MEDICAL CODING AND BILLING CERTIFICATION EXAM
2024 ACTUAL EXAM COMPLETE 200 QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100% CORRECT
ANSWERS) / ALREADY GRADED A+
ICD-10-CM is a _______. - ANSWER: classification
What reimbursement system sets payment rates in advance for future inpatient
services? - ANSWER: IPPS
Which system, starting October 1, 2015, classifies hospital inpatient claims for
procedures in the U.S.? - ANSWER: ICD-10-PCS
Codes that identify vendors and products and package size of all drugs are ____. -
ANSWER: NDC
What is a classification for oncology? - ANSWER: ICD-O-3
Which is not a section of CPT? - ANSWER: rehabilitation
Level 1 HCPCS is _________. - ANSWER: CPT codes
Which would not be a Level 2 HCPCS code? - ANSWER: appendectomy
Which is an input system? - ANSWER: SNOMED CT
What is the second part of DSM? - ANSWER: diagnostic criteria sets
AHA - ANSWER: American Hospital Association
AHIMA - ANSWER: American Health Information Management Association
CMS - ANSWER: Centers for Medicare and Medicaid Services
NCHS - ANSWER: National Center for Health Statistics
HHS - ANSWER: Department of Health and Human Services
NCHS - ANSWER: A federal organization within the CDC that collects, analyzes, and
distributes health care statistics. The NCHS maintains the ICD-n-CM codes.
AHA - ANSWER: serves as the official U.S. Clearinghouse on medical coding for the
proper use of the ICD-9-CM and ICD-10-CM/PCS systems and Level I HCPCS (CPT-4
codes) for hospital providers and certain Level II HCPCS codes for hospitals,
physicians and other health professionals.
,AHIMA - ANSWER: educates health information professionals to ensure the patient
stays connected to their data throughout the healthcare process.
CMS - ANSWER: an agency established to oversee various numbers of medical care
programs within the U.S. The agency falls under the Department of Health and
Human Services (HHS) to ensure smooth administration of all the major medical care
programs like Medicaid, Medicare and Health Insurance Exchanges. Intending to run
a high-quality health care system CMS offers access to coverage, better medical care,
and improved health.
HHS - ANSWER: risk adjustment model is a concurrent model, which means it uses
diagnoses from a time period to predict cost in that same period. All data reporting
for the HHS-operated risk adjustment program must include ICD-10-CM codes for
claims with dates of service on or after October 1, 2015.
When two or more interrelated conditions are present that qualify for principal
diagnosis, either may be listed first.
Group of answer choices - ANSWER: True
Possible diabetes mellitus would be reported using the code for diabetes mellitus in
the physician setting. - ANSWER: False
The patient is admitted to the observation unit of the hospital for chest pain. The
next day he is admitted to the inpatient floor because of worsening of symptoms and
a diagnosis of acute myocardial infarction. The principal diagnosis for the hospital is
chest pain.
Group of answer choices - ANSWER: false
The patient came to the surgery center for dilation of esophageal stricture. After
anesthesia was administered he experienced arrhythmia, diagnosed as atrial
fibrillation, and was admitted to the hospital for treatment. What is the principal
diagnosis for the hospital inpatient stay? - ANSWER: atrial fibrillation
Section III of the ICD-10-CM Coding Guidelines applies to physicians and outpatient
services.
Group of answer choices - ANSWER: False
History codes (Z80-Z87) are not used in the inpatient setting. - ANSWER: False
The patient was in the hospital for dehydration. It was documented by the provider
that the blood sugar was extremely high, and the patient was evaluated for diabetes
mellitus and started on insulin. Dehydration and diabetes mellitus are coded at
discharge. - ANSWER: True
The inpatient coder notices that the echocardiogram report (interpreted by a
physician) has the diagnosis of mitral valve prolapse. This diagnosis was not
, documented by the provider. At discharge the coder codes mitral valve prolapse as
an additional diagnosis. - ANSWER: False
The patient is admitted for pneumonia. The coder notices low potassium levels in the
laboratory report. The physician documents palpitations and prescribes IV potassium
chloride. What should the coder do? - ANSWER: query the physician to see if the
hypokalemia should be added
Section IV ICD-10 Guidelines are used by physician services. - ANSWER: True
Encounter and visit can be used interchangeably in the outpatient setting. - ANSWER:
True
In the physician office, the term principal diagnosis is used. - ANSWER: False
The patient comes to outpatient surgery for a tonsillectomy for chronic tonsillitis.
