,SOLUTION MANUAL FOR 3 3-2-1 Code It! 2026 Edition 14th Edition Green
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provided.
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, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Solution and Answer Guide
GREEN, 3-2-1 CODE IT!, 14E, 2026, 9798214481968;
CHAPTER 1: OVERVIEW OF CODING
TABLE OF CONTENTS
Exercises......................................................................................................................................1
Exercise 1.1: Career as a Coder ............................................................................................... 1
Exercise 1.2: Professional Associations....................................................................................2
Exercise 1.3: Coding Systems and Processes..........................................................................3
Exercise 1.4: Other Classification Systems and Databases......................................................5
Exercise 1.5: Documentation as Basis for Coding.....................................................................6
Exercise 1.6: Health Data Collection ......................................................................................... 8
Review..........................................................................................................................................9
Multiple Choice .......................................................................................................................... 9
EXERCISES
EXERCISE 1.1: CAREER AS A CODER
1. A coder is required to have a working knowledge of the CPT, HCPCS Level II, ICD-10-CM, and
__________ coding systems.
Answer: ICD-10-PCS
Analysis: A coder must have a working knowledge of the CPT, HCPCS Level II, ICD-10-CM, and
ICD-10-PCS coding systems.
2. The complexity and intensity of procedures performed and services provided during an outpatient
or physician office encounter are captured as part of __________ coding.
Answer: professional
Analysis: The complexity and intensity of procedures performed and services provided during an
outpatient or physician office encounter are captured as part of professional coding.
3. The intensity of services and severity of illness associated with inpatient care are captured as part of
__________ (or facility) coding.
Answer: institutional
Analysis: The intensity of services and severity of illness associated with inpatient care are
captured as part of institutional (or facility) coding.
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 1
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
4. When a multi-hospital system provides physician office services along with traditional inpatient,
outpatient, and emergency department hospital care, the concept of __________ coding is
adopted to facilitate professional and institutional billing.
Answer: single-path
Analysis: When a multi-hospital system provides physician office services along with traditional
inpatient, outpatient, and emergency department hospital care, the concept of single-path coding
is adopted to facilitate professional and institutional billing.
5. A professional who reviews health-related claims to determine whether the costs are reasonable
and medically necessary based on the patient’s diagnosis reported for procedures performed and
services provided is called a health _______ specialist (or claims examiner).
Answer: insurance
Analysis: A health insurance specialist (or claims examiner) reviews health-related claims to
determine whether the costs are reasonable and medically necessary based on the patient’s
diagnosis reported for procedures performed and services provided. This role is closely related to
that of a coder.
EXERCISE 1.2: PROFESSIONAL ASSOCIATIONS
1. Reduced certification exam fees and website access for members only are common benefits of
a(n) __________ association.
Answer: professional
Analysis: Reduced certification exam fees and website access for members only are common
benefits of a professional association.
2. Attending professional association conferences and meetings provides opportunities to
__________ (or interact) with other professionals, which can facilitate internship or job
placement.
Answer: network
Analysis: Attending professional association conferences and meetings provides opportunities to
network (or interact) with other professionals, which can facilitate internship or job placement.
3. A medical assistant usually joins the American Medical Technologists (AMT) or the __________.
Answer: American Association of Medical Assistants (AAMA)
Analysis: A medical assistant usually joins the American Medical Technologists (AMT) or the
American Association of Medical Assistants (AAMA).
4. An Internet-based discussion forum that covers a variety of professional topics and issues is
called an online discussion board or _______.
Answer: forum
Analysis: An Internet-based discussion forum that covers a variety of professional topics and
issues is called an online discussion board or forum.
5. A coder usually joins either the American Health Information Management Association (AHIMA)
or the __________.
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 2
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Answer: AAPC
Analysis: A coder usually joins either the American Health Information Management Association
(AHIMA) or the AAPC. (The AAPC was founded as the American Academy of Professional
Coders and uses just the abbreviation today.)
EXERCISE 1.3: CODING SYSTEMS AND PROCESSES
1. A medical nomenclature that is organized according to similar conditions, diseases, procedures,
and services, and contains codes for each, is called a __________ (or classification) system.
