Certification Examination Practice

Illinois Medical Coding Specialist Certification Examination Practice Questions And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A | Instant Download Pdf

Includes ICD-10-CM, CPT, HCPCS, Medicare, Medicaid, compliance, modifiers, anatomy terminology, NCCI, claims, E/M, and coding ethics.

• What does ICD-10-CM primarily code?
• Procedures
• Supplies
• Diagnoses
• Laboratory results

ICD-10-CM is used to classify and code patient diagnoses and health conditions. 1 / 3

• What does CPT primarily code?
• Diagnoses
• Procedures
• Hospital stay duration
• Insurance eligibility

Current Procedural Terminology (CPT) codes represent medical, surgical, and diagnostic services.

• What does HCPCS Level II identify?
• Diagnoses
• Facility fees
• Supplies, drugs, equipment, and non-physician services
• Anesthesia

HCPCS Level II complements CPT by covering products and services not included in CPT.

• Which organization maintains ICD-10-CM codes in the U.S.?

A. AMA

B. CDC/NCHS

C. CMS

D. WHO

The CDC’s National Center for Health Statistics maintains the ICD-10- CM code set for U.S. healthcare.

5. CPT Category I codes are used for:

• Experimental procedures 2 / 3

• Non-medical services
• Established, widely used services
• Deleted codes

Category I codes represent standard, widely accepted procedures and services.

6. Modifier -25 is used to indicate:

• Bilateral procedure
• Significant, separately identifiable E/M service on the same day
• Multiple surgeons
• Reduced services

-25 shows that a separate E/M service occurred in addition to another procedure.

7. Modifier -59 indicates:

• Two surgeons
• Increased services
• Distinct procedural service
• Assistant surgeon

-59 is used to bypass NCCI edits by showing procedures are independent of each other.

8. POS codes refer to:

• Procedure outcome standards
• Place of Service
• Physician office standards
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