CPC 2025 EXAM STUDY GUIDE QUESTIONS
WITH CORRECT ANSWERS 2025
ProperWcodeWassignmentWisWdeterminedWbothWbyW_____________WinWtheWmedicalWrecordWandWbyWtheWu
niqueWrulesWthatWgovernWeachWcodeWsetWinWthatWinstanceW-WCORRECTWANSWERW-
DocumentationW(content)
TheWroleWaWcoderWmayWtakeWonWtoWverifyWthatWtheWdocumentationWsupportsWtheWcodesWtheWphysicianWh
asWselectedW-WCORRECTWANSWERW-AnWauditor
IfWtheWmedicalWrecordWisWinaccurateWorWincomplete,WitWwillWnotWtranslateWproperlyWtoWtheWlanguageWofW
codes.WWhatWcanWaWcoderWdoWinWorderWforWtheWmedicalWrecordWtoWbeWcompleteWandWaccurateWsoWtheyW
canWbillWproperly?W-WCORRECTWANSWERW-QueryWtheWphysician
HowWoftenWareWcodesWandWinsuranceWpaymentWpoliciesWupdated?W-WCORRECTWANSWERW-
QuarterlyW(usually)
Non-PhysicianWProviderW(alsoWknownWasWmid-levelWprovidersWorWphysicianWextenders)W-
WCORRECTWANSWERW-NPP
PhysicianWassistantW-WCORRECTWANSWERW-PA
NurseWpractitionerW-WCORRECTWANSWERW-NP
TheWtwoWtypesWofWprimaryWinsurancesW-WCORRECTWANSWERW-CommercialWandWGovernment
PrivateWpayersWthatWmayWofferWbothWgroupWandWindividualWplansW-WCORRECTWANSWERW-
CommercialWCarriers
TheWmostWsignificantWgovernmentWinsurer;WaWfederalWhealthWinsuranceWprogramW-WCORRECTWANSWERW-
Medicare
, MedicareWprovidesWcoverageWforWwhatWkindWofWpeople?W-WCORRECTWANSWERW-
PeopleWoverW65,WblindWorWdisabledWindividuals,WandWpeopleWwithWpermanentWkidneyWfailureWorWend-
stageWrenalWdisease
end-stageWrenalWdiseaseW-WCORRECTWANSWERW-ESRD
HelpsWcoverWinpatientWhospitalWcare,WasWwellWasWcareWprovidedWinWskilledWnursingWfacilities,WhospiceWcar
e,WandWhomeWhealthcare,W-WCORRECTWANSWERW-MedicareWPartWA
CoversWmedicallyWnecessaryWphysicians'Wservices,WoutpatientWcare,WandWotherWmedicalWservicesW(includi
ngWsomeWpreventiveWservices)WnotWcoveredWunderWMedicareWPartWA.WItWcanWbeWanWoptionalWbenefit.W-
WCORRECTWANSWERW-MedicareWPartWB
AlsoWcalledWMedicareWAdvantage,WcombinesWtheWbenefitsWofWMedicareWPartWA,WPartWB,Wand-sometimes-
WPartWD.WTheWplansWareWmanagedWbyWprivateWinsurersWapprovedWbyWMedicare.W-WCORRECTWANSWERW-
MedicareWPartWC
AWprescriptionWdrugWprogramWavailableWtoWallWMedicareWbeneficiaries.W-WCORRECTWANSWERW-
MedicareWPartWD
AWhealthWinsuranceWassistanceWprogramWforWsomeWlow-
incomeWpeopleW(especiallyWchildrenWandWpregnantWwomen)WsponsoredWbyWfederalWandWstateWgovernme
nts.W-WCORRECTWANSWERW-Medicaid
Resource-BasedWRelativeWValueWScaleW-WCORRECTWANSWERW-RBRVS
MedicareWpaymentsWforWphysicianWservicesWareWstandardizedWusingW_____WandWareWdividedWintoWthreeW
components.W-WCORRECTWANSWERW-Resource-BasedWRelativeWValueWScaleW(RBRVS)
TheWthreeWcomponentsWusedWtoWdetermineWresourceWcostWforWphysicianWservices.W-
WCORRECTWANSWERW-
TheWphysicianWworkWcomponent,WpracticeWexpense,WandWprofessionalWliabilityWinsuranceW(PLI)
