Test Bank For
Medical Coding Certification Exam Preparation A Comprehensive Guide Release 2025 Author
Cynthia Stewart
Chapter 1-21
Chapter 1
MULTIPLE CHOICE - Choose the one alternative that best completes the statement or
answers the question.
1) A clean claim:
A) Guarantees the B) Slows the C) Results in accurate D) Releases the payer
provider will receive reimbursement and timely from the contractual
payment process reimbursement adjudication time frame
2) Accounts receivable, denials, and modifiers are examples of __________ language.
A) Provider B) Payer C) Compliance D) Billing
3) Compliance language includes:
A) Services, B) Unbundling, C) Noncovered services, D) Denials, modifiers,
procedures, and medical fraud, and abuse medical necessity, and and advanced
terminology unbundling beneficiary notices
4) An ICD-10-CM (tenth revision) code represents:
A) the demographics B) the procedure C) the service D) the diagnosis
5) The following coding habit would be most likely to trigger a payer audit:
A) Consistently B) Billing an even C) Consistently D) Consistently billing the
billing the same, low distribution of low billing the same, same, low level E/M service
level E/M service and high level E/M high level E/M code and consistently billing
code service codes service code the same, high level E/M
service code
6) The acronym AAPC stands for:
A) American Academy B) Academy of C) American D) Academy of
of Professional Coders American Physician Academy of Physician Auditors and Physician
Coders Coders Coders
,7) The organization that administers the CPC exam and confers the Certified Professional Coder
credential is called:
A) American Health B) American C) American D) American Health
Information Federation of Academy of Information Management
Association Professional Coders Professional Coders Association
8) Medical coding is defined as:
A) The process of B) Identifying C) The process of D) Verifying services
reporting patient index noncovered translating provider are covered by a payer
information to payer services documentation into codes prior to providing the
auditors services
9) A Certified Professional Coder is an individual who has demonstrated his or her knowledge
of medical coding by successfully completing the __________ exam:
A) CPC B) CPA C) APC D) PAC
10) An individual who has demonstrated his or her knowledge of medical coding by successfully
completing the CPC exam is known as:
A) Certified Coding B) Certified C) Certified Coding D) Certified Coding
Association Professional Coder Professional Specialist
11) CPT stands for:
A) Coding Physician B) Current Procedural C) Coding D) Current Physician
Terminology Terminology Process Tabular Terminology
12) The code set(s) used to translate the specific services, procedures, and supplies performed on
a date of service is/are:
A) ICD, CPT B) CPT C) ICD, HCPCS D) HCPCS Level II, CPT
13) The __________ form becomes the source of the statistical medical data for the practice,
payer, and governing bodies.
A) Advanced Beneficiary Notice (ABN) B) Billing language C) UB-04 D) CMS 1500
14) Coding guidelines and regulations can change:
A) Annually B) Monthly C) Quarterly D) Weekly
,15) To be of value to the practices or organizations they work for, medical coders should:
A) Memorize B) Be diligent in maintaining and C) Consistently audit D) Demonstrate
all procedure updating their knowledge of the use of ICD-10 strong organizational
codes medical coding and billing codes skills
policies
16) When a charge is paid in full, the revenue cycle:
A) Begins B) Concludes C) Moves to the charge phase D) Moves to the submission phase of
of the cycle the cycle
17) The adjudication period begins upon:
A) Providing B) Receipt of a C) Receipt of a clean D) Submission of a claim to the
services claim claim payer
18) Medical practices contract with multiple insurance payers for all of the following reasons
except:
A) Facilitate payment for B) To maintain the C) To increase the D) To ensure the
patients covered by diverse number of patients number of patients uninsured receive
insurance plans they serve they serve services
19) Creating a clean claim requires that all involved in its creation have all of the following
except:
A) A good working B) A good working C) A good D) A good working
knowledge of each of the knowledge of working knowledge of the
patient's medically government knowledge of practice/provider-payer
managed conditions regulations payer policies contract limitations
20) A diagnosis which may not receive direct treatment during an encounter but which the
provider has to consider when determining treatment for other conditions is called a:
A) Concurrent B) Medically managed C) Additional D) Secondary
diagnosis diagnosis diagnosis diagnosis
21) Medical necessity is:
A) Represented by a B) Documented in the C) Any diagnosis, condition, D) Determined by
HCPCS code on the patient's chart and is not procedure, or service the Certified
CMS 1500 claim a translated piece of documented in the patient Professional Coder
form provider information record as having been treated
or medically managed
22) ICD-10 codes are reported in field __________ of the CMS form.
