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Question 1. Which of the following ICD- 10 - CM chapters contains the code range for infectious diseases? A) Chapter 1 B) Chapter 3 C) Chapter 6 D) Chapter 9 Answer: A Explanation: Chapter 1 (A00-B99) of ICD- 10 - CM is dedicated to infectious and parasitic diseases. Question 2. In CPT, the code 11042 represents: A) Simple repair of a skin laceration B) Debridement of subcutaneous tissue, first 20 cm² C) Excision of a benign skin lesion, up to 0.5 cm D) Incision and drainage of a pilonidal cyst Answer: B Explanation: 11042 is the CPT code for “Debridement, subcutaneous tissue (includes epidermis and dermis), first 20 cm²”. Question 3. The modifier “- 25 ” is used when: A) The service is performed on a bilateral site B) A significant, separately identifiable E/M service is provided on the same day as a procedure C) The procedure is performed on a different anatomical region than listed D) The claim is for a global period service Answer: B Explanation: Modifier - 25 indicates a significant, separately identifiable E/M service on the same day as a procedure.
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Question 4. Which laterality term indicates a structure located toward the midline? A) Proximal B) Distal C) Medial D) Lateral Answer: C Explanation: “Medial” refers to a position nearer the midline of the body. Question 5. The NCCI “Column 2” edit prevents: A) Duplicate billing of the same service B) Unbundling of a comprehensive procedure into component parts C) Use of an outdated CPT code D) Billing for a service without a diagnosis code Answer: B Explanation: NCCI Column 2 edits prohibit unbundling of services that should be reported together as a single comprehensive code. Question 6. Which CPT code is appropriate for a diagnostic colonoscopy with biopsy? A) 45378 B) 45385 C) 45380 D) 45390 Answer: C Explanation: 45380 is “Colonoscopy, flexible; diagnostic, with biopsy, single or multiple”. Question 7. A “code first” instruction in ICD- 10 - CM means:
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D) Patient is a geriatric (age > 70) Answer: A Explanation: Modifier P3 is used for patients age 1-12 years in anesthesia billing. Question 11. Which of the following is a correct abbreviation for “right lower quadrant”? A) RLQ B) R/LQ C) RQ D) R-LQ Answer: A Explanation: RLQ is the standard abbreviation for “right lower quadrant”. Question 12. The CPT code 27447 represents: A) Total knee arthroplasty, primary, with cemented components B) Partial knee arthroplasty, unicondylar, with allograft C) Open reduction of femoral fracture, internal fixation D) Knee arthroscopy, meniscectomy, medial and lateral Answer: A Explanation: 27447 is “Arthroplasty, knee, condyle and plateau; total, with or without patellar component; cemented”. Question 13. Which ICD- 10 - CM code is used for a type 2 diabetes mellitus with peripheral angiopathy? A) E11. B) E11. C) E11. D) E11. Answer: D
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Explanation: E11.22 denotes “Type 2 diabetes mellitus with diabetic peripheral angiopathy”. Question 14. The “X” placeholder in ICD- 10 - CM is required when: A) The code has a seventh character indicating encounter type B) The code is for a condition that does not require a laterality indicator C) The code’s fourth character is a decimal point D) The code’s third character is a digit Answer: A Explanation: An “X” is used as a filler to allow a seventh character (e.g., encounter, laterality) when the code does not otherwise have enough characters. Question 15. In CPT, the code 27486 is used for: A) Revision of total knee replacement, all components B) Removal of prosthetic joint infection, total knee C) Arthroplasty, knee, tibial component, with or without patellar component, cementless D) Unicondylar knee arthroplasty, primary, cemented Answer: C Explanation: 27486 describes “Arthroplasty, knee, tibial component, with or without patellar component, cementless”. Question 16. Which of the following statements about HIPAA is true? A) It requires all providers to use ICD- 10 - CM exclusively for reporting diagnoses. B) It prohibits the use of any electronic transmission of PHI. C) It establishes national standards for the protection of PHI. D) It allows unlimited disclosure of PHI for marketing without patient consent. Answer: C Explanation: HIPAA (Health Insurance Portability and Accountability Act) sets national standards for safeguarding protected health information.