After recording the temperature, the surgery was postponed because of an acute
upper respiratory infection. The acute upper respiratory infection is coded as the
primary diagnosis for the encounter. - ANSWER: false
Sign/symptom codes are appropriate when an established diagnosis has not been
made. - ANSWER: True
The code for acute myocardial infarction would be assigned for the diagnosis of
possible acute MI in the emergency room. - ANSWER: false
Chronic diseases that are being treated may be coded as many times as necessary. -
ANSWER: True
The order for the test states: Rule out mitral valve prolapse. The outpatient coder
notices that the echocardiogram report (interpreted by a physician) has the
diagnosis of mitral valve prolapse.The coder codes mitral valve prolapse. - ANSWER:
True
What code is assigned for routine laboratory testing when there are no signs or
symptoms? - ANSWER: Z01.89
If there is inconsistent or missing documentation by the provider, the coder can
make the best choice to assign the POA. - ANSWER: False
What is considered present on admission? - ANSWER: present at time the order for
inpatient admission occurs
conditions developing during an outpatient encounter
conditions developing during outpatient surgery
all of the above
2024 ACTUAL EXAM COMPLETE 200 QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100% CORRECT
ANSWERS) / ALREADY GRADED A+
ICD-10-CM is a _______. - ANSWER: classification
What reimbursement system sets payment rates in advance for future inpatient
services? - ANSWER: IPPS
Which system, starting October 1, 2015, classifies hospital inpatient claims for
procedures in the U.S.? - ANSWER: ICD-10-PCS
Codes that identify vendors and products and package size of all drugs are ____. -
ANSWER: NDC
What is a classification for oncology? - ANSWER: ICD-O-3
Which is not a section of CPT? - ANSWER: rehabilitation
Level 1 HCPCS is _________. - ANSWER: CPT codes
Which would not be a Level 2 HCPCS code? - ANSWER: appendectomy
Which is an input system? - ANSWER: SNOMED CT
What is the second part of DSM? - ANSWER: diagnostic criteria sets
AHA - ANSWER: American Hospital Association
AHIMA - ANSWER: American Health Information Management Association
CMS - ANSWER: Centers for Medicare and Medicaid Services
NCHS - ANSWER: National Center for Health Statistics
HHS - ANSWER: Department of Health and Human Services
NCHS - ANSWER: A federal organization within the CDC that collects, analyzes, and
distributes health care statistics. The NCHS maintains the ICD-n-CM codes.
AHA - ANSWER: serves as the official U.S. Clearinghouse on medical coding for the
proper use of the ICD-9-CM and ICD-10-CM/PCS systems and Level I HCPCS (CPT-4
codes) for hospital providers and certain Level II HCPCS codes for hospitals,
physicians and other health professionals.
,AHIMA - ANSWER: educates health information professionals to ensure the patient
stays connected to their data throughout the healthcare process.
CMS - ANSWER: an agency established to oversee various numbers of medical care
programs within the U.S. The agency falls under the Department of Health and
Human Services (HHS) to ensure smooth administration of all the major medical care
programs like Medicaid, Medicare and Health Insurance Exchanges. Intending to run
a high-quality health care system CMS offers access to coverage, better medical care,
and improved health.
HHS - ANSWER: risk adjustment model is a concurrent model, which means it uses
diagnoses from a time period to predict cost in that same period. All data reporting
for the HHS-operated risk adjustment program must include ICD-10-CM codes for
claims with dates of service on or after October 1, 2015.
When two or more interrelated conditions are present that qualify for principal
diagnosis, either may be listed first.
Group of answer choices - ANSWER: True
Possible diabetes mellitus would be reported using the code for diabetes mellitus in
the physician setting. - ANSWER: False
The patient is admitted to the observation unit of the hospital for chest pain. The
next day he is admitted to the inpatient floor because of worsening of symptoms and
a diagnosis of acute myocardial infarction. The principal diagnosis for the hospital is
chest pain.
Group of answer choices - ANSWER: false
The patient came to the surgery center for dilation of esophageal stricture. After
anesthesia was administered he experienced arrhythmia, diagnosed as atrial
fibrillation, and was admitted to the hospital for treatment. What is the principal
diagnosis for the hospital inpatient stay? - ANSWER: atrial fibrillation
Section III of the ICD-10-CM Coding Guidelines applies to physicians and outpatient
services.
Group of answer choices - ANSWER: False
History codes (Z80-Z87) are not used in the inpatient setting. - ANSWER: False
The patient was in the hospital for dehydration. It was documented by the provider
that the blood sugar was extremely high, and the patient was evaluated for diabetes
mellitus and started on insulin. Dehydration and diabetes mellitus are coded at
discharge. - ANSWER: True
The inpatient coder notices that the echocardiogram report (interpreted by a
physician) has the diagnosis of mitral valve prolapse. This diagnosis was not
, documented by the provider. At discharge the coder codes mitral valve prolapse as
an additional diagnosis. - ANSWER: False
The patient is admitted for pneumonia. The coder notices low potassium levels in the
laboratory report. The physician documents palpitations and prescribes IV potassium
chloride. What should the coder do? - ANSWER: query the physician to see if the
hypokalemia should be added
Section IV ICD-10 Guidelines are used by physician services. - ANSWER: True
Encounter and visit can be used interchangeably in the outpatient setting. - ANSWER:
True
In the physician office, the term principal diagnosis is used. - ANSWER: False
The patient comes to outpatient surgery for a tonsillectomy for chronic tonsillitis.
After recording the temperature, the surgery was postponed because of an acute
upper respiratory infection. The acute upper respiratory infection is coded as the
primary diagnosis for the encounter. - ANSWER: false
Sign/symptom codes are appropriate when an established diagnosis has not been
made. - ANSWER: True
The code for acute myocardial infarction would be assigned for the diagnosis of
possible acute MI in the emergency room. - ANSWER: false
Chronic diseases that are being treated may be coded as many times as necessary. -
ANSWER: True
The order for the test states: Rule out mitral valve prolapse. The outpatient coder
notices that the echocardiogram report (interpreted by a physician) has the
diagnosis of mitral valve prolapse.The coder codes mitral valve prolapse. - ANSWER:
True
What code is assigned for routine laboratory testing when there are no signs or
symptoms? - ANSWER: Z01.89
If there is inconsistent or missing documentation by the provider, the coder can
make the best choice to assign the POA. - ANSWER: False
What is considered present on admission? - ANSWER: present at time the order for
inpatient admission occurs
conditions developing during an outpatient encounter
conditions developing during outpatient surgery
all of the above
