Medical Coding Interview Questions

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Medical coders play a significant role in today’s healthcare environment because they take physician documentation and patient records and convert them into universal medical codes. Medical codes are extremely important for billing appropriately, insurance processing, medical audits, and even for public health research. Coders serve as a liaison between the healthcare provider, insurance company, and patient by accurately translating documentation into the appropriate codes and classifications. This helps the healthcare provider bill correctly, the insurance company pays the correct reimbursement, and the patient will not be overbilled, thereby promoting transparency.

While there is an increased demand for qualified medical coders, there are also more people competing for the same job. As you begin preparing for your job search, it is important to build an understanding of industry vocabulary, coding systems (ICD, CPT, HCPCS), and regulations (HIPAA). One of the best ways to prepare for interviews is to review common questions being asked in interviews. This blog will cover the most common medical coding interview questions at the basic, intermediate, and advanced levels, and help you prepare for your interview.

Table of Contents:

• What is Medical Coding?
• Recruitment Process for Medical Coding Roles
• Basic Medical Coding Interview Questions for Freshers
• Intermediate Medical Coding Interview Questions
• Advanced Medical Coding Interview Questions for Experienced
• Medical Coding Roles and Salaries
• Conclusion

Medical coding is when a doctor’s notes, diagnoses, treatment, and services are coded into special codes made from letters and numbers. These codes are part of a coding system used all over the world to create a clear and organized healthcare information that can be tracked and shared easily.
When a patient goes to a doctor’s office or hospital, many different things can happen, which may include checking symptoms, running tests, and delivering treatment using the medical equipment. All these things must be documented, especially for billing and insurance purposes, and the medical coders take all this information and code it into standard coded descriptions.

There are many reasons to use coding:

• Billing: Coding tells the insurance companies what services were provided so that hospitals, clinics, etc., can be paid for their services.
• Records: Keeps a record of what care was provided to the patient.
• Research: Coding helps track diseases, treatment, and healthcare trends.
• Communication: Codes provide a consistent and universal way for healthcare providers, insurance companies, and government agencies to understand the care that was provided.

• Application Submission: Candidates submit their resume along with a cover letter for medical coding roles.
• Screening: Basic candidates are judged based on a test of their aptitude or basic coding knowledge, which is needed for medical coding.
• Interview: In-person or virtual, with consideration to focusing on technical or scenario-based questioning.
• Assessment Test: Candidates have to pass an assessment test that contains sample coding tasks.
• Final Round/HR Discussion: Discuss role expectations, salary expectations, and onboarding.

Q1. Explain the importance of medical coding in the healthcare system?

Medical coding is essential in ensuring healthcare providers receive appropriate payment for services. It enables insurance companies to know what procedures were performed and the purpose of the procedure. It also maintains accurate patient records, which are important in healthcare planning and research. In fact, without medical coding, billing would be difficult to navigate and prone to mistakes.

Q2. How can you ensure accuracy in medical coding?

To be accurate, medical coders must carefully read and understand the healthcare provider’s notes, documentation, and orders. They must use the most recent manuals and coding resources, double-check codes, and avoid making assumptions. Auditing records and continuing certification training will also help reduce errors in coding. With the rise of Data Science in Healthcare, coders are increasingly relying on electronic health records (EHRs), automation tools, and health analytics to ensure better accuracy and compliance.

Q3. What are the skills that a medical coder should possess?

A good medical coder has the following capabilities:

• Attention to detail.
• Analytical thinking and reasoning.
• Knowledge of anatomy and medical terminology.
• Knowledge and experience with the various code references for ICD, CPT, and HCPCS.
• Time management and Computer skills.

Q4. What are some common phrases used in clinical coding?

Some commonly used words are diagnosis, procedure, encounter, medical necessity, modifier, claim, denial, upcoding, downcoding, and E/M coding. These words are common when dealing with patient charts and billing systems. Understanding these words is necessary to do proper coding. They also allow coders to communicate clearly with providers and insurance companies.

Q5. What are ICD codes?

International Classification of Diseases Codes (ICD), which are assigned and established by the World Health Organization (WHO), are used to identify, describe diseases and health conditions, and are used internationally to report and measure illnesses.

