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Coding Exam Questions and Answers
(Latest Update 2026)
What are medical coders? - correct answer ✅They translate healthcare provider's report of a patients visit into a procedure and/or diagnosis codes for billing purposes. What are medical billers? - correct answer ✅They submit the codes given by the medical coder as a claim for an insurance company to determine payment for the services. It is their responsibility checking for accuracy in transaction reports, creating bills for patients, creating formally correct claims, and collecting payments What is a claim? (Medical billing) - correct answer ✅Itemize list of procedures, services, and costs that is sent from a healthcare provider to a payer to collect reimbursement for the provided services. The medical biller receives _______ which explains what services and procedures the insurance company paid for, analyze them, and then creates bills for
Coding Exam Questions and Answers
(Latest Update 2026)
patients. - correct answer ✅explanation of benefits (EOB) What does EOB stand for? - correct answer ✅explanation of benefits What is an example of a medical biller's job? - correct answer ✅They take the procedural and diagnosis codes at the medical coder has translated and creates aclaim from these using a form or a type of software program. The biller that reviews the patient's insurance policy determine if the procedures and services performed by the healthcare provider a covered by that patient's plan. The medical biller needs to make sure that each code, and less each procedure listed on the claim, is actually billable, and since the claim to the insurance company. The insurance company then performs an evaluation known as payer adjudication, which determines the amount of the bill they will Reimburse the provider for, and then sends this information back to the provider in the form of an EOB. The EOB explains the amount paid for by the insurance company, as well as any obligation the patient may have. The biller then
Coding Exam Questions and Answers
(Latest Update 2026)
Why is medical coding needed? - correct answer ✅It's to translate what transpired in any exchange between a patient and a healthcare provider in a uniform practice, MAINLY for the purpose of reimbursement for healthcare services. Every injury, diagnosis, and medical service there is a corresponding code. True False - correct answer ✅True The codes in the medical office act as the universal language between doctors, hospitals, insurance companies and clearinghouses, government agencies, and other health-specific organizations. True False - correct answer ✅True
Coding Exam Questions and Answers
(Latest Update 2026)
Every code has the same guidelines and rules. True Fase - correct answer ✅False. Every code has its OWN set of guidelines and rules. This will affect the status of a claim. The code do not have to be accurate. True False - correct answer ✅False. The codes MUST be accurate. The codes for the procedure performed, correspond to the diagnoses made by the physician. This ensures that healthcare providers and patients will be properly reimbursed by insurance companies. There are 4 different types of code sets. True
Coding Exam Questions and Answers
(Latest Update 2026)
What are the 3 types of code sets? - correct answer ✅CPT, ICD, HCPCs (Hick-Picks) What does CPT stand for? - correct answer ✅Current Procedural Terminology What do CPT code do? - correct answer ✅Document the medical services performed within a healthcare setting. The CPT code set is published, maintained and copyrighted by the _______________ (AMA), and are updated annually. - correct answer ✅American Medical Association CPT codes are _____ digit numeric codes that are divided 3 categories. - correct answer ✅Five What is the first category of CPT codes? - correct answer ✅It's used most often and is divided
Coding Exam Questions and Answers
(Latest Update 2026)
into 6 ranges which correspond to 6 major medical fields. Which category of CPT codes are used mode often? - correct answer ✅First cateogry What are the 6 major medical fields? - correct answer ✅Evaluation and management, anesthesia, surgery, pathology and laboratory, medicine and radiology What is the second category of CPT codes? - correct answer ✅Corresponds to performance measurement, and in some cases, laboratory and radiology test results. Category II codes cannot be used in place of Category I codes. True False - correct answer ✅True.
Coding Exam Questions and Answers
(Latest Update 2026)
ICD codes are used to represent a doctors _____ and the patients _______ - correct answer ✅Diagnosis , condition What does HCPCS mean? - correct answer ✅Healthcare Common Procedure Coding System What is HCPCS? - correct answer ✅Set of codes based on CPT codes. Who developed the HCPCS codes? - correct answer ✅CMS What does CMS stand for? - correct answer ✅Centers for Medicare and Medicaid Services HCPCS codes are maintained by the ______ - correct answer ✅American medical association (AMA)
Coding Exam Questions and Answers
(Latest Update 2026)
HCPCS codes are also called? - correct answer ✅Hick-Picks HCPCS codes primarily correspond to _____, _______, and _______ not covered by CPT codes. - correct answer ✅Services, procedures, and equipment What are a couple examples of things covered by the HCPCS? - correct answer ✅Ambulance rides, prosthetics, certain drugs and medicines, and durable medical equipment. HCPCS is not the official code set for outpatient hospital care, chemotherapy drugs, and Medicaid and Medicare True False - correct answer ✅False. HCPCS is the official code set for outpatient hospital care, chemotherapy drugs, and Medicaid and Medicare
