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Medical Coding and Billing Certification (MCBC) Study Guide I, Exams of Medicine

Medical Coding and Billing Certification (MCBC) Study Guide I

Typology: Exams

2024/2025

Available from 07/11/2025

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Medical |! Coding |! and |! Billing |! Certification |!
(MCBC) |! Study |! Guide |! I
The |! services |! medically |! necessary |! for |! diagnostic |! code |! linkage |! - |! Correct |!
answer |! What |! must |! a |! coder |! understand |! in |! order |! to |! determine |! the |! correct |!
diagnosis |! code |! assignment?
Correctly |! identifying |! primary |! and |! secondary |! insurance |! policies |! in |! order |! to |!
preserve |! coordination |! of |! benefits |! - |! Correct |! answer |! Avoiding |! the |!
duplication |! of |! benefits |! paid |! by |! the |! primary |! and |! secondary |! insurance |! is |!
achieved |! by:
Use |! the |! combination |! code |! - |! Correct |! answer |! If |! a |! combination |! code |! is |!
available, |! a |! coder |! should:
blue |! triangle |! - |! Correct |! answer |! When |! a |! code |! is |! "revised" |! in |! the |! CPT |!
manual, |! it |! will |! be |! indicated |! by:
particular |! radiology |! service |! provided |! is |! not |! described |! by |! a |! specific |! CPT |!
code |! - |! Correct |! answer |! A |! coder |! should |! use |! an |! "unlisted' |! radiology |! CPT |!
code |! when:
Code |! blocks |! - |! Correct |! answer |! Major |! topic |! headings |! in |! the |! Tabular |! List |! of
|! ICD-10-CM |! are |! known |! as:
pf3
pf4
pf5

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Medical|! Coding|! and|! Billing|! Certification|!

(MCBC)|! Study|! Guide|! I

The |! services |! medically |! necessary |! for |! diagnostic |! code |! linkage |! - |! Correct |! answer |! ✔What |! must |! a |! coder |! understand |! in |! order |! to |! determine |! the |! correct |! diagnosis |! code |! assignment? Correctly |! identifying |! primary |! and |! secondary |! insurance |! policies |! in |! order |! to |! preserve |! coordination |! of |! benefits |! - |! Correct |! answer |! ✔Avoiding |! the |! duplication |! of |! benefits |! paid |! by |! the |! primary |! and |! secondary |! insurance |! is |! achieved |! by: Use |! the |! combination |! code |! - |! Correct |! answer |! ✔If |! a |! combination |! code |! is |! available, |! a |! coder |! should: blue |! triangle |! - |! Correct |! answer |! ✔When |! a |! code |! is |! "revised" |! in |! the |! CPT |! manual, |! it |! will |! be |! indicated |! by: particular |! radiology |! service |! provided |! is |! not |! described |! by |! a |! specific |! CPT |! code |! - |! Correct |! answer |! ✔A |! coder |! should |! use |! an |! "unlisted' |! radiology |! CPT |! code |! when: Code |! blocks |! - |! Correct |! answer |! ✔Major |! topic |! headings |! in |! the |! Tabular |! List |! of |! ICD-10-CM |! are |! known |! as:

Healthcare |! Common |! Procedure |! Coding |! System |! - |! Correct |! answer |! ✔Most |! state |! Medicaid |! programs |! use |! what |! type |! of |! system |! to |! report |! professional |! services, |! procedures, |! supplies, |! and |! equipment? always |! a |! letter |! - |! Correct |! answer |! ✔The |! first |! character |! of |! ICD-10-CM: Using |! a |! fourth, |! fifth, |! sixth |! or |! seventh |! digit |! when |! required |! - |! Correct |! answer |! ✔Coding |! to |! the |! highest |! level |! of |! specificity |! means: Without |! - |! Correct |! answer |! ✔According |! to |! the |! ICD-10-CM |! conventions, |! if |! the |! documentation |! is |! unclear |! or |! does |! not |! state |! that |! the |! complication |! or |! comorbidity |! listed |! in |! the |! code |! description |! is |! present |! with |! the |! condition, |! the |! default |! is: E/M |! service |! codes |! - |! Correct |! answer |! ✔Reported |! in |! addition |! to |! the |! appropriate |! casting |! code |! when |! a |! cast |! or |! splint |! is |! intended |! to |! be |! the |! definitive |! treatment |! of |! a |! fracture Subsequent |! Encounter |! - |! Correct |! answer |! ✔Care |! encounter |! after |! the |! initial |! care |! event Diagnostic |! codes |! from |! encounter |! form |! - |! Correct |! answer |! ✔What |! information |! is |! needed |! to |! fill |! out |! a |! CMS-1500 |! claim |! form?

