Free CCC exam Practice Questions

Sample Practice Questions

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

1. 1A cardiology office note states a diagnosis. What is the correct first step when locating its ICD-10-CM code?

   1. A. Start in the Alphabetic Index, then verify the code in the Tabular List.
   2. B. Start in the Tabular List, then verify the code in the Alphabetic Index.
   3. C. Use the Alphabetic Index entry without checking the Tabular List.
   4. D. Use the first code found in the Tabular List without reviewing notes.

   Answer: A

   Explanation: The official guidelines state, "first locate the term in the Alphabetic Index, and then verify the code in the Tabular List." The office diagnosis therefore requires that sequence; B reverses it, and C and D omit a required reference.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2026 — Page 12 of 121, General Coding Guidelines: Locating a code in the ICD-10-CM

2. 2For an office E/M visit, which two bases may be used to select the service level under the CPT guidance?

   1. A. History length or examination length.
   2. B. Medical decision making or total time on the encounter date.
   3. C. Diagnosis count or number of medication names.
   4. D. Face-to-face minutes or number of examination systems.

   Answer: B

   Explanation: CPT instructs, "Select the appropriate level of E/M services based on the following: 1. The level of the MDM as defined for each service, or 2. The total time for E/M services performed on the date of the encounter". The other pairs substitute measures that do not establish the level.

   Reference: AMA CPT E/M Office or Other Outpatient Code and Guideline Changes — Instructions for Selecting a Level of Office or Other Outpatient E/M Services, page 8

3. 3For ordinary Medicare incident-to office services, which prior involvement is required of the physician or other listed practitioner?

   1. A. An initial personal service and continued active involvement in treatment.
   2. B. A telephone approval after every auxiliary visit only.
   3. C. No initial service if auxiliary personnel document the visit.
   4. D. Only a signature on the claim after treatment ends.

   Answer: A

   Explanation: CMS requires services to be "an integral part of the patient’s normal treatment when the physician or other listed practitioner personally performed an initial service and remains actively involved in the course of treatment." The other choices omit that initial and continuing role.

   Reference: CMS Incident To Services & Supplies — Incident To Services & Supplies, requirements list

4. 4During a coronary bypass using a venous graft, the surgeon procures the vein. How should procurement be coded under the 2026 Medicare NCCI cardiovascular policy?

   1. A. As an integral component of the venous bypass.
   2. B. As a separately coded saphenous vein ligation.
   3. C. As a separately coded peripheral bypass.
   4. D. As a separately coded diagnostic angiogram.

   Answer: A

   Explanation: NCCI states, "Coronary artery bypass procedures using venous grafts (CPT codes 33510-33523) include procurement of the venous graft(s) as an integral component of the procedure." Separate vein ligation for procurement would unbundle the bypass.

   Reference: Medicare NCCI Policy Manual 2026, Chapter V — Section D.1, Cardiovascular System, page V-10

5. 5In a cardiology note, what does 'angina' describe?

   1. A. Chest pain or discomfort from insufficient blood to heart muscle.
   2. B. An irregular heartbeat arising in the atria.
   3. C. A tear in the wall of the aorta.
   4. D. A stiff valve that cannot open fully.

   Answer: A

   Explanation: CDC defines angina as "chest pain or discomfort that happens when the heart muscle is not getting enough blood." The other descriptions correspond to rhythm, aortic, and valve problems.

   Reference: CDC About Other Conditions Related to Heart Disease — Conditions related to heart disease, Angina

6. 6Which heart chambers receive blood returning to the heart?

   1. A. The right and left atria.
   2. B. The right and left ventricles.
   3. C. The right and left coronary arteries.
   4. D. The aortic and pulmonary valves.

   Answer: A

   Explanation: NHLBI defines an atrium as "One of the two upper chambers of the heart that collect blood as it flows into the heart." Thus the atria receive returning blood; ventricles pump it out.

   Reference: NHLBI How the Heart Works: What the Heart Looks Like — Heart chambers, atrium definition

7. 7A physician documents a confirmed diagnosis at the highest available specificity. Which ICD-10-CM code form should the coder report?

   1. A. The shortest category code that names the disease.
   2. B. The full code with all required characters and documented specificity.
   3. C. A three-character code even when the category is subdivided.
   4. D. A code that omits a required seventh character when laterality is known.

   Answer: B

   Explanation: The guidelines require codes "at their highest number of characters available and to the highest level of specificity documented in the medical record." A truncated category or omitted required character cannot meet that requirement.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2026 — Page 12 of 121, General Coding Guidelines: Level of Detail in Coding

8. 8A cardiologist documents a lengthy history and examination during an office E/M visit. What role does their extent play in choosing the CPT office visit level?

   1. A. History extent alone determines the level.
   2. B. Examination extent alone determines the level.
   3. C. Neither extent is an element for selecting the level.
   4. D. The longer of history or examination determines the level.

   Answer: C

   Explanation: The AMA guidelines state, "The extent of history and physical examination is not an element in selection of the level of office or other outpatient codes." The services still require medically appropriate work, but its documented extent is not the level selector.

   Reference: AMA CPT E/M Office or Other Outpatient Code and Guideline Changes — Guidelines for Office or Other Outpatient E/M Services, page 3

9. 9Under the general Medicare incident-to rule for office services, who may bill when auxiliary personnel furnish a service under the required direct supervision?

   1. A. The auxiliary employee who furnished the service.
   2. B. Any practitioner in the group who later signs the chart.
   3. C. The physician or listed practitioner who supervised the service.
   4. D. The practitioner who made the initial diagnosis, regardless of supervision.

   Answer: C

   Explanation: CMS states that these services "Are provided under direct supervision by a physician or other listed practitioner for the incident to services, and only the physician or other listed practitioner who supervises the incident to services may bill them." The billing practitioner is tied to supervision.

   Reference: CMS Incident To Services & Supplies — Incident To Services & Supplies, requirements list

10. 10A coronary bypass uses only venous grafting. How many codes from CPT range 33510-33516 does NCCI permit for that bypass?

    1. A. One code from the range.
    2. B. One code for each anastomosis plus the primary code.
    3. C. Two codes from the range whenever two veins are used.
    4. D. A separate code for each conduit procurement.

    Answer: A

    Explanation: NCCI directs, "When venous grafting only is performed, only one code in the range of coronary artery bypass CPT codes 33510-33516 may be reported." The code selected describes the comprehensive venous bypass, rather than separate conduit or graft counts.

    Reference: Medicare NCCI Policy Manual 2026, Chapter V — Section D.2, Cardiovascular System, page V-10