Code sets • Guidelines • Modifiers • Queries • Compliance • 2026

Medical Coder Interview Questions

30 questions What each one tests, an answer frame, a spoken answer 33 min read

Medical coding interviews check two things: that you know the rules well enough to code a chart correctly, and that you stay honest and careful when the chart is messy or the queue is long. Expect a few questions on your path and training, a run of knowledge checks on code sets, guidelines, modifiers and terminology, a short chart to code out loud, stories from past work and some what-would-you-do scenarios on queries and compliance. The code sets named here are the ones used in the US system; other countries use their own versions of ICD-10, so check which one the employer codes in. Each question shows what the interviewer wants and a short answer to say out loud.

Search all questions by round, difficulty and level, or save the ones you want to practise.

Motivation 3 questions

Easy Screening round Fresher, Mid-level Practice question

1. Walk me through how you got into medical coding and why you picked it over other healthcare roles.

What the interviewer is really testing:
Whether you chose coding on purpose and understand what the day really looks like: long focus on charts, rules and accuracy, not patient contact.
Answer frame:

Path: your background in a line or two, such as life sciences, nursing support or billing.

What pulled you in: the part of coding you genuinely like, such as the detective work in a chart.

Fit: why a detail-heavy, rules-based job suits how you work.

Sample spoken answer:

"I studied life sciences, so anatomy and medical terms already made sense to me, but I knew I didn't want a lab job. A friend who worked in coding showed me how a chart turns into codes, and I liked that it's part puzzle and part rulebook. You read what the doctor wrote, work out exactly what happened and why, and then find the codes that say that precisely. I took a coding course, practised on sample charts every day, and found I could sit with a long operative note without losing focus. I picked coding over a patient-facing role because I'm at my best with careful, quiet work where accuracy really matters, and every chart I code correctly helps a claim go through cleanly."

Red flag to avoid:

Saying you chose coding only because it's a desk job or work from home, with no interest in the actual work.

They may ask next:
  • What did you find hardest when you first started learning to code?
  • What kind of charts do you enjoy coding most, and why?
Say it in 60 seconds
Easy Screening round Fresher, Mid-level Practice question

2. Tell me about your coding training and any certification you hold or are working toward.

What the interviewer is really testing:
Whether your training is real and current, and whether you understand that a credential proves a baseline while the job still needs ongoing learning.
Answer frame:

Training: where and how you learned, and roughly how many practice charts you worked.

Credential: what you hold or are preparing for, stated plainly, with the exam date if you have one.

Staying current: how you keep up with yearly code changes and continuing education.

Sample spoken answer:

"I completed a structured coding course that covered anatomy, medical terminology, the diagnosis and procedure code sets and the official guidelines. After that I coded a few hundred practice charts across different specialties, and I kept a notebook of every mistake I made so I wouldn't repeat it. I passed a professional coding certification exam earlier this year. Because I don't have the work experience yet, it carries an apprentice label for now, and that comes off once I log the required experience. I'm keeping up with continuing education, and I read the yearly code updates rather than waiting for someone to tell me what changed. I see the certificate as proof I know the basics, not proof I'm finished learning."

Red flag to avoid:

Overstating a credential you don't hold yet, or implying that passing the exam means there's nothing left to learn.

They may ask next:
  • Which part of the certification exam did you find hardest?
  • How do you plan to earn your continuing education credits?
Say it in 60 seconds
Medium Screening round Mid-level, Senior Practice question

3. This team codes mainly for outpatient specialty clinics. Which specialties have you coded, and how quickly do you get up to speed on a new one?

What the interviewer is really testing:
Whether your experience matches the work, and whether you have a real method for learning a new specialty rather than guessing until the audits catch you.
Answer frame:

Specialties: the ones you've coded, with rough volume and setting.

Method: how you learn a new one: anatomy, common procedures, specialty rules and payer edits.

Safety net: how you protect accuracy while you learn, such as early audits and asking questions.

Sample spoken answer:

"Most of my experience is in orthopedics and general surgery clinic work, plus a good amount of internal medicine office visits. When I move to a new specialty, I start with the anatomy and the handful of procedures that make up most of the volume, then read the guideline sections and the payer edits that apply to those codes. I build a short cheat sheet of common diagnosis and procedure pairs and the modifiers they usually need. For the first couple of weeks I ask for a higher audit rate on my charts, because I'd rather get corrected early than build a bad habit. Usually after two or three weeks I'm at normal speed, and after a month or so the tricky cases stop surprising me."

Red flag to avoid:

Claiming every specialty is the same, or saying you'd just keep coding and let the auditors find the mistakes.

They may ask next:
  • Which specialty would you find hardest to learn, and why?
  • What would you put on your cheat sheet for a cardiology clinic?
Say it in 60 seconds

Code Sets 3 questions

Easy Role knowledge round Fresher, Mid-level Practice question

4. Explain ICD-10-CM, CPT and HCPCS Level II. What does each one describe, and how do they work together on a claim?

What the interviewer is really testing:
Whether you have the basic map right: diagnoses explain why, procedures explain what was done, and the two must agree.
Answer frame:

ICD-10-CM: diagnoses, symptoms and reasons for the encounter; the why.

CPT: procedures and services such as visits, surgery, imaging and lab work; the what.