Answer: coding
Analysis: A medical nomenclature that is organized according to similar conditions, diseases,
procedures, and services, and contains codes for each, is called a coding (or classification)
system.
2. All diseases, injuries, and reasons for an encounter, whether patients are treated as inpatients or
outpatients, are coded using the __________ classification system.
Answer: ICD-10-CM
Analysis: All diseases, injuries, and reasons for an encounter, whether patients are treated as
inpatients or outpatients, are coded using the ICD-10-CM classification system.
3. Inpatient hospital procedures and services are coded using the __________ classification
system.
Answer: ICD-10-PCS
Analysis: Inpatient hospital procedures and services are coded using the ICD-10-PCS
classification system.
4. A public or private entity that processes or facilitates the processing of health information and
claims from a nonstandard to a standard format is called a health care __________.
Answer: clearinghouse
Analysis: A public or private entity that processes or facilitates the processing of health
information and claims from a nonstandard format to a standard format is called a health care
clearinghouse.
5. Routinely assigning lower-level CPT codes for convenience instead of reviewing patient record
documentation and the coding manual to determine the proper code to be reported is called
__________.
Answer: downcoding
Analysis: Routinely assigning lower-level CPT codes as a convenience instead of reviewing
patient record documentation and the coding manual to determine the proper code to be reported
is called downcoding.
6. Reporting codes that are not supported by documentation in the patient record for the purpose of
increasing reimbursement is called __________.
Answer: upcoding
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 3
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Analysis: Reporting codes that are not supported by documentation in the patient record for the
purpose of increasing reimbursement is called upcoding.
7. Reporting codes for signs and symptoms in addition to the established diagnosis code is called
__________.
Answer: overcoding
Analysis: Reporting codes for signs and symptoms in addition to the established diagnosis code
is called overcoding.
8. Reporting multiple codes to increase reimbursement when a single combination code should be
reported is called __________.
Answer: unbundling
Analysis: Reporting multiple codes to increase reimbursement when a single combination code
should be reported is called unbundling.
9. Coders should always avoid assumption coding, and can do so by generating a physician
__________ when documentation needs clarification prior to the assignment of codes.
Answer: query
Analysis: Coders should always avoid assumption coding, and can do so by generating a
physician query when documentation needs clarification prior to the assignment of codes.
10. Technology that uses a natural language processing engine to “read” electronic health records
and generate codes, which are then reviewed and validated by coders, is called __________.
Answer: computer-assisted coding (CAC)
Analysis: Automating the medical coding process is the goal of computer-assisted coding (CAC),
which uses a natural language processing engine to “read” electronic health records and
generate codes, while artificial intelligence software uses machine learning and algorithms during
the analysis of patient data to generate codes, which are then reviewed and validated by coders.
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 4
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
EXERCISE 1.4: OTHER CLASSIFICATION SYSTEMS AND DATABASES
1. The classification of neoplasms used by cancer registries throughout the world to record the
incidence of malignancy and survival rates is called the __________.
Answer: International Classification of Diseases for Oncology, Third Edition (ICD-O-3)
Analysis: The classification of neoplasms used by cancer registries throughout the world to record
the incidence of malignancy and survival rates is called the International Classification of Diseases
for Oncology, Third Edition (ICD-O-3). (Note: The capital letter O in the classification system’s
abbreviation refers to Oncology.)
2. Specific sets of patient characteristics (or case-mix groups) that are used to make payment
determinations for prospective payment systems are represented by __________ rate codes.
Answer: Health Insurance Prospective Payment System (HIPPS)
Analysis: Specific sets of patient characteristics (or case-mix groups) that are used to make
payment determinations for prospective payment systems are represented by Health Insurance
Prospective Payment System (HIPPS) rate codes.
3. The integration and distribution of key terminology, classification and coding standards, and
associated resources to facilitate the use of effective and interoperable biomedical information
systems and services uses the __________.