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Question 20. Which code set includes the “Z” codes used for factors influencing health status? A) CPT B) HCPCS Level II C) ICD- 10 - CM D) ICD- 10 - PCS Answer: C Explanation: “Z” codes are part of ICD- 10 - CM and represent factors influencing health status and contact with health services. Question 21. The CPT code 43235 is used for: A) Upper endoscopy with biopsy of the stomach B) Colonoscopy with removal of polyps C) Endoscopic ultrasound of the pancreas D) Esophagogastroduodenoscopy (EGD) with biopsy, single or multiple Answer: D Explanation: 43235 denotes “Esophagogastroduodenoscopy, diagnostic, with biopsy, single or multiple”. Question 22. Which of the following is an example of a “global period” service? A) Initial surgical procedure only B) Follow-up visit within 90 days after a major surgery C) Separate anesthesia claim for the same surgery D) Radiology interpretation performed on the day of the procedure Answer: B Explanation: A global period includes postoperative care (e.g., visits) within a defined time after the primary surgical service. Question 23. In CPT, the code 29881 describes: A) Arthroscopy, knee, with meniscectomy
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B) Arthroscopy, shoulder, with subacromial decompression C) Arthroscopy, hip, with labral repair D) Arthroscopy, elbow, with debridement Answer: B Explanation: 29881 is “Arthroscopy, shoulder, surgical; with subacromial decompression”. Question 24. Which ICD- 10 - CM code indicates a left-sided acute myocardial infarction of the anterior wall? A) I21. B) I21. C) I21. D) I21. Answer: B Explanation: I21.11 is “ST elevation (STEMI) myocardial infarction of anterior wall, left coronary artery”. The laterality is indicated by “left”. Question 25. The CPT code 99285 is used for: A) Emergency department visit, high complexity MDM B) Office visit, new patient, moderate complexity MDM C) Hospital observation care, moderate complexity MDM D) Inpatient consult, high complexity MDM Answer: A Explanation: 99285 is the highest level ED visit code, representing high complexity decision making. Question 26. Which modifier indicates a distinct procedural service performed on the same day as another procedure? A) - 51 B) - 59
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Explanation: 36415 is “Collection of venous blood by venipuncture”. Question 30. The ICD- 10 - CM code “R07.9” corresponds to: A) Chest pain, unspecified B) Shortness of breath C) Acute myocardial infarction, unspecified D) Cough, unspecified Answer: A Explanation: R07.9 is “Chest pain, unspecified”. Question 31. Which CPT code describes a percutaneous coronary intervention (PCI) with stent placement in one coronary artery? A) 92920 B) 92928 C) 92933 D) 92941 Answer: B Explanation: 92928 is “Percutaneous coronary intervention, single vessel, with stent”. Question 32. The HCPCS code J3490 is used for: A) Unlisted drug, not otherwise classified B) Injection of a corticosteroid, unspecified C) Infusion of normal saline, 100 ml D) Disposable surgical mask, each Answer: A Explanation: J3490 is “Unclassified drugs”. Question 33. Which CPT code is appropriate for a simple removal of a benign skin lesion, 0.4 cm in diameter?
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A) 11400
B) 11401
C) 11300
D) 11301
Answer: C Explanation: 11300 is “Excision, benign lesion, face or scalp, ≤0.5 cm”. Question 34. The CPT code 99214 is typically used for: A) New patient office visit, moderate complexity MDM, 25 minutes B) Established patient office visit, moderate complexity MDM, 25 minutes C) Established patient office visit, high complexity MDM, 40 minutes D) New patient office visit, low complexity MDM, 15 minutes Answer: B Explanation: 99214 is an established patient office visit with moderate complexity decision making, usually 25 minutes. Question 35. Which of the following is a correct ICD- 10 - CM code for a right-sided fractured femur, closed? A) S72.001A B) S72.002A C) S72.011A D) S72.012A Answer: B Explanation: S72.002A denotes “Fracture of shaft of right femur, closed, initial encounter for closed fracture”. Question 36. The CPT code 99223 is used for: A) Inpatient hospital admission, initial encounter, high complexity MDM B) Outpatient consult, new patient, moderate complexity MDM C) Emergency department visit, moderate complexity MDM
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Explanation: J44.9 is “Chronic obstructive pulmonary disease, unspecified”. Question 40. The CPT code 36410 is applied for: A) Insertion of a peripheral intravenous catheter, age ≤ 3 years B) Central venous catheter placement, subclavian, percutaneous C) Arterial line placement, percutaneous D) Insertion of a tunneled central venous catheter, percutaneous Answer: A Explanation: 36410 is “Insertion of peripheral intravenous catheter (excluding neonatal), age ≤ 3 years”. Question 41. Which CPT code represents a simple cataract extraction with intraocular lens implantation? A) 66984 B) 66982 C) 66986 D) 66991 Answer: A Explanation: 66984 is “Extracapsular cataract removal with insertion of intraocular lens prosthesis, complex, any technique”. Question 42. The ICD- 10 - CM code “M54.5” corresponds to: A) Low back pain B) Cervicalgia C) Thoracic spine pain D) Lumbosacral radiculopathy Answer: A Explanation: M54.5 is “Low back pain”.