HCPCS Level II: supplies, equipment, certain drugs and services CPT doesn't cover.

Together: each procedure line points to the diagnosis that justifies it.

Sample spoken answer:

"ICD-10-CM is the diagnosis code set. It tells the payer why the patient was seen: the conditions, symptoms or other reasons for the visit. CPT describes what the provider did, like office visits, surgeries, imaging and lab tests, and it's maintained by the American Medical Association. HCPCS Level II fills the gaps CPT leaves, things like durable medical equipment, supplies, some injectable drugs and ambulance services, and those codes start with a letter followed by four digits. CPT is technically Level I of HCPCS. On a claim, each procedure line is linked to the diagnosis that supports it, so the two sets have to tell the same story. If they don't, you can get a medical necessity denial. And for hospital inpatient procedures there's a separate code set, ICD-10-PCS."

Red flag to avoid:

Mixing up which code set carries the diagnosis and which carries the procedure.

They may ask next:
  • Where would ICD-10-PCS come in, and who uses it?
  • What's something you'd code with HCPCS Level II rather than CPT?
Say it in 60 seconds
Medium Role knowledge round Fresher, Mid-level Practice question

5. Take an ICD-10-CM code apart for me. What do its characters tell you, and when do you need a placeholder X or a seventh character?

What the interviewer is really testing:
Whether you know how the codes are built well enough to avoid invalid, truncated codes, which are one of the most common avoidable denials.
Answer frame:

Structure: three to seven characters, starting with a letter; the first three are the category.

Specificity: characters after the decimal add detail such as cause, site, severity or side.

Seventh character and X: some categories need a seventh character; X fills empty spots before it.

Sample spoken answer:

"An ICD-10-CM code has between three and seven characters, and the first one is always a letter. The first three characters are the category, which tells you the general condition. After the decimal point, each extra character adds detail, such as the cause, the body site, the severity or which side of the body. A code is only valid when you've used every character available for it, so if a category has subdivisions you can't stop at three characters. Some categories, like injuries, need a seventh character, for example to show whether it's the initial encounter, a subsequent one or a sequela. The seventh character always has to sit in the seventh position, so if the code is shorter than six characters, you fill the gap with the placeholder X. Leave out the X and the code is invalid."

Red flag to avoid:

Saying a three-character code is fine whenever you're unsure, or not knowing why the placeholder X exists.

They may ask next:
  • What happens on the claim if you send a code that isn't coded to its full length?
  • Which chapters use the seventh character most often?
Say it in 60 seconds
Medium Behavioral round Mid-level, Senior Practice question

6. Code sets change at least once a year. Tell me how you handled the last update and one change that affected your work.

What the interviewer is really testing:
Whether you actively keep up with code and guideline changes and turn them into changes in daily practice, rather than waiting for denials.
Answer frame:

Timing: when the updates arrive for the code sets you use.

Process: how you reviewed the changes that affect your specialty.

Example: one change and how you applied it.

Sample spoken answer:

"The diagnosis codes update every October and the procedure codes every January, so I block time before each one to read the changes for the specialties I code. I don't read everything line by line; I look for new, deleted and revised codes that touch our common diagnoses and procedures, plus any guideline changes. One that affected me was when chronic kidney disease stage 3 was split into 3a and 3b. We coded a lot of nephrology follow-ups, so I made a note for the team that the old stage 3 code would no longer be valid, and I asked our providers, through our lead, to document which sub-stage the patient was in. For the first few weeks I checked my charts against the new codes before closing them, and we didn't get any rejections from it."

Red flag to avoid:

Saying you rely on the coding software or your manager to tell you what changed.

They may ask next:
  • Where do you go to find the official changes each year?
  • How do you handle charts from before the update date that you're coding after it?
Say it in 60 seconds

Coding Guidelines 5 questions

Medium Role knowledge round Fresher, Mid-level Practice question

7. What's the difference between an Excludes1 note and an Excludes2 note, and how does each one change what you report?

What the interviewer is really testing:
Whether you read the tabular list instructions and apply them, rather than picking codes from the index alone.
Answer frame:

Excludes1: not coded here; the two conditions are normally not reported together.

Exception: both may be reported when the conditions are truly unrelated.

Excludes2: not included here; the patient can have both, so both can be coded.

Sample spoken answer:

"An Excludes1 note basically means not coded here. The excluded condition can't normally be reported with the code above it, usually because they're mutually exclusive, like a congenital form and an acquired form of the same condition. There's one exception in the guidelines: if the two conditions are clearly unrelated to each other, you can report both. An Excludes2 note means not included here. The excluded condition isn't part of the condition the code describes, but a patient can have both at the same time, so if the provider documents both, I code both. The practical habit is that I always check the tabular list for these notes after finding a code in the index, because the index alone won't warn me."

Red flag to avoid:

Treating the two notes as the same thing, or coding straight from the index without checking the tabular list.

They may ask next:
  • What other tabular instructions do you watch for, such as code first or use additional code?
  • How would you handle a case where you're not sure the two conditions are unrelated?
Say it in 60 seconds
Hard Role knowledge round Mid-level, Senior Practice question

8. The note says probable pneumonia. How do you code that for a clinic visit, and would your answer change for an inpatient stay?