Answer: Unified Medical Language System (UMLS)
Analysis: The integration and distribution of key terminology, classification and coding standards,
and associated resources to facilitate the use of effective and interoperable biomedical
information systems and services uses the Unified Medical Language System (UMLS).
4. The coding system that is used to classify dental procedures and services is called the
__________.
Answer: Current Dental Terminology (CDT)
Analysis: The coding system that is used to classify dental procedures and services is called the
Current Dental Terminology (CDT).
5. The system that classifies health and health-related domains to describe body functions and
structures, activities, participation, and environmental factors is called the __________.
Answer: International Classification of Functioning, Disability and Health (ICF)
Analysis: The system that classifies health and health-related domains to describe body functions
and structures, activities, participation, and environmental factors is called the International
Classification of Functioning, Disability and Health (ICF).
6. The system that describes complementary and alternative medicine remedies, services, and
supplies is called __________.
Answer: Alternative Billing Codes (ABC codes)
Analysis: The system that describes complementary and alternative medicine remedies, services,
and supplies is called Alternative Billing Codes (ABC codes).
7. The normalized naming system for generic and branded drugs is called __________.
Answer: RxNorm
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 5
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Analysis: The normalized naming system for generic and branded drugs is called RxNorm.
8. A common language that includes codes, identifiers, and names for identifying health
measurements, observations, and documents is called the __________.
Answer: Logical Observation Identifiers Names and Codes (LOINC)
Analysis: A common language that includes codes, identifiers, and names for identifying health
measurements, observations, and documents is called the Logical Observation Identifiers Names
and Codes (LOINC).
9. The American Psychiatric Association published a standard classification of mental disorders
called the __________-5-TR.
Answer: DSM
Analysis: The American Psychiatric Association published a standard classification of mental
disorders called the DSM-5-TR. DSM means Diagnostic and Statistical Manual of Mental
Disorders, -5 refers to the fifth edition, and -TR refers to text revision.
10. The system that supports electronic health record (EHR) documentation of nursing plans of care
and includes nursing terminologies that focus on nursing diagnoses, nursing
interventions/actions, and nursing outcomes is called the __________ System.
Answer: Clinical Care Classification (CCC)
Analysis: The system that supports electronic health record (EHR) documentation
of nursing plans of care and includes nursing terminologies that focus on nursing diagnoses,
nursing interventions/actions, and nursing outcomes is called the Clinical Care Classification
(CCC) System.
EXERCISE 1.5: DOCUMENTATION AS BASIS FOR CODING
1. Continuity of patient care is considered a __________ purpose of the patient record.
a. primary
b. secondary
Answer: a
Analysis:
a. Correct. Continuity of patient care is considered a primary purpose of the patient record, and
it involves documenting patient care procedures and services so that others who treat the
patient have a source of information upon which to base additional care and treatment.
b. Incorrect. Secondary purposes of the record include evaluating the quality of patient care;
providing data for use in clinical research, epidemiology studies, education, public policy
making, facilities planning, and health care statistics; providing information to third-party
payers for reimbursement; and serving the medicolegal interests of the patient, facility, and
care providers. Continuity of patient care is a primary purpose of the patient, and it involves
documenting patient care procedures and services so that others who treat the patient have a
source of information upon which to base additional care and treatment.
2. Evaluating the quality of patient care is considered a __________ purpose of the patient record.
a. primary
b. secondary
Answer: b
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 6
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Analysis:
a. Incorrect. The primary purpose of the patient record is to provide for continuity of care, which
involves documenting patient care services so that others who treat the patient have a source
of information on which to base additional care and treatment. Evaluating the quality of
patient care is considered a secondary purpose of the patient record. Secondary purposes of
the record include evaluating the quality of patient care; providing data for use in clinical research,
epidemiology studies, education, public policy making, facilities planning, and health care
statistics; providing information to third-party payers for reimbursement; and serving the
medicolegal interests of the patient, facility, and care providers.
b. Correct. Evaluating the quality of patient care is considered a secondary purpose
of the patient record. Secondary purposes of the record include evaluating the quality of patient
care; providing data for use in clinical research, epidemiology studies, education, public policy
making, facilities planning, and health care statistics; providing information to third-party payers for
reimbursement; and serving the medicolegal interests of the patient, facility, and care providers.
