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Coding Ultimate Exam
Question 1. Which CPT modifier indicates a significant, separately identifiable evaluation and management service on the same day as a procedure? A) - B) - C) - D) - Answer: B Explanation: Modifier -25 is appended to an E/M code when a distinct E/M service is performed on the same day as another procedure. Question 2. In ICD- 10 - CM, the seventh character “A” for a traumatic fracture code indicates: A) Initial encounter for closed fracture B) Initial encounter for open fracture C) Subsequent encounter for routine healing D) Subsequent encounter for delayed healing Answer: A Explanation: “A” designates an initial encounter for a closed fracture; “B” would be for an open fracture. Question 3. Which of the following best describes the “code first” instruction in the ICD- 10 - CM Official Guidelines? A) Assign the code for the most severe condition first.
Coding Ultimate Exam
B) Code the condition that caused the manifestation of another condition before the manifestation. C) List the primary diagnosis before any secondary diagnoses. D) Use the code with the highest reimbursement value first. Answer: B Explanation: “Code first” directs coders to assign the underlying condition that caused the manifestation before the manifestation itself. Question 4. A patient undergoes a colonoscopy with polypectomy. Which CPT code accurately reflects this service? A) 45378 B) 45380 C) 45385 D) 45390 Answer: B Explanation: CPT 45380 includes colonoscopy with removal of one or more polyps by snare technique. Question 5. Under the 2026 CPT updates, telehealth E/M services are reported with which modifier? A) - B) - C) - D) - Answer: A
Coding Ultimate Exam
A) ST elevation myocardial infarction of lateral wall B) Non-ST elevation myocardial infarction C) Unspecified acute myocardial infarction D) STEMI of inferior wall Answer: A Explanation: I21.3 specifies ST elevation (STEMI) of the lateral wall of the heart. Question 9. Which HCPCS Level II code is used for a single-use insulin pen? A) J B) J C) J D) J Answer: C Explanation: J1818 corresponds to a single-use insulin pen, while J1815, J1817, and J1819 are for other insulin delivery devices. Question 10. In the CPT 2026 Surgery section, code 29881 is used for: A) Arthroscopic meniscectomy, medial or lateral compartment B) Arthroscopic partial meniscectomy, each compartment C) Arthroscopic meniscus repair, each meniscus D) Arthroscopic synovectomy, knee Answer: C
Coding Ultimate Exam
Explanation: CPT 29881 describes arthroscopic repair of each meniscus. Question 11. A patient with a new diagnosis of type 2 diabetes mellitus with diabetic neuropathy should have which ICD- 10 - CM code as the principal diagnosis? A) E11. B) E11. C) E11. D) E11. Answer: B Explanation: E11.42 denotes type 2 diabetes mellitus with diabetic peripheral neuropathy, a specific complication requiring coding. Question 12. Which CPT code represents a simple skin graft (less than 5 cm²)? A) 15100 B) 15120 C) 15130 D) 15135 Answer: A Explanation: CPT 15100 is for a simple skin graft of ≤5 cm². Question 13. The ICD- 10 - CM placeholder “X” is used in which of the following scenarios?
Coding Ultimate Exam
Answer: B Explanation: “Excludes1” notes a mutually exclusive condition; when present, the excluded code should not be reported. Question 16. A surgeon performs a laparoscopic cholecystectomy with intra-operative cholangiography. Which CPT code set is correct? A) 47562, 47563 B) 47562, 47564 C) 47562, 47570 D) 47562, 47571 Answer: B Explanation: 47562 is laparoscopic cholecystectomy; 47564 is intra-operative cholangiography performed during the same session. Question 17. Which HCPCS Level II modifier indicates a professional component only? A) -TC B) - C) -TC D) - Answer: B Explanation: Modifier -26 designates the professional (physician) component of a service when the technical component is reported separately.
Coding Ultimate Exam
Question 18. For a patient with a new diagnosis of “essential (primary) hypertension” without complication, the correct ICD- 10 - CM code is: A) I B) I11. C) I12. D) I13. Answer: A Explanation: I10 is the code for essential (primary) hypertension without mention of heart disease or kidney involvement. Question 19. Which CPT code describes a transthoracic echocardiogram, complete, with Doppler study? A) 93306 B) 93307 C) 93308 D) 93312 Answer: C Explanation: CPT 93308 is for a complete transthoracic echocardiogram with Doppler. Question 20. In the ICD- 10 - CM Chapter 15 (Pregnancy, childbirth, and the puerperium), the code “O80” represents: A) Single spontaneous delivery, unspecified gestational age B) Single delivery by cesarean section, uncomplicated
Coding Ultimate Exam
Question 23. When coding a fracture of the distal radius with an associated dislocation, which ICD- 10 - CM code is most specific? A) S52.501A B) S52.501D C) S52.502A D) S52.502D Answer: A Explanation: S52.501A indicates a distal radius fracture, closed, with initial encounter for fracture care. The dislocation is captured by the fracture description; “A” denotes initial encounter. Question 24. Which CPT modifier should be appended when a service is performed on a different day than the original procedure but is considered a repeat procedure? A) - B) - C) - D) - Answer: A Explanation: Modifier -76 indicates a repeat procedure or service by the same physician on the same day (or a different day) as the original. Question 25. A radiology report includes a CT scan of the abdomen and pelvis with contrast. Which CPT code is correct?