What the interviewer is really testing:
Whether you know one of the biggest splits between outpatient and inpatient rules, and code to the right level of certainty for each setting.
Answer frame:

Outpatient: don't code probable, suspected or rule out; code the signs, symptoms or findings instead.

Inpatient: an uncertain diagnosis documented at discharge is coded as if it were confirmed.

Check: confirm the setting and the facility type before applying either rule.

Sample spoken answer:

"For a clinic or other outpatient visit, I don't code the uncertain diagnosis. Words like probable, suspected, likely or rule out mean it isn't confirmed, so I code to the highest degree of certainty I have, which is the signs and symptoms. Here that might be the cough, the fever and any documented abnormal findings. For an inpatient admission to an acute care hospital, the rule is different. If the provider still documents it as probable or suspected at the time of discharge, I code it as if it exists, because the workup and treatment were built around that diagnosis. A few conditions, like HIV, are exceptions and are only coded when confirmed, even inpatient. So the same words in the note lead to different codes depending on the setting, which is why I always confirm the encounter type before I start."

Red flag to avoid:

Coding a probable diagnosis on an outpatient visit as if it were confirmed.

They may ask next:
  • Which rules would you follow when coding the physician's own claim for that inpatient visit?
  • What would you do if the discharge summary and the progress notes disagree about the diagnosis?
Say it in 60 seconds
Hard Role knowledge round Mid-level, Senior Practice question

9. How do you choose the level for an office visit under the current E/M rules?

What the interviewer is really testing:
Whether you know that office visits are leveled by medical decision making or total time, and can apply the two-of-three rule for decision making.
Answer frame:

Two routes: medical decision making or the provider's total time on the date of the visit.

Decision making: problems addressed, data reviewed and analysed, and risk of management; two of three set the level.

Not counted: history and exam must be medically appropriate but no longer pick the level.

Sample spoken answer:

"Since the office visit rules changed in 2021, the level is chosen either by medical decision making or by total time, whichever the provider documents and whichever supports the service better. History and exam still have to be medically appropriate, but they don't decide the level any more. For decision making there are three elements: the number and complexity of problems addressed, the amount and complexity of data reviewed and analysed, and the risk of the patient's management. Two of the three have to meet or beat a level to support it. For time, it's the total time the physician or other qualified provider spent on that patient on the date of the visit, including things like reviewing results and documenting, but not staff time. So when I level a visit, I check whether time is documented, then walk through the three elements."

Red flag to avoid:

Still counting history and exam bullet points to pick an office visit level.

They may ask next:
  • A patient with two stable chronic conditions gets a prescription change. What level of decision making might that support?
  • What doesn't count toward total time?
Say it in 60 seconds
Hard Role knowledge round Mid-level, Senior Practice question

10. A patient comes back for a second visit about the same fracture. Is that always a subsequent encounter? How do you choose the seventh character?

What the interviewer is really testing:
Whether you know the seventh character follows the type of care being given, not whether it's the patient's first or second visit.
Answer frame:

Initial: used while the patient is getting active treatment, even across several visits or providers.

Subsequent: used for routine care during healing, such as cast changes or follow-up checks.

Sequela: used for a condition caused by the injury after the acute phase, like a scar.

Sample spoken answer:

"No, it isn't always subsequent. That's a common trap. The seventh character follows the kind of care, not the count of visits. Initial encounter is used while the patient is receiving active treatment, so an emergency visit and then a separate visit to the orthopedic surgeon who evaluates and treats the fracture can both be initial encounters. Subsequent encounter is for care after active treatment is done, during the healing phase, like a cast change, an X-ray to check healing or a medication adjustment. Sequela is for a complication or condition that results from the injury later, such as a scar after a burn, and there the condition itself, like the scar, is coded first, with the injury code after it carrying the sequela character. Fractures also have extra seventh characters for things like open fractures, delayed healing or nonunion."

Red flag to avoid:

Saying the first visit is initial and every visit after it is subsequent.

They may ask next:
  • How would you code a visit for a fracture that isn't healing as expected?
  • Which seventh character would a physical therapy visit for the healing fracture usually get?
Say it in 60 seconds
Hard Case round Mid-level, Senior Practice question

11. Here's a short note: established patient, type 2 diabetes on insulin, chronic kidney disease stage 3a, hypertension, seen to adjust medicines. Walk me through how you'd code it.

What the interviewer is really testing:
Whether you can apply linking conventions, combination codes, use-additional-code notes and visit leveling together, and explain your thinking out loud.
Answer frame:

Linked conditions: the diabetes-with convention and the hypertension-kidney link create combination codes.

Extra codes: follow the instructions to add the kidney disease stage and long-term insulin use.

Visit level: level the established visit from decision making, if the note supports it.

Checks: query anything unclear rather than assuming.

Sample spoken answer:

"First, the diagnoses. The guidelines presume a link between diabetes and kidney disease through the with convention, unless the provider says they're unrelated, so I'd use the combination code for type 2 diabetes with diabetic chronic kidney disease. Hypertension with chronic kidney disease is also presumed linked, so that's the hypertensive chronic kidney disease code for stages one to four rather than plain hypertension. Both of those tell me to add a code for the stage, so I'd add stage 3a. Because the patient is on insulin, I'd add the long-term insulin use code. The reason for the visit decides which goes first. For the visit itself, several chronic conditions plus a prescription change would usually support moderate decision making, so an established level four, but only if the note actually shows that work."

