2024 Edition

Medical Coder Practice Test

Try this free AAPC CPC medical coding practice test to see what's on a certification exam for medical coders. The test is also applicable to the AHIMA CCA medical coding exam

Certification as a medical coder demonstrates one's knowledge and skill in the field of medical coding and can help one get a job as a medical coder and earn more in pay. The American Academy of Professional Coders (AAPC) and AHIMA provide training and credentialling for medical coders across the United States. After passing the AAPC medical coding exam, a medical coder earns the Certified Professional Coder (CPC) credential and after passing the AHIMA medical coding exam, the medical coder earns the Certified Coding Associate (CCA) credential. The medical coder exam must be passed to earn certificaiton. The AAPC medical coding exam has 100 multiple choice questions and four hours is given to complete the exam.  The AHIMA exam has between 90 and 115 questions and must be completed in two hours.

For a comprehensive practice test, use our 600 Question Medical Coding Practice Test covering both the AAPC CPC exam and the AHIMA CCA exam. It includes flash cards, exam review and testing tips.

For additional practice for medical billing, use our 500 Question Medical Billing Practice Exam.

 
 
 
 

Clinical Classification Systems

1. A patient presents with CKD stage III, edema and hypertension. The correct ICD-10 CM codes for this chart are:
Study Online Instantly
Medical-Coding-Practice-Exam
Click to Save 50% Now
2. A patient presents with hematemesis and is diagnosed with esophagitis. The provider states that the hematemesis is due to erosion in the esophagus. Assign the correct ICD-10-CM codes.
3. A 42-year-old female, who is a new patient, presents with foul-smelling urine, frequency, flank pain and fever for 4 days. Patient denies nausea and headache. Patient is not sexually active and is a non-smoker. The provider performs the following exam in addition to patient's height, weight and blood pressure check:

General: Well-developed, well nourished, in no acute distress
Ears: external ears normal, TM bilaterally intact
Neck: Supple, no thyromegaly
Extremities: No edema
Cardiovascular: RRR, no bruits
Lungs: Clear to auscultation

The patient is prescribed ciprofloxacin and given a diagnosis of acute cystitis without hematuria. The correct coding for this encounter, using 1997 E/M guidelines is:
4. A patient presents to the operating room with chronic pelvic pain and left renal vein impingement. The surgeon performs a renal to ovarian vein transposition to relieve the pressure. What is the correct code assignment?
5. A patient presents with a cyst at the base of his tailbone. It is swollen and painful for the patient to sit down. The provider drapes the patient in the usual fashion, administers lidocaine and uses a scalpel to excise the 2cm cyst and a subcutaneous extension, rinses it with sterile saline, performs an intermediate repair of the wound with a layered closure. The correct CPT code assignment for this procedure is:
6. A patient is placed under general anesthesia for an emergency surgery due to a severe brain bleed and receives a craniotomy. The patient's blood pressure has also spiked drastically and is declared in a hypertensive emergency. Which anesthesia codes would be billed?
7. A 7-year-old child presents for a series of vaccines. The patient receives MMR and DTaP and counseling on vaccines. The correct CPT code assignment for this procedure is:
8. How should an internal presacral abscess and an intra-abdominal abscess be coded when the patient's history includes complex continuing diverticulitis that caused a sigmoid colectomy resulting in an end colostomy, and repeated pelvic abscesses?
9. ICD-10 codes are used:
Study Online Instantly
Medical-Coding-Practice-Exam
Click to Save 50% Now
10. For urosepsis, a coder must:

Confidentiality and Privacy

11. Stacey finds a particularly scandalous story told in the patient's medical record, filled with plot twists and jealous neighbors and occasional commentary on the situation by the patient's physician. She calls her supervisor over to see the drastic outcome (and the reason the patient is in the hospital). Is this allowed, per HIPAA?
12. Which of the following organizations are not a covered entity under HIPAA?

Clinical Classification Systems

13. A patient comes into the office with white fuzzy patches on their tongue and is diagnosed with oral hairy leukoplakia. The provider runs a test for HIV and notates that the patient has HIV in the chart, but does not have a positive lab test yet. The patient is a smoker. What is the correct sequencing of these ICD-10 codes?
14. A 25-year-old patient is 27 weeks and 6 days pregnant. The patient is experiencing dysuria and blood in her urine. She is diagnosed with acute cystitis. What is the correct coding of this patient's chart?
15. A patient comes in after her pressure cooker has exploded and covered her face with boiling soup. She was luckily wearing a sweater which protected her arms. She has partial-thickness burns covering her entire face. What is the correct CPT code to be assigned as the hospital removes chicken, celery and burnt tissue from her face and places dressings on it?
16. A 2-year-old child had their humerus fractured by a falling dresser and requires anesthesia to repair the break because they will not hold still for a reduction. The procedure billed is 24505. What anesthesia service is reported?

