Medical Coding Interview Questions and Answers for Freshers and Experienced

Medical Coding Interview Questions and Answers for Freshers and Experienced

In India, the demand for medical coders is growing rapidly due to the increasing adoption of medical insurance and healthcare facilities. To succeed in a medical coding interview, you must be well-prepared with technical knowledge, anatomy and physiology, as well as hands-on coding experience. This guide will walk you through the most common medical coding interview questions and provide sample answers that are relevant for both freshers and experienced professionals. Let’s dive into the essential topics, keywords, and industry-specific scenarios that will help you ace your next interview.

Here are 40 detailed medical coding interview questions and answers, categorized to cover various aspects like basics, anatomy, coding guidelines, specific coding systems, and experience-related scenarios. These questions include practical examples to help illustrate key points.

1Q: What is Medical Coding?

Answer: Medical coding is the process of translating medical diagnoses, procedures, services, and equipment into standardized codes from various medical coding systems like ICD-10, CPT, and HCPCS. These codes are used for billing, insurance claims, and record-keeping.

2Q: What is ICD-10 and how does it differ from ICD-9?

Answer: The ICD-10 (International Classification of Diseases, 10th Edition) is a coding system that replaced ICD-9. It provides greater specificity and detail. For example:

• ICD-9: 250.0 (Diabetes Mellitus)
• ICD-10: E11.9 (Type 2 Diabetes Mellitus without complications)

3Q: What are CPT codes, and how are they used?

Answer: CPT (Current Procedural Terminology) codes are used to document medical procedures and services for billing purposes. For example, a colonoscopy procedure would be coded as 45378.

4Q: Can you explain HCPCS and its levels?

Answer: HCPCS (Healthcare Common Procedure Coding System) is used for billing Medicare and other health programs.

• Level I: CPT codes (procedures and services)
• Level II: Non-physician services (e.g., ambulance rides)

5Q: How do you handle coding for a diagnosis with multiple symptoms?

Answer: Always code the primary diagnosis first, followed by secondary diagnoses. For example, if a patient is diagnosed with pneumonia and COPD, ICD-10 J18.9 (Pneumonia) should be listed first, followed by ICD-10 J44.9 (COPD).

6Q: What is the difference between primary and secondary diagnosis codes?

Answer: The primary diagnosis is the main reason for a patient's visit, while secondary diagnoses are additional conditions or symptoms. For example:

• Primary: E11.9 (Diabetes Type 2)
• Secondary: N18.9 (Chronic Kidney Disease)

7Q: How would you code a patient with multiple fractures?

Answer: Each fracture would be coded separately, including the location and type of fracture. For example:
S72.002A: Unspecified fracture of the left femur, initial encounter.

8Q: What coding guidelines should be followed when coding for surgeries?

Answer: For surgeries, coders must follow CPT guidelines, ensuring that they capture the exact procedure, including modifiers like -51 (multiple procedures). Example: CPT 47562 (Laparoscopic Cholecystectomy) with modifier -59 (distinct procedural service).

9Q: Explain medical coding modifiers.

Answer: Modifiers are two-digit codes added to CPT codes to provide additional information. For example:

• Modifier -22: Increased procedural services
• Modifier -59: Distinct procedural service

10Q: What is the global period in medical coding?

Answer: The global period refers to the period during which all post-operative care related to a surgical procedure is covered by a single payment. For example, CPT 66984 (Cataract Surgery) has a 90-day global period.

11Q: How would you code a patient receiving chemotherapy?

Answer: Use both the procedure code for chemotherapy administration (e.g., 96413 for intravenous chemotherapy) and the diagnosis code for the cancer type (e.g., C50.912 for breast cancer).

12Q: What is medical necessity, and why is it important?

Answer: Medical necessity refers to services that are essential for a patient's diagnosis or treatment. Codes must match the medical necessity for insurance claims to be approved.

13Q: Can you explain the difference between inpatient and outpatient coding?

Answer: Inpatient coding uses ICD-10-PCS for procedures and is typically more complex, while outpatient coding uses CPT/HCPCS for procedures.

14Q: What is DRG coding?

Answer: DRG (Diagnosis-Related Group) coding is used for inpatient hospital stays. It assigns a payment level based on the diagnosis and procedures performed.

15Q: How do you handle a situation where no code exists for a procedure?