Code:
E11.22  Type 2 diabetes with diabetic chronic kidney disease
I12.9   Hypertensive CKD, stage 1-4 or unspecified
N18.31  Chronic kidney disease, stage 3a
Z79.4   Long-term (current) use of insulin
99214   Established office visit, moderate decision making (if documented)
Red flag to avoid:

Coding plain hypertension and plain kidney disease separately without knowing about the presumed links.

They may ask next:
  • What changes if the provider writes that the kidney disease is not caused by the diabetes?
  • How would you code it if the patient also had heart failure?
Say it in 60 seconds

Modifiers And Edits 2 questions

Hard Role knowledge round Mid-level, Senior Practice question

12. When do you use modifier 25 and when do you use modifier 59? What makes each one easy to misuse?

What the interviewer is really testing:
Whether you understand the two modifiers auditors watch most closely, and that the documentation must support them, not just the claim edit.
Answer frame:

Modifier 25: on an E/M service that is significant and separately identifiable from a same-day procedure.

Modifier 59: on a procedure that is distinct, such as a separate site, lesion or session.

Misuse: added by habit to get past an edit when the note doesn't show separate work.

Sample spoken answer:

"Modifier 25 goes on the evaluation and management code when the same provider does a procedure on the same day and also does a significant, separately identifiable visit. The visit has to go beyond the normal check before and after the procedure. A different diagnosis helps but isn't required. Modifier 59 goes on a procedure code, never on an E/M, to show it was distinct from another procedure that's normally bundled with it, for example a different site, a separate lesion or a separate session. It's the modifier of last resort, so if a more specific one fits, like a side modifier or one of the X modifiers some payers prefer, I use that. Both get misused when people add them just to get past a bundling edit. That's why I only add them when I can point to the part of the note that shows separate work."

Red flag to avoid:

Saying you add 59 or 25 whenever an edit fires, without checking the documentation.

They may ask next:
  • What would you look for in the note before adding modifier 25 to a visit on the same day as a joint injection?
  • What are the X modifiers, and when would you use one instead of 59?
Say it in 60 seconds
Medium Role knowledge round Fresher, Mid-level, Senior Practice question

13. What are NCCI edits, and how do they affect coding two procedures done on the same day?

What the interviewer is really testing:
Whether you understand bundling rules and the difference between an edit a modifier can bypass and one it can't.
Answer frame:

Pair edits: code pairs that normally shouldn't be reported together for the same patient, day and provider.

Modifier indicator: shows whether a modifier can ever allow the pair; if not, no modifier helps.

Unit limits: medically unlikely edits cap the units per day for a code.

Sample spoken answer:

"NCCI is the National Correct Coding Initiative, a set of edits Medicare uses, and many other payers use it or something similar. The main piece is the procedure-to-procedure edits: pairs of codes that normally shouldn't be reported together for the same patient on the same day by the same provider, usually because one is part of the other. The second code in the pair gets denied unless an appropriate modifier is used. Each pair has a modifier indicator. If it allows a modifier, I can use one, but only if the documentation shows the services really were separate, like a different site or session. If it doesn't allow one, no modifier will get the second code paid. There are also medically unlikely edits, which cap how many units of a code one provider can report for one patient on one day."

Red flag to avoid:

Seeing edits as obstacles to get around with a modifier, rather than rules that describe what work is already included.

They may ask next:
  • Where would you check whether a code pair is bundled before sending the claim?
  • What do you do if a payer doesn't follow NCCI and has its own bundling rules?
Say it in 60 seconds

Terminology And Anatomy 2 questions

Easy Role knowledge round Fresher Practice question

14. Quick terminology check: what's the difference between an -ectomy, an -otomy and an -ostomy, and why does it matter when you code?

What the interviewer is really testing:
Whether your medical terminology is solid enough to read an operative note correctly, because one wrong suffix means a completely different procedure code.
Answer frame:

-ectomy: surgical removal.

-otomy: cutting into or an incision.

-ostomy: creating a new opening, often to the outside of the body.

Why it matters: each describes different work and leads to different codes.

Sample spoken answer:

"An -ectomy means removing something, like an appendectomy, which is taking out the appendix. An -otomy means cutting into something, like a laparotomy, which is an incision into the abdomen, often to explore it. An -ostomy means creating a new opening, like a colostomy, where the colon is brought out through the abdominal wall. They sound alike, but they're completely different operations, so they point to completely different procedure codes. A couple of others I watch for are -plasty, which is a surgical repair, and -scopy, which is looking inside with a scope. If I misread one suffix in an operative note, I've coded the wrong surgery, so I never skim the procedure title. I read the whole description of what was done."

Red flag to avoid:

Guessing at suffixes, or saying you'd rely on the procedure title without reading the body of the note.

They may ask next:
  • What does -centesis mean, and give me an example?
  • What's the difference between proximal and distal?
Say it in 60 seconds
Easy Role knowledge round Fresher, Mid-level Practice question

15. Why do anatomy and laterality matter so much in coding? Give me an example where getting them wrong changes the code.

What the interviewer is really testing:
Whether you know that many codes depend on the exact site and side, and that you check both instead of defaulting to unspecified.
Answer frame:

Site: many codes change with the exact part of the body, not just the organ or limb.

