CPC Certification Study Guide Overview and Key Concepts
Questions With Complete Solutions
Can social determinants of health (SDOH) documented by
clinicians be reported? Correct Answers Yes, SDOH
documented by clinicians may be reported as they represent
social information.
Can the code for the acute phase of an illness be used with the
code for the cause of the sequela? Correct Answers No, the
code for the acute phase is never used with a code for the cause
of the sequela.
Complete the series: Incus, stapes, ... Correct Answers Malleus
Describe the anatomic position. Correct Answers An upright,
face-forward position with arms by the side and palms facing
forward.
Do non-Medicare payers recognize the ABN? Correct Answers
No, non-Medicare payers may not recognize an ABN.
Give an example of a situation requiring an additional code for a
hemorrhagic disorder. Correct Answers For D68.32
Hemorrhagic disorder due to extrinsic circulating
anticoagulants, use additional code T45.515 for adverse effects
if applicable.
Give an example of an Excludes1 note. Correct Answers
Category code H26 for Other cataract excludes congenital
cataract (Q12.0).
,Hemiplegia is a disorder caused by a defect in which anatomical
system? Correct Answers Nervous
How are borderline diagnoses treated in coding? Correct
Answers They are coded as a confirmed diagnosis unless there
is an Index entry of borderline for that classification.
How are congenital and acquired conditions treated in relation to
Excludes1 notes? Correct Answers They should not be
reported together if they are related, as indicated by the
Excludes1 note.
How are gases exchanged in the lungs? Correct Answers
Across the single-cell layer of tissue in the alveolar sac into the
pulmonary circulation via diffusion.
How are three-character category codes structured in the Tabular
List? Correct Answers Three-character category codes consist
of a letter followed by two additional characters that may be
numbers or letters.
How did the Patient Protection and Affordable Care Act of 2010
(ACA) amend the definition of fraud? Correct Answers It
removed the intent requirement, meaning a person does not need
to have knowledge of the violation for it to be considered fraud.
How do medical coders contribute to healthcare reform?
Correct Answers By being instrumental in advising, decision-
making, and ensuring compliance with coding regulations.
,How do subterms in the Alphabetic Index modify main terms?
Correct Answers Subterms describe differences in site,
etiology, or clinical type, adding further modification to the
main term.
How do the male and female urethras differ? Correct Answers
They are different anatomically but perform the same functions.
How do veins function in the circulatory system? Correct
Answers Most veins carry deoxygenated blood back to the
heart.
How does a compliance program enhance patient care? Correct
Answers Increased accuracy of physician documentation from
a compliance program may assist in enhancing patient care.
How does ICD-10-CM allow for reporting laterality? Correct
Answers It allows for reporting right, left, or bilateral
conditions, with the final character of the code indicating
laterality.
How does the Includes note affect the coding of a diagnosis?
Correct Answers It clarifies what conditions are included under
a specific code, guiding accurate coding.
How does the lymphatic system operate without a pump?
Correct Answers It uses a series of valves to ensure fluid
travels in one direction back to the heart.
, How does the study guide help with real-life coding
applications? Correct Answers By providing real-life
examples of how to apply coding guidelines.
How is Medicaid administered? Correct Answers On a state-
by-state basis, adhering to certain federal guidelines.
How many chapters are in the ICD-10-CM Tabular List?
Correct Answers There are 22 chapters.
How many chapters are in the Tabular List of coding guidelines?
Correct Answers 22 chapters.
How many local chapters does AAPC offer? Correct Answers
More than 500.
How many ocular muscles are there, and what is their function?
Correct Answers There are six ocular muscles that move the
eye in multiple directions to facilitate a wide field of vision.
How often do code updates and insurance payment policies
change? Correct Answers Code updates and insurance
payment policies may change as often as quarterly.
How should a compliance program respond to detected
violations? Correct Answers It should investigate allegations
and disclose incidents to appropriate government entities.
How should codes be selected from the Alphabetic Index?
Correct Answers Refer to the main term and check for any
applicable subterms.
