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CPC STUDY COURSE · 2026 EDITION

Flashcards

Recall a short concept, compare the answer, and return to the cards that need another review.

Flashcards support recall. Application questions and charts test how you use the rules. Your ratings schedule another review on this device; they do not count toward exam readiness.

New cards are due now. Knew it schedules the next review after 1, 3, 7, 14 and then 30 days. Review again schedules ten minutes. These are simple study intervals, not a measure of clinical competence.

All flashcards

Terminology roots

What does cardi/o refer to?

The heart. Use the surrounding word parts and the clinical context to interpret the complete term.

  1. NIH/NLM MedlinePlus — Understanding Medical Words. accessed 2026. Accessed 2026-09-10.
What does gastr/o refer to?

The stomach. It does not mean the entire digestive tract in every compound word.

  1. NIH/NLM MedlinePlus — Understanding Medical Words. accessed 2026. Accessed 2026-09-10.
What does neur/o refer to?

A nerve or the nervous system, depending on the complete term.

  1. NIH/NLM MedlinePlus — Understanding Medical Words. accessed 2026. Accessed 2026-09-10.

Prefixes and suffixes

What distinction separates hyper- from hypo-?

Hyper- indicates above normal or excessive; hypo- indicates below normal or deficient. Read the full term to identify what is increased or decreased.

  1. NIH/NLM MedlinePlus — Understanding Medical Words. accessed 2026. Accessed 2026-09-10.
What does the suffix -itis indicate?

Inflammation. The suffix alone does not establish its cause.

  1. NIH/NLM MedlinePlus — Understanding Medical Words. accessed 2026. Accessed 2026-09-10.
How do -ectomy and -otomy differ?

-ectomy indicates removal or excision; -otomy indicates cutting into or making an incision. The full procedure term supplies the structure and context.

  1. NIH/NLM MedlinePlus — Understanding Medical Words. accessed 2026. Accessed 2026-09-10.

Anatomy

What does proximal mean when describing a limb?

Nearer its point of attachment or origin. The elbow is proximal to the wrist.

  1. NIH/NCI SEER — Anatomical Terminology. accessed 2026. Accessed 2026-09-10.
Which vessels carry blood away from the heart?

Arteries. Direction of flow, rather than oxygen content alone, distinguishes arteries from veins.

  1. NCI SEER — Classification and structure of blood vessels. 2026. Accessed 2026-09-10.
How do ureters and the urethra differ?

Ureters carry urine from the kidneys to the bladder; the urethra carries urine from the bladder out of the body.

  1. NIDDK — The urinary tract and how it works. 2026. Accessed 2026-09-10.

ICD conventions

Why must an Index candidate be checked in the Tabular List?

The Tabular List verifies the complete code and its applicable instructions, including characters, exclusions and sequencing notes.

  1. CDC/NCHS and CMS — ICD-10-CM April 1 2026 Guidelines. FY2026 April. Accessed 2026-09-10.
How is a suspected outpatient diagnosis handled?

Do not report it as established. Code the documented highest degree of certainty for the encounter under the outpatient instructions.

  1. CDC/NCHS and CMS — ICD-10-CM April 1 2026 Guidelines. FY2026 April. Accessed 2026-09-10.
Does a first visit to a new clinician always mean an initial injury encounter?

No. The injury encounter character follows the treatment phase, not simply the first meeting with that clinician.

  1. CDC/NCHS and CMS — ICD-10-CM April 1 2026 Guidelines. FY2026 April. Accessed 2026-09-10.

Modifiers

What does NCCI modifier indicator 1 permit?

Consideration of an appropriate modifier exception when the actual circumstances and instructions justify it. It is not automatic permission to bypass the edit.

  1. CMS — Medicare NCCI 2026 Chapter I: General Correct Coding Policies. 2026. Accessed 2026-09-10.
Does a different diagnosis by itself justify separate E/M on a procedure day?

No. The record must establish significant, separately identifiable E/M work under the applicable instructions.

  1. CMS — Medicare NCCI 2026 Chapter I: General Correct Coding Policies. 2026. Accessed 2026-09-10.
Why identify the billing party before selecting a component modifier?

The claim must describe the professional, technical or combined service actually furnished by that party, using an entry that allows the chosen reporting method.

  1. CMS — Medicare Claims Processing Manual, Chapter 13: Radiology and Other Diagnostic Procedures. 2026 service window; cited current manual sections. Accessed 2026-09-10.

Medicare and compliance vocabulary

What is medical necessity in a coding review?

Whether the service is reasonable and necessary under the applicable coverage requirements. A valid code alone does not establish that requirement.

  1. CMS — Medicare Provider Compliance Tips: Evaluation and Management Services. Current 2026 page. Accessed 2026-09-10.
What does NPP mean in the cited Medicare E/M guidance?

Nonphysician practitioner. Eligibility to furnish and bill a service depends on the applicable professional and Medicare requirements.

  1. CMS — Medicare Provider Compliance Tips: Evaluation and Management Services. Current 2026 page. Accessed 2026-09-10.
What is a split or shared E/M visit in the cited Medicare policy?

An eligible facility E/M service furnished by a physician and an NPP in the same group, with billing based on the applicable substantive-portion rule.

  1. CMS — Medicare Provider Compliance Tips: Evaluation and Management Services. Current 2026 page. Accessed 2026-09-10.

Coding workflow

What three facts start an E/M selection?

The service family, the applicable patient or visit status, and the supported level under that family’s instructions.

  1. CMS — Evaluation and Management Services MLN006764. May 2026. Accessed 2026-09-10.
What does a future-effective code release change about an earlier service?

Its early publication does not make the new entry applicable before its effective date. Use the service date and relevant release.

  1. CMS — HCPCS Quarterly Update. 2026 Q3. Accessed 2026-09-10.
What should happen when the record cannot support the needed detail?

Identify the gap, review the complete record and obtain appropriate clarification rather than inventing a more specific fact.

  1. CMS — Evaluation and Management Services MLN006764. May 2026. Accessed 2026-09-10.