Medical Coding CCS Exam Questions & Answers 2026 (1–10)

Question 1

CPT Category I codes consist of how many digits?

TheoryPractice · Accepted Answer

5. All CPT Category I codes are exactly 5 numeric digits. Category II and III codes also use 5-character alphanumeric formats but are distinct from Category I.

Question 2

Under the 2021 E/M guidelines for outpatient visits, the level of service for established patients is based primarily on which two elements?

TheoryPractice · Accepted Answer

Medical decision making or total time. Since 2021, outpatient E/M levels for established patients are determined by either medical decision making (MDM) or total time on the date of the encounter — not the three-component history/exam/MDM framework.

Question 3

Which CPT code range covers outpatient office or other outpatient visit services for new patients?

TheoryPractice · Accepted Answer

99202–99205. As of 2021, CPT codes 99202–99205 represent new patient outpatient office visits (99201 was deleted). The established patient codes are 99211–99215.

Question 4

A physician spends 45 minutes with an established outpatient patient on the date of service, with more than half that time spent on counseling. Under 2021 E/M guidelines, which code is most appropriate?

TheoryPractice · Accepted Answer

99215. Under 2021 guidelines, CPT 99215 covers 40–54 minutes of total time for established patient office visits. Since 45 minutes falls in the 40–54 minute range, 99215 is appropriate.

Question 5

Which element of Medical Decision Making (MDM) reflects 'Prescription drug management' as its highest level of risk?

TheoryPractice · Accepted Answer

Risk of complications and/or morbidity or mortality. The MDM 'Risk' column addresses risk of complications, morbidity, or mortality. Prescription drug management is cited under the Moderate risk level within this column of the MDM table.

Question 6

Under MDM, a patient presents with a new presenting problem requiring additional workup, and the physician reviews external records. This scenario most likely maps to which level of MDM?

TheoryPractice · Accepted Answer

Moderate. A new presenting problem requiring workup falls under the 'Moderate' complexity level in the number/complexity of problems column, and reviewing external records can also support Moderate in the data column, making Moderate the appropriate MDM level.

Question 7

The global surgical package for a major procedure typically includes post-operative care for how many days?

TheoryPractice · Accepted Answer

90 days. Major surgical procedures carry a 90-day global period that includes pre-op care one day before surgery, the day of surgery, and 90 post-operative days. Minor procedures typically have a 0- or 10-day global period.

Question 8

Which modifier is used to indicate that a procedure was performed on the left side of the body?

TheoryPractice · Accepted Answer

-LT. Modifier -LT (Left side) is the HCPCS Level II modifier used to identify procedures performed on the left side of the body. Modifier -RT is used for the right side.

Question 9

A surgeon performs two separate procedures on the same day through the same incision. Which modifier is most appropriate for the secondary procedure?

TheoryPractice · Accepted Answer

-51. Modifier -51 (Multiple procedures) is appended to the secondary procedure when multiple procedures are performed at the same session to indicate they are not bundled and allows for appropriate reimbursement adjustment.

Question 10

Modifier -22 is used when:

TheoryPractice · Accepted Answer

The service provided was substantially greater than typically required. Modifier -22 (Increased procedural services) indicates the work required was substantially greater than usual due to unusual complexity, and supports a request for additional reimbursement with documentation.

Medical Coding CCS Exam Questions & Answers 2026 (1–10)

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