Free NCMA Medical Billing and Coding Questions and Answers

Question 1

What is the primary purpose of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code set?

Accepted Answer

To classify diagnoses, symptoms, and reasons for a patient encounter.

Answer

ICD-10-CM codes are used to report diagnoses and describe a patient's medical condition. This allows for accurate tracking of diseases, health statistics, and provides the medical necessity for services billed.

Question 2

A patient visit for a routine annual physical would be coded using which category of CPT codes?

Accepted Answer

Evaluation and Management

Answer

Evaluation and Management (E/M) codes are a section of CPT used to report services like office visits, consultations, and preventive medicine check-ups. An annual physical is a form of preventive E/M service.

Question 3

In many ICD-10-CM codes, particularly for injuries, what does the 7th character extension typically signify?

Accepted Answer

The episode of care (e.g., initial, subsequent, sequela).

Answer

The 7th character provides information about the episode of care for the condition. 'A' often stands for the initial encounter, 'D' for a subsequent encounter, and 'S' for sequela (a late effect of the injury).

Question 4

A provider performs a minor surgical procedure during the same visit as a significant, separately identifiable Evaluation and Management (E/M) service. Which CPT modifier should be appended to the E/M code?

Accepted Answer

-25 (Significant, Separately Identifiable E/M Service)

Answer

Modifier -25 is used to indicate that on the day a procedure was performed, the patient's condition required a significant, separately identifiable E/M service above and beyond the other service provided. This allows for both the procedure and the E/M service to be billed.

Question 5

Intentionally using a code to bill for a more complex and expensive service than the one that was actually performed is known as what?

Accepted Answer

Upcoding

Answer

Upcoding is a form of fraudulent billing where the provider submits codes for more serious or complex services than were actually rendered to receive higher reimbursement. This is illegal and can result in severe penalties.

NCMA - National Certified Medical Assistant Practice Test

NCMA - National Certified Medical Assistant Practice Test

Free NCMA Medical Billing and Coding Questions and Answers