3. Which is an example of patient demographic data?
a. date of birth
b. discharge diagnosis
Answer: a
Analysis:
a. Correct. The date of birth is an example of patient demographic data. Demographic data are
patient identification information that is collected according to facility policy.
b. Incorrect. The discharge diagnosis is an example of patient clinical data. The date of birth is
an example of patient demographic data. Demographic data are patient identification
information that is collected according to facility policy.
4. Medical necessity requires providers to document procedures, services, and supplies that are
proper and needed for the
a. convenience of the physician or health care facility.
b. diagnosis or treatment of a patient’s medical condition.
Answer: b
Analysis:
a. Incorrect. Performing procedures, services, and supplies for the convenience of the physician
or health care facility is not permitted. Medical necessity requires providers to document
procedures, services, and supplies that are proper and needed for the diagnosis or treatment
of a patient’s medical condition.
b. Correct. Medical necessity requires providers to document procedures, services, and
supplies that are proper and needed for the diagnosis or treatment of a patient’s medical
condition.
5. Which is the business record for a patient encounter because it documents health care services
provided?
a. demographic data collected on admission
b. patient record housed in the facility
Answer: b
Analysis:
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 7
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
a. Incorrect. Demographic data collected on admission is included on the face sheet of the
manual patient record or in the electronic health record; however, it is not the business record
for a patient record because it does not document health care services provided. The patient
record housed in the facility is the business record for a patient encounter because it
documents health care services provided.
b. Correct. The patient record housed in the facility is the business record for a patient
encounter because it documents health care services provided.
EXERCISE 1.6: HEALTH DATA COLLECTION
1. Appointment scheduling and claims processing are processes associated with medical
__________ software.
Answer: management
Analysis: Appointment scheduling and claims processing are processes associated with medical
management software, which is a combination of practice management and medical billing
software that automates the daily workflow and procedures of a physician’s office or clinic. The
software automates appointment scheduling, claims processing, patient invoicing, patient
management, and generating reports.
2. To collect and report inpatient and outpatient data for statistical analysis and reimbursement
purposes, hospital coders and abstractors use automated case ______ software.
Answer: abstracting
Analysis: Hospital (and other health care facility) coders and abstractors use automated case
abstracting software to collect and report inpatient and outpatient data for statistical analysis and
reimbursement purposes. Data is entered into an abstracting software program, and the facility’s
billing department imports it to the UB-04 claim for submission to third-party payers.
3. Physicians’ offices submit data to third-party payers on the __________ claim.
Answer: CMS-1500
Analysis: Physicians’ offices submit data to third-party payers on the CMS-1500 claim, which is
the standard claim submitted by physicians to third-party payers for office encounters and
professional services (e.g., provided to hospital inpatients). Physician offices use medical
management software to enter claims data for electronic submission to third-party payers or
clearinghouses. Some eligible medical practices continue to print paper-based CMS-1500 claims
and are mailed or faxed to clearinghouses or third-party payers for processing.
4. Hospitals submit data to third-party payers on the __________ (or CMS-1450) claim.
Answer: UB-04
Analysis: Hospitals submit data to third-party payers on the UB-04 (or CMS-1450) claim, which is
the standard claim submitted by health care institutions to third-party payers for inpatient and
outpatient services. (UB means “uniform bill.”)
5. Claims are denied if __________ necessity of procedures or services is not established.
Answer: medical
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 8
website, in whole or in part.
Important Notes
The file includes the complete test bank, organized chapter by chapter.
A sample of selected pages has been provided for preview.
All available appendices and Excel files (if included in the original resources) are
provided.
We continuously update our files to ensure you receive the latest and most accurate
editions.
New editions are added regularly – stay connected for updates!
⚠️Note on Answer Keys: If the answer key is not included within the chapter
questions, you will find the complete answers and solutions at the end of each
chapter.
✅ Why Buy From Us?
📚 Complete & organized chapter-by-chapter – no missing content, no guessing.
⚡ Instant digital delivery – get your file the moment you pay, no waiting.