Questions With Complete Solutions
Can social determinants of health (SDOH) documented by
clinicians be reported? Correct Answers Yes, SDOH
documented by clinicians may be reported as they represent
social information.
Can the code for the acute phase of an illness be used with the
code for the cause of the sequela? Correct Answers No, the
code for the acute phase is never used with a code for the cause
of the sequela.
Complete the series: Incus, stapes, ... Correct Answers Malleus
Describe the anatomic position. Correct Answers An upright,
face-forward position with arms by the side and palms facing
forward.
Do non-Medicare payers recognize the ABN? Correct Answers
No, non-Medicare payers may not recognize an ABN.
Give an example of a situation requiring an additional code for a
hemorrhagic disorder. Correct Answers For D68.32
Hemorrhagic disorder due to extrinsic circulating
anticoagulants, use additional code T45.515 for adverse effects
if applicable.
Give an example of an Excludes1 note. Correct Answers
Category code H26 for Other cataract excludes congenital
cataract (Q12.0).
,Hemiplegia is a disorder caused by a defect in which anatomical
system? Correct Answers Nervous
How are borderline diagnoses treated in coding? Correct
Answers They are coded as a confirmed diagnosis unless there
is an Index entry of borderline for that classification.
How are congenital and acquired conditions treated in relation to
Excludes1 notes? Correct Answers They should not be
reported together if they are related, as indicated by the
Excludes1 note.
How are gases exchanged in the lungs? Correct Answers
Across the single-cell layer of tissue in the alveolar sac into the
pulmonary circulation via diffusion.
How are three-character category codes structured in the Tabular
List? Correct Answers Three-character category codes consist
of a letter followed by two additional characters that may be
numbers or letters.
How did the Patient Protection and Affordable Care Act of 2010
(ACA) amend the definition of fraud? Correct Answers It
removed the intent requirement, meaning a person does not need
to have knowledge of the violation for it to be considered fraud.
How do medical coders contribute to healthcare reform?
Correct Answers By being instrumental in advising, decision-
making, and ensuring compliance with coding regulations.
,How do subterms in the Alphabetic Index modify main terms?
Correct Answers Subterms describe differences in site,
etiology, or clinical type, adding further modification to the
main term.
How do the male and female urethras differ? Correct Answers
They are different anatomically but perform the same functions.
How do veins function in the circulatory system? Correct
Answers Most veins carry deoxygenated blood back to the
heart.
How does a compliance program enhance patient care? Correct
Answers Increased accuracy of physician documentation from
a compliance program may assist in enhancing patient care.
How does ICD-10-CM allow for reporting laterality? Correct
Answers It allows for reporting right, left, or bilateral
conditions, with the final character of the code indicating
laterality.
How does the Includes note affect the coding of a diagnosis?
Correct Answers It clarifies what conditions are included under
a specific code, guiding accurate coding.
How does the lymphatic system operate without a pump?
Correct Answers It uses a series of valves to ensure fluid
travels in one direction back to the heart.
, How does the study guide help with real-life coding
applications? Correct Answers By providing real-life
examples of how to apply coding guidelines.
How is Medicaid administered? Correct Answers On a state-
by-state basis, adhering to certain federal guidelines.
How many chapters are in the ICD-10-CM Tabular List?
Correct Answers There are 22 chapters.
How many chapters are in the Tabular List of coding guidelines?
Correct Answers 22 chapters.
How many local chapters does AAPC offer? Correct Answers
More than 500.
How many ocular muscles are there, and what is their function?
Correct Answers There are six ocular muscles that move the
eye in multiple directions to facilitate a wide field of vision.
How often do code updates and insurance payment policies
change? Correct Answers Code updates and insurance
payment policies may change as often as quarterly.
How should a compliance program respond to detected
violations? Correct Answers It should investigate allegations
and disclose incidents to appropriate government entities.
How should codes be selected from the Alphabetic Index?
Correct Answers Refer to the main term and check for any
applicable subterms.
