Certified Coding Associate Knowledge Flashcards
7 cards from real Certified Coding Associate Exam 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 Coding Associate Knowledge flashcards as text
Which of the following is the correct definition of 'upcoding'?
Answer: Assigning a higher-level code than what is documented to increase reimbursement
Upcoding is the fraudulent practice of billing for a higher level of service or more complex code than what the documentation supports.
In ICD-10-PCS, how many characters does every procedure code contain?
Answer: 7
Every ICD-10-PCS code is exactly 7 characters long, with each character representing a specific aspect of the procedure.
Which CPT modifier indicates that a service was reduced or eliminated at the physician's discretion?
Answer: -52
Modifier -52 (Reduced Services) is used when a service is partially reduced or eliminated at the physician's discretion, with a corresponding reduction in reimbursement.
A patient with end-stage renal disease (ESRD) also has hypertension. Per ICD-10-CM guidelines, how should this be coded?
Answer: I12.11 and N18.6
ICD-10-CM assumes a causal relationship between hypertension and CKD; I12.11 (hypertensive CKD with ESRD) is assigned with N18.6 for the ESRD stage.
Which of the following is NOT a component considered when selecting the level of an E/M service under the 2021 revised guidelines?
Answer: Physical examination elements
The 2021 E/M guidelines eliminated the use of physical examination elements as a scoring component; level is now based on MDM or total time.
What is the purpose of ICD-10-CM's 'code also' instruction?
Answer: Alerts the coder that a second code may be needed to fully describe the condition
The 'code also' instruction alerts the coder that two codes may be required to fully describe a condition, though sequencing depends on the circumstances.
Which of the following scenarios requires the use of an external cause code (V00–Y99) in ICD-10-CM?
Answer: A patient with a fracture sustained in a motor vehicle accident
External cause codes (V00–Y99) are used to describe the cause, intent, and location of injuries and other health conditions, such as a fracture from a motor vehicle accident.