EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
Certified Professional Coder Coding Test
Study Guide with Complete Solutions
Coding is - Answer✔✔-the process of translating this written or dictated fmedical record into a
series of numeric or alpha-numeric codes
Proper code assignment is determined by - Answer✔✔-content of the medical record and by
the unique rules that governs each code set
what are 3 things that Coder must master - Answer✔✔-1. anatomy
2. medical terminology
3. must be detail-oriented
Medical coders assign a code to what - Answer✔✔-1. Each diagnosis
2. service/procedure
3. Supply, using the classification system when applicable
The classification system determines what - Answer✔✔-the amount health care providers will
be reimbursed if the patient is covered by Medicare, Medicaid, or other insurance programs
using the system
A coder must evaluate the medical record for - Answer✔✔-1. completeness and accuracy
Page 1/43
,EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
2. communicate regularly with physicians and othe health care professional to clarify DX or
obtain additonal PT info.
Techicians who speciallize in coding inpatient hospital services are referred as - Answer✔✔-1.
Health information coders
2. medical record coders
3. Coder/abstractors
4. Coding Specialist
What is MS-DRGs and what is it - Answer✔✔-1. Medicare Severity-Diagnosis Related Groups
2. Determines the amt the hospital will be reimbursed if the PT is covered by Medicare or other
insurance programs
What is EHR - Answer✔✔-Electronic health record
Skill coders may become - Answer✔✔-consulatants, educators or medical auditors
What is the difference between Hospital and Physican Services - Answer✔✔-1. Outpatient
coding (physician services)- learning CPT, HCPCS, LEVEL II, ICD-9 CM codes Volume 1 and 2
2. Inpatient coding (Hospital services)- Learning CPT, ICD-9 CM codes Volumes 1,2,3 and MS-
DRGS
What is APC and who uses it - Answer✔✔-Ambulatory Payment Classification- outpatient facility
coders (physician services
Page 2/43
,EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
What is the coder role in a physician's office - Answer✔✔-Extremely important to proper
reimbursement and the livelihood of the physican
What is a physican degree of education - Answer✔✔-4 years of college, 4 years of medical
school plus 3 to 5 years of residency.
What is a mid-level providers and who - Answer✔✔-1. Mid-level providers are know as
physician extenders
2. Physician assistants (PA) and Nurse Practitioners (NP)
What are the requirement for a PA and what - Answer✔✔-1. 26 1/2 month to complete
2. Lincense to practice medicine with physician supervision
NP must have - Answer✔✔-A Master Degree in Nursing
How many payers in the most simplest form? - Answer✔✔-2
Private insurance plans and government insurance plans
Commerical carriers are considered what - Answer✔✔-Private payers that offer both group and
individual plans.
Private Payers contracts may - Answer✔✔-Vary but may include hospitalization, basic and major
medical coverage.
What is the most significant government insurer - Answer✔✔-Medicare
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, EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
What is Medicare - Answer✔✔-Federal health insurance program- Administerd by the Center
for Medicare &Medicaid Services (CMS)
What is CMS and what does it provide - Answer✔✔-Center for Medicare & Medicaid Services
(CMS) provides coverage for people over the age of 65, blind, or disabled individuals, people
with end -stage renal disease
CMS regulations often serves as ____ word in coding requirement for Medicare and Non-
Medicare payers alike - Answer✔✔-Last
What are the parts of Medicare - Answer✔✔-Medicare A
Medicare B
Medicare C
Medicare D
What is Medicare Part A - Answer✔✔-Covers inpatient hospital care, as well as care provided in
skilled nursing facilites, hospice care, and home health care
What is Medicare Part B - Answer✔✔-Covered Medically necessary doctors' services, outpatient
care, other medical services (including some preventive service not covered under Medicare
Part A
Medicare Part B is considered what - Answer✔✔-A optional benefit for which the patient must
pay a premium and which generally requires a yearly copay
Where is Medicare Part B usually used - Answer✔✔-Physician offices (Outpatient Facility)
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Certified Professional Coder Coding Test
Study Guide with Complete Solutions
Coding is - Answer✔✔-the process of translating this written or dictated fmedical record into a
series of numeric or alpha-numeric codes
Proper code assignment is determined by - Answer✔✔-content of the medical record and by
the unique rules that governs each code set
what are 3 things that Coder must master - Answer✔✔-1. anatomy
2. medical terminology
3. must be detail-oriented
Medical coders assign a code to what - Answer✔✔-1. Each diagnosis
2. service/procedure
3. Supply, using the classification system when applicable
The classification system determines what - Answer✔✔-the amount health care providers will
be reimbursed if the patient is covered by Medicare, Medicaid, or other insurance programs
using the system
A coder must evaluate the medical record for - Answer✔✔-1. completeness and accuracy
Page 1/43
,EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
2. communicate regularly with physicians and othe health care professional to clarify DX or
obtain additonal PT info.
