CPC Medical Coding Systems 2 — Questions and Answers
Question 1: Which ICD-10-CM convention indicates that a code cannot be used as a principal diagnosis?
- NEC
- Code first (Correct answer)
- Excludes1
- Use additional code
Correct answer: Code first
'Code first' instructs the coder that the condition must be sequenced after an underlying disease.
Question 2: In CPT, what does the term 'separate procedure' indicate?
- The procedure requires a separate operative report
- The procedure is integral to a larger service and should not be billed when done with a related procedure (Correct answer)
- The procedure must be billed with modifier -59
- The procedure is reimbursed at a separate rate
Correct answer: The procedure is integral to a larger service and should not be billed when done with a related procedure
A 'separate procedure' designation means the code is bundled when performed alongside a related, more complex procedure.
Question 3: HCPCS Level II codes are maintained by which organization?
- AMA
- WHO
- CMS (Correct answer)
- AHIMA
Correct answer: CMS
CMS (Centers for Medicare & Medicaid Services) maintains HCPCS Level II codes used for supplies, equipment, and non-physician services.
Question 4: When coding an encounter for a patient with a confirmed HIV infection being treated for pneumonia, which code is sequenced first?
- The pneumonia code
- The HIV code (B20) (Correct answer)
- A Z-code for HIV status
- The encounter reason code
Correct answer: The HIV code (B20)
ICD-10-CM guidelines require B20 (HIV disease) to be sequenced first when a patient with confirmed HIV is treated for an HIV-related condition.
Question 5: Which CPT modifier indicates a procedure was performed bilaterally?
- -50 (Correct answer)
- -51
- -52
- -53
Correct answer: -50
Modifier -50 is appended to report bilateral procedures performed during the same operative session.
Question 6: In ICD-10-PCS, the 'approach' character describes:
- The body system being treated
- The technique used to reach the operative site (Correct answer)
- The device left in the body
- The objective of the procedure
Correct answer: The technique used to reach the operative site
The approach character (5th character) in ICD-10-PCS defines the technique used to reach the procedure site, such as open, percutaneous, or endoscopic.
Question 7: Which coding system is used to report diagnoses on inpatient hospital claims?
- CPT
- ICD-10-CM (Correct answer)
- ICD-10-PCS
- HCPCS Level II
Correct answer: ICD-10-CM
ICD-10-CM is used to report diagnoses on both inpatient and outpatient claims in the United States.
CPC Medical Coding Systems 2
Which ICD-10-CM convention indicates that a code cannot be used as a principal diagnosis?