Q6. What is ICD-10-CM?

ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) is a system used in the United States to classify and assign codes to diagnoses in inpatient or outpatient services. It has a more extensive array of codes specifically for diagnoses than previous versions. This supports billing, research, and monitoring health trends.

Q7. Why are ICD-10 codes used?

ICD-10 codes are used to describe a patient’s health condition and the reasons for care. ICD codes accurately describe diagnostic information used for billing to insurance companies. ICD codes assist in tracking disease, measuring incidence for health reporting, and helping develop policies. 

Q8. What are HCPCS codes?

HCPCS (Healthcare Common Procedure Coding System) codes are billable services that are used primarily for billing Medicare and Medicaid services. There are two levels of HCPCS codes: Level I, which includes CPT codes, and Level II, which mainly include non-physician services.

Q9. What are CPT codes?

CPT (Current Procedural Terminology) Codes are codes used to describe medical, surgical, and diagnostic services. CPT codes enable healthcare providers to communicate which services they performed during a patient visit. CPT codes are vital to billing and insurance purposes. The American Medical Association (AMA) maintains and organizes the CPT codes.

Q10. What is the difference between outpatient and inpatient coding?

Outpatient coding is used when a patient receives care without being admitted to the hospital, such as at a clinic or during same-day surgery. Inpatient coding is used when a patient has formally been admitted to the hospital and stays at least one night. Both outpatient and inpatient settings have distinct coding rules and guidelines.

Q11. What is the importance of HIPAA in medical coding?

HIPAA (Health Insurance Portability and Accountability Act) assures patients that their health information is protected and secure. Medical coders must follow HIPAA rules when they access or share patient information. If HIPAA is violated, legal actions are possible. HIPAA builds trust between patients and providers.

Q12. What is a “J” code in medical billing?

“J” codes are part of the HCPCS coding system, which are used to bill for injectable drugs. This includes chemotherapy drugs and other medications given under professional supervision. These drugs are typically billed when outpatients are given medications and require particular documentation. Effective utilization of J codes ensures proper reimbursement.

Q13. What are DRG codes?

Diagnosis-Related Group (DRG) codes are a classification of groups of similar medical cases used for hospital inpatient billing. Each DRG has a payment amount, budgeted based on diagnosis, age, and other factors. DRG coding assists hospitals in cost management and consistency in reimbursement and is a part of Medicare billing.

Q14. What are the common billing errors in medical coding, and how do you prevent them?

Frequent billing mistakes include incorrect patient information, mismatch of diagnosis and procedure codes, upcoding, unbundling, and duplicate billing. All of which can result in claim denials or delayed payment. To prevent such mistakes, coders should verify documentation, make use of the most updated code sets, and follow payer guidelines. Conducting regular audits, as well as training, will help reduce mistakes and improve accuracy. Additionally, Data Analytics in Healthcare plays a key role in identifying billing trends, spotting anomalies, and enhancing overall revenue cycle management.

Q15. What are the methods for organizing bill payments?

Organizing bill payments helps in identifying all due dates, using billing software, organizing claims according to their status (pending, approved, denied), and documenting everything properly. Coders and billing specialists often use spreadsheets, EHR systems, and medical billing programs. Also, providing reminders to complete bill payment regularly allows billings to be paid on time as well. By organizing billing documentation correctly, errors can be reduced, and revenue cycle management can be improved.

Q16. What is the meaning of epistaxis?

Epistaxis is the clinical term for nosebleeds. It happens when blood vessels break in the nose, and it can be a result of dry air, injury, allergies, or high blood pressure. Nosebleeds are generally not serious and will stop on their own, but if they continue regularly or if they are really heavy, a doctor may need to look into them. 

Q17. How many chambers does a human heart have?

The human heart has four chambers – two atria (upper chambers) and two ventricles (lower chambers). The right side pumps blood to the lungs to receive oxygen, while the left side pumps oxygenated blood throughout the body. Each chamber plays an essential role in blood circulation. The heart continues to beat and pump to allow humans to live on.