Side: many diagnosis codes carry right, left or bilateral, and procedures may need side modifiers.

Example: show one case where a wrong site or side gives a wrong or rejected claim.

Sample spoken answer:

"A lot of diagnosis codes are built around exact anatomy. A fracture near the wrist end of the radius has a different code from one in the middle of the shaft, and each has separate codes for the right side, the left side and unspecified. So if the note says right distal radius and I pick the left side by mistake, the claim describes the wrong injury. On the procedure side, some payers want side modifiers like right or left, or a bilateral modifier, and a mismatch between the diagnosis side and the procedure side can get the claim denied. I also avoid unspecified side codes when the chart tells me the side, because payers often push back on those. If the side really isn't documented anywhere, that's a query, not a guess."

Red flag to avoid:

Defaulting to unspecified codes to save time when the chart clearly states the site and side.

They may ask next:
  • What would you do if the diagnosis says left and the procedure note says right?
  • When is an unspecified code still the correct choice?
Say it in 60 seconds

Documentation And Queries 6 questions

Medium Role knowledge round Fresher, Mid-level Practice question

16. Which parts of the record can you code a diagnosis from, and which can't you? Say, a nurse's note or an abnormal lab value.

What the interviewer is really testing:
Whether you know diagnoses must come from the treating provider, and the narrow exceptions where other clinicians' notes can be used.
Answer frame:

Provider only: diagnoses come from the physician or other qualified provider treating the patient.

Narrow exceptions: details like BMI or pressure ulcer stage can come from other clinicians.

Lab values: an abnormal result alone isn't a diagnosis; the provider must document its meaning.

Sample spoken answer:

"Diagnoses have to come from the provider who's responsible for the patient's care, so the physician or another qualified provider like a nurse practitioner. I can't take a diagnosis from a nurse's note or a dietitian's note on its own. There are a few narrow exceptions where other clinicians can document a detail, like the BMI, the stage of a pressure ulcer or laterality, but the related condition, say obesity or the ulcer itself, still has to be documented by the provider. Lab values are similar. If the potassium is low, I can't code low potassium just from the number. In any setting, abnormal findings are only coded if the provider says they're clinically significant. If the lab and the treatment strongly suggest a condition the provider didn't name, I send a query instead of adding it myself."

Red flag to avoid:

Coding a diagnosis from a lab value or a nurse's note because it seems obvious.

They may ask next:
  • Can you code from a radiology report on an outpatient visit?
  • The dietitian documents severe malnutrition but the physician doesn't mention it. What do you do?
Say it in 60 seconds
Medium Behavioral round Mid-level, Senior Practice question

17. Tell me about a physician query you wrote. What was missing, how did you word it, and what happened next?

What the interviewer is really testing:
Whether you write compliant, non-leading queries that cite the record and let the provider decide, rather than suggesting the answer that pays best.
Answer frame:

Gap: what the chart was missing or where it conflicted.

Query: how you cited the clinical facts and offered options without leading.

Result: what the provider documented and what you learned.

Sample spoken answer:

"At my last job I had an emergency visit where the note said wrist fracture, but nothing said which side or which bone. The imaging order in the chart mentioned the right wrist, but I can't code from an order alone. So I wrote a short query to the physician. I quoted the line from his note and the imaging order, and asked him to clarify the site and side of the fracture, with options for right, left, other and unable to determine. I didn't hint at which answer I wanted or mention payment at all. He answered the same day with an addendum confirming a right distal radius fracture, and I coded it fully. What I took from it is that a good query is short, quotes the record and makes it easy for a busy doctor to answer in one click."

Red flag to avoid:

Describing a query that suggested the higher-paying diagnosis or mentioned reimbursement.

They may ask next:
  • What makes a query leading, and why is that a compliance problem?
  • What do you do when a provider doesn't answer your query?
Say it in 60 seconds
Hard Behavioral round Mid-level, Senior Practice question

18. Tell me about a provider whose documentation habits kept causing coding problems. How did you raise it and what changed?

What the interviewer is really testing:
Whether you can spot a pattern, bring it to a physician respectfully with examples, and fix the cause instead of querying the same gap forever.
Answer frame:

Pattern: the recurring gap and how you noticed it was a habit, not a one-off.

Approach: who you went through and how you framed it with examples.

Result: what changed in the notes and in queries or denials.

Sample spoken answer:

"One physician in our primary care clinic often wrote just diabetes in his assessment, with no type and none of the conditions he was treating alongside it, even when his own plan was clearly managing kidney disease or neuropathy. I was sending him three or four queries a week on the same thing. So I pulled five recent examples, removed the patient details we didn't need, and asked our coding lead if we could set up fifteen minutes with him. I didn't frame it as him doing it wrong. I showed how a small change, naming the type and the linked conditions, would stop the queries and make his notes reflect how sick his patients really were. He was open to it and his template got a prompt for diabetes type and complications. Within a month my queries to him dropped to almost none."

Red flag to avoid:

Complaining about doctors in general, or suggesting you just fill in what you assumed they meant.

