CERTIFIED PROFESSIONAL CODER
(CPC) CERTIFICATION EXAM 2025
QUESTIONS AND ANSWERS
Coding is ____. - ANS The process of translating this written or dictated medical record into a
series of numeric or alpha-numeric codes.
Proper code assignment is determined by? - ANS Content of the medical record and by the
unique rules that governs each code set.
What are the three things that coders must master? - ANS 1) Anatomy
2) Medical terminology
3) Must be detail-oriented
Medical coders assign a code to what? - ANS 1) Each diagnosis
2) Service/procedure
1 @COPYRIGHT THESTAR 2025/2026
,3) Supply, using the classification system when applicable.
What does the classification system determine? - ANS The amount health care providers will
be reimbursed if the patient is covered by Medicare, Medicaid, or other insurance programs
using the system.
What does the coder evaluate the medical record for? - ANS 1) Completeness and accuracy
2) Communicate regularly with physicians and other health care professionals to clarify DX or
obtain additional PT information.
Technicians who specialize in coding inpatient hospital services are referred to as? - ANS 1)
Health information coders
2) Medical record coders
3) Coders/abstractors
4) Coding specialist
What is MS-DRGs? What is it? - ANS 1) Medicare Severity- Diagnosis Related Groups
2 @COPYRIGHT THESTAR 2025/2026
,2) Determines the amount the hospital will be reimbursed if the patient is covered by Medicare
or other insurance groups.
EHR - ANS Electronic Health Record
What can skilled coders become? - ANS Consultants, educators, or medical auditors
What is the difference between hospital and physician services? - ANS 1) Outpatient
coding(physician services): Learning CPT, HCPCS, Level II, ICD-10 CM codes volumes 1 and 2.
2) Impatient coding(Hospital services): Learning CPT, IC10-CM codes Volumes 1, 2, 3 and MS-
DRGs.
What is APC and who would use it? - ANS Ambulatory Payment Classification- outpatient
facility coders (physician services).
What is the coder's role in a physician's office? - ANS Extremely important to properly
reimburse and the livelihood of the physician.
3 @COPYRIGHT THESTAR 2025/2026
, What is a physician's degree of education? - ANS 4 years of college, 4 years of medical school
plus 3 to 5 years of residency.
What are mid-level providers and who? - ANS 1) Mid-level providers are known as physician
extenders.
2) Physician assistants (PA) and nurse practitioners (NP).
What are the requirements for a PA and what do they do? - ANS 1) 26 1/2 months to
complete
2) License to practice medicine with physician supervision.
A nurse practitioner must have______. - ANS A master's degree in nursing.
Commercial carrier are considered what? - ANS Private payers that offer both group and
individual plans.
4 @COPYRIGHT THESTAR 2025/2026
(CPC) CERTIFICATION EXAM 2025
QUESTIONS AND ANSWERS
Coding is ____. - ANS The process of translating this written or dictated medical record into a
series of numeric or alpha-numeric codes.
Proper code assignment is determined by? - ANS Content of the medical record and by the
unique rules that governs each code set.
What are the three things that coders must master? - ANS 1) Anatomy
2) Medical terminology
3) Must be detail-oriented
Medical coders assign a code to what? - ANS 1) Each diagnosis
2) Service/procedure
1 @COPYRIGHT THESTAR 2025/2026
,3) Supply, using the classification system when applicable.
What does the classification system determine? - ANS The amount health care providers will
be reimbursed if the patient is covered by Medicare, Medicaid, or other insurance programs
using the system.
What does the coder evaluate the medical record for? - ANS 1) Completeness and accuracy
2) Communicate regularly with physicians and other health care professionals to clarify DX or
obtain additional PT information.
Technicians who specialize in coding inpatient hospital services are referred to as? - ANS 1)
Health information coders
2) Medical record coders
3) Coders/abstractors
4) Coding specialist
What is MS-DRGs? What is it? - ANS 1) Medicare Severity- Diagnosis Related Groups
2 @COPYRIGHT THESTAR 2025/2026
,2) Determines the amount the hospital will be reimbursed if the patient is covered by Medicare
or other insurance groups.
EHR - ANS Electronic Health Record
What can skilled coders become? - ANS Consultants, educators, or medical auditors
What is the difference between hospital and physician services? - ANS 1) Outpatient
coding(physician services): Learning CPT, HCPCS, Level II, ICD-10 CM codes volumes 1 and 2.
2) Impatient coding(Hospital services): Learning CPT, IC10-CM codes Volumes 1, 2, 3 and MS-
DRGs.
What is APC and who would use it? - ANS Ambulatory Payment Classification- outpatient
facility coders (physician services).
What is the coder's role in a physician's office? - ANS Extremely important to properly
reimburse and the livelihood of the physician.
3 @COPYRIGHT THESTAR 2025/2026
, What is a physician's degree of education? - ANS 4 years of college, 4 years of medical school
plus 3 to 5 years of residency.
What are mid-level providers and who? - ANS 1) Mid-level providers are known as physician
extenders.
2) Physician assistants (PA) and nurse practitioners (NP).
What are the requirements for a PA and what do they do? - ANS 1) 26 1/2 months to
complete
2) License to practice medicine with physician supervision.
A nurse practitioner must have______. - ANS A master's degree in nursing.
Commercial carrier are considered what? - ANS Private payers that offer both group and
individual plans.
4 @COPYRIGHT THESTAR 2025/2026
