8/7/25, 3:54 PM MO Metrix CCS Exam Practice Test
MO Metrix CCS Exam Practice Test BANK
QUESTIONS AND CORRECT DETAILED ANSWERS
LATEST VERSION 2025-2026
Which of the following is not a covered entity in the
HIPAA Privacy rule?
a. The Centers for Disease
a. The Centers for Disease Control and Prevention
Control and Prevention
b. Employer-sponsored health plan
c. Third-party billing agency
d. Healthcare provider
Which of the following is a risk adjustment model used
by Medicare to predict health care costs and
resource consumption of specific patient populations
over time?
d. Hierarchical condition
category (HCC) coding
a. Risk adjustment factor (RAF)
b. Diagnosis-related groups
c. Outcome and Assessment information set
d. Hierarchical condition category (HCC) coding
1/34
,8/7/25, 3:54 PM MO Metrix CCS Exam Practice Test
CPT cod 20650 is a column 2 code that has a National
Correct Coding Initiative (NCCI) edit of 1 when paired
with CPT code 21813. How would this be interpreted?
a. The two codes are inclusive of each other and can
d. The two codes can be
never be billed together.
billed together with an
b. If being billed together, only report one unit of
appropriate modifier
each
c. The two codes are exclusive of each other and can
never be billed together
d. The two codes can be billed together with an
appropriate modifier
Based on the following documentation, what would
the overall medical decision-making be?
Numbered of diagnosis or management options:
Minimal
Amount and complexity of data: Moderate
c. Moderate complexity
Level of risk: Moderate
a. Straightforward
b. Low complexity
c. Moderate complexity
d. High complexity
A patient was seen by her gynecologist to remove her
intrauterine device. The removal was attempted but
terminated due to excessive bleeding. How should
the gynecologist report the encounter?
a. 58301-53
a. 58301-53
b. 58301-52
c. 99212-25, 58301
d. 99212, 58301-59
2/34
,8/7/25, 3:54 PM MO Metrix CCS Exam Practice Test
A technician performs an ultrasound of a patient's
thyroid at a privately owned family practice
immediately following her annual health screening.
The primary care physician determines that the
images are normal and advises the patient to return in
c. 76536
one year. How should the primary care physician
report the ultrasound?
no modifier
a. 76536-26
b. 76536-TC
c. 76536
d. 76536-TC, 26
Which type of edit identifies the maximum number of
units that may be reported for a CPT/HCPCS code
that relates to an individual patient?
a. Medically unlikely edits
a. Medically unlikely edits
b. Add-on-code edits
c. Correspondence edits
d. Procedure-to-procedure coding edits
Which statement best describes a comorbidity?
a. Two or more life-threatening illnesses occurring at
the same time
d. Two or more unrelated
b. Three or more minor injuries occurring at the same
diseases occurring at the
time
same time.
c. Three or more chronic illness occurring at the same
time
d. Two or more unrelated diseases occurring at the
same time.
3/34
, 8/7/25, 3:54 PM MO Metrix CCS Exam Practice Test
A healthcare employee happens to meet a well-
known actor during a lunch break. Unknown to the
employee, the actor is currently admitted in the
hospital and has chosen to eat in the cafeteria to not
feel cooped up any longer. The employee takes a
photo and shares it with his co-workers and social
a. Protect privacy and media. Which AHIMA standard(s) of Ethical Coding
confidentiality; protect has been violated?
personal health
information; and use a. Protect privacy and confidentiality; protect
technology, data, and personal health information; and use technology,
information resources in data, and information resources in the way they are
the way they are intended. intended.
b. Respect the dignity of every person, put the welfare
of persons before self-interest.
c. Refuse to participate in unethical practices, privacy
and confidentiality, respect the dignity of every
person
d. None, the act was unintentional
The smoking status of a patient should generally be
found in which section of a medical record?
d. Social history a. Chief complaint
b. Plan
c. Examination
d. Social history
Which of the following is not a data element required
by the uniform Hospital Discharge Data set (UHDDS)
c. Family history a. Location of residence
b. Provider name
c. Family history
d. Total charges for services rendered.
