Medical Coding (CMCS) Sample Flashcards
7 cards from real Certified Medical Coding Specialist practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medical Coding (CMCS) Sample flashcards as text
Which of the following modifiers is used when a procedure is performed by two surgeons of different specialties?
Answer: -62
Modifier -62 indicates that two surgeons of different specialties each perform a distinct portion of a single procedure.
What is the purpose of the Correct Coding Initiative (CCI) edits?
Answer: To prevent improper payment of unbundled procedure codes
CCI edits are developed by CMS to prevent improper Medicare payments for incorrectly unbundled or mutually exclusive procedure codes.
A patient presents with a chief complaint of shortness of breath. After workup, the physician documents 'possible congestive heart failure.' Under inpatient coding guidelines, how is this coded?
Answer: Code congestive heart failure as if confirmed
Inpatient guidelines allow coding of conditions documented as 'possible,' 'probable,' or 'suspected' as if established.
When a physician documents 'acute on chronic' heart failure, how should this be coded in ICD-10-CM?
Answer: Code the combined 'acute on chronic' combination code
ICD-10-CM provides specific combination codes for acute on chronic conditions such as heart failure (e.g., I50.23 for acute-on-chronic systolic heart failure).
Which of the following is classified as a Category III CPT code?
Answer: A temporary code for emerging technology or services
Category III CPT codes are temporary codes used to track emerging technologies and services to support data collection for potential future Category I status.
Under the CMS-1500 claim form, Box 21 is used to enter:
Answer: Diagnosis codes
Box 21 of the CMS-1500 form is designated for ICD diagnosis codes that support medical necessity of the billed services.
A coder assigns an E/M code based on medical decision making (MDM). Which of the following represents 'high complexity' MDM?
Answer: Threat to life or bodily function requiring urgent decision-making
High complexity MDM involves problems that pose a threat to life or bodily function and require extensive data review and high-risk management.