Answer: Use the unlisted code and provide documentation explaining the procedure. For example, if a procedure is not listed in CPT, you might use CPT 19499 (unlisted procedure, breast).

16Q: How would you code an E/M visit?

Answer: E/M (Evaluation and Management) codes range from 99201-99499 based on the complexity of the visit. A new patient visit with a moderate level of decision-making might use 99203.

17Q: What is the importance of HIPAA in medical coding?

Answer: HIPAA ensures the confidentiality of patient information. Medical coders must ensure that patient data is protected and only used for billing and treatment.

18Q: What steps do you follow when coding a complex medical case?

Answer: Review the medical record, identify the main diagnosis, locate additional diagnoses, and choose the most specific codes for each. Ensure all procedures are captured accurately.

19Q: How would you code a heart attack?

Answer: A heart attack would be coded using ICD-10 I21.9 (Acute Myocardial Infarction, unspecified).

20Q: What is the difference between upcoding and unbundling?

Answer:

• Upcoding: Assigning a code that reflects a higher level of service than was performed.
• Unbundling: Coding multiple services separately that should be billed as one. Both are unethical and illegal.

21Q: How do you stay updated with coding changes?

Answer: Stay updated by regularly reviewing coding updates from organizations like the AAPC and AHIMA, and attending webinars and training sessions.

22Q: What are some common coding errors and how do you avoid them?

Answer: Common errors include upcoding, unbundling, and using outdated codes. To avoid these, always cross-check your codes and use updated resources.

23Q: How would you code for a newborn with jaundice?

Answer: Use ICD-10 P59.9 (Neonatal jaundice, unspecified).

24Q: What is the significance of the 'present on admission' indicator?

Answer: This indicator shows whether a condition was present at the time of admission. It’s important for determining hospital reimbursement and quality measures.

25Q: How do you handle coding for follow-up visits?

Answer: Use follow-up diagnosis codes such as Z09 (Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm).

26Q: How would you code a patient with a broken wrist?

Answer: Use the appropriate fracture code. For example, ICD-10 S52.501A (Fracture of unspecified distal end of radius, initial encounter).

27Q: What do you do if a provider's documentation is incomplete?

Answer: Request additional information or clarification from the provider before assigning codes.

28Q: How would you code a flu vaccination?

Answer: Use CPT 90658 for the flu vaccine and ICD-10 Z23 (Encounter for immunization).

29Q: How do you ensure accuracy in your coding?

Answer: Double-check codes, cross-reference coding guidelines, and utilize coding software tools for accuracy.

30Q: How would you code a biopsy?

Answer: For example, a liver biopsy could be coded as CPT 47000.

31Q: What is the difference between CPT and ICD-10 codes?

Answer: CPT codes are used for procedures, while ICD-10 codes are used for diagnoses.

32Q: Can you explain how to code for an emergency room visit?

Answer: Use E/M codes based on the complexity of the visit, such as 99281 for a minor emergency or 99285 for a critical case.

33Q: What is the significance of the place of service codes?

Answer: These codes, like POS 11 for the office or POS 21 for inpatient hospital, indicate where the service was performed.

34Q: How do you code an allergic reaction?

Answer: Code the reaction based on the type, such as ICD-10 T78.40XA (Allergy, unspecified, initial encounter).

35Q: What is your approach to coding radiology reports?

Answer: Focus on the main findings and use the appropriate radiology CPT codes, such as CPT 71045 (chest X-ray, single view).

36Q: How do you code for chronic conditions?

Answer: Chronic conditions, like hypertension, are coded as ongoing diagnoses. For example, ICD-10 I10 for essential hypertension.

37Q: How would you code a preventive visit?

Answer: Use CPT codes like 99385 (Initial comprehensive preventive visit for patients aged 18-39).

38Q: How do you handle coding for telehealth visits?

Answer: Use telehealth-specific modifiers like 95 or GT along with the relevant E/M codes.

39Q: What is hierarchical condition category (HCC) coding?

Answer: HCC coding is used to adjust payments for patients with chronic conditions. For example, ICD-10 E11.9 (Type 2 Diabetes) maps to an HCC category.

40Q: How would you code a lab test?

Answer: For example, a basic metabolic panel (BMP) would be coded as CPT 80048.

These questions and answers can serve as a strong foundation for medical coding interviews, helping to demonstrate both knowledge and practical application.