Free CHONC exam Practice Questions

Sample Practice Questions

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

1. 1A pathology report documents the histologic term adenoma. Which lookup should the coder make first when assigning the neoplasm diagnosis?

   1. A. Go directly to the Neoplasm Table by site.
   2. B. Look up adenoma in the Alphabetic Index.
   3. C. Select the benign column before checking the Index.
   4. D. Select the code from the Tabular List without an Index lookup.

   Answer: B

   Explanation: The guidelines state, "if the histological term is documented, that term should be referenced first, rather than going immediately to the Neoplasm Table". The documented histology controls the first lookup; the Table and Tabular List follow.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2026 — Chapter 2, General Guidelines, p. 33

2. 2Under Medicare's drug administration guidance, which broad administration route is described by the chemotherapy administration code family for non-radionuclide antineoplastic drugs?

   1. A. Parenteral administration.
   2. B. Oral self-administration.
   3. C. Topical self-application.
   4. D. Inhaled self-administration.

   Answer: A

   Explanation: CMS states, "Chemotherapy administration codes apply to parenteral administration of non-radionuclide anti-neoplastic drugs". A take-home oral drug does not itself meet this administration description.

   Reference: Medicare Claims Processing Manual, Chapter 12 — §30.5.D, Chemotherapy Administration

3. 3Which radiation treatment technique changes the intensity within different parts of individual beams as treatment is delivered?

   1. A. Intensity modulated radiation therapy using variable intensity within a beam.
   2. B. Three-dimensional conformal therapy using fixed intensity across each beam.
   3. C. Stereotactic delivery defined chiefly by target coordinates and high precision.
   4. D. Brachytherapy using a source positioned in or near the target.

   Answer: A

   Explanation: The LCD defines IMRT as a form of radiation therapy that "changes the intensity of radiation within different parts of single radiation beams while the treatment is delivered." The beam-intensity feature identifies IMRT.

   Reference: LCD Radiation Therapies (L39553) — Coverage Guidance, Overview, Intensity Modulated Radiation Therapy

4. 4Under Medicare OPPS, a hematology patient receives two units of red cells in one transfusion service. On what basis is the transfusion service code billed?

   1. A. Per transfusion service, not per blood-product unit.
   2. B. Once for each red-cell unit.
   3. C. Once for each compatibility test.
   4. D. Once for each hour of infusion.

   Answer: A

   Explanation: CMS states, "Transfusion services codes are billed on a per service basis, and not by the number of units of blood product transfused." Product quantity is handled separately from the service code.

   Reference: Medicare Claims Processing Manual, Chapter 4 — §231.8, Billing for Transfusion Services

5. 5A primary malignant lesion overlaps two contiguous anatomic sites, and the combination is not specifically indexed elsewhere. Which neoplasm coding approach applies?

   1. A. Assign separate primary codes for each contiguous site.
   2. B. Assign an unspecified-site primary code.
   3. C. Classify the lesion to the overlapping-lesion .8 code.
   4. D. Classify it as a secondary malignant neoplasm.

   Answer: C

   Explanation: The guideline says, "A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere." The stated absence of a separate indexed combination makes .8 applicable.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2026 — Chapter 2, General Guidelines, p. 33

6. 6An antineoplastic agent is administered parenterally to treat an autoimmune condition, and the service meets Medicare's chemotherapy administration requirements. Does the noncancer diagnosis alone rule out this code family?

   1. A. Yes, chemotherapy administration codes require a cancer diagnosis.
   2. B. Yes, unless radiation therapy is given on the same day.
   3. C. No, antineoplastic agents may qualify when used for noncancer diagnoses.
   4. D. No, but only if the drug is administered orally.

   Answer: C

   Explanation: CMS includes "anti-neoplastic agents provided for treatment of noncancer diagnoses" within the chemotherapy administration discussion. The drug, administration, and complexity still must meet the applicable rules; diagnosis alone does not rule it out.

   Reference: Medicare Claims Processing Manual, Chapter 12 — §30.5.D, Chemotherapy Administration

7. 7During an IMRT course, the radiation source moves in an arc around the patient while delivering treatment. Which named form of IMRT is documented?

   1. A. Volumetric modulation arc radiotherapy (VMAT).
   2. B. Stationary-field IMRT.
   3. C. Remote afterloading brachytherapy.
   4. D. Stereotactic radiosurgery.

   Answer: A

   Explanation: The LCD states, "Volumetric modulation arc radiotherapy (VMAT) is a form of IMRT in which the radiation source moves in an arc around the patient while delivering the radiation treatment." Motion of the source through an arc distinguishes VMAT.

   Reference: LCD Radiation Therapies (L39553) — Coverage Guidance, Overview, Intensity Modulated Radiation Therapy

8. 8For Medicare OPPS payment of a transfusion service, what additional code type is required with the transfusion service code?

   1. A. A blood-product HCPCS code.
   2. B. A compatibility-testing CPT code in place of the product code.
   3. C. A second transfusion-service code to represent the blood product.
   4. D. Only a blood revenue code without a product HCPCS code.

   Answer: A

   Explanation: The manual states, "For payment, a blood product HCPCS code is required when billing a transfusion service code." The product and its administration are separate aspects of the claim.

   Reference: Medicare Claims Processing Manual, Chapter 4 — §231.8, Billing for Transfusion Services

9. 9Two documented primary tumors occur in different quadrants of the same breast and are not contiguous. How should the distinct sites be represented?

   1. A. Assign codes for each site.
   2. B. Use one overlapping-lesion code.
   3. C. Use only a personal-history code.
   4. D. Use one disseminated-malignancy code.

   Answer: A

   Explanation: The guidelines state, "For multiple neoplasms of the same site that are not contiguous such as tumors in different quadrants of the same breast, codes for each site should be assigned." Their noncontiguous locations distinguish this from an overlapping lesion.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2026 — Chapter 2, General Guidelines, p. 33

10. 10For Medicare drug administration coding, can qualifying monoclonal antibody agents fall under the chemotherapy administration code family?

    1. A. Yes, CMS includes monoclonal antibody agents among potentially qualifying substances.
    2. B. No, every monoclonal antibody is limited to hydration coding.
    3. C. No, all biologic response modifiers are excluded from drug administration.
    4. D. Yes, but only when the patient also receives external beam radiation.

    Answer: A

    Explanation: CMS includes "substances such as monoclonal antibody agents, and other biologic response modifiers" in its description, while noting that complexity requires more than a drug name alone.

    Reference: Medicare Claims Processing Manual, Chapter 12 — §30.5.D, Chemotherapy Administration