Medical Billing & Coding Lesson 20 Ultimate Q&A
for Exam Mastery (Passed with Excellence)
June 29, 2025
,1 Introduction
This document is the ultimate practice exam for Lesson 20 of the Medical Billing and Coding curriculum, crafted for certification exam
success (e.g., CPC, CCS). It features 150 multiple-choice questions across five domains: CPT coding, ICD-10-CM coding, HCPCS Level
II coding, billing compliance, and medical terminology. Each question includes a detailed explanation to deepen understanding, verified
with 2025 AMA and CMS guidelines as of June 29, 2025. Designed for beginner to advanced learners, this 10-page resource ensures
comprehensive preparation for real-world billing and coding challenges, with a focus on clarity, accuracy, and exam readiness.
Instructions: Select the best answer for each question. Answers and explanations align with 2025 AMA and CMS guidelines. Consult official coding manuals (CPT, ICD-10-CM, HCPCS Level II)
for further details.
Metadata: Version 1.0, Last updated June 29, 2025. For feedback, email .
2 Practice Questions and Verified Solutions
2.1 CPT Coding
Question Answer and Explanation Difficulty
What CPT code is used for 99212. This code is for an
a level 2 established office visit with a Beginner
patient office visit? problem-focused history,
examination, and
straightforward
decision-making. Per 2025
AMA guidelines, 99212
requires 1019 minutes of total
time or two of three E/M
components (history, exam,
decision-making) at a low
level. Its commonly used for
minor issues like a follow-up
for a stable condition.
What CPT section 1002169990. The surgery
includes surgical section of the CPT manual Beginner
procedures? (2025 edition) covers
procedures from minor (e.g.,
biopsies) to complex (e.g.,
organ transplants). Codes are
organized by body system,
ensuring precise reporting of
surgical interventions in
various specialties.
What CPT code is used for 90471. This code covers the
an influenza vaccine administration of a single Beginner
administration? vaccine, such as influenza, via
intramuscular or subcutaneous
injection. Per 2025 AMA, it
includes counseling when
performed, ensuring accurate
billing for preventive services.
What modifier indicates a -26. The -26 modifier denotes
professional service only? the professional component of Beginner
a service (e.g., physicians
interpretation of a test),
excluding technical costs like
equipment. Its critical for split
billing in radiology or
pathology, per 2025 AMA
guidelines.
What CPT code is used for 42826. This code is for a
a tonsillectomy, age 12+? tonsillectomy in patients 12 Beginner
years or older, reflecting the
procedures complexity. Per
2025 AMA, it includes
removal of tonsils via surgical
excision, typically under
general anesthesia.
, What CPT code is used for 90834. This code covers 3852
a 30-minute minutes of psychotherapy for Beginner
psychotherapy session? an individual, per 2025 AMA
guidelines. Its used for mental
health sessions addressing
psychological conditions,
requiring detailed
documentation of time spent.
What CPT code is used for G0121. This HCPCS code,
a screening colonoscopy? recognized by CMS in 2025, is Beginner
for colorectal cancer screening
in average-risk patients. It
ensures coverage for
preventive services, distinct
from diagnostic colonoscopies
(e.g., 45378).
What modifier indicates a -53. Used when a procedure is
discontinued procedure? stopped due to patient safety Beginner
concerns (e.g., intolerance to
anesthesia), per 2025 AMA
guidelines. It ensures partial
reimbursement and
distinguishes from incomplete
services (-52).
What CPT code is used for 99211. This code is for
a simple suture removal? minimal E/M services, like Beginner
suture removal by a nurse,
requiring no physician
presence. Per 2025 AMA, its
used for brief encounters with
established patients.
What CPT code is used for 71046. This code covers a
a two-view chest X-ray? radiologic exam of the chest Beginner
with two views (e.g., PA and
lateral), per 2025 AMA. Its
used for diagnosing respiratory
conditions, requiring
documentation of views
performed.
What CPT code is used for 44950. This code is for the
an open appendectomy? surgical removal of the Beginner
appendix via an open approach,
per 2025 AMA. Its used for
acute appendicitis cases,
distinct from laparoscopic
codes (e.g., 44970).
What CPT code is used for 66984. This code covers
a cataract extraction with extracapsular cataract removal Beginner
IOL? with intraocular lens insertion,
per 2025 AMA. Its a common
ophthalmic procedure,
requiring documentation of
lens implantation.
What CPT code is used for 27130. This code is for hip
a total hip arthroplasty? replacement surgery, including Intermediate
acetabular and femoral
components, per 2025 AMA.
