MEDICAL CODING EXAM QUESTIONS
AND ANSWERS
The Coding Clinic for ICD-9-CM - Answer-advice given is to be followed by coders in
all settings, including physician office, clinic, outpatient, and hospital inpatient coding
sequencing - Answer-arranging codes in the proper order according to the definitions
of principal or primary diagnosis
NCHS - Answer-maintains and updates the diagnosis portion of ICD-9-CM
CMS - Answer-maintains and updates the procedure portion (Volume 3)
AHA - Answer-maintains the Central Office on ICD-9-CM to answer questions from
coders and produces the Coding Clinic for ICD-9-CM, the official guidelines for ICD-
9-CM usage
AHIMA - Answer-provides training and certification for coding professionals
principal diagnosis - Answer-the reason, after study, which caused the patient to be
admitted to the hospital, inpatient
first-listed diagnosis - Answer-in the outpatient setting, the primary diagnosis is the
main reason for the visit. it is usually the diagnosis taking the majority of resources
for the visit
How to look up a ICD-9-CM term - Answer-Step 1- locate the main term
Step 2- identify subterms
ICD-9-CM Step 1 locating the main term - Answer-look in the alphabetic index of
Volume Two under the main term.
main term - Answer-the patients illness or disease, in the ICD-9-CM the main term is
the primary way to locate the disease in the alphabetic index. are printed in boldface,
even with the left margin on each page
main terms examples - Answer-fracture, pneumonia, disease, injury, and enlarged
not main terms examples - Answer-anatomic terms : kidney, shoulder
alphabetic index - Answer-*Volume 2 of the ICD-9-CM, the alphabetic listing of
diagnoses
*cross-refrenced extremely well to allow the coder to locate the correct code using
several different terms. Ex. "congestive heart failure" can be found under the main
term " failure" and/or "congestive"
ICD-9-CM three alphanumeric classifications - Answer-V codes, E codes, M codes
, V codes (ICD-9-CM) - Answer-used to describe the main reason for the patient's visit
in cases where the patient is not sick. used as a secondary diagnosis to provide
further information about the patient's medical condition.
E codes (ICD-9-CM) - Answer-are external causes of injury and poisoning. are
optional by some carriers, many state statues require the assignment of an E code to
a claim form. E codes are secondary diagnosis to show the cause of injury, such as
a fall or automobile accident, if it is known.
M codes, Morphology Codes (ICD-9-CM) - Answer-located in the alphabetic index,
used to further identify the behavior and cell type of a neoplasm and are used in
conjunction with neoplasm codes from the main classification
M codes (ICD-9-CM) - Answer-used primarily by cancer registries and are not
assigned when submitting a claim to a carrier by the physician office
category - Answer-categories are three-digit representations of a single disease or
group of similar conditions, such as category 250, Diabetes Mellitus. Many
categories are divided further into subcategories and classifications.
subcateory - Answer-four-digit subcategories are subdivisions of categories to
provide greater specificity regarding etiology, site, or manifestations.