Q18. How many bones are in the human body?

A human adult has 206 bones in their body. These bones make up the skeleton or skeletal system, which provides support, protection for internal organs, and enables movement. Babies are born with about 270 bones, but they later fuse during development. Bones store minerals (like calcium and phosphorus) and produce blood cells in the bone marrow.

Q19. How many lobes do the lungs have?

The human lungs have a total of five lobes, three in the right lung (upper, middle, and lower lobes), and two in the left lung (upper and lower lobes). The left lung is smaller than the right lung because it needs to accommodate space for the heart. While the lobes function independently from one another, they do work together in unison for breathing and the exchange of oxygen for survival.

Q20. Which is the largest and smallest organ in the human body?

Our largest organ is the skin, which acts as a barrier for the protection of the internal organs, regulates temperature, and allows for sensation. Our smallest organ is the pineal gland, which is used to control sleep by producing melatonin. Both organs serve an important role in the homeostasis of the body. Coders will often need to reference both organ systems in documenting services during dermatology or neurology encounters.

Q21. Which organ produces insulin?

Insulin is a hormone produced by the pancreas that regulates blood sugar levels. Located behind the stomach, the pancreas serves both digestive and endocrine functions. Diabetes occurs when the pancreas does not produce sufficient insulin. Correct coding is crucial for tracking diabetes and proper documentation on insulin and pancreatic dysfunctions.

Q22. Name all the systems present in the human body.

There are 11 major systems in the human body:

1. Circulatory system
2. Respiratory system
3. Digestive system
4. Nervous system
5. Muscular system
6. Skeletal system
7. Endocrine system
8. Reproductive system
9. Urinary (Excretory) System
10. Immune (Lymphatic) system
11. Integumentary system (skin, hair, nails)
    Each system has specific functions and works in coordination to keep the body healthy.

Intermediate Medical Coding Interview Questions

Q23. What is the difference between ICD and CPT coding?

ICD codes (International Classification of Diseases) identify a patient’s diagnosis or condition.

CPT codes (Current Procedural Terminology) identify the procedures or services performed by the provider.

Q24. Why do we use modifiers in CPT?

CPT modifiers provide additional detail about a medical procedure or service. Modifiers help explain special circumstances, like if a procedure was performed on both sides of the body, performed multiple times, or performed only partially. Modifiers clarify and give context without changing the actual code, which is important with billing accuracy.

Q25. When are HCPCS modifiers used?

HCPCS Modifiers are added to Medicare and Medicaid claims to give extra details about the service, which provides information related to where the service was provided and the reason the service was necessary.

Q26. How is medical coding used in the practical world?

Medical coders convert clinical provider notes and patient files into standard codes using advanced medical coding systems. This coded information is used to bill sponsors, submit claims to insurance companies, maintain medical records, and support health research. With the growing role of AI in Healthcare, automation tools and intelligent systems are increasingly helping coders improve accuracy, reduce manual errors, and enhance the speed of documentation

Q27. What are CPT Category I, II, and III codes?

• The Category I codes are the most commonly used types of codes. They represent typical approved medical procedures and services that are used in everyday practice.
• The Category II codes are optional and are primarily utilized for tracking performance and reporting on quality metrics.
  
• The Category III codes are temporary codes for new, emerging, or experimental procedures that are not typically approved.

Q28. What is the difference between primary and secondary diagnosis codes?

Primary diagnosis is the condition, or reason, for which the patient was receiving treatment or evaluation. It represents the major issue that required care during that visit. Secondary diagnosis is the additional condition, existing at the same time, which might have an impact on patient treatment, recovery, and state of health. Both the primary and secondary diagnoses exist for accurate coding and timely reimbursement.

Q29. What is upcoding and downcoding?

Upcoding in medical coding occurs when a coder bills a more expensive or more complicated service than what was to get higher fees. This can lead to increased scrutiny from the payer (to potentially audits, fines, or legal actions). 

Downcoding in medical coding occurs when a coding provider downcodes or codes a less expensive or less complicated service, even though the more complicated or expensive services were provided (leading to less pay to the provider).