Its used for conditions like
osteoarthritis, requiring
detailed operative notes.
for Exam Mastery (Passed with Excellence)
June 29, 2025
,1 Introduction
This document is the ultimate practice exam for Lesson 20 of the Medical Billing and Coding curriculum, crafted for certification exam
success (e.g., CPC, CCS). It features 150 multiple-choice questions across five domains: CPT coding, ICD-10-CM coding, HCPCS Level
II coding, billing compliance, and medical terminology. Each question includes a detailed explanation to deepen understanding, verified
with 2025 AMA and CMS guidelines as of June 29, 2025. Designed for beginner to advanced learners, this 10-page resource ensures
comprehensive preparation for real-world billing and coding challenges, with a focus on clarity, accuracy, and exam readiness.
Instructions: Select the best answer for each question. Answers and explanations align with 2025 AMA and CMS guidelines. Consult official coding manuals (CPT, ICD-10-CM, HCPCS Level II)
for further details.
Metadata: Version 1.0, Last updated June 29, 2025. For feedback, email .
2 Practice Questions and Verified Solutions
2.1 CPT Coding
Question Answer and Explanation Difficulty
What CPT code is used for 99212. This code is for an
a level 2 established office visit with a Beginner
patient office visit? problem-focused history,
examination, and
straightforward
decision-making. Per 2025
AMA guidelines, 99212
requires 1019 minutes of total
time or two of three E/M
components (history, exam,
decision-making) at a low
level. Its commonly used for
minor issues like a follow-up
for a stable condition.
What CPT section 1002169990. The surgery
includes surgical section of the CPT manual Beginner
procedures? (2025 edition) covers
procedures from minor (e.g.,
biopsies) to complex (e.g.,
organ transplants). Codes are
organized by body system,
ensuring precise reporting of
surgical interventions in
various specialties.
What CPT code is used for 90471. This code covers the
an influenza vaccine administration of a single Beginner
administration? vaccine, such as influenza, via
intramuscular or subcutaneous
injection. Per 2025 AMA, it
includes counseling when
performed, ensuring accurate
billing for preventive services.
What modifier indicates a -26. The -26 modifier denotes
professional service only? the professional component of Beginner
a service (e.g., physicians
interpretation of a test),
excluding technical costs like
equipment. Its critical for split
billing in radiology or
pathology, per 2025 AMA
guidelines.
What CPT code is used for 42826. This code is for a
a tonsillectomy, age 12+? tonsillectomy in patients 12 Beginner
years or older, reflecting the
procedures complexity. Per
2025 AMA, it includes
removal of tonsils via surgical
excision, typically under
general anesthesia.
, What CPT code is used for 90834. This code covers 3852
a 30-minute minutes of psychotherapy for Beginner
psychotherapy session? an individual, per 2025 AMA
guidelines. Its used for mental
health sessions addressing
psychological conditions,
requiring detailed
documentation of time spent.
What CPT code is used for G0121. This HCPCS code,
a screening colonoscopy? recognized by CMS in 2025, is Beginner
for colorectal cancer screening
in average-risk patients. It
ensures coverage for
preventive services, distinct
from diagnostic colonoscopies
(e.g., 45378).
What modifier indicates a -53. Used when a procedure is
discontinued procedure? stopped due to patient safety Beginner
concerns (e.g., intolerance to
anesthesia), per 2025 AMA
guidelines. It ensures partial
reimbursement and
distinguishes from incomplete
services (-52).
What CPT code is used for 99211. This code is for
a simple suture removal? minimal E/M services, like Beginner
suture removal by a nurse,
requiring no physician
presence. Per 2025 AMA, its
used for brief encounters with
established patients.
What CPT code is used for 71046. This code covers a
a two-view chest X-ray? radiologic exam of the chest Beginner
with two views (e.g., PA and
lateral), per 2025 AMA. Its
used for diagnosing respiratory
conditions, requiring
documentation of views
performed.
What CPT code is used for 44950. This code is for the
an open appendectomy? surgical removal of the Beginner
appendix via an open approach,
per 2025 AMA. Its used for
acute appendicitis cases,
distinct from laparoscopic
codes (e.g., 44970).
What CPT code is used for 66984. This code covers
a cataract extraction with extracapsular cataract removal Beginner
IOL? with intraocular lens insertion,
per 2025 AMA. Its a common
ophthalmic procedure,
requiring documentation of
lens implantation.
What CPT code is used for 27130. This code is for hip
a total hip arthroplasty? replacement surgery, including Intermediate
acetabular and femoral
components, per 2025 AMA.
Its used for conditions like
osteoarthritis, requiring
detailed operative notes.
