Page 1 of 45
CERTIFIED PROFESSIONAL CODER CODING TEST EXAM
2025 COMPLETE EXAM QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100% CORRECT ANSWERS)
/ALREADY GRADED A+
Coding is ......ANSWER........the process of translating this written
or dictated fmedical record into a series of numeric or alpha-
numeric codes
Proper code assignment is determined by
......ANSWER........content of the medical record and by the unique
rules that governs each code set
what are 3 things that Coder must master ......ANSWER........1.
anatomy
2. medical terminology
3. must be detail-oriented
Medical coders assign a code to what ......ANSWER........1. Each
diagnosis
2. service/procedure
3. Supply, using the classification system when applicable
The classification system determines what ......ANSWER........the
amount health care providers will be reimbursed if the patient is
covered by Medicare, Medicaid, or other insurance programs
using the system
A coder must evaluate the medical record for ......ANSWER........1.
completeness and accuracy
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2. communicate regularly with physicians and othe health care
professional to clarify DX or obtain additonal PT info.
Techicians who speciallize in coding inpatient hospital services
are referred as ......ANSWER........1. Health information coders
2. medical record coders
3. Coder/abstractors
4. Coding Specialist
What is MS-DRGs and what is it ......ANSWER........1. Medicare
Severity-Diagnosis Related Groups
2. Determines the amt the hospital will be reimbursed if the PT is
covered by Medicare or other insurance programs
What is EHR ......ANSWER........Electronic health record
Skill coders may become ......ANSWER........consulatants, educators
or medical auditors
What is the difference between Hospital and Physican Services
......ANSWER........1. Outpatient coding (physician services)-
learning CPT, HCPCS, LEVEL II, ICD-9 CM codes Volume 1 and 2
2. Inpatient coding (Hospital services)- Learning CPT, ICD-9 CM
codes Volumes 1,2,3 and MS-DRGS
What is APC and who uses it ......ANSWER........Ambulatory
Payment Classification- outpatient facility coders (physician
services
What is the coder role in a physician's office
......ANSWER........Extremely important to proper reimbursement
and the livelihood of the physican
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What is a physican degree of education ......ANSWER........4
years of college, 4 years of medical school plus 3 to 5 years of
residency.
What is a mid-level providers and who ......ANSWER........1. Mid-
level providers are know as physician extenders
2. Physician assistants (PA) and Nurse Practitioners (NP)
What are the requirement for a PA and what ......ANSWER........1.
26 1/2 month to complete
2. Lincense to practice medicine with physician supervision
NP must have ......ANSWER........A Master Degree in Nursing
How many payers in the most simplest form? ......ANSWER........2
Private insurance plans and government insurance plans
Commerical carriers are considered what
......ANSWER........Private payers that offer both group and
individual plans.
Private Payers contracts may ......ANSWER........Vary but may
include hospitalization, basic and major medical coverage.
What is the most significant government insurer
......ANSWER........Medicare
What is Medicare ......ANSWER........Federal health insurance
program- Administerd by the Center for Medicare &Medicaid
Services (CMS)
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What is CMS and what does it provide ......ANSWER........Center
for Medicare & Medicaid Services (CMS) provides coverage for
people over the age of 65, blind, or disabled individuals,
people with end -stage renal disease
CMS regulations often serves as ____ word in coding
requirement for Medicare and Non-Medicare payers alike
......ANSWER........Last
What are the parts of Medicare ......ANSWER........Medicare A
Medicare B
Medicare C
Medicare D
What is Medicare Part A ......ANSWER........Covers inpatient
hospital care, as well as care provided in skilled nursing facilites,
hospice care, and home health care
What is Medicare Part B ......ANSWER........Covered Medically
necessary doctors' services, outpatient care, other medical
services (including some preventive service not covered under
Medicare Part A
Medicare Part B is considered what ......ANSWER........A optional
benefit for which the patient must pay a premium and which
generally requires a yearly copay
Where is Medicare Part B usually used
......ANSWER........Physician offices (Outpatient Facility)
What is Medicare Part C ......ANSWER........Combines the benefits
of Medicare Part A, Part B, and sometimes Part D.