They may ask next:
  • What would you have done if he'd refused to change?
  • How do you decide when a pattern needs education rather than individual queries?
Say it in 60 seconds
Medium Behavioral round Mid-level, Senior Practice question

19. Tell me about the hardest chart you've coded. What made it hard, and how did you work through it?

What the interviewer is really testing:
Whether you have a clear method for complex charts: reading fully, breaking the work down, checking guidelines and asking when needed.
Answer frame:

Chart: what made it complex, such as several procedures, conflicting notes or a new specialty.

Method: the steps you took, in order.

Result: how it turned out and what you'd reuse.

Sample spoken answer:

"The hardest one was a trauma patient from a fall with several injuries and three procedures on the same day, including a fracture repair and a wound repair in two different places. The notes were spread across the emergency physician, the surgeon and the imaging reports. I read everything once without coding, just to understand the full story. Then I listed each injury with its site, side and encounter type, and each procedure with where it was done, since the wound repairs had to be grouped by type and site. I checked the bundling edits between the procedures and added the modifiers the notes supported. One wound length wasn't documented, so I queried. It took me well over my normal time, but it passed audit cleanly, and I still use that list-first approach on any multi-injury chart."

Red flag to avoid:

Describing a hard chart but no method, or saying you guessed on the parts you weren't sure of.

They may ask next:
  • How do you decide when a chart needs a second opinion from a senior coder?
  • How do you handle the extra time a chart like that takes against your daily target?
Say it in 60 seconds
Medium Situational round Fresher, Mid-level, Senior Practice question

20. The operative note says left knee, but the consent form and the order both say right knee. What do you do?

What the interviewer is really testing:
Whether you refuse to pick a side yourself, query the surgeon, and recognise that a side conflict can also be a patient safety matter.
Answer frame:

Don't pick: you never choose the side that seems more likely.

Query: ask the surgeon to clarify, quoting both documents.

Escalate: flag it to your lead, since it may need a safety review under local policy.

Sample spoken answer:

"I wouldn't code it by picking the side that appears more often. The operative note is the key document, so a conflict with the consent and the order means I need the surgeon to clarify. I'd put the chart on hold and send a query quoting both, the op note saying left and the consent and order saying right, and ask which knee was operated on. Most of the time it's a typing error in the note, and the surgeon corrects it with an addendum. But a side mismatch in surgery can also be a sign of a real safety event, so I'd let my lead know as well, and follow whatever the facility's process is for reporting it. It's not my job to investigate, but it's my job not to quietly code around it."

Red flag to avoid:

Choosing a side yourself because two documents outvote one.

They may ask next:
  • What if the surgeon doesn't reply before the billing deadline?
  • Who else in the organisation would need to know if it turned out the wrong knee was operated on?
Say it in 60 seconds
Medium Culture fit round Fresher, Mid-level, Senior Practice question

21. Coding sometimes means telling a senior doctor that their note isn't enough. How do you feel about that part of the job?

What the interviewer is really testing:
Whether you're comfortable raising documentation gaps with confidence and respect, rather than avoiding them or being preachy.
Answer frame:

Attitude: you see it as part of the job, not a confrontation.

How: facts from the record, short questions, no lecturing.

Why it matters: accurate records protect the patient, the doctor and the organisation.

Sample spoken answer:

"I'm comfortable with it, because I see it as part of doing the job properly, not as correcting the doctor on medicine. They know the patient; I know how the record has to read for the codes to be right. When I raise something, I keep it short and factual. I quote what's in the note, say what's missing, and give them an easy way to clarify. I never tell them what the diagnosis should be. Most doctors are fine with it once they see the query is quick and helps them. If someone is short with me, I don't take it personally, and if it keeps happening I'd bring in my lead. In the end an accurate record protects the patient, the doctor and the organisation, so a slightly awkward question is worth it."

Red flag to avoid:

Saying you'd avoid querying senior doctors, or that you'd tell them what to write.

They may ask next:
  • How would you handle a doctor who ignores every query you send?
  • What did you do the last time a provider pushed back on your query?
Say it in 60 seconds

Accuracy And Productivity 3 questions

Medium Behavioral round Mid-level, Senior Practice question

22. Tell me about an audit finding on your coding that you disagreed with. How did you handle it?

What the interviewer is really testing:
Whether you can challenge a finding with guideline references and calm facts, and accept the outcome either way without getting defensive.
Answer frame:

Finding: what the auditor marked and why you thought it was wrong.

Evidence: the guideline, note text or payer policy you used.

Outcome: what was decided and how it changed your work or the team's.

Sample spoken answer:

"An auditor marked one of my established visits as over-leveled, a level four scored down to a three. She agreed the problems were moderate, since the patient had two stable chronic conditions, but she scored the data as limited and the risk as low. When I went back to the note, the provider had started a new prescription drug, and prescription drug management counts as moderate risk. So two of the three elements, problems and risk, met moderate, which supports the level I'd chosen. I wrote a short rebuttal through our dispute process, quoting the plan section of the note and the matching row of the decision making table, and kept the tone neutral. The lead reviewed it and reversed the finding. I didn't treat it as a win, though. I asked to add that example to the team's leveling notes, because if an auditor read it differently, other coders probably would too."

Red flag to avoid:

Arguing from opinion rather than the guidelines, or saying you've never had a finding you disagreed with or learned from.

