AMCA BILLING & CODING LATEST 2026 EXAM QUESTIONS
AND SOLUTIONS RATED A+
✔✔What is meant by the term "Code to the Highest Level of Specificity"?
a. Using the most specific code possible
b. Using the code the doctor annotates, even if the physician notes do not coincide
c. Code using the four-digit subcategory code, even when a five-digit code is available.
d. Code using inconclusive and rule out diagnoses - ✔✔A
✔✔A medical term that contains the root word meaning "uterus":
a. Oophrectomy
b. Colporrhaphy
c. Hysterectomy
d. Salpingectomy - ✔✔C
✔✔If the patient is treated for both an acute and chronic condition, each of which has a
separate code, how should the codes be listed?
a. Acute code, chronic code
b. Chronic code, acute code
c. V code, condition code
d. Acute code, V code - ✔✔A
✔✔A new patient is one who has not received services from the physician or any other
physician in that group for:
a. 3 years
b. 1 year
c. 2 years
d. 90 days - ✔✔A
✔✔The abbreviation for PFSH is:
a. Present, family and social history
b. Past, family and/or social history
c. Patient, family and/or systems history
d. Past, family and systems history - ✔✔B
✔✔The three key factors in selecting E/M codes are:
a. Time, severity of presenting problem and history
b. History, examination and time
c. History, examination and medical decision making
d. Past history, history of present illness and chief complaint - ✔✔C
✔✔When a panel code from the Pathology and Laboratory section is reported:
a. 50% of the listed tests must have been performed
b. 90% of the listed tests must have been performed
, c. All the listed tests must have been performed
d. All of the listed tests must have been performed on the same day - ✔✔C
✔✔What is the Medicare Coverage Gap also know as the "donut hole"?
a. The amount of out of pocket costs after a certain amount of money has been spent
from Medicare on prescription drugs
b. It is the gap in coverage from month to month
c. It is out of pocket costs associated with a hospital stay
d. It is a specific part of Medicare coverage that can be subscribed to - ✔✔A
✔✔CPT is what level of Healthcare Common and Procedure coding system?
a. Level IV
b. Level III
c. Level I
d. Level II - ✔✔C
✔✔Most individuals receiving TANF payments are limited to a _____________ - year
benefit period.
a. 1
b. 7
c. 10
d. 5 - ✔✔A
✔✔Which of the following is not a commonly used transmission method for HIPAA
claims?
a. Direct transmission
b. Fax
c. Clearinghouse
d. Direct data entry - ✔✔D
✔✔Medicare Part A covers:
a. Physician services
b. MACs
c. Hospital services
d. Prescription drugs - ✔✔A
✔✔A payer's initial processing of a claim screens for:
a. Utilization guidelines
b. Medical edits
c. Claim attachments
d. Basic errors in claim data or missing information - ✔✔D
✔✔A claim may be downcoded because:
a. The claim does not list a charge for every procedure code
AND SOLUTIONS RATED A+
✔✔What is meant by the term "Code to the Highest Level of Specificity"?
a. Using the most specific code possible
b. Using the code the doctor annotates, even if the physician notes do not coincide
c. Code using the four-digit subcategory code, even when a five-digit code is available.
d. Code using inconclusive and rule out diagnoses - ✔✔A
✔✔A medical term that contains the root word meaning "uterus":
a. Oophrectomy
b. Colporrhaphy
c. Hysterectomy
d. Salpingectomy - ✔✔C
✔✔If the patient is treated for both an acute and chronic condition, each of which has a
separate code, how should the codes be listed?
a. Acute code, chronic code
b. Chronic code, acute code
c. V code, condition code
d. Acute code, V code - ✔✔A
✔✔A new patient is one who has not received services from the physician or any other
physician in that group for:
a. 3 years
b. 1 year
c. 2 years
d. 90 days - ✔✔A
✔✔The abbreviation for PFSH is:
a. Present, family and social history
b. Past, family and/or social history
c. Patient, family and/or systems history
d. Past, family and systems history - ✔✔B
✔✔The three key factors in selecting E/M codes are:
a. Time, severity of presenting problem and history
b. History, examination and time
c. History, examination and medical decision making
d. Past history, history of present illness and chief complaint - ✔✔C
✔✔When a panel code from the Pathology and Laboratory section is reported:
a. 50% of the listed tests must have been performed
b. 90% of the listed tests must have been performed
, c. All the listed tests must have been performed
d. All of the listed tests must have been performed on the same day - ✔✔C
✔✔What is the Medicare Coverage Gap also know as the "donut hole"?
a. The amount of out of pocket costs after a certain amount of money has been spent
from Medicare on prescription drugs
b. It is the gap in coverage from month to month
c. It is out of pocket costs associated with a hospital stay
d. It is a specific part of Medicare coverage that can be subscribed to - ✔✔A
✔✔CPT is what level of Healthcare Common and Procedure coding system?
a. Level IV
b. Level III
c. Level I
d. Level II - ✔✔C
✔✔Most individuals receiving TANF payments are limited to a _____________ - year
benefit period.
a. 1
b. 7
c. 10
d. 5 - ✔✔A
✔✔Which of the following is not a commonly used transmission method for HIPAA
claims?
a. Direct transmission
b. Fax
c. Clearinghouse
d. Direct data entry - ✔✔D
✔✔Medicare Part A covers:
a. Physician services
b. MACs
c. Hospital services
d. Prescription drugs - ✔✔A
✔✔A payer's initial processing of a claim screens for:
a. Utilization guidelines
b. Medical edits
c. Claim attachments
d. Basic errors in claim data or missing information - ✔✔D
✔✔A claim may be downcoded because:
a. The claim does not list a charge for every procedure code