CERTIFIED PROFESSIONAL CODER CODING TEST EXAM
2025 COMPLETE EXAM QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100% CORRECT ANSWERS)
/ALREADY GRADED A+
Coding is ......ANSWER........the process of translating this written
or dictated fmedical record into a series of numeric or alpha-
numeric codes
Proper code assignment is determined by
......ANSWER........content of the medical record and by the unique
rules that governs each code set
what are 3 things that Coder must master ......ANSWER........1.
anatomy
2. medical terminology
3. must be detail-oriented
Medical coders assign a code to what ......ANSWER........1. Each
diagnosis
2. service/procedure
3. Supply, using the classification system when applicable
The classification system determines what ......ANSWER........the
amount health care providers will be reimbursed if the patient is
covered by Medicare, Medicaid, or other insurance programs
using the system
A coder must evaluate the medical record for ......ANSWER........1.
completeness and accuracy
,Page 2 of 45
2. communicate regularly with physicians and othe health care
professional to clarify DX or obtain additonal PT info.
Techicians who speciallize in coding inpatient hospital services
are referred as ......ANSWER........1. Health information coders
2. medical record coders
3. Coder/abstractors
4. Coding Specialist
What is MS-DRGs and what is it ......ANSWER........1. Medicare
Severity-Diagnosis Related Groups
2. Determines the amt the hospital will be reimbursed if the PT is
covered by Medicare or other insurance programs
What is EHR ......ANSWER........Electronic health record
Skill coders may become ......ANSWER........consulatants, educators
or medical auditors
What is the difference between Hospital and Physican Services
......ANSWER........1. Outpatient coding (physician services)-
learning CPT, HCPCS, LEVEL II, ICD-9 CM codes Volume 1 and 2
2. Inpatient coding (Hospital services)- Learning CPT, ICD-9 CM
codes Volumes 1,2,3 and MS-DRGS
What is APC and who uses it ......ANSWER........Ambulatory
Payment Classification- outpatient facility coders (physician
services
What is the coder role in a physician's office
......ANSWER........Extremely important to proper reimbursement
and the livelihood of the physican
,Page 3 of 45
What is a physican degree of education ......ANSWER........4
years of college, 4 years of medical school plus 3 to 5 years of
residency.
What is a mid-level providers and who ......ANSWER........1. Mid-
level providers are know as physician extenders
2. Physician assistants (PA) and Nurse Practitioners (NP)
What are the requirement for a PA and what ......ANSWER........1.
26 1/2 month to complete
2. Lincense to practice medicine with physician supervision
NP must have ......ANSWER........A Master Degree in Nursing
How many payers in the most simplest form? ......ANSWER........2
Private insurance plans and government insurance plans
Commerical carriers are considered what
......ANSWER........Private payers that offer both group and
individual plans.
Private Payers contracts may ......ANSWER........Vary but may
include hospitalization, basic and major medical coverage.
What is the most significant government insurer
......ANSWER........Medicare
What is Medicare ......ANSWER........Federal health insurance
program- Administerd by the Center for Medicare &Medicaid
Services (CMS)
, Page 4 of 45
What is CMS and what does it provide ......ANSWER........Center
for Medicare & Medicaid Services (CMS) provides coverage for
people over the age of 65, blind, or disabled individuals,
people with end -stage renal disease
CMS regulations often serves as ____ word in coding
requirement for Medicare and Non-Medicare payers alike
......ANSWER........Last
What are the parts of Medicare ......ANSWER........Medicare A
Medicare B
Medicare C
Medicare D
What is Medicare Part A ......ANSWER........Covers inpatient
hospital care, as well as care provided in skilled nursing facilites,
hospice care, and home health care
What is Medicare Part B ......ANSWER........Covered Medically
necessary doctors' services, outpatient care, other medical
services (including some preventive service not covered under
Medicare Part A
Medicare Part B is considered what ......ANSWER........A optional
benefit for which the patient must pay a premium and which
generally requires a yearly copay
Where is Medicare Part B usually used
......ANSWER........Physician offices (Outpatient Facility)
What is Medicare Part C ......ANSWER........Combines the benefits
of Medicare Part A, Part B, and sometimes Part D.