A) 21 B) 22 C) 18 D) 25
, 23) The diagnostic portion of the CMS 1500 form:
A) Is found at B) Includes information such C) Is found at the D) Includes information such
the top of the as the patient's name and date bottom of the as the patient's medical
form of birth form condition
24) The demographic portion of the CMS 1500 form:
A) Is found at B) Is found at C) Contains information D) Contains information such as
the bottom of the the top of the such as the patient's medical the services provided on a date of
form form condition service
25) Revenue that is due to the practice or provider for services or procedures rendered to the
patient is:
A) adjudication B) accounts payable C) accounts receivable D) remittance advice
26) Revenue included in the accounts receivable cycle may be due to the provider from all of the
following except:
A) recovery audit B) health insurance C) workers' compensation D) the
contractors coverage patient
27) Errors in the medical records may be corrected by doing which of the following?
A) Erasing the B) Drawing a strike- C) Creating an D) Drawing a strike-through line
error, writing the through line through addendum to the through the error, writing the
correction in its the error, writing the record that is dated correction beside it, and initialing
place, and correction beside it, and legibly signed or creating an addendum to the
initialing and initialing record that is dated and legibly
signed
28) The most effective way to increase revenue at a physician practice is to:
A) Hire more B) Remain aware of billing and C) Hire more D) Increase patient
physicians coding guidelines office staff workload
29) Physicians need to be aware of what is necessary in their documentation in all of the
following medical documents except:
A) dictated reports B) superbill C) CMS 1500 form D) handwritten notes in charts
30) Which of the following are areas being audited by payers:
A) medical necessity B) incorrect use of modifiers C) duplicate claims D) all of these
31) Certified coders, on average, earn __________ percent more than noncertified coders.
A) 30 B) 20 C) 15 D) 10
Medical Coding Certification Exam Preparation A Comprehensive Guide Release 2025 Author
Cynthia Stewart
Chapter 1-21
Chapter 1
MULTIPLE CHOICE - Choose the one alternative that best completes the statement or
answers the question.
1) A clean claim:
A) Guarantees the B) Slows the C) Results in accurate D) Releases the payer
provider will receive reimbursement and timely from the contractual
payment process reimbursement adjudication time frame
2) Accounts receivable, denials, and modifiers are examples of __________ language.
A) Provider B) Payer C) Compliance D) Billing
3) Compliance language includes:
A) Services, B) Unbundling, C) Noncovered services, D) Denials, modifiers,
procedures, and medical fraud, and abuse medical necessity, and and advanced
terminology unbundling beneficiary notices
4) An ICD-10-CM (tenth revision) code represents:
A) the demographics B) the procedure C) the service D) the diagnosis
5) The following coding habit would be most likely to trigger a payer audit:
A) Consistently B) Billing an even C) Consistently D) Consistently billing the
billing the same, low distribution of low billing the same, same, low level E/M service
level E/M service and high level E/M high level E/M code and consistently billing
code service codes service code the same, high level E/M
service code
6) The acronym AAPC stands for:
A) American Academy B) Academy of C) American D) Academy of
of Professional Coders American Physician Academy of Physician Auditors and Physician
Coders Coders Coders
,7) The organization that administers the CPC exam and confers the Certified Professional Coder
credential is called:
A) American Health B) American C) American D) American Health
Information Federation of Academy of Information Management
Association Professional Coders Professional Coders Association
8) Medical coding is defined as:
A) The process of B) Identifying C) The process of D) Verifying services
reporting patient index noncovered translating provider are covered by a payer
information to payer services documentation into codes prior to providing the
auditors services
9) A Certified Professional Coder is an individual who has demonstrated his or her knowledge
of medical coding by successfully completing the __________ exam:
A) CPC B) CPA C) APC D) PAC
10) An individual who has demonstrated his or her knowledge of medical coding by successfully
completing the CPC exam is known as:
A) Certified Coding B) Certified C) Certified Coding D) Certified Coding
Association Professional Coder Professional Specialist
11) CPT stands for:
A) Coding Physician B) Current Procedural C) Coding D) Current Physician
Terminology Terminology Process Tabular Terminology
12) The code set(s) used to translate the specific services, procedures, and supplies performed on
a date of service is/are:
A) ICD, CPT B) CPT C) ICD, HCPCS D) HCPCS Level II, CPT
13) The __________ form becomes the source of the statistical medical data for the practice,
payer, and governing bodies.