📅 Always up to date – we track new editions so you always get the latest version.
💬 Friendly support – real humans ready to help, anytime you need us.
🔒 Safe & secure – thousands of satisfied students trust us every semester.
🛡️Our Guarantees
💰 Money-Back Guarantee: Not satisfied? We offer a full refund – no questions asked.
🔄 Wrong File? No Problem: Contact us and we will replace it immediately with the
correct version, free of charge.
⏰ 24/7 Support: We are always here – reach out anytime and expect a fast response.
Contact Email:
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Solution and Answer Guide
GREEN, 3-2-1 CODE IT!, 14E, 2026, 9798214481968;
CHAPTER 1: OVERVIEW OF CODING
TABLE OF CONTENTS
Exercises......................................................................................................................................1
Exercise 1.1: Career as a Coder ............................................................................................... 1
Exercise 1.2: Professional Associations....................................................................................2
Exercise 1.3: Coding Systems and Processes..........................................................................3
Exercise 1.4: Other Classification Systems and Databases......................................................5
Exercise 1.5: Documentation as Basis for Coding.....................................................................6
Exercise 1.6: Health Data Collection ......................................................................................... 8
Review..........................................................................................................................................9
Multiple Choice .......................................................................................................................... 9
EXERCISES
EXERCISE 1.1: CAREER AS A CODER
1. A coder is required to have a working knowledge of the CPT, HCPCS Level II, ICD-10-CM, and
__________ coding systems.
Answer: ICD-10-PCS
Analysis: A coder must have a working knowledge of the CPT, HCPCS Level II, ICD-10-CM, and
ICD-10-PCS coding systems.
2. The complexity and intensity of procedures performed and services provided during an outpatient
or physician office encounter are captured as part of __________ coding.
Answer: professional
Analysis: The complexity and intensity of procedures performed and services provided during an
outpatient or physician office encounter are captured as part of professional coding.
3. The intensity of services and severity of illness associated with inpatient care are captured as part of
__________ (or facility) coding.
Answer: institutional
Analysis: The intensity of services and severity of illness associated with inpatient care are
captured as part of institutional (or facility) coding.
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 1
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
4. When a multi-hospital system provides physician office services along with traditional inpatient,
outpatient, and emergency department hospital care, the concept of __________ coding is
adopted to facilitate professional and institutional billing.
Answer: single-path
Analysis: When a multi-hospital system provides physician office services along with traditional
inpatient, outpatient, and emergency department hospital care, the concept of single-path coding
is adopted to facilitate professional and institutional billing.
5. A professional who reviews health-related claims to determine whether the costs are reasonable
and medically necessary based on the patient’s diagnosis reported for procedures performed and
services provided is called a health _______ specialist (or claims examiner).
Answer: insurance
Analysis: A health insurance specialist (or claims examiner) reviews health-related claims to
determine whether the costs are reasonable and medically necessary based on the patient’s
diagnosis reported for procedures performed and services provided. This role is closely related to
that of a coder.
EXERCISE 1.2: PROFESSIONAL ASSOCIATIONS
1. Reduced certification exam fees and website access for members only are common benefits of
a(n) __________ association.
Answer: professional
Analysis: Reduced certification exam fees and website access for members only are common
benefits of a professional association.
2. Attending professional association conferences and meetings provides opportunities to
__________ (or interact) with other professionals, which can facilitate internship or job
placement.
Answer: network
Analysis: Attending professional association conferences and meetings provides opportunities to
network (or interact) with other professionals, which can facilitate internship or job placement.
3. A medical assistant usually joins the American Medical Technologists (AMT) or the __________.
Answer: American Association of Medical Assistants (AAMA)
Analysis: A medical assistant usually joins the American Medical Technologists (AMT) or the
American Association of Medical Assistants (AAMA).
4. An Internet-based discussion forum that covers a variety of professional topics and issues is
called an online discussion board or _______.
Answer: forum
Analysis: An Internet-based discussion forum that covers a variety of professional topics and
issues is called an online discussion board or forum.
5. A coder usually joins either the American Health Information Management Association (AHIMA)
or the __________.
