CPC 2026 – 2026 Exam Study Guide (With Complete Solution) (9pages)

Documentation (content) - Proper code assignment is determined both by _____________ in the medical record and by the unique rules that govern each code set in that instance An auditor - The role a coder may take on to verify that the documentation supports the codes the physician has selected Query the physician - If the medical record is inaccurate or incomplete, it will not translate properly to the language of codes. What can a coder do in order for the medical record to be complete and accurate so they can bill properly? Quarterly (usually) - How often are codes and insurance payment policies updated? NPP - Non-Physician Provider (also known as mid-level providers or physician extenders) PA - Physician assistant NP - Nurse practitioner Commercial and Government - The two types of primary insurances Commercial Carriers - Private payers that may offer both group and individual plans Medicare - The most significant government insurer; a federal health insurance program People over 65, blind or disabled individuals, and people with permanent kidney failure or endstage renal disease - Medicare provides coverage for what kind of people?