4/34
MO Metrix CCS Exam Practice Test BANK
QUESTIONS AND CORRECT DETAILED ANSWERS
LATEST VERSION 2025-2026
Which of the following is not a covered entity in the
HIPAA Privacy rule?
a. The Centers for Disease
a. The Centers for Disease Control and Prevention
Control and Prevention
b. Employer-sponsored health plan
c. Third-party billing agency
d. Healthcare provider
Which of the following is a risk adjustment model used
by Medicare to predict health care costs and
resource consumption of specific patient populations
over time?
d. Hierarchical condition
category (HCC) coding
a. Risk adjustment factor (RAF)
b. Diagnosis-related groups
c. Outcome and Assessment information set
d. Hierarchical condition category (HCC) coding
1/34
,8/7/25, 3:54 PM MO Metrix CCS Exam Practice Test
CPT cod 20650 is a column 2 code that has a National
Correct Coding Initiative (NCCI) edit of 1 when paired
with CPT code 21813. How would this be interpreted?
a. The two codes are inclusive of each other and can
d. The two codes can be
never be billed together.
billed together with an
b. If being billed together, only report one unit of
appropriate modifier
each
c. The two codes are exclusive of each other and can
never be billed together
d. The two codes can be billed together with an
appropriate modifier
Based on the following documentation, what would
the overall medical decision-making be?
Numbered of diagnosis or management options:
Minimal
Amount and complexity of data: Moderate
c. Moderate complexity
Level of risk: Moderate
a. Straightforward
b. Low complexity
c. Moderate complexity
d. High complexity
A patient was seen by her gynecologist to remove her
intrauterine device. The removal was attempted but
terminated due to excessive bleeding. How should
the gynecologist report the encounter?
a. 58301-53
a. 58301-53
b. 58301-52
c. 99212-25, 58301
d. 99212, 58301-59
2/34
,8/7/25, 3:54 PM MO Metrix CCS Exam Practice Test
A technician performs an ultrasound of a patient's
thyroid at a privately owned family practice
immediately following her annual health screening.
The primary care physician determines that the
images are normal and advises the patient to return in
c. 76536
one year. How should the primary care physician
report the ultrasound?
no modifier
a. 76536-26
b. 76536-TC
c. 76536
d. 76536-TC, 26
Which type of edit identifies the maximum number of
units that may be reported for a CPT/HCPCS code
that relates to an individual patient?
a. Medically unlikely edits
a. Medically unlikely edits
b. Add-on-code edits
c. Correspondence edits
d. Procedure-to-procedure coding edits
Which statement best describes a comorbidity?
a. Two or more life-threatening illnesses occurring at
the same time
d. Two or more unrelated
b. Three or more minor injuries occurring at the same
diseases occurring at the
time
same time.
c. Three or more chronic illness occurring at the same
time
d. Two or more unrelated diseases occurring at the
same time.
3/34
, 8/7/25, 3:54 PM MO Metrix CCS Exam Practice Test
A healthcare employee happens to meet a well-
known actor during a lunch break. Unknown to the
employee, the actor is currently admitted in the
hospital and has chosen to eat in the cafeteria to not
feel cooped up any longer. The employee takes a
photo and shares it with his co-workers and social
a. Protect privacy and media. Which AHIMA standard(s) of Ethical Coding
confidentiality; protect has been violated?
personal health
information; and use a. Protect privacy and confidentiality; protect
technology, data, and personal health information; and use technology,
information resources in data, and information resources in the way they are
the way they are intended. intended.
b. Respect the dignity of every person, put the welfare
of persons before self-interest.
c. Refuse to participate in unethical practices, privacy
and confidentiality, respect the dignity of every
person
d. None, the act was unintentional
The smoking status of a patient should generally be
found in which section of a medical record?
d. Social history a. Chief complaint
b. Plan
c. Examination
d. Social history
Which of the following is not a data element required
by the uniform Hospital Discharge Data set (UHDDS)
c. Family history a. Location of residence
b. Provider name
c. Family history
d. Total charges for services rendered.
4/34