Q30. How do Evaluation and Management (E/M) codes work?

E/M codes are used to submit bills for patient visits such as office visits, consultations, and other face-to-face encounters. The code selected is based on time spent with the patient, medical decision-making complexity, and visit type. E/M codes help you describe the level of care provided and get paid accordingly.

Q31. What is the purpose of Z codes in ICD-10?

Z Codes in ICD-10 represent situations where the patient does not have an active problem, but has visited a provider of health care for reasons such as wellness exams, vaccines, screenings, follow-up from treatment, and other non-active illness-related reasons. They satisfy documentation for preventive measures and other services unrelated to illness. Utilizing Z Codes will provide complete and appropriate documentation in the patient record.

Q32. What steps do you take when you find incomplete or conflicting documentation?

Example:

I always ask the healthcare provider if the documentation is unclear or incomplete. I document all the communication, and do not code for anything that is not fully supported by the medical records. Following this method ensures accurate coding, compliance with coding guidelines, and minimizes errors and claim denials.

Q33. What’s your experience with electronic health records (EHR) systems?

Example:

I have experience using EHR systems, including Epic, Cerner, and Allscripts, to read patient notes, assign the appropriate codes, and create reports. These tools assist with coding by streamlining the process, enhancing precision, and expediting documentation. Additionally, utilizing these systems helps guarantee that coding is performed closely matching up with a patient’s medical records and supports efficient billing.

Q34. How do you handle denied insurance claims due to coding errors?

Example:

When a claim is denied, I review the reason for the denial closely. I then take a look at the patient documentation and coding to see if there are any errors or omissions in the required documentation. As soon as the error has been corrected, I will submit the claim again in a timely fashion. In addition, I try to track patterns in denials to reduce the likelihood of similar situations in the future.

Q35. How do you stay updated with changes in medical coding regulations?

Example:

I keep myself up to date by using resources of organizations such as AAPC and AHIMA. I participate in webinars, take continuing education (CEU) courses, and read newsletters. I also keep up with payer-specific rules to ensure I am complying with their criteria. This keeps me updated and helps keep my coding accurate.

Q36. How does risk adjustment affect coding?

Risk adjustment helps ensure payments are aligned with patient health needs. Coders ensure chronic conditions are documented correctly, which helps insurance companies estimate costs and health interventions. Inaccurate or incomplete coding could result in payment issues or changes to financial risk for those providing care.

Q37. What is the use of the National Correct Coding Initiative (NCCI)?

The NCCI helps stop improper coding and billing by identifying code pairs that should not be billed together. The NCCI identifies edits that warn coders when two procedures are mutually exclusive or have already been bundled into a single payment. The NCCI edits prompt compliance with the Medicare rules, which can help eliminate overbilling. The coders use the NCCI tools to minimize denials and provide accurate reporting.

Q38. What is the role of a coding auditor?

A coding auditor evaluates medical records and coding for total adherence and accuracy. The coding auditor will ensure that the codes submitted are reflective of the services rendered, following all payer regulations. They monitor coder behaviour patterns and provide constructive feedback and recommendations.

Q39. How do you handle confidential patient data in compliance with regulations?

Example:

I ensure our team codes and documents all chronic and significant conditions annually to allow for the clarity of the patient’s overall health. I review physician notes to ensure there is nothing they miss, and I ask if questions arise. I do my part to provide clear codes to benefit correct billing and plan better care.

Q40. What is a superbill, and how is it used in coding?

A superbill captures the services provided during a patient’s visit to a health care provider in a specific format. A superbill typically includes diagnosis and procedure codes, the provider’s name, practice, NPI, and office information (integrated into or accompanied by the superbill), and details about the patient. It is employed by coders or billers to generate insurance claims. Having a superbill is important in regards to billing and reimbursement for medical services provided to the patient, particularly for smaller or private practices.

Q41. How do you approach HCC (Hierarchical Condition Category) coding to ensure accurate risk scores?

Example:

I guarantee that coders and the team members are documenting and coding all chronic and relevant conditions each year, accurately representing the patient’s true health status. I make sure to check provider notes for any missed HCC coding opportunities and follow up with queries when needed.