Ambulatory |! care |! - |! Correct |! answer |! ✔refers |! to |! treatment |! without |! admission |! to |! hospital Electronic |! Medical |! Records |! (EMR) |! - |! Correct |! answer |! ✔are |! computerized |! records |! of |! one |! physician's |! encounter |! with |! a |! patient |! over |! time Acute |! care |! - |! Correct |! answer |! ✔most |! often |! refers |! to |! a |! hospital, |! treats |! patients |! with |! urgent |! problems |! that |! cannot |! be |! handled Centers |! for |! Medicare |! and |! Medicaid |! Services |! (CMS) |! - |! Correct |! answer |! ✔Which |! of |! the |! following |! entities |! is |! responsible |! for |! implementing |! the |! various |! provisions |! of |! HIPAA |! in |! Health |! Care? Date |! - |! Correct |! answer |! ✔Which |! of |! the |! following |! is |! not |! a |! key |! component |! in |! selecting |! a |! level |! of |! Evaluation |! and |! Management |! (E/M) |! services? solid |! circle |! - |! Correct |! answer |! ✔New |! Codes |! in |! the |! CPT |! Manual |! are |! represented |! by: False |! - |! Correct |! answer |! ✔When |! a |! code |! has |! less |! than |! 6 |! characters |! and |! a |! 7th |! character |! applies, |! it |! is |! appropriate |! to |! leave |! a |! space |! in |! the |! code? True |! - |! Correct |! answer |! ✔A |! sequela |! of |! an |! injury |! is |! reported |! with |! the |! code |! that |! describes |! the |! sequela |! followed |! by |! the |! code |! for |! the |! injury |! with |! 7th |! character |! 'S'.

Volume |! 3 |! - |! The |! Alphabetical |! Index. |! - |! Correct |! answer |! ✔Karen |! has |! been |! in |! a |! car |! accident |! and |! broke |! her |! arm. |! Which |! volume |! will |! you |! refer |! to |! first |! to |! find |! a |! code |! representing |! her |! problem? Chapter |! XXI |! - |! Factors |! influencing |! health |! status |! and |! contact |! with |! health |! services |! (Z00-Z99) |! - |! Correct |! answer |! ✔Janice |! has |! breast |! cancer |! and |! is |! coming |! into |! the |! office |! today |! for |! Chemotherapy. |! In |! which |! chapter |! would |! you |! find |! the |! code |! for |! chemotherapy? Chapter |! II |! Neoplasms |! - |! Correct |! answer |! ✔In |! which |! chapter |! would |! you |! find |! a |! malignant |! cancer |! of |! the |! esophagus? Insufficient |! tear |! production |! - |! Correct |! answer |! ✔In |! the |! diagnostic |! statement |! "eye |! dryness |! from |! insufficient |! tear |! production" |! the |! primary |! diagnosis |! is:

. |! Outpatient |! hospital |! - |! Correct |! answer |! ✔C |! codes, |! in |! the |! HCPCS |! describe |! some |! services, |! such |! as |! drugs, |! biologicals, |! devices |! and |! supplies |! that |! are |! provided |! in |! the |! ________________ |! setting? Indicates |! the |! use |! of |! code |! assignment |! for |! "other" |! when |! a |! more |! specific |! code |! does |! not |! exist |! - |! Correct |! answer |! ✔What |! do |! the |! letters |! NEC |! indicate? malignant |! - |! Correct |! answer |! ✔Used |! to |! describe |! a |! cancerous |! tumor |! that |! grows |! worse |! over |! time

o |! : |! Colons |! are |! used |! in |! the |! Tabular |! List |! after |! an |! incomplete |! term |! which |! needs |! one |! or |! more |! of |! the |! modifiers Most |! common |! errors |! in |! billing |! - |! Correct |! answer |! ✔Billing |! non-covered |! services Billing |! over |! limit |! services Upcoding |! - |! using |! a |! procedure |! code |! that |! provides |! a |! higher |! reimbursement |! rate |! than |! the |! correct |! code Billing |! without |! signatures Using |! outdated |! codes