2019 Edition

Medical Coder Practice Test

Try this free medical coding practice test to see what's on a certification exam for medical coders.

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) provides training and credentialling for medical coders across the United States. After passing the AAPC medical coding exam, a medical coder earns the Certified Professinal Coder (CPC) credential. The medical coder exam must be passed to earn certificaiton. The medical coding exams has 150 multiple choice questions and five hours and forty minutes is give to complete the 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:
2. 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:
3. 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:
4. 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:
5. ICD-10 codes are used:
6. For urosepsis, a coder must:
7. 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?
8. 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?
9. 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?
10. 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

11. 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.
12. 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?
13. 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

14. Facility payments are based on:
15. Conversion factors:
16. Pressure ulcers, catheter-associated urinary tract infections, falls and head trauma, DVTs and pulmonary embolisms are all examples of:
17. Relative Value Units are:
18. Medicare pays Skilled Nursing Facilities with a prospective payment system. Reimbursement is based on:
19. For Medicare's OPPS, payment status indicator C indicates that the HCPCS is:

Health Records and Data Content

20. CMS requires that the patient's history and physical be completed and documented in the patient's record
21. These components create a patient's history:
22. According to CMS, the provider's final authentication of the patient's health record must NOT be by:
23. An open-record review is when:
24. Which of the following is NOT a component of Personal Health Information

Information Technologies

25. What is the difference between an EHR and an EMR?
26. Which of the following standards are used to create standardized nomenclature within an electronic health record program?
27. Implemented in 2012, what standard changed the way that PHI was submitted electronically?

Compliance

28. 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?
29. Which of the following are considered fraudulent:
30. Which of the following is an example of a compliant query to a physician:


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