Free ACS-CODING Practice Questions

Question 1

At a 2026 office follow-up, an internist addresses type 2 diabetes and hyperlipidemia, both at the patient's documented treatment goals. After assessing the response, the physician continues prescription therapy. The physician reviews an outside hospital discharge summary, a complete blood count result, and a metabolic panel result, then discusses ongoing management directly with a hospitalist from another practice. The discussion is not separately reported. No intensive toxicity monitoring or hospitalization decision occurs. For this established patient, which office E/M code is supported by medical decision-making rather than time?

Accepted Answer

99214 - moderate medical decision-making

Answer

99212 - straightforward medical decision-making

Answer

99215 - high medical decision-making

Answer

99213 - low medical decision-making

Question 2

An asymptomatic 67-year-old Original Medicare beneficiary undergoes a first average-risk screening colonoscopy in July 2026. The examination reaches the cecum. An 8-mm sigmoid polyp is completely removed with a cold snare; no forceps biopsy or other therapeutic procedure is performed. Which professional-procedure reporting preserves the examination's original screening purpose?

Accepted Answer

45385-PT, reporting the snare removal with screening conversion

Answer

G0121 alone, retaining the screening colonoscopy code

Answer

G0121 plus 45385-59, separating screening from polyp removal

Answer

45380-PT, treating cold-snare sampling as a biopsy

Question 3

After taking warfarin exactly as instructed on a newly dispensed bottle, a patient receives emergency treatment for gastrointestinal hemorrhage. The pharmacist confirms that a dispensing error placed twice the prescribed dose in the patient's daily regimen. The emergency physician attributes the hemorrhage to that error. Under FY 2026 ICD-10-CM rules, how should the drug event be classified and sequenced on the ED claim?

Accepted Answer

Accidental poisoning; sequence the drug-poisoning code before the hemorrhage.

Answer

Adverse effect; sequence the hemorrhage before the drug adverse-effect code.

Answer

Accidental poisoning; sequence the hemorrhage before the drug-poisoning code.

Answer

Undetermined-intent poisoning; sequence the drug-poisoning code before the hemorrhage.

Question 4

Before a Medicare patient's knee replacement, the anesthesiologist performs a peripheral nerve block solely for postoperative analgesia. The surgeon has documented why the anticipated pain requires management beyond the surgeon's usual care and has requested anesthesia assistance. A separate block note records the nerve, side, technique, and purpose. Operative anesthesia is general anesthesia and does not depend on the block. The applicable NCCI edit permits a supported distinct-service modifier. A charge reviewer objects that the block occurred before incision. Which response is supported?

Accepted Answer

Report the block separately with XU to identify nonoverlapping postoperative pain management.

Answer

Bundle the block into anesthesia because a preincision block is part of the operative anesthetic.

Answer

Hold the block charge until the surgeon documents a different diagnosis to justify the additional service.

Answer

Report the block separately only if its placement occurred after the postoperative anesthesia recovery period ended.

Question 5

A hospital CT report documents imaging of the abdomen and pelvis after oral contrast, with no intravenous or other intravascular contrast administered. The hospital furnished the scanner, supplies, and technologist. An independent radiologist interpreted the study and signed the report. Select the radiologist's professional service.

Accepted Answer

74176-26 - professional interpretation of CT without contrast

Answer

74177-26 - professional interpretation of CT with contrast

Answer

74178-26 - professional interpretation of CT without, then with, contrast

Answer

74176 without a component modifier - the global CT service

Question 6

A clinic administers 8 mg from a 10-mg single-dose vial and documents discarding the remaining 2 mg. One HCPCS billing unit represents 10 mg. The drug is separately payable under Original Medicare Part B in 2026 and is subject to the JW/JZ requirements. Medicare accepts only whole billing units. What belongs on the drug claim?

Accepted Answer

One unit with JZ on the administered-drug line, with no separate JW line.

Answer

One unit without a modifier, because the vial contained discarded medication.

Answer

One unit for administration and another unit with JW for the discarded medication.

Answer

One unit with JW on the administered-drug line, because the vial was partially discarded.

Question 7

Seven months after fixation of a Gustilo-Anderson type IIIB open tibial shaft fracture, a patient transfers to a new orthopedist. Active fracture treatment has ended. At today's assessment-only visit, the physician documents nonunion and arranges continued healing surveillance; no reduction, operation, or other active fracture treatment is provided. The applicable fracture category has separate seventh characters for open-fracture type and healing status. Which character describes today's encounter?

Accepted Answer

N - subsequent encounter for a type III open fracture with nonunion

Answer

C - initial encounter for a type IIIA, IIIB, or IIIC open fracture

Answer

J - subsequent encounter for a type III open fracture with delayed healing

Answer

S - sequela of the previously treated open fracture

Question 8

A 4-year-old is evaluated by a pediatric gastroenterologist for recurrent abdominal pain. Because the child cannot provide a reliable history, the physician obtains the necessary history directly from the mother. The physician also reviews one referral note from an outside pediatrician and orders a complete blood count, whose result is reviewed during the same encounter. There is no independent test interpretation or external management discussion. Considering only the MDM data element, what level is supported?

Accepted Answer

Moderate: the unique test, outside note, and required historian satisfy Category 1.

Answer

Limited: the blood count and outside note count, but a parent's history is not data.

Answer

Extensive: the test order, test result, outside note, and mother's history provide four items.

Answer

Limited: the historian counts, but a test ordered during the visit cannot also contribute.

Question 9

The operative note describes cystoscopic access followed by left ureteroscopy, laser fragmentation of a ureteral stone, and insertion of an indwelling stent into that same ureter. There is no contralateral work or separate encounter. Considering the procedure codes, which reporting avoids unbundling the operative work?

Accepted Answer

52356 - ureteroscopic lithotripsy with indwelling stent insertion

Answer

52353 plus 52332 - separate lithotripsy and ureteral stent codes

Answer

52356 plus 52000 - lithotripsy with stent and separate cystoscopic inspection

Answer

50590 plus 52332 - extracorporeal stone fragmentation and ureteral stent insertion

Question 10

On postoperative day 12 of a Medicare 90-day global surgical period, the original surgeon returns a patient to the operating room to evacuate a hematoma caused by the operation. This return was not planned or staged. Identify the return-procedure modifier and its effect on the postoperative period.

Accepted Answer

78; the original global period continues without restarting.

Answer

58; a new global period begins for staged or more extensive related treatment.

Answer

79; a new global period begins because this is a second operation.

Answer

78; a new postoperative period begins on the date of the return procedure.

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