CPC Cheat Sheet 2026

The 30 highest-yield CPC facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which modifier is used to indicate that a service was performed by a nurse practitioner or physician assistant acting as the primary provider? → -SA
2. When coding an obstetric case, the default assumption about the trimester should be: → The trimester documented in the medical record
3. Why do medical coders need to stay updated with regulatory changes? → To follow the latest rules and maintain compliance
4. What is a 'remittance advice' (RA) in medical billing? → A document sent to the provider by the payer showing claim payment or denial details
5. What are the key components of the Affordable Care Act (ACA) related to medical coding? → Tracking insurance claims
6. Which chapter in ICD-10-CM contains codes for factors influencing health status (Z codes)? → Chapter 21
7. Which type of code is used to indicate that a patient has a personal history of a condition that no longer exists? → Z code (personal history)
8. In ICD-10-CM, the abbreviation 'NEC' stands for: → Not elsewhere classifiable
9. When a patient is seen for a condition that is both acute and chronic, how should it be coded? → Code the acute condition first, then the chronic
10. Which modifier indicates that only the professional component of a service was provided by the reporting physician? → -26
11. What is the importance of accurate documentation in medical billing? → To ensure correct billing and prevent issues
12. When a procedure is performed a second time by the same physician due to a complication, which modifier is used? → -76
13. Under HIPAA, which transaction standard is used for electronic health care claim submission? → ASC X12 837
14. What is the role of coding compliance programs? → To ensure legal and ethical standards are followed in coding
15. Which directional term means closer to the point of attachment or trunk of the body? → Proximal
16. HCPCS Level II codes are used primarily to report: → Supplies, equipment, non-physician services, and drugs not covered by CPT
17. Which modifier is used when a procedure is performed by a resident under the supervision of a teaching physician? → -GC
18. The term 'hematuria' means blood in which body substance? → Urine
19. What is the purpose of a 'late effect' or sequela code (7th character 'S') in ICD-10-CM? → Identifies residual conditions that remain after the acute phase of an illness or injury
20. What does a placeholder character 'X' serve in ICD-10-CM coding? → Allows future expansion and fills empty character positions
21. What does the combining form 'cardi/o' refer to? → Heart
22. What does the suffix '-plasty' mean in medical terminology? → Surgical repair or reconstruction
23. What is the role of modifiers in procedure coding? → To provide additional context for a procedure or service
24. Add-on codes in CPT are identified by which notation and are NEVER reported: → A '+' symbol; never reported without a primary procedure code
25. Which CPT code range covers office or other outpatient E/M services for established patients? → 99211–99215
26. A patient is admitted due to dehydration caused by chemotherapy. Which condition is sequenced first? → The dehydration
27. Why are procedure codes used in insurance claims? → To specify services and treatments for reimbursement
28. In the Medicare reimbursement system, what does 'participating provider' status mean? → The provider accepts Medicare's approved amount as payment in full and cannot balance bill
29. Which of the following is NOT one of the three elements of medical decision making (MDM)? → Number of organ systems examined
30. Modifier -62 is used when two surgeons each perform distinct parts of a procedure. This is called: → Co-surgery