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 2
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Answer: AAPC
Analysis: A coder usually joins either the American Health Information Management Association
(AHIMA) or the AAPC. (The AAPC was founded as the American Academy of Professional
Coders and uses just the abbreviation today.)
EXERCISE 1.3: CODING SYSTEMS AND PROCESSES
1. A medical nomenclature that is organized according to similar conditions, diseases, procedures,
and services, and contains codes for each, is called a __________ (or classification) system.
Answer: coding
Analysis: A medical nomenclature that is organized according to similar conditions, diseases,
procedures, and services, and contains codes for each, is called a coding (or classification)
system.
2. All diseases, injuries, and reasons for an encounter, whether patients are treated as inpatients or
outpatients, are coded using the __________ classification system.
Answer: ICD-10-CM
Analysis: All diseases, injuries, and reasons for an encounter, whether patients are treated as
inpatients or outpatients, are coded using the ICD-10-CM classification system.
3. Inpatient hospital procedures and services are coded using the __________ classification
system.
Answer: ICD-10-PCS
Analysis: Inpatient hospital procedures and services are coded using the ICD-10-PCS
classification system.
4. A public or private entity that processes or facilitates the processing of health information and
claims from a nonstandard to a standard format is called a health care __________.
Answer: clearinghouse
Analysis: A public or private entity that processes or facilitates the processing of health
information and claims from a nonstandard format to a standard format is called a health care
clearinghouse.
5. Routinely assigning lower-level CPT codes for convenience instead of reviewing patient record
documentation and the coding manual to determine the proper code to be reported is called
__________.
Answer: downcoding
Analysis: Routinely assigning lower-level CPT codes as a convenience instead of reviewing
patient record documentation and the coding manual to determine the proper code to be reported
is called downcoding.
6. Reporting codes that are not supported by documentation in the patient record for the purpose of
increasing reimbursement is called __________.
Answer: upcoding
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 3
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Analysis: Reporting codes that are not supported by documentation in the patient record for the
purpose of increasing reimbursement is called upcoding.
7. Reporting codes for signs and symptoms in addition to the established diagnosis code is called
__________.
Answer: overcoding
Analysis: Reporting codes for signs and symptoms in addition to the established diagnosis code
is called overcoding.
8. Reporting multiple codes to increase reimbursement when a single combination code should be
reported is called __________.
Answer: unbundling
Analysis: Reporting multiple codes to increase reimbursement when a single combination code
should be reported is called unbundling.
9. Coders should always avoid assumption coding, and can do so by generating a physician
__________ when documentation needs clarification prior to the assignment of codes.
Answer: query
Analysis: Coders should always avoid assumption coding, and can do so by generating a
physician query when documentation needs clarification prior to the assignment of codes.
10. Technology that uses a natural language processing engine to “read” electronic health records
and generate codes, which are then reviewed and validated by coders, is called __________.
Answer: computer-assisted coding (CAC)
Analysis: Automating the medical coding process is the goal of computer-assisted coding (CAC),
which uses a natural language processing engine to “read” electronic health records and
generate codes, while artificial intelligence software uses machine learning and algorithms during
the analysis of patient data to generate codes, which are then reviewed and validated by coders.
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 4
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
EXERCISE 1.4: OTHER CLASSIFICATION SYSTEMS AND DATABASES
1. The classification of neoplasms used by cancer registries throughout the world to record the
incidence of malignancy and survival rates is called the __________.
Answer: International Classification of Diseases for Oncology, Third Edition (ICD-O-3)
Analysis: The classification of neoplasms used by cancer registries throughout the world to record
the incidence of malignancy and survival rates is called the International Classification of Diseases
for Oncology, Third Edition (ICD-O-3). (Note: The capital letter O in the classification system’s
abbreviation refers to Oncology.)
2. Specific sets of patient characteristics (or case-mix groups) that are used to make payment
determinations for prospective payment systems are represented by __________ rate codes.
