Certified Coding Associate Exam Certified Coding Associate Classification 3 — Questions and Answers
Question 1: In the ICD-10-PCS Medical and Surgical section, which character position represents the 'Root Operation'?
- Character 1
- Character 2
- Character 3 (Correct answer)
- Character 4
Correct answer: Character 3
In ICD-10-PCS Medical and Surgical section, character 3 represents the root operation (e.g., Excision, Repair, Fusion).
Question 2: What is the correct ICD-10-CM coding guideline when a patient has both an acute and a chronic condition?
- Code only the acute condition
- Code only the chronic condition
- Code both, sequencing the acute condition first (Correct answer)
- Code both, sequencing the chronic condition first
Correct answer: Code both, sequencing the acute condition first
When both an acute and chronic form of a condition exist, ICD-10-CM guidelines instruct coding both with the acute condition sequenced first.
Question 3: HCPCS Level II codes are primarily used to report which of the following?
- Physician evaluation and management services
- Supplies, durable medical equipment, and non-physician services not in CPT (Correct answer)
- Inpatient hospital procedures
- Diagnosis codes for Medicare claims
Correct answer: Supplies, durable medical equipment, and non-physician services not in CPT
HCPCS Level II codes cover items not described by CPT codes, including DME, ambulance services, drugs, and prosthetics.
Question 4: Which CPT code range covers Evaluation and Management (E/M) services?
- 10004–69990
- 70010–79999
- 99202–99499 (Correct answer)
- 00100–01999
Correct answer: 99202–99499
E/M service codes in CPT are found in the range 99202–99499, covering office visits, hospital care, consultations, and other E/M categories.
Question 5: When a patient is admitted to the hospital and the working diagnosis changes by the time of discharge, the coder should:
- Code the admitting diagnosis as principal
- Code the final confirmed diagnosis established at discharge as principal (Correct answer)
- Code both the admitting and discharge diagnoses
- Query the physician to verify the admitting diagnosis only
Correct answer: Code the final confirmed diagnosis established at discharge as principal
Inpatient coding guidelines require coding the diagnosis confirmed at the time of discharge, not the working or admitting diagnosis.
Question 6: In ICD-10-CM, the Alphabetic Index entry 'see also' instructs the coder to:
- Ignore the current main term and go to a different one
- Look at an alternative main term for additional information (Correct answer)
- Code both the current and referenced conditions
- Use only the referenced code and discard the current one
Correct answer: Look at an alternative main term for additional information
'See also' in the Alphabetic Index directs the coder to another main term that may provide additional or alternative code options.
Question 7: A coder assigns CPT code 99213 with modifier -25. What does modifier -25 indicate?
- The service was performed by a different provider
- A significant, separately identifiable E/M service on the same day as a procedure (Correct answer)
- The procedure was reduced or eliminated
- The service was performed in an outpatient hospital setting
Correct answer: A significant, separately identifiable E/M service on the same day as a procedure
CPT modifier -25 indicates that a significant, separately identifiable E/M service was provided on the same day as a procedure or other service.