Q42. What strategies do you use to ensure proper coding for telemedicine services under CMS guidelines?

Example:

I stay updated on CMS telehealth coding policies, including valid CPT/HCPCS codes, valid place of service (POS) codes, and valid modifiers (i.e., 95 or GT). I will ensure that a given service satisfies the CMS documentation requirements (engaged provider/patient interaction through audio/video and medical necessity). Proper documentation and honest billing, including modifiers, are important for compliant billing.

Q43. How do you manage coding in a multi-specialty environment with conflicting documentation across providers?

Example:

I look at notes from all the providers involved to see if there are inconsistencies, and I ask for clarification when necessary. I believe that documentation can and should be consistent and clear, so I collaborate with clinical teams to address discrepancies. I find that communication and collaboration help assign the most accurate codes and reduce errors with billing and compliance.

Q44. How does revenue integrity tie into coding audits and charge capture accuracy?

Revenue integrity makes sure that all services performed are documented, coded, and billed correctly. Coders assist in revenue integrity by identifying under-/over coding, missed charges, and matching documentation to claims. Moreover, audits facilitate identifying the revenue leakage. Also, charge capture ensures that the facility is paid for every service it provides.

Q45. What are the specific challenges in coding oncology and chemotherapy-related services?

Oncology coding requires a comprehensive documentation of the cancer case, including the type, stage, and type of treatment. There are challenges in accurately assigning ICD-10 codes with primary and secondary neoplasms, as well as coding chemotherapy administration (e.g., hydration, push, infusion). It’s also important to match NDC and HCPCS codes on time and understand payer rules, especially because cancer drugs are expensive.

Q46. What role does medical necessity play when coding procedures with prior authorization requirements?

Medical necessity means demonstrating that a medical service or procedure is medically necessary because of the patient’s health condition. It helps to obtain approval for that service from insurance. Medical coders help clear up the discrepancy when diagnosis and procedure codes do not match the doctor’s interpretation in the patient’s records.

Q47. What is the process for implementing coding updates (ICD, CPT, HCPCS) annually in a large healthcare system?

Implementation begins with reviewing official update releases, training coders and providers, updating the coding software, and subsequently testing the systems for compliance. I assist in the development of training materials and observe issues with the system. Evaluating updates promptly will ultimately enhance coding accuracy, reduce denials, and maintain compliance.

Q48. Describe how NDC (National Drug Code) mapping is used in conjunction with HCPCS for drug administration coding?

NDCs identify the specific drug product, while HCPCS codes identify how the drug is administered to the patient. To bill correctly (especially under Medicaid or Medicare Part B), the correct NDC must link to the appropriate HCPCS code. The right NDC must watch the right HCPCS code. This helps with payment, follows the rules, and is important for expensive or injectable drugs.

Q49. What are some common pitfalls in coding for chronic conditions in longitudinal care plans?

Chronic conditions (like diabetes or heart disease) can be overlooked in coding if the physician does not mention these at every visit. Coders must update conditions at least once per year, and the chronic condition needs to be connected to the patient’s current visit.

Another problem is documenting the seriousness of the chronic condition, which can also have an impact on HCC coding and risk scores. That’s why it is important to document the current condition and how a chronic condition currently affects the patient.

Q50. How do CPT codes correlate with RVUs (Relative Value Units), and why is this important for revenue cycle management?

Each CPT code is given an RVU for work, practice expense, and malpractice expense. RVUs are used to determine provider reimbursement rates and productivity. Coders are responsible for assigning accurate CPT codes to ensure fair compensation.

Medical coding is a broad profession with various career options, ranging from entry-level coding instruction to specialty and management positions. Below are common Medical Coding job titles and average 2025 salary ranges for each:

Conclusion

Preparing for a medical coding interview means understanding both the technical side of coding and how it applies in real-world healthcare settings. From knowing key terminology and code sets to staying updated with regulations, every detail counts. Practice answering common questions confidently and clearly. Focus on accuracy, compliance, and a strong grasp of industry tools. With the right preparation, you can step into your coding career with confidence and clarity.