Answer: Health Insurance Prospective Payment System (HIPPS)
Analysis: Specific sets of patient characteristics (or case-mix groups) that are used to make
payment determinations for prospective payment systems are represented by Health Insurance
Prospective Payment System (HIPPS) rate codes.
3. The integration and distribution of key terminology, classification and coding standards, and
associated resources to facilitate the use of effective and interoperable biomedical information
systems and services uses the __________.
Answer: Unified Medical Language System (UMLS)
Analysis: The integration and distribution of key terminology, classification and coding standards,
and associated resources to facilitate the use of effective and interoperable biomedical
information systems and services uses the Unified Medical Language System (UMLS).
4. The coding system that is used to classify dental procedures and services is called the
__________.
Answer: Current Dental Terminology (CDT)
Analysis: The coding system that is used to classify dental procedures and services is called the
Current Dental Terminology (CDT).
5. The system that classifies health and health-related domains to describe body functions and
structures, activities, participation, and environmental factors is called the __________.
Answer: International Classification of Functioning, Disability and Health (ICF)
Analysis: The system that classifies health and health-related domains to describe body functions
and structures, activities, participation, and environmental factors is called the International
Classification of Functioning, Disability and Health (ICF).
6. The system that describes complementary and alternative medicine remedies, services, and
supplies is called __________.
Answer: Alternative Billing Codes (ABC codes)
Analysis: The system that describes complementary and alternative medicine remedies, services,
and supplies is called Alternative Billing Codes (ABC codes).
7. The normalized naming system for generic and branded drugs is called __________.
Answer: RxNorm
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 5
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Analysis: The normalized naming system for generic and branded drugs is called RxNorm.
8. A common language that includes codes, identifiers, and names for identifying health
measurements, observations, and documents is called the __________.
Answer: Logical Observation Identifiers Names and Codes (LOINC)
Analysis: A common language that includes codes, identifiers, and names for identifying health
measurements, observations, and documents is called the Logical Observation Identifiers Names
and Codes (LOINC).
9. The American Psychiatric Association published a standard classification of mental disorders
called the __________-5-TR.
Answer: DSM
Analysis: The American Psychiatric Association published a standard classification of mental
disorders called the DSM-5-TR. DSM means Diagnostic and Statistical Manual of Mental
Disorders, -5 refers to the fifth edition, and -TR refers to text revision.
10. The system that supports electronic health record (EHR) documentation of nursing plans of care
and includes nursing terminologies that focus on nursing diagnoses, nursing
interventions/actions, and nursing outcomes is called the __________ System.
Answer: Clinical Care Classification (CCC)
Analysis: The system that supports electronic health record (EHR) documentation
of nursing plans of care and includes nursing terminologies that focus on nursing diagnoses,
nursing interventions/actions, and nursing outcomes is called the Clinical Care Classification
(CCC) System.
EXERCISE 1.5: DOCUMENTATION AS BASIS FOR CODING
1. Continuity of patient care is considered a __________ purpose of the patient record.
a. primary
b. secondary
Answer: a
Analysis:
a. Correct. Continuity of patient care is considered a primary purpose of the patient record, and
it involves documenting patient care procedures and services so that others who treat the
patient have a source of information upon which to base additional care and treatment.
b. Incorrect. Secondary purposes of the record include evaluating the quality of patient care;
providing data for use in clinical research, epidemiology studies, education, public policy
making, facilities planning, and health care statistics; providing information to third-party
payers for reimbursement; and serving the medicolegal interests of the patient, facility, and
care providers. Continuity of patient care is a primary purpose of the patient, and it involves
documenting patient care procedures and services so that others who treat the patient have a
source of information upon which to base additional care and treatment.
2. Evaluating the quality of patient care is considered a __________ purpose of the patient record.
a. primary
b. secondary
Answer: b
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 6
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
Analysis:
a. Incorrect. The primary purpose of the patient record is to provide for continuity of care, which
involves documenting patient care services so that others who treat the patient have a source
of information on which to base additional care and treatment. Evaluating the quality of
patient care is considered a secondary purpose of the patient record. Secondary purposes of
the record include evaluating the quality of patient care; providing data for use in clinical research,
epidemiology studies, education, public policy making, facilities planning, and health care
statistics; providing information to third-party payers for reimbursement; and serving the
medicolegal interests of the patient, facility, and care providers.
b. Correct. Evaluating the quality of patient care is considered a secondary purpose
of the patient record. Secondary purposes of the record include evaluating the quality of patient
care; providing data for use in clinical research, epidemiology studies, education, public policy
making, facilities planning, and health care statistics; providing information to third-party payers for
reimbursement; and serving the medicolegal interests of the patient, facility, and care providers.