They may ask next:
  • Which audit finding that you accepted has changed how you code?
  • What would you do if the reviewer still disagreed after your rebuttal?
Say it in 60 seconds
Medium Behavioral round Fresher, Mid-level Practice question

23. Tell me about a time you fell behind your daily chart target. How did you catch up without letting accuracy slip?

What the interviewer is really testing:
Whether you balance speed and accuracy honestly, and speak up early instead of rushing charts to hit a number.
Answer frame:

Cause: why you fell behind, such as a new specialty or a run of complex charts.

Action: what you changed in how you worked and who you told.

Balance: how you protected accuracy while getting back on target.

Sample spoken answer:

"When our clinic added a pain management service, I was moved onto those charts and my daily count dropped by nearly a third for about two weeks. The notes were long and the procedure coding was new to me. I told my lead in the first few days rather than waiting for the report to show it. I asked to spend an hour going through a batch with a senior coder, and I built a short guide for the common injection and imaging combinations and their bundling rules. I also stopped switching between specialties during the day, which saved me a lot of re-reading. By the third week I was back on target, and my audit score on those charts stayed above the team standard. I'd rather be slow for a week than fast and wrong for a month."

Red flag to avoid:

Admitting you rushed through charts or skipped reading notes to hit the number.

They may ask next:
  • What would you do if your lead said the target couldn't move at all?
  • Which tools or shortcuts help you code faster without cutting corners?
Say it in 60 seconds
Easy Situational round Fresher, Mid-level Practice question

24. You get a chart with a procedure you've never coded, and it has to go out today. How do you handle it?

What the interviewer is really testing:
Whether you research methodically and ask for help rather than guessing to meet a deadline.
Answer frame:

Understand: read the full note and look up the anatomy and the procedure itself.

Find the code: index first, then the full code description and section guidelines.

Check: bundling edits and modifiers, then a quick second look from a senior coder.

Sample spoken answer:

"First, I'd read the whole procedure note, not just the title, and look up anything I don't understand, like the approach or the anatomy involved. Then I'd use the index to find the likely codes and read the full description of each one, plus the guidelines at the start of that section, because they often say what's included. I'd check whether it bundles with anything else done that day and whether a modifier is needed. Since I've never coded it before, I'd ask a senior coder to take a two-minute look before I close it, and I'd tell my lead early if it might slip past the deadline. I'd rather send it a bit later and right than on time and wrong. Then I'd add it to my notes so next time I'm quick."

Red flag to avoid:

Picking the closest-sounding code from a web search to meet the deadline.

They may ask next:
  • What if nobody senior is available to check it?
  • Which resources do you trust, and which do you avoid?
Say it in 60 seconds

Denials 2 questions

Medium Behavioral round Fresher, Mid-level, Senior Practice question

25. Tell me about a coding mistake of yours that caused a denial or was caught in review. What did you change afterwards?

What the interviewer is really testing:
Whether you own mistakes plainly and put a real check in place so they don't repeat.
Answer frame:

Mistake: what you coded wrong, in plain words, without blaming the system.

Fix: how the claim or chart was corrected.

Prevention: the habit or check you added and whether it worked.

Sample spoken answer:

"Early on, I coded several injection visits without the right drug unit count. The note gave the dose in milligrams, but the supply code was defined per a different amount, and I'd entered one unit instead of working out how many units the dose actually was. A couple came back underpaid and our billing team flagged the pattern. I owned it with my lead, went back through my recent charts with the same drugs, and we sent corrected claims for the ones affected. After that I built a small reference table for the drugs our clinic used most, with the code's unit definition next to each one, and I made the unit calculation a fixed step before closing any chart with a drug. I haven't had that error since, and a couple of other coders started using the table too."

Red flag to avoid:

Picking a trivial mistake, blaming the software, or having no change in habit afterwards.

They may ask next:
  • How do you check your own work before you close a chart?
  • How did you feel when the pattern was pointed out?
Say it in 60 seconds
Medium Situational round Fresher, Mid-level, Senior Practice question

26. A claim comes back denied because the diagnosis doesn't support the test. The chart does support it; the code was just too vague. What do you do?

What the interviewer is really testing:
Whether you correct the code to what the record supports, not to what the payer covers, and look for the pattern behind the denial.
Answer frame:

Verify: reread the note and confirm the more specific diagnosis is documented.

Correct: fix the code to the documented specificity and send it through the corrected-claim process.

Prevent: check whether other claims have the same problem and fix the cause.

Sample spoken answer:

"First, I'd reread the note to make sure the specific diagnosis really is documented, not just implied. If it is, I'd correct the code to the level of detail the provider wrote and pass it to billing through our corrected-claim process, with a short note on what changed and why. What I'd never do is hunt through the payer's coverage list for a diagnosis that gets the test paid. The code has to match the record, whether it's covered or not. Then I'd look at why it happened. If I or others are picking unspecified codes for that test, I'd check other open claims and share the fix with the team, and maybe suggest an edit in our system that flags that combination before it goes out."

Red flag to avoid:

Choosing a diagnosis from the payer's covered list because it gets paid, when the provider didn't document it.

They may ask next:
  • What if the documentation really doesn't support the test being medically necessary?
  • How would you track whether coding-related denials are going down?
Say it in 60 seconds

Compliance 4 questions

Medium Situational round Fresher, Mid-level, Senior Practice question

27. A doctor asks you to bill a higher visit level because the appointment ran long, but the note doesn't support it. What do you do?

