100+ Free CASCC Practice Questions

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Question 1

Score: 0/0

When a definitive diagnosis is not established at the time of an outpatient/ASC encounter, what should be coded?

Z03.89 (other specified observation) only

A placeholder code R99 (ill-defined and unknown cause of mortality)

The 'rule out' or 'probable' diagnosis as if confirmed

Signs, symptoms, abnormal test results, or other reason for the visit

to track

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2026 Statistics

Key Facts: CASCC Exam

150

Total Items

AAPC

5h 40m

Exam Time

AAPC

$299

AAPC Member Fee

AAPC

55-60%

ASC vs HOPD Payment

Approximate

The AAPC CASCC consists of 150 MCQ items over 5h40m with 70% passing. Fee $299 for AAPC members. Covers multi-specialty ASC surgery coding, modifiers (especially 73/74 for discontinued ASC procedures), ASC PPS reimbursement, and the ASC-covered procedure list.

Sample CASCC Practice Questions

Try these sample questions to test your CASCC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which anatomical structure is the primary target during a colonoscopy procedure performed in an ASC?

A.Esophagus and stomach

B.Small intestine only

C.Cecum, ascending, transverse, descending, and sigmoid colon

D.Rectum and anus only

Explanation: A complete colonoscopy examines the entire large intestine from the rectum through the sigmoid, descending, transverse, and ascending colon to the cecum. CPT code 45378 requires advancement of the scope to the cecum (or to the colon-small intestine anastomosis).

2The crystalline lens of the eye is removed and replaced during which common ASC procedure?

A.Trabeculectomy

B.Cataract extraction with IOL insertion

C.Vitrectomy

D.YAG capsulotomy

Explanation: Cataract extraction with intraocular lens (IOL) insertion (CPT 66982 complex or 66984 routine) involves removing the clouded crystalline lens and replacing it with a synthetic IOL. This is the highest-volume ophthalmologic procedure performed in ASCs.

3The median nerve passes through which anatomical structure that is released during a common ASC orthopedic procedure?

A.Tarsal tunnel

B.Cubital tunnel

C.Carpal tunnel

D.Guyon's canal

Explanation: The median nerve passes through the carpal tunnel at the wrist, formed by the carpal bones and the transverse carpal ligament. Carpal tunnel release (CPT 64721 open or 29848 endoscopic) is one of the most common upper-extremity ASC procedures.

4During an arthroscopic knee procedure, the meniscus is identified as which type of structure?

A.Bone

B.Synovial membrane

C.Fibrocartilage

D.Hyaline cartilage

Explanation: The medial and lateral menisci are C-shaped fibrocartilage structures that cushion the tibiofemoral joint. Arthroscopic meniscectomy (29881 medial OR lateral; 29880 medial AND lateral) is among the most common ASC orthopedic procedures.

5Which sinus is most commonly accessed during functional endoscopic sinus surgery (FESS) in an ASC?

A.Frontal sinus only

B.Maxillary sinus

C.Sphenoid sinus only

D.Cavernous sinus

Explanation: The maxillary sinus is the largest paranasal sinus and most commonly accessed during FESS, typically via maxillary antrostomy (CPT 31256 or 31267). Chronic maxillary sinusitis is a leading indication for ASC sinus surgery.

6The prostate gland surrounds which anatomical structure?

A.Ureter

B.Vas deferens

C.Prostatic urethra

D.Bladder neck only

Explanation: The prostate gland surrounds the prostatic portion of the urethra, which is why prostatic enlargement causes urinary obstruction. ASC procedures including transurethral resection and prostate biopsy access the gland through or around the urethra.

7The epidural space, where epidural steroid injections are administered, is located between which two structures?

A.Pia mater and arachnoid mater

B.Dura mater and ligamentum flavum

C.Subarachnoid space and CSF

D.Vertebral body and intervertebral disc

Explanation: The epidural space lies between the dura mater (the outermost meningeal layer) and the ligamentum flavum/vertebral periosteum. Epidural injections (62321 cervical/thoracic via interlaminar or 62323 lumbar/sacral) deposit medication in this space.

8The palatine tonsils are located in which anatomical region?

A.Nasopharynx

B.Oropharynx between the palatoglossal and palatopharyngeal arches

C.Hypopharynx

D.Larynx

Explanation: The palatine tonsils sit in the tonsillar fossa of the oropharynx, bordered by the palatoglossal arch (anterior) and palatopharyngeal arch (posterior). Tonsillectomy (42820/42821) is a common pediatric ASC procedure.

