AMCA BILLING & CODING STUDY GUIDE 2026 QUESTIONS
AND SOLUTIONS RATED A+
✔✔Which one of the following instructional notes suggests that a second code may be
required?
a. Code also
b. Includes
c. See also
d. See - ✔✔A
✔✔Which CPT modifier should the billing and coding specialist attach to a consultation
code when the service performed is required by a third party-payer r governmental
regulatory body?
a. -59 (Distinct Procedural Services)
b. -32 (Mandated Services)
c. -22 (Unusual Procedural Services)
d. -26 (Professional Component) - ✔✔B
✔✔What do the letters NOS (not otherwise specified) indicate?
a. Equals unspecified
b. Encloses synonyms, alternative words or explanatory phrases
c. Indicated terns that are to be codes elsewhere
d. Appears under a code to further define or explain the content - ✔✔A
✔✔What do the letters NEC (not elsewhere classified) indicate?
a. Encloses synonyms, alternative words, or explanatory phrases
b. Appears under a code to further define or explain the content
c. Indicates the use of code assignment for "other" when a more specific code does not
exist
d. Indicates terms that are to be coded elsewhere - ✔✔C
✔✔An established patient presents to the clinic complaining of a sore throat, cough, and
a stuffy nose. This is a patient with known diabetes and hypertension. The physician
documents diabetes, hypertension, and upper respiratory infection. Which of the
following is the first listed diagnosis.
a. Hypertension
b. Sore throat
c. Diabetes
d. Upper respiratory infection - ✔✔D
✔✔A new patient presents to the office complaining of shortness of breath, cough, and
pain in the chest. The physician performs a history and medical exam. The patient has a
history of diabetes and hypertension. She suspects the patient is suffering from
pneumonia and performs a sputum culture. The physician asks the patient to return in
, three days to discuss the results. Which of the following diagnosis would be coded if
there were no further documentation?
a. Diabetes, hypertension
b. Shortness of breath, cough, pain, diabetes, hypertension
c. Pneumonia, diabetes, hypertension
d. Pneumonia, diabetes, hypertension shortness of breath cough, pain - ✔✔B
✔✔In the following question, identify the term for the first-listed diagnosis in the
following encounter or visit.
Established patient presented to clinic with exacerbation of Crohn's disease. Patient's
rheumatoid arthritis stable.
a. Arthritis
b. Crohn's disease
c. Rheumatoid arthritis
d. Established patient - ✔✔B
✔✔Identify the term for first-listed diagnosis in the following encounter or visit.
Initial office visit fir patient requiring management of COPD and CHF.
a. Established patient
b. Initial visit
c. COPD and CHF
d. Pain management - ✔✔C
✔✔The UB-04 is used for primarily what type of patient visit?
a. Clinic
b. Hospital inpatient
c. Urgent care
d. Emergency room - ✔✔B
✔✔The term malignant refers to:
a. Site of origin or where the tumor originated
b. Site to which a malignant tumor has spread
c. Used to describe a cancerous tumor that grows worse over time
d. Malignancy that is located within the original site if development - ✔✔C
✔✔Which of the following terms refers to a cancerous neoplasm in its original location?
a. Ca in situ
b. Benign
c. Malignant primary
d. Malignant secondary - ✔✔A
✔✔In accordance to the Health Insurance Portability and Accountability Act (HIPAA),
which of the following organizations considers health plans, health care providers and
clearinghouses as covered entities?
a. American Heart Association (AHA)
AND SOLUTIONS RATED A+
✔✔Which one of the following instructional notes suggests that a second code may be
required?
a. Code also
b. Includes
c. See also
d. See - ✔✔A
✔✔Which CPT modifier should the billing and coding specialist attach to a consultation
code when the service performed is required by a third party-payer r governmental
regulatory body?
a. -59 (Distinct Procedural Services)
b. -32 (Mandated Services)
c. -22 (Unusual Procedural Services)
d. -26 (Professional Component) - ✔✔B
✔✔What do the letters NOS (not otherwise specified) indicate?
a. Equals unspecified
b. Encloses synonyms, alternative words or explanatory phrases
c. Indicated terns that are to be codes elsewhere
d. Appears under a code to further define or explain the content - ✔✔A
✔✔What do the letters NEC (not elsewhere classified) indicate?
a. Encloses synonyms, alternative words, or explanatory phrases
b. Appears under a code to further define or explain the content
c. Indicates the use of code assignment for "other" when a more specific code does not
exist
d. Indicates terms that are to be coded elsewhere - ✔✔C
✔✔An established patient presents to the clinic complaining of a sore throat, cough, and
a stuffy nose. This is a patient with known diabetes and hypertension. The physician
documents diabetes, hypertension, and upper respiratory infection. Which of the
following is the first listed diagnosis.
a. Hypertension
b. Sore throat
c. Diabetes
d. Upper respiratory infection - ✔✔D
✔✔A new patient presents to the office complaining of shortness of breath, cough, and
pain in the chest. The physician performs a history and medical exam. The patient has a
history of diabetes and hypertension. She suspects the patient is suffering from
pneumonia and performs a sputum culture. The physician asks the patient to return in
, three days to discuss the results. Which of the following diagnosis would be coded if
there were no further documentation?
a. Diabetes, hypertension
b. Shortness of breath, cough, pain, diabetes, hypertension
c. Pneumonia, diabetes, hypertension
d. Pneumonia, diabetes, hypertension shortness of breath cough, pain - ✔✔B
✔✔In the following question, identify the term for the first-listed diagnosis in the
following encounter or visit.
Established patient presented to clinic with exacerbation of Crohn's disease. Patient's
rheumatoid arthritis stable.
a. Arthritis
b. Crohn's disease
c. Rheumatoid arthritis
d. Established patient - ✔✔B
✔✔Identify the term for first-listed diagnosis in the following encounter or visit.
Initial office visit fir patient requiring management of COPD and CHF.
a. Established patient
b. Initial visit
c. COPD and CHF
d. Pain management - ✔✔C
✔✔The UB-04 is used for primarily what type of patient visit?
a. Clinic
b. Hospital inpatient
c. Urgent care
d. Emergency room - ✔✔B
✔✔The term malignant refers to:
a. Site of origin or where the tumor originated
b. Site to which a malignant tumor has spread
c. Used to describe a cancerous tumor that grows worse over time
d. Malignancy that is located within the original site if development - ✔✔C
✔✔Which of the following terms refers to a cancerous neoplasm in its original location?
a. Ca in situ
b. Benign
c. Malignant primary
d. Malignant secondary - ✔✔A
✔✔In accordance to the Health Insurance Portability and Accountability Act (HIPAA),
which of the following organizations considers health plans, health care providers and
clearinghouses as covered entities?
a. American Heart Association (AHA)
