CPC Basic 5 — Questions and Answers
Question 1: Which section of ICD-10-CM contains codes for factors influencing health status (such as immunizations or family history)?
- Chapter 18
- Chapter 19
- Chapter 21 (Correct answer)
- Chapter 22
Correct answer: Chapter 21
Chapter 21 of ICD-10-CM contains Z codes, which describe factors influencing health status and contact with health services.
Question 2: A claim is submitted with an ICD-10-CM code that is not at its highest level of specificity. This is called:
- Upcoding
- Downcoding
- Truncated coding (Correct answer)
- Unbundling
Correct answer: Truncated coding
Truncated coding occurs when a code is not reported at the maximum specificity available in ICD-10-CM.
Question 3: When reporting anesthesia services, time is calculated in units. What is one standard anesthesia time unit?
- 10 minutes
- 15 minutes (Correct answer)
- 20 minutes
- 30 minutes
Correct answer: 15 minutes
One anesthesia time unit equals 15 minutes of anesthesia administration time.
Question 4: Which of the following best describes 'unbundling' in medical coding?
- Reporting a more complex code than what was performed
- Reporting multiple component codes when a comprehensive code should be used (Correct answer)
- Reporting an inaccurate diagnosis to justify a procedure
- Reporting a code without supporting documentation
Correct answer: Reporting multiple component codes when a comprehensive code should be used
Unbundling is the improper practice of billing multiple separate codes when a single comprehensive code should be used.
Question 5: A patient is admitted with chest pain; workup reveals unstable angina. What is the principal diagnosis for the inpatient stay?
- Chest pain
- Unstable angina (Correct answer)
- Both chest pain and unstable angina
- Atypical chest pain
Correct answer: Unstable angina
The principal diagnosis for an inpatient stay is the condition determined after study to be chiefly responsible for admission — here, unstable angina.
Question 6: Which CPT modifier is used when a procedure is discontinued after anesthesia induction but before the surgical incision?
- -52
- -53 (Correct answer)
- -74
- -73
Correct answer: -53
Modifier -53 is used by the physician when a procedure is discontinued after anesthesia has been administered but before the procedure is completed.
Question 7: In CPT coding, what does a triangle (▲) symbol next to a code indicate?
- New code
- Revised code description (Correct answer)
- Add-on code
- Code exempt from modifier -51
Correct answer: Revised code description
A triangle (▲) symbol in the CPT codebook indicates that the code's description has been revised from the prior year.
CPC Basic 5
Which section of ICD-10-CM contains codes for factors influencing health status (such as immunizations or family history)?