Knowledge Skill 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 Knowledge Skill flashcards as text
Which code set is used to report diagnoses and reasons for encounters in outpatient settings in the United States?
Answer: ICD-10-CM
ICD-10-CM is the diagnosis coding system used for outpatient and inpatient encounters in the US.
A coder notices that a surgeon's operative note describes a procedure that is more extensive than the CPT code billed. What is the most appropriate action?
Answer: Query the physician for clarification before coding
The coder should query the physician to clarify the documentation before assigning the appropriate code.
Which modifier is appended to indicate a service was performed by a physician other than the primary surgeon during the postoperative period?
Answer: -55
Modifier -55 is used when postoperative care is transferred to and performed by a different physician.
What does the term 'unbundling' refer to in medical coding?
Answer: Reporting separate codes for services included in a comprehensive code
Unbundling is the practice of reporting component services separately when a single comprehensive code should be used.
In ICD-10-CM, a 7th character 'A' appended to a fracture code indicates:
Answer: Initial encounter for fracture
The 7th character 'A' designates the initial encounter while the patient is receiving active treatment for the fracture.
Which section of CPT contains Evaluation and Management codes?
Answer: Section 99202–99499
E/M codes are found in the 99202–99499 range of the CPT code set.
What is the primary purpose of the National Correct Coding Initiative (NCCI) edits?
Answer: To prevent improper payment of procedures that should not be billed together
NCCI edits identify pairs of CPT codes that should not be billed together because one is bundled into the other.