Techicians who speciallize in coding inpatient hospital services are referred as - Answer✔✔-1.
Health information coders
2. medical record coders
3. Coder/abstractors
4. Coding Specialist
What is MS-DRGs and what is it - Answer✔✔-1. Medicare Severity-Diagnosis Related Groups
2. Determines the amt the hospital will be reimbursed if the PT is covered by Medicare or other
insurance programs
What is EHR - Answer✔✔-Electronic health record
Skill coders may become - Answer✔✔-consulatants, educators or medical auditors
What is the difference between Hospital and Physican Services - Answer✔✔-1. Outpatient
coding (physician services)- learning CPT, HCPCS, LEVEL II, ICD-9 CM codes Volume 1 and 2
2. Inpatient coding (Hospital services)- Learning CPT, ICD-9 CM codes Volumes 1,2,3 and MS-
DRGS
What is APC and who uses it - Answer✔✔-Ambulatory Payment Classification- outpatient facility
coders (physician services
Page 2/43
,EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
What is the coder role in a physician's office - Answer✔✔-Extremely important to proper
reimbursement and the livelihood of the physican
What is a physican degree of education - Answer✔✔-4 years of college, 4 years of medical
school plus 3 to 5 years of residency.
What is a mid-level providers and who - Answer✔✔-1. Mid-level providers are know as
physician extenders
2. Physician assistants (PA) and Nurse Practitioners (NP)
What are the requirement for a PA and what - Answer✔✔-1. 26 1/2 month to complete
2. Lincense to practice medicine with physician supervision
NP must have - Answer✔✔-A Master Degree in Nursing
How many payers in the most simplest form? - Answer✔✔-2
Private insurance plans and government insurance plans
Commerical carriers are considered what - Answer✔✔-Private payers that offer both group and
individual plans.
Private Payers contracts may - Answer✔✔-Vary but may include hospitalization, basic and major
medical coverage.
What is the most significant government insurer - Answer✔✔-Medicare
Page 3/43
, EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024
What is Medicare - Answer✔✔-Federal health insurance program- Administerd by the Center
for Medicare &Medicaid Services (CMS)
What is CMS and what does it provide - Answer✔✔-Center for Medicare & Medicaid Services
(CMS) provides coverage for people over the age of 65, blind, or disabled individuals, people
with end -stage renal disease
CMS regulations often serves as ____ word in coding requirement for Medicare and Non-
Medicare payers alike - Answer✔✔-Last
What are the parts of Medicare - Answer✔✔-Medicare A
Medicare B
Medicare C
Medicare D
What is Medicare Part A - Answer✔✔-Covers inpatient hospital care, as well as care provided in
skilled nursing facilites, hospice care, and home health care
What is Medicare Part B - Answer✔✔-Covered Medically necessary doctors' services, outpatient
care, other medical services (including some preventive service not covered under Medicare
Part A
Medicare Part B is considered what - Answer✔✔-A optional benefit for which the patient must
pay a premium and which generally requires a yearly copay
Where is Medicare Part B usually used - Answer✔✔-Physician offices (Outpatient Facility)
Page 4/43
