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Cheat Sheets

Why candidates miss this

This item is missed when the learner follows a familiar-looking code, shortcut, or billing instinct instead of the controlling rule. The decisive distinction is: Facility and professional claims are separate billing pathways even when they arise from the same encounter. Apply the documented facts first; do not add assumptions. Likely wrong answer: The hospital facility uses only a pharmacy claim form. Review focus: CMS Hospital OPPS — 2026 Quarterly Addenda

Interview question

Q: What is the core claim-form distinction between hospital facility services and physician professional services? Strong answer: Hospital facility services generally use the institutional CMS-1450/UB-04 or 837I pathway; physician/professional services generally use CMS-1500/837P.

UB-04
837I
CMS-1500
837P
facility vs professional

Caution: Look for reasoning tied to the documentation and controlling rule, not memorization of a naked code number or a restatement of the original multiple-choice stem.

Why this matters

Hospital facility services are generally submitted on the institutional CMS-1450/UB-04 or 837I pathway; physician/professional services generally use CMS-1500/837P. Understanding the payment rule prevents the coder from confusing coverage, packaging, payment status, or inpatient/outpatient methodology and helps keep the institutional claim accurate.

Question 1 A hospital outpatient department bills its facility services, while the physician separately bills professional work. Which claim-form distinction is generally correct?

Answer choices

A. Both facility and professional services must be combined on a single CMS-1500.
B. The hospital facility uses only a pharmacy claim form.
C. The hospital submits an institutional claim (CMS-1450/UB-04 format), while professional services are generally billed on the CMS-1500/837P pathway.
D. The physician professional service is always included in the hospital UB-04 and may never be billed separately.

Correct answer

The hospital submits an institutional claim (CMS-1450/UB-04 format), while professional services are generally billed on the CMS-1500/837P pathway.

Medicare separates institutional and professional billing pathways. Hospital facility charges use the institutional claim format; physicians and other professionals typically use the professional claim format.

Wrong-answer review

A. Both facility and professional services must be combined on a single CMS-1500.: Incorrect. Combining facility and professional billing onto one professional claim misstates the billing entity and claim type.
B. The hospital facility uses only a pharmacy claim form.: Incorrect. Hospital outpatient facility services are not limited to pharmacy billing.
D. The physician professional service is always included in the hospital UB-04 and may never be billed separately.: Incorrect. Professional payment is distinct from the hospital facility claim in many outpatient settings.

Extra learning features

Objective/domain: Facility reimbursement

Source: CMS Medicare Claims Processing Manual, Chapter 4 — Part B Hospital and OPPS

Question 2 A patient is discharged from the hospital outpatient department after evaluation for right-lower-quadrant pain. The physician’s final note states, “Possible appendicitis; CT is equivocal; return if symptoms worsen.” Which diagnosis coding approach is correct for this encounter?

A. Report the documented symptom; do not code appendicitis as established.
B. Report acute appendicitis because it is the leading differential diagnosis.
C. Report both abdominal pain and acute appendicitis so the claim reflects the workup.
D. Hold the claim until appendicitis is either confirmed or ruled out at a later visit.

Report the documented symptom; do not code appendicitis as established.

Objective/domain: ICD-10-CM diagnosis coding

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026 — April 1, 2026 Update

Question 3 A cardiologist performs a procedure in a hospital outpatient department. The hospital submits the facility claim, and the cardiologist submits a professional claim when appropriate. Which statement is correct?

A. The hospital facility payment and physician professional payment are distinct components governed by different Medicare payment rules.
B. The physician may never bill separately when a hospital receives an APC payment.
C. The hospital’s APC automatically includes every physician professional service.
D. The physician must bill the hospital’s revenue code instead of a professional CPT service.

The hospital facility payment and physician professional payment are distinct components governed by different Medicare payment rules.

Source: CMS Medicare Payment Systems — Hospital OPPS

Question 4 A supply line on an OPPS claim has status indicator N in the applicable Addendum B. What does that generally signal for OPPS payment?

A. Packaged; no separate OPPS payment.
B. The item is always denied as noncovered.
C. The item must be paid under an inpatient DRG.
D. The item receives a separate pass-through payment.

Packaged; no separate OPPS payment.

Question 5 A patient returns for medication management of essential hypertension. Blood pressure is controlled on the current regimen, and the physician documents “hypertension — stable.” Which diagnosis coding is correct?

