CERTIFIED PROFESSIONAL CODER (CPC)
EXAMINATION QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
| INSTANT DOWNLOAD PDF
1. What is the correct CPT code for a routine office visit for a new patient with
low complexity medical decision making?
A. 99202
B. 99212
C. 99203
D. 99213
Correct Answer: A. 99202
Rationale: A new patient office visit with straightforward or low complexity
medical decision making is reported with 99202. Established patient visits use a
different code range (99211–99215).
2. What does ICD-10-CM primarily classify?
A. Procedures
B. Diagnoses
C. Drugs
D. Supplies
Correct Answer: B. Diagnoses
Rationale: ICD-10-CM is used to classify and code diagnoses, symptoms, and
conditions, not procedures or supplies.
, 3. Which modifier indicates a procedure was discontinued after anesthesia
was administered?
A. 53
B. 73
C. 74
D. 52
Correct Answer: C. 74
Rationale: Modifier 74 is used for discontinued outpatient procedures after
anesthesia has been administered.
4. What is the main purpose of HCPCS Level II codes?
A. Inpatient procedures
B. Physician services
C. Supplies and equipment
D. Laboratory tests only
Correct Answer: C. Supplies and equipment
Rationale: HCPCS Level II codes are used to report non-physician services,
supplies, prosthetics, and durable medical equipment.
5. Which section of CPT includes anesthesia services?
A. 10000 series
B. 20000 series
C. 30000 series
D. 00100–01999
Correct Answer: D. 00100–01999
Rationale: The anesthesia section of CPT is located in codes 00100–01999.
, 6. What is the definition of upcoding?
A. Coding fewer services than performed
B. Reporting unlisted codes
C. Assigning a higher-level code than documentation supports
D. Using modifiers incorrectly
Correct Answer: C. Assigning a higher-level code than documentation supports
Rationale: Upcoding is fraudulent billing where higher-paying codes are used
without clinical justification.
7. Which organ system is included in CPT digestive system codes?
A. Heart
B. Liver
C. Brain
D. Skin
Correct Answer: B. Liver
Rationale: The digestive system includes organs such as the liver, stomach, and
intestines.
8. What is a key characteristic of a surgical global period?
A. Only includes pre-op services
B. Includes pre-op, intra-op, and post-op care
C. Only includes hospital stay
D. Includes lab services only
Correct Answer: B. Includes pre-op, intra-op, and post-op care
Rationale: The global surgical package includes all related services before,
during, and after surgery.
9. Which code set is used for outpatient hospital reporting?
A. ICD-10-PCS
, B. CPT
C. DRG
D. NDC
Correct Answer: B. CPT
Rationale: CPT codes are used for outpatient and physician-based services.
10.What does a Category II CPT code represent?
A. Temporary procedure codes
B. Performance measurement tracking codes
C. Experimental procedures
D. Radiology codes
Correct Answer: B. Performance measurement tracking codes
Rationale: Category II codes are used for quality performance tracking, not
billing for reimbursement.
11.What does the term “bundling” mean in coding?
A. Reporting multiple separate codes for each component
B. Combining related services into one code
C. Using only ICD codes
D. Separating global services
Correct Answer: B. Combining related services into one code
Rationale: Bundling refers to grouping related services into a single
comprehensive code.
12.Which modifier is used for bilateral procedures?
A. 50
B. 51
C. 59
D. 26
EXAMINATION QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
| INSTANT DOWNLOAD PDF
1. What is the correct CPT code for a routine office visit for a new patient with
low complexity medical decision making?
A. 99202
B. 99212
C. 99203
D. 99213
Correct Answer: A. 99202
Rationale: A new patient office visit with straightforward or low complexity
medical decision making is reported with 99202. Established patient visits use a
different code range (99211–99215).
2. What does ICD-10-CM primarily classify?
A. Procedures
B. Diagnoses
C. Drugs
D. Supplies
Correct Answer: B. Diagnoses
Rationale: ICD-10-CM is used to classify and code diagnoses, symptoms, and
conditions, not procedures or supplies.
, 3. Which modifier indicates a procedure was discontinued after anesthesia
was administered?
A. 53
B. 73
C. 74
D. 52
Correct Answer: C. 74
Rationale: Modifier 74 is used for discontinued outpatient procedures after
anesthesia has been administered.
4. What is the main purpose of HCPCS Level II codes?
A. Inpatient procedures
B. Physician services
C. Supplies and equipment
D. Laboratory tests only
Correct Answer: C. Supplies and equipment
Rationale: HCPCS Level II codes are used to report non-physician services,
supplies, prosthetics, and durable medical equipment.
5. Which section of CPT includes anesthesia services?
A. 10000 series
B. 20000 series
C. 30000 series
D. 00100–01999
Correct Answer: D. 00100–01999
Rationale: The anesthesia section of CPT is located in codes 00100–01999.
, 6. What is the definition of upcoding?
A. Coding fewer services than performed
B. Reporting unlisted codes
C. Assigning a higher-level code than documentation supports
D. Using modifiers incorrectly
Correct Answer: C. Assigning a higher-level code than documentation supports
Rationale: Upcoding is fraudulent billing where higher-paying codes are used
without clinical justification.
7. Which organ system is included in CPT digestive system codes?
A. Heart
B. Liver
C. Brain
D. Skin
Correct Answer: B. Liver
Rationale: The digestive system includes organs such as the liver, stomach, and
intestines.
8. What is a key characteristic of a surgical global period?
A. Only includes pre-op services
B. Includes pre-op, intra-op, and post-op care
C. Only includes hospital stay
D. Includes lab services only
Correct Answer: B. Includes pre-op, intra-op, and post-op care
Rationale: The global surgical package includes all related services before,
during, and after surgery.
9. Which code set is used for outpatient hospital reporting?
A. ICD-10-PCS
, B. CPT
C. DRG
D. NDC
Correct Answer: B. CPT
Rationale: CPT codes are used for outpatient and physician-based services.
10.What does a Category II CPT code represent?
A. Temporary procedure codes
B. Performance measurement tracking codes
C. Experimental procedures
D. Radiology codes
Correct Answer: B. Performance measurement tracking codes
Rationale: Category II codes are used for quality performance tracking, not
billing for reimbursement.
11.What does the term “bundling” mean in coding?
A. Reporting multiple separate codes for each component
B. Combining related services into one code
C. Using only ICD codes
D. Separating global services
Correct Answer: B. Combining related services into one code
Rationale: Bundling refers to grouping related services into a single
comprehensive code.
12.Which modifier is used for bilateral procedures?
A. 50
B. 51
C. 59
D. 26
