AAPC CIC Certification Sample Questions

The AAPC Certified Inpatient Coder Certification Sample Question Set on this page is designed to familiarize you with the actual AAPC CIC exam format and question types. These sample questions help you understand how questions are structured and what to expect on test day. While they provide a useful starting point, they represent only a limited preview of the real exam experience.

These sample questions are intended for evaluation and familiarization only. To understand exam style, pacing, and reasoning patterns more clearly, we recommend trying our online sample practice environment. If you are preparing for the AAPC Certified Inpatient Coder (CIC) and want to assess your readiness more rigorously, structured, timed, scenario-based practice is recommended. This approach aligns with the cognitive demands and professional expectations typically associated with inpatient coders, facility medical coders, hospital coding professionals and related roles working in settings such as hospitals, skilled nursing facilities, inpatient rehabilitation or long-term care facilities and related settings.

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The demo introduces core concepts, while full-length premium simulations provide deeper, scenario-based coverage that more closely reflects the actual cognitive demands of the AAPC Certified Inpatient Coder exam, particularly in areas such as ICD-10-CM diagnosis coding, ICD-10-PCS inpatient procedure coding, MS-DRG/IPPS and inpatient documentation review. You can use these sample questions as a starting point, then progress to the AAPC CIC Certification Practice Exam for stronger readiness. Our premium simulations are designed to mirror real exam conditions, helping you refine reasoning, pacing, and decision-making before your official exam attempt.

AAPC CIC Sample Questions:

01. During inpatient registration, a patient reports active employer group health coverage in addition to Medicare. The billing team is reviewing payer order before submitting the institutional claim. Which action best supports accurate payer reporting?
a) Remove Medicare from the account because another payer exists
b) Determine whether Medicare is primary or secondary under applicable coordination and Medicare secondary payer rules
c) Bill the employer plan only if Medicare denies the claim first
d) Bill Medicare first automatically because the patient is eligible for Medicare

02. An acute care hospital discharges a Medicare inpatient to another acute care hospital for continued treatment. The discharge disposition is mistakenly coded as home. The MS-DRG is subject to transfer payment rules. Which concern is most appropriate?
a) The discharge disposition has no payment effect once the MS-DRG is assigned
b) The receiving hospital must assign the first hospital’s discharge disposition code
c) The claim should omit all diagnosis codes because the patient was transferred
d) The incorrect discharge disposition may affect transfer payment calculations

03. A patient develops a pulmonary embolism after inpatient orthopedic surgery. The provider documents “postoperative pulmonary embolism due to immobility after surgery". Anticoagulation is started. The coder is reviewing whether the embolism should be captured as a clinically significant condition. Which reasoning is most appropriate?
a) The pulmonary embolism should not be coded because it occurred after admission
b) The pulmonary embolism should be coded only if it was the principal diagnosis
c) The pulmonary embolism is reportable because it is documented, clinically significant, and treated during the admission
d) The pulmonary embolism should be ignored because anticoagulation is routine after orthopedic surgery

04. A hospital compliance team plans an internal audit after a rise in MS-DRGs with MCCs. The team wants the sample to detect patterns rather than focus only on one coder’s accounts. Which approach is most appropriate?
a) Select a defined sample across coders, service lines, and high-risk MS-DRGs based on the audit objective
b) Avoid sampling because internal audits must include every claim or none at all
c) Review only the claims with the highest reimbursement and assume all others are correct
d) Ask coders to choose only their strongest accounts for review

05. A 62-year-old inpatient is admitted for surgical treatment of lumbar spinal stenosis with neurogenic claudication. Conservative therapy has failed. The surgeon performs open lumbar laminectomy for decompression at L4-L5 and posterior lumbar interbody fusion using an interbody fusion device with autologous bone graft.
The operative report documents release of compressed lumbar nerve roots by removing lamina and ligamentous tissue, followed by fusion of the lumbar vertebral joint with interbody device and autologous tissue substitute.
Based on the inpatient documentation, the correct coding concept sequence is: __________
a) Lumbar sprain, drainage of spinal canal, percutaneous endoscopic approach
b) Lumbar spinal stenosis with neurogenic claudication, release of lumbar nerve roots/decompression, fusion of lumbar vertebral joint with interbody device and autologous tissue substitute
c) Low back pain only, inspection of lumbar spine, no fusion code because bone graft was used
d) Cervical disc disorder, replacement of lumbar vertebra with synthetic substitute only

06. A 22-year-old inpatient with sickle cell disease is admitted with severe chest pain, fever, hypoxia, pulmonary infiltrate, and worsening anemia. The provider documents sickle cell crisis with acute chest syndrome. The patient receives oxygen, IV fluids, opioid analgesia, antibiotics, and transfusion. Based on the inpatient documentation, the correct ICD-10-CM code selection is: __________
a) Sickle-cell disease with crisis and acute chest syndrome
b) Chest pain, pneumonia unspecified, and anemia unspecified only
c) Sickle-cell trait with acute respiratory failure
d) Chronic anemia with fever and hypoxemia

07. A hospital admits a patient to an inpatient rehabilitation facility after an acute care stroke admission. A trainee assumes that all inpatient claims are paid using the same MS-DRG methodology as acute care hospitals. Which clarification is most accurate?
a) Inpatient rehabilitation claims are always billed as outpatient therapy claims
b) Different inpatient facility types may use different payment methodologies and reporting requirements
c) Facility type does not matter once the patient is admitted as an inpatient
d) All inpatient facility claims are paid under the acute care MS-DRG system

08. A Medicare inpatient no longer requires acute inpatient hospital care, but the patient refuses discharge after being informed that continued stay may not be covered. The hospital is reviewing the appropriate notice process. Which notice is most relevant to this inpatient noncoverage situation?
a) Explanation of benefits from a commercial payer
b) Advance Beneficiary Notice of Noncoverage for outpatient laboratory testing
c) CMS-1500 professional claim form
d) Hospital-Issued Notice of Noncoverage

09. A payer authorized an inpatient procedure before admission. After claim submission, the payer denies part of the stay, stating that the last two hospital days were not medically necessary. The billing team assumes the prior authorization prevents any medical necessity review. Which interpretation is most accurate?
a) The hospital should delete the denied days from the medical record
b) Prior authorization guarantees payment for every day and service regardless of documentation
c) Prior authorization does not always eliminate later review of medical necessity or continued-stay support
d) Medical necessity review applies only when no authorization was obtained

10. An operative report documents “removal of infected hardware from left femur,” but does not specify whether all hardware was removed, whether a spacer or other device was inserted, or the surgical approach used. The discharge summary states only “orthopedic procedure completed". Which action best supports accurate ICD-10-PCS coding?
a) Query the provider for the missing operative details needed to assign the ICD-10-PCS code
b) Code only the infection diagnosis because incomplete operative notes cannot support any procedure code
c) Assign an unspecified orthopedic procedure code because the discharge summary confirms a procedure occurred
d) Use the implant inventory sheet as the sole source for the ICD-10-PCS root operation and approach

Answers:

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Note: These sample questions are not official exam questions and are intended only for familiarization and study purposes. If you find any typos or data entry errors in these AAPC Certified Inpatient Coder (CIC) sample questions, please let us know by emailing us at feedback@medicoexam.com