A) Advanced Beneficiary Notice (ABN) B) Billing language C) UB-04 D) CMS 1500
14) Coding guidelines and regulations can change:
A) Annually B) Monthly C) Quarterly D) Weekly
,15) To be of value to the practices or organizations they work for, medical coders should:
A) Memorize B) Be diligent in maintaining and C) Consistently audit D) Demonstrate
all procedure updating their knowledge of the use of ICD-10 strong organizational
codes medical coding and billing codes skills
policies
16) When a charge is paid in full, the revenue cycle:
A) Begins B) Concludes C) Moves to the charge phase D) Moves to the submission phase of
of the cycle the cycle
17) The adjudication period begins upon:
A) Providing B) Receipt of a C) Receipt of a clean D) Submission of a claim to the
services claim claim payer
18) Medical practices contract with multiple insurance payers for all of the following reasons
except:
A) Facilitate payment for B) To maintain the C) To increase the D) To ensure the
patients covered by diverse number of patients number of patients uninsured receive
insurance plans they serve they serve services
19) Creating a clean claim requires that all involved in its creation have all of the following
except:
A) A good working B) A good working C) A good D) A good working
knowledge of each of the knowledge of working knowledge of the
patient's medically government knowledge of practice/provider-payer
managed conditions regulations payer policies contract limitations
20) A diagnosis which may not receive direct treatment during an encounter but which the
provider has to consider when determining treatment for other conditions is called a:
A) Concurrent B) Medically managed C) Additional D) Secondary
diagnosis diagnosis diagnosis diagnosis
21) Medical necessity is:
A) Represented by a B) Documented in the C) Any diagnosis, condition, D) Determined by
HCPCS code on the patient's chart and is not procedure, or service the Certified
CMS 1500 claim a translated piece of documented in the patient Professional Coder
form provider information record as having been treated
or medically managed
22) ICD-10 codes are reported in field __________ of the CMS form.
A) 21 B) 22 C) 18 D) 25
, 23) The diagnostic portion of the CMS 1500 form:
A) Is found at B) Includes information such C) Is found at the D) Includes information such
the top of the as the patient's name and date bottom of the as the patient's medical
form of birth form condition
24) The demographic portion of the CMS 1500 form:
A) Is found at B) Is found at C) Contains information D) Contains information such as
the bottom of the the top of the such as the patient's medical the services provided on a date of
form form condition service
25) Revenue that is due to the practice or provider for services or procedures rendered to the
patient is:
A) adjudication B) accounts payable C) accounts receivable D) remittance advice
26) Revenue included in the accounts receivable cycle may be due to the provider from all of the
following except:
A) recovery audit B) health insurance C) workers' compensation D) the
contractors coverage patient
27) Errors in the medical records may be corrected by doing which of the following?
A) Erasing the B) Drawing a strike- C) Creating an D) Drawing a strike-through line
error, writing the through line through addendum to the through the error, writing the
correction in its the error, writing the record that is dated correction beside it, and initialing
place, and correction beside it, and legibly signed or creating an addendum to the
initialing and initialing record that is dated and legibly
signed
28) The most effective way to increase revenue at a physician practice is to:
A) Hire more B) Remain aware of billing and C) Hire more D) Increase patient
physicians coding guidelines office staff workload
29) Physicians need to be aware of what is necessary in their documentation in all of the
following medical documents except:
A) dictated reports B) superbill C) CMS 1500 form D) handwritten notes in charts
30) Which of the following are areas being audited by payers:
A) medical necessity B) incorrect use of modifiers C) duplicate claims D) all of these
31) Certified coders, on average, earn __________ percent more than noncertified coders.
A) 30 B) 20 C) 15 D) 10
