Free CDEO® exam Practice Questions

Sample Practice Questions

Try these 10 sample questions from the CDEO® exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1In outpatient CDI, what should a reviewer primarily compare with the codes proposed for a claim?

   1. A. Whether the provider selected the most familiar codes from a pick list
   2. B. Whether the documentation supports the reported CPT, HCPCS, and ICD-10-CM codes
   3. C. Whether a prior encounter used the same codes for this patient
   4. D. Whether a payer's fee schedule lists all proposed codes

   Answer: B

   Explanation: CMS directs reviewers to "Make sure the documentation in the patient’s medical record supports the CPT, HCPCS, and ICD-10-CM codes reported on the claim form or billing statement". The record, rather than a prior claim or fee schedule, controls code support.

   Reference: Evaluation & Management Services — Medical Record Documentation

2. 2A provider answers a CDI query, and the organization wants to use that response for code assignment. What must happen to the response?

   1. A. It must remain only in the query professional's private notes
   2. B. It must become part of the health record or be added through provider documentation
   3. C. It must be sent to the payer without entering the record
   4. D. It must be repeated in every later encounter note

   Answer: B

   Explanation: The guideline states, "In order for a query response to be utilized to support code assignment, the query and response must be incorporated as part of the health record". Alternatively, the provider can document the answer or add an addendum as specified there.

   Reference: Guidelines for Achieving a Compliant Query Practice (2026 Update) — Section V.I, Required elements of a compliant query, p. 7

3. 3For ICD-10-CM HIV coding, what documentation can confirm HIV infection without a positive serology report in the record?

   1. A. A coder's inference from an antiretroviral medication list
   2. B. The provider's diagnostic statement that the patient is HIV positive
   3. C. An inconclusive laboratory result alone
   4. D. A historical note mentioning possible exposure

   Answer: B

   Explanation: The FY 2027 guidelines state, "the provider’s diagnostic statement that the patient is HIV positive or has an HIV-related illness is sufficient." Confirmation in this coding context does not require positive serology in the record.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — p. 20

4. 4When beginning an ICD-10-CM code search for an outpatient diagnosis, where do the official guidelines direct the coder to start?

   1. A. The Tabular List
   2. B. The Alphabetic Index
   3. C. The payer fee schedule
   4. D. The previous claim's code list

   Answer: B

   Explanation: The guidelines state, "The most critical rule involves beginning the search for the correct code assignment through the Alphabetic Index." The Tabular List is used afterward to verify the selection.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — Section IV.A, Selection of first-listed condition, p. 112

5. 5A scribe, including an AI transcription tool, prepares an outpatient note for a Medicare provider. Who authenticates the care documented in the entry?

   1. A. The scribe's signature alone authenticates the provider's care
   2. B. The provider signs the entry
   3. C. The billing office signs instead of the provider
   4. D. The EHR automatically authenticates it without review

   Answer: B

   Explanation: CMS instructs, "If you use a scribe, including artificial intelligence technology, sign the entry to authenticate the documents and the care you provided or ordered." The provider retains authentication responsibility.

   Reference: Complying with Medicare Signature Requirements — Common Questions, What if I use a scribe?, p. 2

6. 6Which three resource components are reflected in Medicare Physician Fee Schedule RVUs?

   1. A. Diagnosis severity, hospital length of stay, and readmissions
   2. B. Work, practice expense, and malpractice expense
   3. C. Drug price, room charge, and admission status
   4. D. Patient age, HCC count, and quality score

   Answer: B

   Explanation: CMS states that PFS rates use RVUs "for work, practice expense, and malpractice expense." These components relate to the resources required for a service.

   Reference: Physician Fee Schedule — Physician Fee Schedule, payment rates

7. 7For an office E/M visit selected by MDM, how many of the three MDM elements must reach the high level for overall MDM to be high?

   1. A. None if time is documented
   2. B. One of three
   3. C. All three
   4. D. Two of three

   Answer: D

   Explanation: AMA states, "Two of the three components must be at a high level for the overall MDM level for that encounter to be considered as high." A single high element is insufficient.

   Reference: CPT Evaluation and Management Revisions FAQs — MDM element: Risk of complications, response on surgical risk

8. 8What do the Medicare Advantage and Part D Star Ratings assess?

   1. A. A hospital's surgical case mix alone
   2. B. The number of ICD-10-CM codes a physician reports
   3. C. The time required for an office E/M visit
   4. D. Quality of health and prescription drug services received by plan enrollees

   Answer: D

   Explanation: CMS says the ratings "measure the quality of health and prescription drug services received by consumers enrolled in MA and Part D prescription drug plans." The rated unit is plan performance in those services.

   Reference: 2027 Medicare Advantage and Part D Star Ratings — Opening overview

9. 9A primary malignant lesion spans two contiguous sites and is not specifically indexed as a combined site elsewhere. Which neoplasm subcategory applies?

   1. A. The overlapping-lesion subcategory .8
   2. B. A personal-history code for both sites
   3. C. A code for metastatic disease at both sites
   4. D. An unspecified primary-site code instead of a site code

   Answer: A

   Explanation: The guideline says a primary malignant lesion overlapping contiguous sites "should be classified to the subcategory/code .8 ('overlapping lesion')" unless specifically indexed elsewhere. The stated case meets the condition.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 — p. 32

10. 10Why does CDI attend to inaccurate information in a patient's record even when the billed code would not change?

    1. A. It removes the need to document the current encounter
    2. B. It automatically changes every payer's reimbursement rate
    3. C. It can disrupt clinicians' communication and affect patient outcomes
    4. D. It replaces the clinician's assessment with the coder's

    Answer: C

    Explanation: CMS explains that "providers rely on documentation to communicate important patient information" and that inaccurate documentation "can result in unintended and even dangerous patient outcomes." This makes record accuracy a care issue as well as a coding issue.

    Reference: Documentation Matters Toolkit — Documentation Matters Toolkit