Confidentiality and Privacy

17. The Breach Notification Rule, found in the ______ Rule of HIPAA, states that when _____ individuals have had their confidential data exposed and the covered entity has outdated contact information for them, that the covered entity must_____ for ______ days.
18. Sally calls the coding department to contest the duplicate procedures that her adult sister received while admitted to an inpatient mental health facility. Sally has her sister's date of birth, her name but not her ID number. She says her sister is too depressed to advocate for herself and Sally just wants the charges reviewed. What do you do?
19. You need a second opinion on coding a chart from your Coding Manager, who does not have access to the patient's records. You decide to e-mail a screenshot of the chart to the Coding Manager. What steps must you take to ensure that the patient's data is protected in your email?

Reimbursement Methodologies

20. Facility payments are based on:
Study Online Instantly
Medical-Coding-Practice-Exam
Click to Save 50% Now
21. Conversion factors:
22. Pressure ulcers, catheter-associated urinary tract infections, falls and head trauma, DVTs and pulmonary embolisms are all examples of:
23. Relative Value Units are:
24. Medicare pays Skilled Nursing Facilities with a prospective payment system. Reimbursement is based on:
25. For Medicare's OPPS, payment status indicator C indicates that the HCPCS is:
26. Risk Adjustment payment involves payments between which of the following entities?
27. Which of the following circumstances would indicate a payment over the usual IPPS (Inpatient Prospective Payment System) reimbursement amount?
28. Which of the following is the condition established after study to be chiefly responsible for the patient's admission to the hospital and drives the payment the hospital will receive?
29. Medicare reimburses on GPCI as part of the calculation for the Medicare Physician Fee Schedule (MPFS). The GPCI is multiplied by the RVU to determine pricing amounts. What is the GPCI?

Health Records and Data Content

30. CMS requires that the patient's history and physical be completed and documented in the patient's record:
31. These components create a patient's history:
32. According to CMS, the provider's final authentication of the patient's health record must NOT be by:
33. An open-record review is when:
34. Which of the following is NOT a component of Personal Health Information
Study Online Instantly
Medical-Coding-Practice-Exam
Click to Save 50% Now
35. Which of the following data sets must a home healthcare provider adhere to?
36. Dr. Johns wants to make a correction to the patient's medical record from this morning. You advise him:
37. Where would you find this statement in the patient's medical record: "Continue Mounjaro. Increase dosage of metformin and continue to monitor."
38. An electronic signature at the end of the provider's note which locks the health record is called:

Information Technologies

39. What is the difference between an EHR and an EMR?
40. Which of the following standards are used to create standardized nomenclature within an electronic health record program?
41. Implemented in 2012, what standard changed the way that PHI was submitted electronically?
42. Which of the following might a coder use on a daily basis to access health information?
43. Which of the following is a software tool that coders may use to find the appropriate diagnosis or procedure code?
44. What is the small piece of data that remembers you have visited a website called?
45. An EHR stores all information about patients on an online database. This is an example of:

Compliance

46. You work at a billing company, coding charts for clients. Your manager sends out claims that have not been coded professionally because your team is 2 months behind and out of compliance with your service line agreement in the contract with your client, but says that it is okay because the provider has coded the claims at the time of service and the client does not want to pay for extra coding. Which of the following statements is true?
47. Which of the following are considered fraudulent?
48. Which of the following is an example of a compliant query to a physician:
49. Pass-through billing for laboratories occurs when:
50. The best place to learn about the most up-to-date rules and regulations that have been recently passed concerning healthcare is:

Quality starts with who wrote the material.
Our practice exam writer
s
:
Mandy Colligan,
 is an assistant professor of Health Information Management at the Community College of Allegheny County in Pittsburgh, Pennsylvania and is a remote adjunct professor at Ramussen College in Minnesota. Mandy has been working in medical coding and billing for over fifteen years as a senior medical coder, manager of operations and revenue cycle and coding manager.


Carol Maimone,
 is an assistant professor and program coordinator in medical billing and coding at the State University of New York, Schenectady.  Before SUNY, Carol taught medical coding and billing at Highline Community College, in Wisconsin and at the Mildred Elley School in New York. She has been working in the medical coding field for over ten years as a DRG Analyst, HIM Director and Coding Validation Specialist.


Pamela Davis,
 is an adjunct instructor in medical coding and billing at Trident University in California.
She previously taught medical coding and billing and health information technology at Northwestern College in Illinois, the Colorado Technical University and UMA in Tampa, Florida.  Pamela has worked in the field of healthcare for over twenty years as an emergency room registrar, Medicare Specialist and Coding Abstractor and medical coder/auditor.
Our Medical Coding Practice Test follows the actual exam outline of the AAPC:

- Medical Terminology
- Anatomy
- Compliance and Regs
- Coding Guidelines
- ICD-10-CM
- HCPCS Level II
- CPT
- 10,000 Series
- 20,000 Series
- 30,000 Series
- 40,000 Series
- 50,000 Series
- 60,000 Series
- Radiology Codes
- Pathology Codes
- Laboratory Codes
- Medicine
- E/M
- Anesthesia
- Case Studies