3. Which is an example of patient demographic data?
a. date of birth
b. discharge diagnosis
Answer: a
Analysis:
a. Correct. The date of birth is an example of patient demographic data. Demographic data are
patient identification information that is collected according to facility policy.
b. Incorrect. The discharge diagnosis is an example of patient clinical data. The date of birth is
an example of patient demographic data. Demographic data are patient identification
information that is collected according to facility policy.
4. Medical necessity requires providers to document procedures, services, and supplies that are
proper and needed for the
a. convenience of the physician or health care facility.
b. diagnosis or treatment of a patient’s medical condition.
Answer: b
Analysis:
a. Incorrect. Performing procedures, services, and supplies for the convenience of the physician
or health care facility is not permitted. Medical necessity requires providers to document
procedures, services, and supplies that are proper and needed for the diagnosis or treatment
of a patient’s medical condition.
b. Correct. Medical necessity requires providers to document procedures, services, and
supplies that are proper and needed for the diagnosis or treatment of a patient’s medical
condition.
5. Which is the business record for a patient encounter because it documents health care services
provided?
a. demographic data collected on admission
b. patient record housed in the facility
Answer: b
Analysis:
© 2027 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible 7
website, in whole or in part.
, Solution and Answer Guide: Green, 3-2-1 Code It!, 14e, 2026, 9798214481968;
Chapter 1: Overview of Coding
a. Incorrect. Demographic data collected on admission is included on the face sheet of the
manual patient record or in the electronic health record; however, it is not the business record
for a patient record because it does not document health care services provided. The patient
record housed in the facility is the business record for a patient encounter because it
documents health care services provided.
b. Correct. The patient record housed in the facility is the business record for a patient
encounter because it documents health care services provided.
EXERCISE 1.6: HEALTH DATA COLLECTION
1. Appointment scheduling and claims processing are processes associated with medical
__________ software.
Answer: management
Analysis: Appointment scheduling and claims processing are processes associated with medical
management software, which is a combination of practice management and medical billing
software that automates the daily workflow and procedures of a physician’s office or clinic. The
software automates appointment scheduling, claims processing, patient invoicing, patient
management, and generating reports.
2. To collect and report inpatient and outpatient data for statistical analysis and reimbursement
purposes, hospital coders and abstractors use automated case ______ software.
Answer: abstracting
Analysis: Hospital (and other health care facility) coders and abstractors use automated case
abstracting software to collect and report inpatient and outpatient data for statistical analysis and
reimbursement purposes. Data is entered into an abstracting software program, and the facility’s
billing department imports it to the UB-04 claim for submission to third-party payers.
3. Physicians’ offices submit data to third-party payers on the __________ claim.
Answer: CMS-1500
Analysis: Physicians’ offices submit data to third-party payers on the CMS-1500 claim, which is
the standard claim submitted by physicians to third-party payers for office encounters and
professional services (e.g., provided to hospital inpatients). Physician offices use medical
management software to enter claims data for electronic submission to third-party payers or
clearinghouses. Some eligible medical practices continue to print paper-based CMS-1500 claims
and are mailed or faxed to clearinghouses or third-party payers for processing.
4. Hospitals submit data to third-party payers on the __________ (or CMS-1450) claim.
Answer: UB-04
Analysis: Hospitals submit data to third-party payers on the UB-04 (or CMS-1450) claim, which is
the standard claim submitted by health care institutions to third-party payers for inpatient and
outpatient services. (UB means “uniform bill.”)
5. Claims are denied if __________ necessity of procedures or services is not established.
Answer: medical
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website, in whole or in part.
