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Most states don’t require medical billers and coders to be certified, but employers prefer certification.
If you’ve completed a medical billing and coding program, you may be wondering if you are ready to take a certification exam.
Take our practice test to see if you have the knowledge and skills you need.
Topics covered include medical terminologies, medical specialties, communication, ethical billing practices, CPT codes for coding medical procedures, and national and local HCPCS codes and modifiers.
Medical Billing and Coding Certification Practice Test
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Your answers are highlighted below.
Question 1 |
What is the purpose of ICD-10-CM codes in medical coding?
Identify insurance providers | |
Describe patient demographics | |
Classify diseases and health problems | |
Determine reimbursement rates |
Question 2 |
Which code set is used for reporting procedures and services in outpatient settings?
CPT | |
ICD-10-CM | |
HCPCS Level II | |
DRG |
Question 3 |
Which of the following is true about the CPT code set?
Used for diagnosis coding | |
Published by the World Health Organization | |
Identifies drugs and biologics | |
Describes medical procedures and services |
Question 4 |
What is the primary purpose of the National Correct Coding Initiative (NCCI)?
Determine reimbursement rates | |
Prevent improper coding that leads to incorrect payments | |
Assign ICD-10-CM codes | |
Establish HIPAA regulations |
Question 5 |
Which type of code describes the reason for a patient's encounter with the healthcare system?
E/M code | |
HCPCS code | |
ICD-10-CM code | |
CPT code |
Question 6 |
In medical coding, what does "E/M" stand for?
Evaluation and Management | |
Emergency Medicine | |
Evaluation and Monitoring | |
Epidemiology and Medicine |
Question 7 |
What is the purpose of modifiers in medical coding?
Identify the patient's age | |
Provide additional information to support a claim | |
Determine the type of insurance coverage | |
Specify the location of the healthcare facility |
Question 8 |
Which organization is responsible for maintaining the CPT code set?
Centers for Medicare & Medicaid Services (CMS) | |
American Medical Association (AMA) | |
World Health Organization (WHO) | |
American Hospital Association (AHA) |
Question 9 |
What does DRG stand for in the context of medical coding?
Diagnosis-related group | |
Document Review Guidelines | |
Diagnostic Radiology Group | |
Drug Reference Guide |
Question 10 |
Which of the following is a common use of HCPCS Level II codes?
Identifying surgical procedures | |
Reporting laboratory services | |
Coding for evaluation and management services | |
Describing diseases and conditions |
Question 11 |
What is the purpose of the Health Insurance Portability and Accountability Act (HIPAA) in relation to medical coding?
Establish reimbursement rates | |
Ensure patient confidentiality and data security | |
Determine coding guidelines | |
Classify diseases and conditions |
Question 12 |
Which of the following is an example of a Z code in ICD-10-CM?
Z23 - Encounter for immunization | |
J45.0 - Asthma with mild intermittent exacerbation | |
S72.011A - Displaced fracture of neck of right femur, initial encounter | |
C44.9 - Malignant neoplasm of skin, unspecified |
Question 13 |
What does the acronym NCCI stand for in medical coding?
National Classification of Coding Initiatives | |
National Correct Coding Initiative | |
Non-Covered Code Information | |
National Coding Compliance Index |
Question 14 |
Which of the following is a characteristic of a Category II code in the CPT code set?
Used for temporary codes | |
Five digits with a decimal point | |
Always requires modifier application | |
Describes emerging technologies |
Question 15 |
What is the primary purpose of a CMS-1500 form in medical billing?
Requesting pre-authorization for procedures | |
Submitting claims for reimbursement | |
Capturing patient demographics | |
Documenting patient history |
Question 16 |
In the context of medical coding, what does the term "bundling" refer to?
Combining multiple services or procedures into a single code | |
Separating unrelated services for individual billing | |
Coding for laboratory tests only | |
Assigning a higher code for a complex procedure |
Question 17 |
Which of the following is an example of an E/M code?
99214 - Office or other outpatient visit for the evaluation and management of an established patient | |
31575 - Laryngoscopy, indirect | |
23412 - Closed treatment of rib fracture, each | |
80102 - Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure |
Question 18 |
What is the role of a medical coder in the revenue cycle management process?
Perform surgical procedures | |
Review and assign accurate codes to medical services | |
Manage patient appointments | |
Administer vaccinations |
Question 19 |
Which of the following is an example of a Level III HCPCS code?
G0402 - Initial preventive physical examination | |
99203 - Office or other outpatient visit for the evaluation and management of a new patient | |
A4562 - Ostomy paste, per ounce | |
J9035 - Injection, daratumumab, 10 mg |
Question 20 |
What is the purpose of the CCI (Correct Coding Initiative) edits?
Ensure compliance with HIPAA regulations | |
Prevent improper coding that leads to incorrect payments | |
Establish reimbursement rates | |
Assign ICD-10-CM codes |
Question 21 |
Which of the following is an example of an ICD-10-CM code for a complication of a surgical procedure?
T81.4XXA - Infection following a procedure, initial encounter | |
Z00.00 - Encounter for general adult medical examination without abnormal findings | |
844.9 - Sprain of unspecified site of knee | |
H40.9 - Glaucoma, unspecified |
Question 22 |
What does the acronym HCC stand for in the context of medical coding?
Healthcare Coding Class | |
Hierarchical Condition Category | |
Hospital Compliance Certification | |
High-Cost Code |
Question 23 |
Which of the following is true about the NCCI (National Correct Coding Initiative)?
It only applies to Medicare claims | |
It is voluntary for healthcare providers | |
It includes procedure-to-procedure edits | |
It focuses solely on ICD-10-CM codes |
Question 24 |
What is the primary purpose of a UB-04 form in medical billing?
Submitting claims for outpatient services | |
Capturing physician orders | |
Requesting pre-authorization for procedures | |
Documenting patient history |
Question 25 |
In medical coding, what does the term "bilateral" indicate?
Affecting both sides of the body or a body part | |
Restricted to one side of the body or a body part | |
Involving multiple body systems | |
Limited to a specific anatomical region |
Question 26 |
What is the significance of the E-code category in ICD-10-CM?
Identifies external causes of injury or poisoning | |
Describes signs and symptoms | |
Classifies infectious diseases | |
Codes for laboratory procedures |
Question 27 |
Which of the following is a common use of a Type of Bill code on a UB-04 form?
Identifying the patient's age | |
Designating the type of facility | |
Determining reimbursement rates | |
Indicating the patient's primary diagnosis |
Question 28 |
What is the purpose of the NPI (National Provider Identifier) in medical billing and coding?
Identify the patient's primary insurance | |
Establish reimbursement rates | |
Identify individual healthcare providers | |
Determine the type of medical procedure |
Question 29 |
Which code set is commonly used for reporting services provided in the hospital inpatient setting?
CPT | |
ICD-10-CM | |
HCPCS Level II | |
DRG |
Question 30 |
What is the primary function of a Clearinghouse in the medical billing process?
Collecting patient payments | |
Verifying patient insurance coverage | |
Transmitting electronic claims to insurance payers | |
Assigning diagnosis codes |
Once you are finished, click the button below. Any items you have not completed will be marked incorrect.
There are 30 questions to complete.
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