CPC Certified Professional Coder MCQ 4

Question 1

Under HIPAA, which code set is mandated for reporting diagnoses on professional claims?

Accepted Answer

ICD-10-CM

Answer

HIPAA mandates ICD-10-CM for diagnosis reporting on all covered electronic transactions for outpatient and professional claims.

Question 2

A patient has a malignant neoplasm of the sigmoid colon with metastasis to the liver. What is the correct sequencing?

Accepted Answer

Primary malignancy of colon first, then secondary malignancy of liver

Answer

When both primary and secondary malignant neoplasms are present and both are being treated, the primary site is sequenced first per ICD-10-CM guidelines.

Question 3

Which modifier indicates that a procedure was performed by a resident under the supervision of a teaching physician?

Accepted Answer

Modifier -GC

Answer

Modifier -GC is used to indicate a service was performed in part by a resident under the direction of a teaching physician.

Question 4

When coding a wound repair, which of the following factors determines the appropriate CPT code?

Accepted Answer

Length of repair, complexity, and anatomical site

Answer

Wound repair codes are selected based on the length of the wound (in centimeters), the complexity of repair (simple, intermediate, complex), and the anatomical location.

Question 5

What does the term 'unbundling' mean in medical coding?

Accepted Answer

Reporting multiple procedure codes separately when one comprehensive code should be used

Answer

Unbundling is the practice of billing multiple procedure codes separately when a single, more comprehensive code should be reported, and is considered fraudulent billing.

CPC - Certified Professional Coder Practice Test

CPC - Certified Professional Coder Practice Test

CPC Certified Professional Coder MCQ 4