Coding Ultimate Exam
A) 74176
B) 74178
C) 74150
D) 74170
Answer: B Explanation: CPT 74178 is for CT of abdomen and pelvis with contrast. Question 26. For a patient diagnosed with “acute appendicitis with generalized peritonitis,” which ICD- 10 - CM code is appropriate? A) K35. B) K35. C) K35. D) K35. Answer: B Explanation: K35.31 denotes acute appendicitis with generalized peritonitis. Question 27. Which CPT code represents a simple repair of a traumatic laceration of the scalp, less than 2.5 cm? A) 12001 B) 12002 C) 12004 D) 12005 Answer: A
Coding Ultimate Exam
C) 29881-50, 29881
D) 29881, 29882- 59
Answer: C Explanation: Use 29881 for each knee; append -50 to the first code to indicate bilateral service. The second code is reported without modifier. Question 31. Which ICD- 10 - CM code indicates “unspecified acute myocardial infarction”? A) I21. B) I21. C) I22. D) I25. Answer: A Explanation: I21.9 is “Acute myocardial infarction, unspecified.” Question 32. A patient undergoes a colonoscopy with biopsy of a suspicious lesion. Which CPT code captures both the endoscopic procedure and the biopsy? A) 45378 B) 45380 C) 45385 D) 45388 Answer: C Explanation: CPT 45385 includes colonoscopy with biopsy of one or more lesions.
Coding Ultimate Exam
Question 33. Which HCPCS Level II code is used for a home glucose monitor? A) E B) E C) E D) E Answer: A Explanation: E0601 denotes a blood glucose monitor for home use. Question 34. In CPT, the code 99284 corresponds to which level of emergency department E/M service? A) Level 3 (moderate complexity) B) Level 4 (moderately high complexity) C) Level 5 (high complexity) D) Level 2 (low complexity) Answer: B Explanation: 99284 is an ED visit with moderately high complexity medical decision making. Question 35. Which ICD- 10 - CM code is used for “type 1 diabetes mellitus with ketoacidosis”? A) E10. B) E10. C) E10.
Coding Ultimate Exam
Question 38. In the ICD- 10 - CM “Z” chapter, Z63.5 denotes: A) Unemployment B) Disruption of family by separation or divorce C) Living alone D) Physical abuse of a child Answer: B Explanation: Z63.5 is “Disruption of family by separation or divorce.” Question 39. Which CPT code is used for a percutaneous needle biopsy of the liver? A) 47000 B) 47001 C) 47002 D) 47003 Answer: B Explanation: CPT 47001 describes percutaneous needle biopsy of the liver. Question 40. A patient receives a blood transfusion of one unit of packed red blood cells. Which HCPCS Level II code should be reported? A) P B) P C) P D) P
Coding Ultimate Exam
Answer: A Explanation: P9015 is the code for one unit of packed red blood cells, adult. Question 41. Which ICD- 10 - CM code indicates “acute bronchitis due to Mycoplasma pneumoniae”? A) J20. B) J20. C) J20. D) J20. Answer: B Explanation: J20.5 specifies acute bronchitis due to Mycoplasma pneumoniae. Question 42. For a bilateral mastectomy with immediate reconstruction using a tissue expander, which CPT codes and modifiers are appropriate? A) 19303-50, 19357 B) 19303, 19357- 50 C) 19303-50, 19357- 50 D) 19303, 19357 Answer: A Explanation: 19303 is mastectomy; -50 indicates bilateral. 19357 is placement of tissue expander (single procedure, no bilateral modifier needed).
Coding Ultimate Exam
Answer: B Explanation: CPT 66984 is for cataract extraction with insertion of intraocular lens prosthesis, phacoemulsification technique. Question 46. A patient undergoes a percutaneous vertebroplasty for a compression fracture of L2. Which CPT code is appropriate? A) 22510 B) 22511 C) 22512 D) 22514 Answer: B Explanation: CPT 22511 is percutaneous vertebral augmentation (e.g., vertebroplasty) of a single vertebral body. Question 47. Which ICD- 10 - CM code is used for “acute kidney failure, unspecified”? A) N17. B) N18. C) N D) N20. Answer: A Explanation: N17.9 denotes acute kidney failure, unspecified. Question 48. The CPT code 99213 is used for: A) New patient office visit, moderate complexity
Coding Ultimate Exam
B) Established patient office visit, low complexity C) Established patient office visit, moderate complexity D) New patient office visit, high complexity Answer: C Explanation: 99213 is an established patient office/outpatient visit with moderate complexity. Question 49. Which HCPCS Level II code is used for a powered wheelchair? A) K B) K C) K D) K Answer: A Explanation: K0001 denotes a power wheelchair, standard features. Question 50. In ICD- 10 - CM, the seventh character “D” for a fracture code indicates: A) Initial encounter for closed fracture B) Initial encounter for open fracture C) Subsequent encounter for routine healing D) Subsequent encounter for delayed healing Answer: C Explanation: “D” designates a subsequent encounter for routine healing of a fracture.