CPT Evaluation and Management - Answer-CPT section requires practitioners to
make decisions as to level of service for offices, hospitals, nursing home services
CPT Appendix B - Answer-summarizes the changes since the previous edition,
including additions and deletions essential for updating computer programs and or
encounter forms used in the facilty
CPT Level I Modifers - Answer-Appendix A, is a two -digit code added to the main
CPT code indicating the procedure has been altered by a specific circumstance. Ex.:
19100-50
CPT Level II National Codes (HCPCS) - Answer-alphanumeric "national codes"
supplied by the federal government, these codes supplement CPT codes enabling
providers to report non physician services such as durable medical equipment,
ambulance services, supplies and medications, particularly injectable drugs
Level II HCPCS Modifers - Answer-are either alphanumeric or letters that can be
used with all levels of HCPCS codes. Ex. -LT used to identify procedures performed
ton the left side of the body
International Classification of Diseases, 9th Revision, Clinical Modifications (ICD-9-
CM) - Answer-created by the World Health Organization (WHO) based in Geneva,
Switzerland
*is updated every year with changes every October 1
*coding system used to report diagnoses, diseases, and symptoms and reasons for
encounters for insurance claims
AND ANSWERS
The Coding Clinic for ICD-9-CM - Answer-advice given is to be followed by coders in
all settings, including physician office, clinic, outpatient, and hospital inpatient coding
sequencing - Answer-arranging codes in the proper order according to the definitions
of principal or primary diagnosis
NCHS - Answer-maintains and updates the diagnosis portion of ICD-9-CM
CMS - Answer-maintains and updates the procedure portion (Volume 3)
AHA - Answer-maintains the Central Office on ICD-9-CM to answer questions from
coders and produces the Coding Clinic for ICD-9-CM, the official guidelines for ICD-
9-CM usage
AHIMA - Answer-provides training and certification for coding professionals
principal diagnosis - Answer-the reason, after study, which caused the patient to be
admitted to the hospital, inpatient
first-listed diagnosis - Answer-in the outpatient setting, the primary diagnosis is the
main reason for the visit. it is usually the diagnosis taking the majority of resources
for the visit
How to look up a ICD-9-CM term - Answer-Step 1- locate the main term
Step 2- identify subterms
ICD-9-CM Step 1 locating the main term - Answer-look in the alphabetic index of
Volume Two under the main term.
main term - Answer-the patients illness or disease, in the ICD-9-CM the main term is
the primary way to locate the disease in the alphabetic index. are printed in boldface,
even with the left margin on each page
main terms examples - Answer-fracture, pneumonia, disease, injury, and enlarged
not main terms examples - Answer-anatomic terms : kidney, shoulder
alphabetic index - Answer-*Volume 2 of the ICD-9-CM, the alphabetic listing of
diagnoses
*cross-refrenced extremely well to allow the coder to locate the correct code using
several different terms. Ex. "congestive heart failure" can be found under the main
term " failure" and/or "congestive"
ICD-9-CM three alphanumeric classifications - Answer-V codes, E codes, M codes
, V codes (ICD-9-CM) - Answer-used to describe the main reason for the patient's visit
in cases where the patient is not sick. used as a secondary diagnosis to provide
further information about the patient's medical condition.
E codes (ICD-9-CM) - Answer-are external causes of injury and poisoning. are
optional by some carriers, many state statues require the assignment of an E code to
a claim form. E codes are secondary diagnosis to show the cause of injury, such as
a fall or automobile accident, if it is known.
M codes, Morphology Codes (ICD-9-CM) - Answer-located in the alphabetic index,
used to further identify the behavior and cell type of a neoplasm and are used in
conjunction with neoplasm codes from the main classification
M codes (ICD-9-CM) - Answer-used primarily by cancer registries and are not
assigned when submitting a claim to a carrier by the physician office
category - Answer-categories are three-digit representations of a single disease or
group of similar conditions, such as category 250, Diabetes Mellitus. Many
categories are divided further into subcategories and classifications.
subcateory - Answer-four-digit subcategories are subdivisions of categories to
provide greater specificity regarding etiology, site, or manifestations.
CPT Evaluation and Management - Answer-CPT section requires practitioners to
make decisions as to level of service for offices, hospitals, nursing home services
CPT Appendix B - Answer-summarizes the changes since the previous edition,
including additions and deletions essential for updating computer programs and or
encounter forms used in the facilty
CPT Level I Modifers - Answer-Appendix A, is a two -digit code added to the main
CPT code indicating the procedure has been altered by a specific circumstance. Ex.:
19100-50
CPT Level II National Codes (HCPCS) - Answer-alphanumeric "national codes"
supplied by the federal government, these codes supplement CPT codes enabling
providers to report non physician services such as durable medical equipment,
ambulance services, supplies and medications, particularly injectable drugs
Level II HCPCS Modifers - Answer-are either alphanumeric or letters that can be
used with all levels of HCPCS codes. Ex. -LT used to identify procedures performed
ton the left side of the body
International Classification of Diseases, 9th Revision, Clinical Modifications (ICD-9-
CM) - Answer-created by the World Health Organization (WHO) based in Geneva,
Switzerland
*is updated every year with changes every October 1
*coding system used to report diagnoses, diseases, and symptoms and reasons for
encounters for insurance claims