WITH CORRECT ANSWERS 2025
ProperWcodeWassignmentWisWdeterminedWbothWbyW_____________WinWtheWmedicalWrecordWandWbyWtheWu
niqueWrulesWthatWgovernWeachWcodeWsetWinWthatWinstanceW-WCORRECTWANSWERW-
DocumentationW(content)
TheWroleWaWcoderWmayWtakeWonWtoWverifyWthatWtheWdocumentationWsupportsWtheWcodesWtheWphysicianWh
asWselectedW-WCORRECTWANSWERW-AnWauditor
IfWtheWmedicalWrecordWisWinaccurateWorWincomplete,WitWwillWnotWtranslateWproperlyWtoWtheWlanguageWofW
codes.WWhatWcanWaWcoderWdoWinWorderWforWtheWmedicalWrecordWtoWbeWcompleteWandWaccurateWsoWtheyW
canWbillWproperly?W-WCORRECTWANSWERW-QueryWtheWphysician
HowWoftenWareWcodesWandWinsuranceWpaymentWpoliciesWupdated?W-WCORRECTWANSWERW-
QuarterlyW(usually)
Non-PhysicianWProviderW(alsoWknownWasWmid-levelWprovidersWorWphysicianWextenders)W-
WCORRECTWANSWERW-NPP
PhysicianWassistantW-WCORRECTWANSWERW-PA
NurseWpractitionerW-WCORRECTWANSWERW-NP
TheWtwoWtypesWofWprimaryWinsurancesW-WCORRECTWANSWERW-CommercialWandWGovernment
PrivateWpayersWthatWmayWofferWbothWgroupWandWindividualWplansW-WCORRECTWANSWERW-
CommercialWCarriers
TheWmostWsignificantWgovernmentWinsurer;WaWfederalWhealthWinsuranceWprogramW-WCORRECTWANSWERW-
Medicare
, MedicareWprovidesWcoverageWforWwhatWkindWofWpeople?W-WCORRECTWANSWERW-
PeopleWoverW65,WblindWorWdisabledWindividuals,WandWpeopleWwithWpermanentWkidneyWfailureWorWend-
stageWrenalWdisease
end-stageWrenalWdiseaseW-WCORRECTWANSWERW-ESRD
HelpsWcoverWinpatientWhospitalWcare,WasWwellWasWcareWprovidedWinWskilledWnursingWfacilities,WhospiceWcar
e,WandWhomeWhealthcare,W-WCORRECTWANSWERW-MedicareWPartWA
CoversWmedicallyWnecessaryWphysicians'Wservices,WoutpatientWcare,WandWotherWmedicalWservicesW(includi
ngWsomeWpreventiveWservices)WnotWcoveredWunderWMedicareWPartWA.WItWcanWbeWanWoptionalWbenefit.W-
WCORRECTWANSWERW-MedicareWPartWB
AlsoWcalledWMedicareWAdvantage,WcombinesWtheWbenefitsWofWMedicareWPartWA,WPartWB,Wand-sometimes-
WPartWD.WTheWplansWareWmanagedWbyWprivateWinsurersWapprovedWbyWMedicare.W-WCORRECTWANSWERW-
MedicareWPartWC
AWprescriptionWdrugWprogramWavailableWtoWallWMedicareWbeneficiaries.W-WCORRECTWANSWERW-
MedicareWPartWD
AWhealthWinsuranceWassistanceWprogramWforWsomeWlow-
incomeWpeopleW(especiallyWchildrenWandWpregnantWwomen)WsponsoredWbyWfederalWandWstateWgovernme
nts.W-WCORRECTWANSWERW-Medicaid
Resource-BasedWRelativeWValueWScaleW-WCORRECTWANSWERW-RBRVS
MedicareWpaymentsWforWphysicianWservicesWareWstandardizedWusingW_____WandWareWdividedWintoWthreeW
components.W-WCORRECTWANSWERW-Resource-BasedWRelativeWValueWScaleW(RBRVS)
TheWthreeWcomponentsWusedWtoWdetermineWresourceWcostWforWphysicianWservices.W-
WCORRECTWANSWERW-
TheWphysicianWworkWcomponent,WpracticeWexpense,WandWprofessionalWliabilityWinsuranceW(PLI)