Certified Medical Coding Specialist Professional Standards & Competencies 2

Question 1

Which organization administers the Certified Medical Coding Specialist (CMCS) credential?

Accepted Answer

Medical Association of Billers (MAB)

Answer

The CMCS credential is administered by the Medical Association of Billers (MAB).

Question 2

A medical coder discovers that a physician consistently documents a diagnosis that is not supported by the clinical findings in the record. What is the most appropriate first step?

Accepted Answer

Query the physician for clarification before coding

Answer

Querying the physician is the appropriate first step to clarify documentation before assigning a code.

Question 3

Under HIPAA, which of the following is NOT considered a covered entity?

Accepted Answer

Employers who self-administer wellness programs with no PHI transmission

Answer

Employers who do not transmit PHI electronically in the course of healthcare transactions are not HIPAA covered entities.

Question 4

A coder is asked by a supervisor to upcode a procedure to increase reimbursement. The coder should:

Accepted Answer

Refuse and document the incident per compliance policy

Answer

Upcoding is fraudulent; the coder must refuse and report the request through established compliance channels.

Question 5

Which coding guideline requires that all confirmed conditions present at discharge be coded for inpatient records?

Accepted Answer

UHDDS principal diagnosis definition

Answer

The Uniform Hospital Discharge Data Set (UHDDS) guidelines direct that all conditions present at discharge be coded on inpatient records.

Certified Medical Coding Specialist Practice Test

Certified Medical Coding Specialist Practice Test

Certified Medical Coding Specialist Professional Standards & Competencies 2