MEDICAL CODING TRAINING - AAPC CPC
LATEST 2025-2026 EXAM UPDATE QUESTIONS
AND ANSWERS
Jobs for medical coders - Answer-Medical coding is a technical and
rapidly changing field that offers a variety of career opportunities.
Skilled coders may become consultants, educators, or medical auditors.
The difference between hospital and provider services - Answer-
Outpatient coding pertains to provider services. Coders use CPT,
HCPCS level two, and ICD - 10 - CM codes. Outpatient facility coders
also use ambulatory payment classification a PCS.
Inpatient facility coders use ICD - 10 - CM and ICD - 10 - PCS codes.
These coders also use MS - DRG for reimbursement. Coders usually
have more interaction with providers throughout the day and must
communicate well with them; inpatient coders tend to have less
interaction directly with providers throughout the day.
How a provider office works and how the coder fits - Answer-When a
patient visits a medical practice, a front desk person typically obtains
insurance and demographic information, or this information is entered
electronically before the visit. After the information has been entered
into the practice management system the provider sees the patient. The
provider documents to visit in the patient's medical record and completes
an encounter form, or a form to relay the services rendered, to the front
, desk. Upon completion of the exam, the patient checks out and pays a
co-pay if applicable.
After the patient leaves the medical office, the providers documentation
of the encounter is translated into procedure or supply codes CPT or
HCPCS level two and diagnosis codes ICD - 10 - CM. This information
is submitted on a claim to the patient's insurance company, or payer, to
obtain reimbursement. This translation of the documented information
from the visit is referred to as coding. Coding can be performed by the
provider, EHR, or a medical coder. When the provider or EHR performs
the coding, the coder takes on The role of auditor to verify the
documentation supports the codes selected.
After the documentation is translated into codes, the codes are assigned
a fee and billed to the patient or pear, as appropriate. In addition a place
of service code is reported to indicate where the services were
performed. The charges are billed to the payer using the CMS - 1500
claim form, which is available in both paper and digital formats.
Electronic claims benefit the medical office by allowing timely
submission to the payer and proof of transmission of the claim. The
remittance advice explains the payers determination in payment.
Understanding the hierarchy of providers - Answer-States individually
dictate practice guidelines for each level of a provider. This is referred to
as a providers scope of practice.
Physicians undergo four years of college and four years of medical
school +3 to 5 years or more of residency. Residency is training in a
medical specialty.
LATEST 2025-2026 EXAM UPDATE QUESTIONS
AND ANSWERS
Jobs for medical coders - Answer-Medical coding is a technical and
rapidly changing field that offers a variety of career opportunities.
Skilled coders may become consultants, educators, or medical auditors.
The difference between hospital and provider services - Answer-
Outpatient coding pertains to provider services. Coders use CPT,
HCPCS level two, and ICD - 10 - CM codes. Outpatient facility coders
also use ambulatory payment classification a PCS.
Inpatient facility coders use ICD - 10 - CM and ICD - 10 - PCS codes.
These coders also use MS - DRG for reimbursement. Coders usually
have more interaction with providers throughout the day and must
communicate well with them; inpatient coders tend to have less
interaction directly with providers throughout the day.
How a provider office works and how the coder fits - Answer-When a
patient visits a medical practice, a front desk person typically obtains
insurance and demographic information, or this information is entered
electronically before the visit. After the information has been entered
into the practice management system the provider sees the patient. The
provider documents to visit in the patient's medical record and completes
an encounter form, or a form to relay the services rendered, to the front
, desk. Upon completion of the exam, the patient checks out and pays a
co-pay if applicable.
After the patient leaves the medical office, the providers documentation
of the encounter is translated into procedure or supply codes CPT or
HCPCS level two and diagnosis codes ICD - 10 - CM. This information
is submitted on a claim to the patient's insurance company, or payer, to
obtain reimbursement. This translation of the documented information
from the visit is referred to as coding. Coding can be performed by the
provider, EHR, or a medical coder. When the provider or EHR performs
the coding, the coder takes on The role of auditor to verify the
documentation supports the codes selected.
After the documentation is translated into codes, the codes are assigned
a fee and billed to the patient or pear, as appropriate. In addition a place
of service code is reported to indicate where the services were
performed. The charges are billed to the payer using the CMS - 1500
claim form, which is available in both paper and digital formats.
Electronic claims benefit the medical office by allowing timely
submission to the payer and proof of transmission of the claim. The
remittance advice explains the payers determination in payment.
Understanding the hierarchy of providers - Answer-States individually
dictate practice guidelines for each level of a provider. This is referred to
as a providers scope of practice.
Physicians undergo four years of college and four years of medical
school +3 to 5 years or more of residency. Residency is training in a
medical specialty.
