Certified Medical Coding Specialist Medical Coding (CMCS) Sample 4 — Questions and Answers
Question 1: An add-on code in CPT is best described as:
- A code that can be reported alone
- A code always reported in addition to a primary procedure code (Correct answer)
- A code requiring a -51 modifier
- A code for unlisted procedures
Correct answer: A code always reported in addition to a primary procedure code
Add-on codes (marked with a '+' in CPT) are always reported alongside a primary procedure code and are exempt from the multiple procedure modifier -51.
Question 2: When coding burns, which characteristic determines the first-listed diagnosis when multiple burns are present?
- The burn that required the most nursing care
- The highest degree burn (Correct answer)
- The burn with the largest surface area
- The burn on the most distal body part
Correct answer: The highest degree burn
ICD-10-CM guidelines direct the coder to sequence the highest degree burn as the principal or first-listed diagnosis.
Question 3: Which of the following is an example of an unbundling violation?
- Billing a complex E/M with modifier -25 on the same day as a procedure
- Billing component parts of a surgical package separately to increase reimbursement (Correct answer)
- Appending modifier -50 for bilateral procedures
- Using an unlisted procedure code
Correct answer: Billing component parts of a surgical package separately to increase reimbursement
Unbundling means billing components of a comprehensive service separately to receive higher combined reimbursement, which is fraudulent.
Question 4: In ICD-10-CM, code Z23 is used for:
- A patient with a history of infectious disease
- An encounter for immunization (Correct answer)
- Exposure to communicable disease
- Screening for infectious disease
Correct answer: An encounter for immunization
Z23 is assigned for encounters specifically for immunization/vaccination administration.
Question 5: Which revenue code is commonly associated with pharmacy charges on a UB-04 claim form?
- Revenue code 0250 (Correct answer)
- Revenue code 0100
- Revenue code 0450
- Revenue code 0300
Correct answer: Revenue code 0250
Revenue code 0250 is designated for pharmacy charges on institutional UB-04 claims.
Question 6: The global surgical package typically includes all of the following EXCEPT:
- Preoperative care one day before surgery
- Uncomplicated postoperative follow-up visits
- Treatment of unrelated conditions during the postoperative period (Correct answer)
- Intraoperative services
Correct answer: Treatment of unrelated conditions during the postoperative period
Treatment of conditions unrelated to the original surgery is not included in the global surgical package and may be billed separately.
Question 7: A patient is admitted with chest pain. During the stay, the chest pain is determined to be due to acute myocardial infarction. What is the principal diagnosis?
- Chest pain
- Acute myocardial infarction (Correct answer)
- Both coded equally
- Angina pectoris
Correct answer: Acute myocardial infarction
Once the definitive diagnosis (AMI) is established, it replaces the symptom (chest pain) as the principal diagnosis for inpatient coding.
Certified Medical Coding Specialist Medical Coding (CMCS) Sample 4
An add-on code in CPT is best described as: