Certified Professional Coder MCQ Flashcards
7 cards from real CPC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Certified Professional Coder MCQ flashcards as text
Under HIPAA, which code set is mandated for reporting diagnoses on professional claims?
Answer: ICD-10-CM
HIPAA mandates ICD-10-CM for diagnosis reporting on all covered electronic transactions for outpatient and professional claims.
A patient has a malignant neoplasm of the sigmoid colon with metastasis to the liver. What is the correct sequencing?
Answer: Primary malignancy of colon first, then secondary malignancy of liver
When both primary and secondary malignant neoplasms are present and both are being treated, the primary site is sequenced first per ICD-10-CM guidelines.
Which modifier indicates that a procedure was performed by a resident under the supervision of a teaching physician?
Answer: Modifier -GC
Modifier -GC is used to indicate a service was performed in part by a resident under the direction of a teaching physician.
When coding a wound repair, which of the following factors determines the appropriate CPT code?
Answer: Length of repair, complexity, and anatomical site
Wound repair codes are selected based on the length of the wound (in centimeters), the complexity of repair (simple, intermediate, complex), and the anatomical location.
What does the term 'unbundling' mean in medical coding?
Answer: Reporting multiple procedure codes separately when one comprehensive code should be used
Unbundling is the practice of billing multiple procedure codes separately when a single, more comprehensive code should be reported, and is considered fraudulent billing.
A patient is admitted for pneumonia and also has COPD. The physician treats both conditions. How should these be coded?
Answer: Code pneumonia as principal diagnosis with COPD as an additional diagnosis
Pneumonia is the condition that prompted admission and is the principal diagnosis; COPD is an additional diagnosis that was managed and affects care.
Which of the following best describes a 'global surgical package'?
Answer: All services related to the procedure including pre-op, intra-op, and post-op care within a specified period
The global surgical package includes all pre-operative, intra-operative, and standard post-operative care within the defined global period (0, 10, or 90 days) for no additional charge.