9The trigger finger condition involves stenosis of which structure?

A.Median nerve

B.A1 pulley of the flexor tendon sheath

C.Carpometacarpal joint

D.Extensor digitorum communis tendon

Explanation: Trigger finger (stenosing tenosynovitis) results from thickening at the A1 pulley, which catches the flexor tendon. Trigger finger release (CPT 26055) divides the A1 pulley and is a common ASC hand procedure.

10The labrum of the shoulder is which anatomical structure?

A.Articular cartilage covering the humeral head

B.Fibrocartilaginous rim around the glenoid fossa

C.Rotator cuff tendon

D.Subacromial bursa

Explanation: The glenoid labrum is a fibrocartilaginous rim that deepens the glenoid fossa, increasing shoulder stability. SLAP repairs and Bankart repairs are common arthroscopic ASC procedures targeting the labrum.

About the CASCC Exam

AAPC specialty credential for coders working in Ambulatory Surgical Centers. Validates expertise across multi-specialty ASC procedures (GI, ortho, ophthalmic, ENT, GU, pain management, plastics), ICD-10-CM diagnosis coding, ASC-specific modifiers and bundling rules (NCCI), ASC reimbursement methodology (ASC PPS, APC packaging), and Medicare ASC quality reporting (ASCQR).

Questions

150 scored questions

Time Limit

5 hours 40 minutes

Passing Score

70%

Exam Fee

$299 AAPC member (AAPC)

CASCC Exam Content Outline

15%

ASC Anatomy and Common Procedures

High-volume ASC procedures across GI, ortho, ophthalmic, ENT, GU, pain

30%

CPT Surgery Coding (multi-specialty)

GI endoscopy, arthroscopy, cataract, FESS, cystoscopy, pain procedures

15%

ICD-10-CM Diagnosis Coding

Principal diagnosis selection, symptoms vs definitive Dx, history-of

15%

Modifiers and Bundling (ASC-specific)

50, 51, 52, 73/74 (discontinued before/after anesthesia), 78/79, 59 + X-modifiers

15%

ASC Reimbursement and APC Methodology

ASC PPS, APC packaging, ASC-covered procedure list, device-intensive procedures

10%

Compliance and Coding Guidelines

ASC Quality Reporting (ASCQR), CMS coverage policies, Medicare Conditions for Coverage

How to Pass the CASCC Exam

What You Need to Know

Passing score: 70%
Exam length: 150 questions
Time limit: 5 hours 40 minutes
Exam fee: $299 AAPC member

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CASCC Study Tips from Top Performers

1Master ASC-specific modifiers 73 and 74: 73 (before anesthesia) reduces payment; 74 (after anesthesia start) reimburses fuller amount. Both for ASC discontinued procedures only

2Know high-volume ASC procedures: colonoscopy 45378-45398, EGD 43235-43259, cataract 66982/66984, knee scope 29870-29881, FESS 31254-31298, cystoscopy 52000-52260, pain epidurals 62321-62323

3Understand Medicare colon screening: G0105 (high-risk), G0121 (avg-risk), commercial 45378; if screening becomes therapeutic add modifier PT (changed from screening to diagnostic)

4Know NCCI bundling for ASC: many endoscopy procedures bundle diagnostic with therapeutic at same site; modifier 59 with documentation supporting separate procedural service can override edits with indicator 1

Frequently Asked Questions

What modifiers are unique to ASC coding?

Modifier 73 (procedure discontinued PRIOR to administration of anesthesia) and modifier 74 (procedure discontinued AFTER anesthesia administration) are ASC-specific. Both reduce reimbursement but 74 reimburses more than 73. Other ASC-relevant modifiers include 50 (bilateral), 51 (multiple), 52 (reduced services), 78 (return to OR for related), 79 (unrelated during global), 59 + X-modifiers.

What is ASC PPS?

ASC Prospective Payment System: Medicare's payment methodology for ASC services. Procedures are grouped into APCs (Ambulatory Payment Classifications) with packaging logic — many supplies, drugs, and ancillary services are bundled into the procedure payment. Only services on the ASC-covered procedure list are reimbursed; some procedures considered safe only in HOPD remain inpatient/HOPD-only.

What's the typical ASC vs HOPD payment ratio?

ASC reimbursement is typically 55-60% of the HOPD rate for the same procedure. The exact ratio varies by year (CMS adjusts annually) and procedure category. This payment differential is why CMS continues expanding the ASC-covered procedure list and why some procedures migrate from HOPD to ASC settings.