Certified Coding Associate Exam Certified Coding Associate Professional 3 — Questions and Answers
Question 1: Which CPT code range covers Evaluation and Management (E/M) services?
- 10000-19999
- 99202-99499 (Correct answer)
- 70000-79999
- 90000-99199
Correct answer: 99202-99499
CPT E/M codes are found in the 99202-99499 range and are used to report physician and qualified healthcare professional visits.
Question 2: What is the definition of 'unbundling' in medical coding?
- Combining multiple procedures into one code
- Reporting multiple procedure codes separately when a single comprehensive code should be used (Correct answer)
- Using an unlisted procedure code
- Reporting a bilateral procedure with modifier -50
Correct answer: Reporting multiple procedure codes separately when a single comprehensive code should be used
Unbundling is the practice of using multiple procedure codes that should be captured by a single comprehensive code, and it is considered fraudulent billing.
Question 3: A coder assigns a code from category Z23 (Encounter for immunization). Where in the medical record should the coder look to confirm which vaccine was administered?
- The discharge summary
- The nursing notes only
- The physician's order and immunization record (Correct answer)
- The billing worksheet
Correct answer: The physician's order and immunization record
The physician's order and immunization administration record document the specific vaccine given, which guides accurate code assignment.
Question 4: Which modifier is appended to a CPT code to indicate a procedure was performed bilaterally?
- -51
- -59
- -50 (Correct answer)
- -RT
Correct answer: -50
CPT modifier -50 is used when a procedure is performed bilaterally during the same operative session.
Question 5: An operative report states the surgeon performed a laparoscopic cholecystectomy that was converted to an open procedure. How should this be coded?
- Code only the laparoscopic approach
- Code only the open approach (Correct answer)
- Code both approaches with modifier -52
- Code the open cholecystectomy with a note about conversion
Correct answer: Code only the open approach
Per CPT guidelines, when a laparoscopic procedure is converted to open, only the open procedure code is reported.
Question 6: What is the purpose of the NCCI (National Correct Coding Initiative) edits?
- To establish fee schedules for Medicare services
- To prevent improper payment of procedures that should not be reported together (Correct answer)
- To define medical necessity for outpatient services
- To validate ICD-10-CM diagnosis codes
Correct answer: To prevent improper payment of procedures that should not be reported together
NCCI edits identify pairs of CPT codes that should not be billed together because one code is considered a component of the other.
Question 7: Which code set is primarily used for reporting durable medical equipment (DME) on Medicare claims?
- CPT Category III codes
- ICD-10-PCS codes
- HCPCS Level II codes (Correct answer)
- Revenue codes
Correct answer: HCPCS Level II codes
HCPCS Level II codes are alphanumeric codes (A–V prefixes) used to report DME, supplies, and other services not covered by CPT.
Certified Coding Associate Exam Certified Coding Associate Professional 3
Which CPT code range covers Evaluation and Management (E/M) services?