Certified Professional Coder (CPC) Exam Study Guide – Comprehensive Medical Coding Review for 2025

Certified Professional Coder (CPC) Exam Study Guide – Comprehensive Medical Coding Review for 2025Certified Professional Coder (CPC) Exam Study Guide – Comprehensive Medical Coding Review for 2025Certified Professional Coder (CPC) Exam Study Guide – Comprehensive Medical Coding Review for 2025Certified Professional Coder (CPC) Exam Study Guide – Comprehensive Medical Coding Review for 2025 1. If a provider states in their documentation that medication was reviewed and reconciled and they are managing the patient's medication, what is the risk level?: Moderate 2. If a note states, "Radiology images reviewed today with the patient," which E/M MDM complexity category is this considered?: Category 1 :Review of the results of each unique test 3. What is the benefit of keeping registration errors low?: lower number of claims denials, decrease in accounts receivable aging, increase in patient satisfac- tion 4. Which of the following informational tools is available to check whether Medicare is a secondary payer?: Medicare Secondary Payer Questionnaire 5. What are the most commonly missed HCC codes annually?: Transplant, ostomy, amputation, diabetes, and dialysis 6. Which of the following is the correct ICD-10-CM coding when a patient is identified as having chronic kidney disease (CKD) stage 5 and receiving dialysis?: N18.5, Z99.2 7. Crosswalks can only be developed for which code set?: CPT, HCPCS Level II, ICD-10-CM 8. Which statement is NOT true concerning crosswalk data?: Crosswalks guar- antee payment 9. Which of the following conditions can cause chronic cough?: COPD, GERD, Allergies 10. Subacute coughs last for how long after the initial cold or respiratory infection is over?: 3-8 weeks 11. What are the main parts of an operative report?: Header, body, footer 12. If a provider removes as much of a tumor as possible to aid a patient's chemotherapy or to prolong their life, but cannot remove the entire tumor, this is known as what?: Debulking 13. A new patient presents to the office with pain while urinating and the physician documents a diagnosis of urinary tract infection. No other problems were discussed during the visit. How do you code this office visit based on medical decision making (MDM)?: 99203 14. A patient presents to the office with pain while urinating and the physician diagnoses a urinary tract infection. The physician notes that the patient has diabetes. What level of MDM is the visit?: Moderate 15. Which criteria would support an initial encounter 7th character?: Evalua- tion and coordination for a fracture surgery 16. Which scenario may support a subsequent encounter 7th character?: - Checking the fracture healing progress with an X-ray 17. A patient presented to the office for evaluation of bilateral knee pain following a fall a few days ago. The physician listed possible etiologies and ordered imaging as part of the workup. The patient is to return for follow-up after imaging is done. The doctor documented acute bilateral knee pain. How is this coded?: M25.561, M25.562, G89.11 18. Little Ralphie was so excited about getting an official Red Ryder car- bine-action, 200-shot, range model air rifle, he paid no mind to his mother's warnings that he'll shoot his eye out. He ended up with a black eye because the BB gun malfunctioned, and they headed to the ER. Which code would you use to report the BB gun glitch?: W34.110A 19. Grandma got run over by a reindeer walking home from her son's house Christmas Eve. She was rushed to the ER, where the attending noticed a bruise on her forehead in the shape of a hoof print. When asked what hap- pened, she swore that she was knocked out by one of Santa's reindeer as it flew by. If that was indeed the case, which codes would you report?: V06.00XA, W55.32XA 20. What is the appropriate CPT code for the unilateral insertion of a peri- urethral transperineal balloon continence device?: 53452 21. When educating providers on what to document in the medical record, the use of which acronym was recommended by more than one RISKCON presen- ter because it is more provider-friendly?: DSP (Direct Support Professional) 22. Which test result in NOT indicative of diabetes?: FPG 115 mg/dL 23. According to the Cigna Genetic Testing for Hereditary Cancer Suscep- tibility Syndromes policy, in order to meet medical necessity, who cannot recommend genetic testing?: Primary care physician 24. Under the AETNA Genetic Testing Policy, which CPT coding is covered for cystic fibrosis genetic testing?: 25. The primary diagnostic characteristics of rhabdomyolysis include which of the following?: Tea-colored urine and elevated creatine kinase 26. What is the mainstay treatment for rhabdomyolysis?: Intravenous fluids 27. What is a common complication of rhabdomyolysis?: Acute kidney injury 28. Which of the following is true about clinical intuitiveness?: It is a skilled practice. 29. Based on 2021 E/M guidelines, leveling a service is based on which of the following?: Overall medical decision making 30. How can setting pass rate threshold benefit your organization's compli- ance program?: By ensuring your audit program is measurable to help you make improvements over time 31. Which of the following should be a consideration when setting pass rate thresholds?: They type of audit and industry changes 32. What is the main difference between ablative laser and non-ablative laser techniques?: Only the ablative laser technique has provisional coverage under TRICARE Ablative is a wounding technique and non-ablative is non-wounding Ablative laser techniques are more effective than non-ablative techniques 33. A patient with TRICARE receives AFL treatment for a scar resulting from shrapnel. The dermatologist treats an area measuring 169 cm2. How do you code?: 0479T, 0480T A doctor documents: Patient with a strong family history of colon cancer was found to have a mass in the sigmoid colon that was confirmed to be colon cancer on biopsy. He underwent surgery yesterday to remove the colon cancer, and pathology showed inv