What the interviewer is really testing:
Whether you hold the line on documentation-based coding while still helping the provider find the honest route, such as documenting total time properly.
Answer frame:

Hold the line: you code what the note supports, not what's requested.

Explain: leveling goes by decision making or documented total time.

Help: if the time was real, the provider can document it properly; escalate if pressure continues.

Sample spoken answer:

"I'd explain, politely, that I can only code what the note supports, and right now the documentation supports the lower level. Then I'd try to help, because the doctor may have a fair point. Office visits can be leveled by total time on the date of the visit, so if he really did spend that time, he can document the total time and what it covered, through a properly dated addendum if our policy allows it. If the time or the decision making supports the higher level once it's documented honestly, I'll code it. What I won't do is raise the level on the doctor's word alone. If he pushed me to do it anyway, I'd bring in my coding lead or compliance, because billing a level the record doesn't support is upcoding, whoever asks for it."

Red flag to avoid:

Changing the level because a senior person asked, or refusing to help at all without explaining the honest route.

They may ask next:
  • What would you do if your own manager asked you to change it?
  • What makes an addendum acceptable, and when is it a problem?
Say it in 60 seconds
Easy Situational round Fresher, Mid-level Practice question

28. You recognise a neighbour's name in your coding queue, and later another neighbour asks if you know why they were in hospital. What do you do?

What the interviewer is really testing:
Whether you treat patient information as confidential without exception, and know to access only what your job needs.
Answer frame:

Access: only open what you need to do the assigned work; consider asking to reassign it.

Silence: never confirm or share anything, even that you saw the name.

Report: tell your lead if there's a conflict, and follow the privacy policy.

Sample spoken answer:

"When I see the name, I'd follow our policy on patients I know. Usually that means telling my lead and asking for the chart to be reassigned, so there's no question about why I opened it. If it has to stay with me, I'd look only at what I need to code it and nothing else. When the other neighbour asks, I'd say I can't talk about anything to do with work or patients, and leave it there. I wouldn't confirm or deny that I saw the name, because even saying they were a patient is sharing health information. I wouldn't mention it at home either. Confidentiality isn't just about not leaking the diagnosis, it's about not letting anything slip at all, and privacy laws in most places treat this very seriously."

Red flag to avoid:

Saying you'd just keep it vague, or that it's fine to mention because they're a neighbour who already knows.

They may ask next:
  • What if you open a record out of curiosity by mistake, say a family member's?
  • How do you keep patient information safe when you work from home?
Say it in 60 seconds
Hard Situational round Mid-level, Senior Practice question

29. You notice several notes from one provider are word for word the same across different patients. What do you do?

What the interviewer is really testing:
Whether you recognise cloned documentation as a compliance risk, code only what is truly supported, and escalate through the right channel without accusing anyone.
Answer frame:

Recognise: identical findings across patients suggest copy-forward, which may not reflect the real visit.

Code carefully: code only what's specific to each patient and visit.

Escalate: raise the pattern with your lead or compliance, with examples, not accusations.

Sample spoken answer:

"Identical notes across different patients are a warning sign. It usually means a template or copy-and-paste, and the risk is that the note describes work that wasn't actually done for that patient. I'd be careful on those charts to code only what's clearly specific to each patient and visit, not the generic parts, and I'd query where I can't tell what really happened. Then I'd gather a few examples and take them to my coding lead or compliance through our normal channel. I wouldn't accuse the provider of anything, because there may be an innocent explanation, and it's not my role to decide. But I also wouldn't ignore it and keep coding, because if the notes don't reflect real care, the claims built on them are a problem for the whole organisation."

Red flag to avoid:

Coding the cloned notes at face value because the level looks supported on paper.

They may ask next:
  • How is copying forward from a previous note different from cloning between patients?
  • What would you do if your lead told you not to worry about it?
Say it in 60 seconds
Easy Culture fit round Fresher, Mid-level, Senior Practice question

30. Much of this team codes from home. How do you stay accurate, secure and easy to reach when nobody's watching over your shoulder?

What the interviewer is really testing:
Whether you can manage your own focus and protect patient data at home, and stay connected with a team you rarely see.
Answer frame:

Security: private space, locked screen, approved devices only, nothing printed or saved locally.

Focus: a fixed routine and set times for hard charts.

Connection: answer messages quickly and ask questions in the open.

Sample spoken answer:

"For security, I work in a room where nobody else can see my screen, I lock it every time I step away, and I only use the approved laptop and connection. I don't print, save files locally or write patient details on paper. For accuracy, I keep a fixed routine and do the complex charts in my sharpest hours, usually the morning, and batch the simpler ones later. I also keep my own error log from audits so I can see my weak spots without anyone pointing them out. For staying connected, I keep the team chat open, reply quickly and ask questions in the shared channel rather than privately, because someone else usually has the same question. Working from home only works if your lead never has to wonder where you are or whether the work is right."

Red flag to avoid:

Saying you'd code in a shared space or on a personal device when it's more convenient.

They may ask next:
  • What would you do if your internet went down in the middle of the day?
  • How do you handle distractions at home?
Say it in 60 seconds
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For the call itself

The questions above are the prep. The call has ten more.

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