AHIMA Medical Coding and Classification 1 — Questions and Answers
Question 1: What is ICD-10-CM?
- The International Classification of Diseases, 10th Revision, Clinical Modification — used for diagnostic coding (Correct answer)
- A type of medical device
- A hospital department
- A pharmaceutical classification
Correct answer: The International Classification of Diseases, 10th Revision, Clinical Modification — used for diagnostic coding
ICD-10-CM provides standardized codes for diagnoses and conditions, used for billing, research, and health statistics in the United States.
Question 2: What is CPT coding?
- Current Procedural Terminology — standardized codes for medical procedures and services (Correct answer)
- A type of medical test
- A patient classification system
- A coding language for computers
Correct answer: Current Procedural Terminology — standardized codes for medical procedures and services
CPT codes, maintained by the AMA, describe medical, surgical, and diagnostic procedures for billing and reporting purposes.
Question 3: What is the purpose of medical coding?
- To translate diagnoses, procedures, and services into universal alphanumeric codes for billing and data analysis (Correct answer)
- To encrypt patient records
- To create passwords
- To organize medical supplies
Correct answer: To translate diagnoses, procedures, and services into universal alphanumeric codes for billing and data analysis
Medical coding converts clinical documentation into standardized codes that support billing, research, public health monitoring, and quality measurement.
Question 4: What is a DRG (Diagnosis-Related Group)?
- A patient classification system that groups similar clinical conditions for hospital payment purposes (Correct answer)
- A type of drug
- A diagnostic test
- A department within a hospital
Correct answer: A patient classification system that groups similar clinical conditions for hospital payment purposes
DRGs classify hospital inpatients into groups based on diagnosis, procedures, age, and complications, determining the hospital's Medicare payment for each case.
Question 5: What is HCPCS?
- Healthcare Common Procedure Coding System — codes for services, equipment, and supplies not in CPT (Correct answer)
- A hospital management system
- A health insurance plan
- A patient identifier
Correct answer: Healthcare Common Procedure Coding System — codes for services, equipment, and supplies not in CPT
HCPCS codes cover items and services not included in CPT, such as durable medical equipment, prosthetics, ambulance services, and certain drugs.
Question 6: What is the role of a clinical documentation improvement (CDI) specialist?
- To work with physicians to improve documentation accuracy and completeness for proper coding (Correct answer)
- To write medical notes for doctors
- To manage hospital finances
- To conduct patient satisfaction surveys
Correct answer: To work with physicians to improve documentation accuracy and completeness for proper coding
CDI specialists review medical records and collaborate with providers to ensure documentation accurately reflects patient acuity, supporting appropriate coding and reimbursement.
AHIMA Medical Coding and Classification 1
What is ICD-10-CM?