A. Use a personal-history code because the blood pressure is controlled.
B. Omit hypertension because no abnormal reading occurred today.
C. Use a screening code because the patient has no symptoms.
D. Report I10 for the controlled hypertension.

Report I10 for the controlled hypertension.

Question 6 A wound-care physician documents removal of devitalized skin, subcutaneous tissue, and necrotic fascia with exposed muscle fibers. The deepest tissue actually debrided is fascia. Why does that detail matter to coding?

A. Only the wound’s diagnosis matters; tissue depth never affects procedure coding.
B. Depth matters only when bone is removed, not for fascia or muscle.
C. Depth determines the ICD-10-CM diagnosis but never the CPT procedure family.
D. Debridement code selection depends in part on the deepest tissue level actually debrided.

Debridement code selection depends in part on the deepest tissue level actually debrided.

Objective/domain: Anatomy, terminology and integrated outpatient cases

Source: AAPC 2026 COC® Certification Study Guide

Question 7 A gallbladder removed during cholecystectomy is submitted for gross and microscopic examination. The pathology service meets CPT surgical pathology Level IV criteria. Which code is appropriate?

A. 88305
B. 88302
C. 88307
D. 85025

88305

Objective/domain: CPT coding

Source: CMS Hospital Outpatient Prospective Payment System (OPPS) — 2026 Quarterly Addenda

Question 8 A bed-confined beneficiary requires medically necessary basic life support ground ambulance transportation from a skilled nursing facility to a dialysis facility. The transport is scheduled and nonemergent. Which base HCPCS ambulance code is the best match?

A. A0429
B. A0428
C. A0430
D. A0431

A0428

Objective/domain: HCPCS Level II

Source: CMS HCPCS Quarterly Update — July 2026 Alpha-Numeric HCPCS File

Question 9 A wound-care note states that debridement extended through skin and subcutaneous tissue but did not reach fascia or muscle. Which tissue layer is deepest in the documented debridement?

A. Muscle.
B. Bone.
C. Subcutaneous tissue.
D. Pleura.

Subcutaneous tissue.

Question 10 A physical therapist provides 30 minutes of one-on-one dynamic activities designed to improve functional performance, documented as therapeutic activities rather than therapeutic exercise. Which CPT code family best matches the service?

A. 97110
B. 97530
C. 97535
D. 97140

97530

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A hospital outpatient department bills its facility services, while the physician separately bills professional work. Which claim-form distinction is generally correct?

A patient is discharged from the hospital outpatient department after evaluation for right-lower-quadrant pain. The physician’s final note states, “Possible appendicitis; CT is equivocal; return if symptoms worsen.” Which diagnosis coding approach is correct for this encounter?

A cardiologist performs a procedure in a hospital outpatient department. The hospital submits the facility claim, and the cardiologist submits a professional claim when appropriate. Which statement is correct?

A supply line on an OPPS claim has status indicator N in the applicable Addendum B. What does that generally signal for OPPS payment?

A patient returns for medication management of essential hypertension. Blood pressure is controlled on the current regimen, and the physician documents “hypertension — stable.” Which diagnosis coding is correct?

A wound-care physician documents removal of devitalized skin, subcutaneous tissue, and necrotic fascia with exposed muscle fibers. The deepest tissue actually debrided is fascia. Why does that detail matter to coding?

A gallbladder removed during cholecystectomy is submitted for gross and microscopic examination. The pathology service meets CPT surgical pathology Level IV criteria. Which code is appropriate?

A bed-confined beneficiary requires medically necessary basic life support ground ambulance transportation from a skilled nursing facility to a dialysis facility. The transport is scheduled and nonemergent. Which base HCPCS ambulance code is the best match?

A wound-care note states that debridement extended through skin and subcutaneous tissue but did not reach fascia or muscle. Which tissue layer is deepest in the documented debridement?

A physical therapist provides 30 minutes of one-on-one dynamic activities designed to improve functional performance, documented as therapeutic activities rather than therapeutic exercise. Which CPT code family best matches the service?

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Extra learning features

Why candidates miss this

Interview question

Why this matters

Answer choices

Correct answer

Answer choices

Correct answer

Answer choices

Correct answer

Answer choices

Correct answer

Answer choices

Correct answer

Answer choices

Correct answer

Answer choices

Correct answer

Answer choices

Correct answer

Answer choices

Correct answer

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