Free NHA Medical Coding Systems (ICD-10-CM, CPT, HCPCS) Questions and Answers — Questions and Answers
Question 1: The ICD-10-CM coding system is used to report which of the following?
- Medical services and procedures
- Diagnoses and diseases (Correct answer)
- Medical supplies and equipment
- Pharmaceutical drugs
Correct answer: Diagnoses and diseases
The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is used to code and classify diagnoses, symptoms, and inpatient procedures. It provides a high level of detail to describe a patient's condition.
Question 2: A physician performs a physical examination. Which code set would be used to bill for this service?
- ICD-10-CM
- HCPCS Level II
- CPT (Correct answer)
- NDC (National Drug Codes)
Correct answer: CPT
Current Procedural Terminology (CPT) codes are used to report medical, surgical, and diagnostic procedures and services performed by healthcare providers. A physical examination is a service and would be reported using a CPT code from the Evaluation and Management (E/M) section.
Question 3: HCPCS Level II codes are used to report which of the following?
- Inpatient hospital procedures
- Physician services in an office
- Durable medical equipment and supplies (Correct answer)
- Patient symptoms and diagnoses
Correct answer: Durable medical equipment and supplies
The Healthcare Common Procedure Coding System (HCPCS) Level II is used to identify products, supplies, and services not included in the CPT code set. This includes items like ambulance services, durable medical equipment (DME), prosthetics, and certain drugs.
Question 4: What is the purpose of adding a modifier, such as -50, to a CPT code?
- To indicate the diagnosis
- To specify that a procedure was performed on both sides of the body (Correct answer)
- To increase the reimbursement rate automatically
- To bundle multiple services into one code
Correct answer: To specify that a procedure was performed on both sides of the body
CPT modifiers provide additional information about a service without changing the definition of the code itself. The -50 modifier specifically indicates that a procedure was performed bilaterally, meaning on both sides of the body.
Question 5: In the ICD-10-CM code M19.011, what does the 'M' represent?
- The severity of the condition
- The laterality (left or right side)
- The chapter of the disease classification (Correct answer)
- A placeholder for future expansion
Correct answer: The chapter of the disease classification
In ICD-10-CM, the first character is always an alphabet letter that represents the chapter or category of the disease or condition. The letter 'M' corresponds to the chapter for 'Diseases of the musculoskeletal system and connective tissue'.
Question 6: A patient is seen for an annual wellness visit with no specific complaints. Which type of ICD-10-CM code would be used as the primary diagnosis?
- An S code (Injury, poisoning)
- A Z code (Factors influencing health status) (Correct answer)
- An R code (Symptoms, signs)
- A G code (Diseases of the nervous system)
Correct answer: A Z code (Factors influencing health status)
Z codes are used to report encounters for reasons other than a disease or injury, such as health screenings, immunizations, or annual physicals. They describe circumstances that influence a patient's health status but are not a current illness.
Free NHA Medical Coding Systems (ICD-10-CM, CPT, HCPCS) Questions and Answers
The ICD-10-CM coding system is used to report which of the following?