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Question 43. Which CPT code is used for a transthoracic echocardiogram, complete, with Doppler? A) 93306 B) 93307 C) 93308 D) 93350 Answer: B Explanation: 93307 is “Transthoracic echocardiography, complete, with Doppler and color flow mapping”. Question 44. In the CPT manual, the 10000 series primarily covers which system? A) Musculoskeletal B) Integumentary C) Respiratory D) Digestive Answer: B Explanation: CPT 10000-19999 relates to the integumentary (skin) system. Question 45. Which modifier is required when a service is performed on a different day than the original procedure? A) - 76 B) - 77 C) - 78 D) - 79 Answer: A Explanation: Modifier - 76 indicates a repeat procedure or service on the same patient on a different day. Question 46. The CPT code 99232 is appropriate for:
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D) K
Answer: A Explanation: K0001 is “Standard wheelchair cushion”. Question 50. The CPT code 99285 is distinguished from 99284 by: A) Higher level of medical decision making and/or greater time spent B) Being used for outpatient office visits instead of ED visits C) Inclusion of a procedure component D) Necessity of a consult note Answer: A Explanation: 99285 denotes a higher level (high complexity) ED visit compared with 99284 (moderate complexity). Question 51. Which ICD- 10 - CM code indicates a left-sided, acute appendicitis? A) K35. B) K35. C) K35. D) K35. Answer: B Explanation: K35.81 is “Acute appendicitis, left side”. Laterality is indicated by the second digit after the decimal. Question 52. The CPT code 27418 is used for: A) Arthroscopy, knee, with meniscectomy, medial and lateral B) Arthroscopy, knee, with synovectomy, partial C) Arthroscopy, knee, with debridement of articular cartilage D) Arthroscopy, knee, with removal of loose body Answer: A Explanation: 27418 is “Arthroscopy, knee, surgical; with meniscectomy (medial and lateral)”.
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Question 53. Which modifier should be added when a service is performed by a different provider than the one who performed the original service on the same day? A) - 24 B) - 25 C) - 57 D) - 58 Answer: A Explanation: Modifier - 24 indicates a unrelated E/M service by a different provider during the postoperative period. Question 54. The CPT code 99254 is appropriate for: A) Hospital observation care, low complexity MDM B) Inpatient consult, moderate complexity MDM C) Emergency department visit, high complexity MDM D) Office visit, new patient, high complexity MDM Answer: B Explanation: 99254 is “Consultation, inpatient, moderate complexity”. Question 55. Which ICD- 10 - CM code is used for a patient with essential (primary) hypertension? A) I B) I11. C) I12. D) I13. Answer: A Explanation: I10 is the code for essential (primary) hypertension. Question 56. In CPT, the code 99223 is distinguished from 99221 by:
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D) Immunization administration, unspecified Answer: A Explanation: Z00.00 denotes “General adult medical examination without abnormal findings”. Question 60. Which CPT code describes a lumbar spinal fusion, posterior technique, with instrumentation? A) 22612 B) 22630 C) 22633 D) 22634 Answer: B Explanation: 22630 is “Posterior or posterolateral technique, single level; lumbar vertebral column, with instrumentation”. Question 61. The CPT code 99238 is used for: A) Hospital discharge day management, >30 minutes B) Initial hospital care, high complexity C) Emergency department visit, moderate complexity D) Observation care, low complexity Answer: A Explanation: 99238 is “Hospital discharge day management, >30 minutes”. Question 62. Which ICD- 10 - CM code indicates a right-sided, acute cholecystitis? A) K81. B) K81. C) K81. D) K81. Answer: A
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Explanation: K81.0 is “Acute cholecystitis, right upper quadrant”. Laterality is captured in the first digit after the decimal. Question 63. The CPT code 99291 is distinct from 99292 because: A) 99291 is for the first 30 minutes of critical care; 99292 is each additional 30 minutes. B) 99291 is for inpatient care; 99292 is for outpatient care. C) 99291 requires a consult note; 99292 does not. D) 99291 is for emergency department critical care only. Answer: A Explanation: 99291 covers the first 30 minutes of critical care; 99292 is used for each subsequent 30-minute increment. Question 64. Which HCPCS Level II code is used for a standard hospital bed? A) E B) E C) E D) E Answer: A Explanation: E0250 denotes “Standard hospital bed”. Question 65. The CPT code 29881 includes which of the following procedures? A) Subacromial decompression only B) Rotator cuff repair only C) Both subacromial decompression and rotator cuff repair D) Arthroscopic capsular release only Answer: A Explanation: 29881 is “Arthroscopy, shoulder, surgical; with subacromial decompression”.
