
person
d. None, the act was unintentional
d. Social history - correct answersThe smoking status of a patient should generally be found in which
section of a medical record?
a. Chief complaint
, b. Plan
c. Examination
d. Social history
c. Family history - correct answersWhich of the following is not a data element required by the uniform
Hospital Discharge Data set (UHDDS)
a. Location of residence
b. Provider name
c. Family history
d. Total charges for services rendered.
b. Mentor colleagues to strengthen the professional workforce - correct answersA hospital director
repeatedly refuses to accept residents due to a tight budget that limits training time for students. Which
AHIMA Standard(s) of ethical Coding has been violated?
a. Put the welfare of persons before self-interest
b. Mentor colleagues to strengthen the professional workforce
c. Respect the worth of every person.
d. Represent the profession to the public in a positive manner.
c. 33533, 33517 - correct answersA physician performs a coronary artery bypass grafting using the left
internal mammary artery to the right coronary, and a saphenous vein graft to the circumflex. Which CPT
code(s)
a. 33533, 33510
b. 33534
c. 33533, 33517
d. 35600, 33517
b. 99283-25, 16020, T23.701A, T23.602A, T65.6X1A - correct answersA patient is seen in the emergency
room with second- and third-degree burns on the right hand, and second-degree burns on the left hand
after being exposed to paint thinner. After a comprehensive physical examination reveals that
approximately 4% of the body is affected, the physician begins preventative treatment by debriding the
nonviable tissue, cleansing the areas, and applying gauze. The patient is discharged and advised to
return if experiencing symptoms that indicate an infection. What CPT and ICD-10-CM codes should be
reported for this encounter?
a. 99283-25, 16020, T23.701A, T23.61A, T23.602A, T65.6X4A
b. 99283-25, 16020, T23.701A, T23.602A, T65.6X1A
c. 99283, T23.701A, T23.601A, T23.602A, T65.6X4A
d. 16020, T23.701A, T23.602A T65.6X1A
a. the condition established after study to be the foremost reason for which the patient was admitted -
correct answersThe UHDDS defines a principal diagnosis as___________.
a. the condition established after study to be the foremost reason for which the patient was admitted
b. the condition, sign, and/or symptom with which the patient presented and was admitted
