Allied Health · CPC

Medical Coding CPC Basics

ICD-10-CM, CPT, and HCPCS coding fundamentals tested on the CPC certification exam.

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How many characters make up a complete ICD-10-CM diagnosis code?
3 to 7 characters (alphanumeric)
What does the first character of an ICD-10-CM code always represent?
The chapter or category (always a letter)
In ICD-10-CM, what is the purpose of the 7th character?
To provide additional specificity such as laterality, episode of care, or severity
What does an ICD-10-CM 'Excludes1' note indicate?
The two conditions cannot be coded together and the excluded code should never be used with the current code
What does an ICD-10-CM 'Excludes2' note indicate?
The two conditions can be coded together if both are present; the excluded code may be used with the current code
In ICD-10-CM, when is the placeholder 'X' character used?
When a code requires a 7th character but has fewer than six characters; the X holds the position
ICD-10-CM Chapter 1 codes cover which disease category?
Certain infectious and parasitic diseases
ICD-10-CM Chapter 2 codes cover which disease category?
Neoplasms (tumors and cancers)
What does laterality mean in ICD-10-CM coding?
Indicating which side of the body is affected (left, right, or bilateral)
What is the correct code range for CPT Evaluation and Management (E&M) codes?
99202-99499 (with subcategories by place of service and complexity)
What is the correct code range for CPT Surgery codes?
10000-69999
What is the correct code range for CPT Radiology codes?
70000-79999
What is the correct code range for CPT Pathology and Laboratory codes?
80000-89999
How many digits make up a standard CPT code?
5 numeric digits
What does CPT modifier -25 indicate?
Significant, separately identifiable Evaluation and Management service by the same physician on the same day as a procedure

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