MO METRIX CCS EXAM PRACTICE TEST EXAM QUESTIONS AND
ANSWERS
a. The Centers for Disease Control and Prevention - CORRECT ANSWER✅✅Which of the following is not
a covered entity in the HIPAA Privacy rule?
a. The Centers for Disease Control and Prevention
b. Employer-sponsored health plan
c. Third-party billing agency
d. Healthcare provider
d. Hierarchical condition category (HCC) coding - CORRECT ANSWER✅✅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?
a. Risk adjustment factor (RAF)
b. Diagnosis-related groups
c. Outcome and Assessment information set
d. Hierarchical condition category (HCC) coding
d. The two codes can be billed together with an appropriate modifier - CORRECT ANSWER✅✅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 never be billed together.
b. If being billed together, only report one unit of 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
c. Moderate complexity - CORRECT ANSWER✅✅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
Level of risk: Moderate
a. Straightforward
b. Low complexity
c. Moderate complexity
d. High complexity
a. 58301-53 - CORRECT ANSWER✅✅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
b. 58301-52
c. 99212-25, 58301
d. 99212, 58301-59
c. 76536
no modifier - CORRECT ANSWER✅✅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 one year. How
should the primary care physician report the ultrasound?
a. 76536-26
b. 76536-TC
c. 76536
d. 76536-TC, 26
,a. Medically unlikely edits - CORRECT ANSWER✅✅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
b. Add-on-code edits
c. Correspondence edits
d. Procedure-to-procedure coding edits
d. Two or more unrelated diseases occurring at the same time. - CORRECT ANSWER✅✅Which
statement best describes a comorbidity?
a. Two or more life-threatening illnesses occurring at the same time
b. Three or more minor injuries occurring at the same time
c. Three or more chronic illness occurring at the same time
d. Two or more unrelated diseases occurring at the same time.
a. Protect privacy and confidentiality; protect personal health information; and use technology, data,
and information resources in the way they are intended. - CORRECT ANSWER✅✅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 media. Which
AHIMA standard(s) of Ethical Coding has been violated?
a. Protect privacy and confidentiality; protect personal health information; and use technology, data,
and information resources in the way they are 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
, d. Social history - CORRECT ANSWER✅✅The smoking status of a patient should generally be found in
which section of a medical record?
a. Chief complaint
b. Plan
c. Examination
d. Social history
c. Family history - CORRECT ANSWER✅✅Which of the following is not a data element required by the
uniform Hospital Discharge Data set (UHDDS)
a. Location of residence
b. Provider name
c. Family history
d. Total charges for services rendered.
b. Mentor colleagues to strengthen the professional workforce - CORRECT ANSWER✅✅A hospital
director repeatedly refuses to accept residents due to a tight budget that limits training time for
students. Which AHIMA Standard(s) of ethical Coding has been violated?
a. Put the welfare of persons before self-interest
b. Mentor colleagues to strengthen the professional workforce
c. Respect the worth of every person.
d. Represent the profession to the public in a positive manner.
c. 33533, 33517 - CORRECT ANSWER✅✅A physician performs a coronary artery bypass grafting using
the left internal mammary artery to the right coronary, and a saphenous vein graft to the circumflex.
Which CPT code(s)
a. 33533, 33510
b. 33534
ANSWERS
a. The Centers for Disease Control and Prevention - CORRECT ANSWER✅✅Which of the following is not
a covered entity in the HIPAA Privacy rule?
a. The Centers for Disease Control and Prevention
b. Employer-sponsored health plan
c. Third-party billing agency
d. Healthcare provider
d. Hierarchical condition category (HCC) coding - CORRECT ANSWER✅✅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?
a. Risk adjustment factor (RAF)
b. Diagnosis-related groups
c. Outcome and Assessment information set
d. Hierarchical condition category (HCC) coding
d. The two codes can be billed together with an appropriate modifier - CORRECT ANSWER✅✅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 never be billed together.
b. If being billed together, only report one unit of 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
c. Moderate complexity - CORRECT ANSWER✅✅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
Level of risk: Moderate
a. Straightforward
b. Low complexity
c. Moderate complexity
d. High complexity
a. 58301-53 - CORRECT ANSWER✅✅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
b. 58301-52
c. 99212-25, 58301
d. 99212, 58301-59
c. 76536
no modifier - CORRECT ANSWER✅✅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 one year. How
should the primary care physician report the ultrasound?
a. 76536-26
b. 76536-TC
c. 76536
d. 76536-TC, 26
,a. Medically unlikely edits - CORRECT ANSWER✅✅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
b. Add-on-code edits
c. Correspondence edits
d. Procedure-to-procedure coding edits
d. Two or more unrelated diseases occurring at the same time. - CORRECT ANSWER✅✅Which
statement best describes a comorbidity?
a. Two or more life-threatening illnesses occurring at the same time
b. Three or more minor injuries occurring at the same time
c. Three or more chronic illness occurring at the same time
d. Two or more unrelated diseases occurring at the same time.
a. Protect privacy and confidentiality; protect personal health information; and use technology, data,
and information resources in the way they are intended. - CORRECT ANSWER✅✅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 media. Which
AHIMA standard(s) of Ethical Coding has been violated?
a. Protect privacy and confidentiality; protect personal health information; and use technology, data,
and information resources in the way they are 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
, d. Social history - CORRECT ANSWER✅✅The smoking status of a patient should generally be found in
which section of a medical record?
a. Chief complaint
b. Plan
c. Examination
d. Social history
c. Family history - CORRECT ANSWER✅✅Which of the following is not a data element required by the
uniform Hospital Discharge Data set (UHDDS)
a. Location of residence
b. Provider name
c. Family history
d. Total charges for services rendered.
b. Mentor colleagues to strengthen the professional workforce - CORRECT ANSWER✅✅A hospital
director repeatedly refuses to accept residents due to a tight budget that limits training time for
students. Which AHIMA Standard(s) of ethical Coding has been violated?
a. Put the welfare of persons before self-interest
b. Mentor colleagues to strengthen the professional workforce
c. Respect the worth of every person.
d. Represent the profession to the public in a positive manner.
c. 33533, 33517 - CORRECT ANSWER✅✅A physician performs a coronary artery bypass grafting using
the left internal mammary artery to the right coronary, and a saphenous vein graft to the circumflex.
Which CPT code(s)
a. 33533, 33510
b. 33534
