Medical Coding and Billing Certification
(MCBC) Study Guide I
The services medically necessary for diagnostic code linkage - correct answer What must a coder
understand in order to determine the correct diagnosis code assignment?
Correctly identifying primary and secondary insurance policies in order to preserve coordination of
benefits - correct answer Avoiding the duplication of benefits paid by the primary and secondary
insurance is achieved by:
Use the combination code - correct answer If a combination code is available, a coder should:
blue triangle - correct answer When a code is "revised" in the CPT manual, it will be indicated by:
particular radiology service provided is not described by a specific CPT code - correct answer A coder
should use an "unlisted' radiology CPT code when:
Code blocks - correct answer Major topic headings in the Tabular List of ICD-10-CM are known as:
Healthcare Common Procedure Coding System - correct answer Most state Medicaid programs use what
type of system to report professional services, procedures, supplies, and equipment?
always a letter - correct answer The first character of ICD-10-CM:
Using a fourth, fifth, sixth or seventh digit when required - correct answer Coding to the highest level of
specificity means:
Without - correct answer According to the ICD-10-CM conventions, if the documentation is unclear or
does not state that the complication or comorbidity listed in the code description is present with the
condition, the default is:
, E/M service codes - correct answer Reported in addition to the appropriate casting code when a cast or
splint is intended to be the definitive treatment of a fracture
Subsequent Encounter - correct answer Care encounter after the initial care event
Diagnostic codes from encounter form - correct answer What information is needed to fill out a CMS-
1500 claim form?
Billing more than the proper fee for a service - correct answer Upcoding is:
It ensures the correct patient data information and procedure codes - correct answer Why is a
superbill/encounter form an important document in the office?
EHR should include eight core functions - correct answer 1. Health information and data elements
2. Results management
3. Order management
4. Decision support
5. Electronic communications and connectivity
6. Patient support
7. Administrative processes
8. Reporting and population management
Electronic Health Record (EHR) - correct answer reflects the data from all sources that have treated the
individual
Personal Health Record (PHR) - correct answer maintained and owned by the patient. The patient makes
the decision whether to share the contents with their physician
Ambulatory care - correct answer refers to treatment without admission to hospital
(MCBC) Study Guide I
The services medically necessary for diagnostic code linkage - correct answer What must a coder
understand in order to determine the correct diagnosis code assignment?
Correctly identifying primary and secondary insurance policies in order to preserve coordination of
benefits - correct answer Avoiding the duplication of benefits paid by the primary and secondary
insurance is achieved by:
Use the combination code - correct answer If a combination code is available, a coder should:
blue triangle - correct answer When a code is "revised" in the CPT manual, it will be indicated by:
particular radiology service provided is not described by a specific CPT code - correct answer A coder
should use an "unlisted' radiology CPT code when:
Code blocks - correct answer Major topic headings in the Tabular List of ICD-10-CM are known as:
Healthcare Common Procedure Coding System - correct answer Most state Medicaid programs use what
type of system to report professional services, procedures, supplies, and equipment?
always a letter - correct answer The first character of ICD-10-CM:
Using a fourth, fifth, sixth or seventh digit when required - correct answer Coding to the highest level of
specificity means:
Without - correct answer According to the ICD-10-CM conventions, if the documentation is unclear or
does not state that the complication or comorbidity listed in the code description is present with the
condition, the default is:
, E/M service codes - correct answer Reported in addition to the appropriate casting code when a cast or
splint is intended to be the definitive treatment of a fracture
Subsequent Encounter - correct answer Care encounter after the initial care event
Diagnostic codes from encounter form - correct answer What information is needed to fill out a CMS-
1500 claim form?
Billing more than the proper fee for a service - correct answer Upcoding is:
It ensures the correct patient data information and procedure codes - correct answer Why is a
superbill/encounter form an important document in the office?
EHR should include eight core functions - correct answer 1. Health information and data elements
2. Results management
3. Order management
4. Decision support
5. Electronic communications and connectivity
6. Patient support
7. Administrative processes
8. Reporting and population management
Electronic Health Record (EHR) - correct answer reflects the data from all sources that have treated the
individual
Personal Health Record (PHR) - correct answer maintained and owned by the patient. The patient makes
the decision whether to share the contents with their physician
Ambulatory care - correct answer refers to treatment without admission to hospital
