100+ Free CIMC Practice Questions

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2026 Statistics

Key Facts: CIMC Exam

150

Total Items

AAPC

5h 40m

Exam Time

AAPC

$299

AAPC Member Fee

AAPC

v24→v28

CMS-HCC Transition

2024-2026

The AAPC CIMC consists of 150 MCQ items over 5h40m with 70% passing. Fee $299 AAPC member. Master 2021 office E/M and 2023 inpatient/observation/consult E/M, ICD-10-CM 'with' guideline for chronic disease combinations, HCC risk adjustment with MEAT criteria, and CCM/TCM/AWV care management codes.

Sample CIMC Practice Questions

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

1An established patient presents to her internist for follow-up of hypertension and type 2 diabetes. The physician documents a problem-focused history, examines the patient, reviews her home glucose log and home BP readings, refills two prescriptions, and orders a basic metabolic panel. Total time: 22 minutes. Using 2021 outpatient E/M guidelines based on MDM, what is the most appropriate code?

A.99212

B.99213

C.99214

D.99215

Explanation: 99214 is correct. MDM is moderate: two stable chronic conditions (HTN, T2DM) = moderate problems addressed; review of external records (home logs) plus ordering labs = moderate data; prescription drug management = moderate risk. Two of three moderate elements satisfy 99214. Time of 22 minutes (range 20-29 minutes) also independently supports 99214 under 2021 guidelines.

2A new patient is seen in the internal medicine clinic. The internist spends 47 minutes total on the date of encounter — including review of outside records, the visit itself, ordering tests, and documentation. Which code is correct based on time?

A.99203

B.99204

C.99205

D.99215

Explanation: 99204 is correct. Under 2021 outpatient E/M guidelines, new patient time ranges are: 99202 (15-29), 99203 (30-44), 99204 (45-59), 99205 (60-74). 47 minutes falls in the 45-59 range for 99204. Total time on the date of the encounter includes both face-to-face and non-face-to-face work by the reporting clinician.

3An internist admits a patient to inpatient status with new-onset atrial fibrillation with rapid ventricular response. Documentation supports a comprehensive history, comprehensive examination, and high MDM. Which 2023 inpatient initial hospital code is reported?

A.99221

B.99222

C.99223

D.99231

Explanation: 99223 is the highest level of initial inpatient or observation E/M and requires high MDM (or 75+ minutes total time). New-onset Afib with RVR represents an acute illness with systemic symptoms; the workup and acute management constitute high MDM (acute or chronic illness or injury that poses a threat to life or bodily function plus drug therapy requiring intensive monitoring for toxicity).

4A hospitalist sees an inpatient on day 3 for follow-up of community-acquired pneumonia. Patient is improving on antibiotics, vital signs stable, oxygen weaning. Documentation supports low MDM. Which subsequent hospital care code applies?

A.99231

B.99232

C.99233

D.99238

Explanation: 99231 is reported for subsequent hospital care with straightforward or low MDM (or 25 minutes total time). A stable, improving patient on antibiotics with no new problems represents low complexity.

5A hospitalist provides hospital discharge day management requiring 45 minutes of work, including final examination, discussion of stay, instructions, prescriptions, and discharge documentation. Which code is reported?

A.99217

B.99238

C.99239

D.99234

Explanation: 99239 is reported for hospital discharge day management requiring more than 30 minutes. 99238 is used for 30 minutes or less. Time must be documented to support 99239.

6An internist is asked by a surgeon to provide a written consultation for a patient with multiple comorbidities prior to elective surgery. The patient has commercial insurance (NOT Medicare). Documentation supports moderate MDM. Which code is reported?

A.99203

B.99243

C.99244

D.99254

Explanation: 99244 is the office/outpatient consultation code for moderate MDM (or 40-54 minutes). Outpatient consult codes are 99242 (low/15-29 min), 99243 (low/30-39 min — note 99241 was deleted in 2023), 99244 (moderate/40-54 min), 99245 (high/55-69 min). Commercial payers generally still recognize consult codes; Medicare does not.

7An internist provides a consultation for a Medicare inpatient with sepsis at the request of the admitting hospitalist. Documentation supports high MDM. Which code is reported?

A.99255

B.99223

C.99245

D.99233

Explanation: 99223 is reported. Medicare does NOT pay consultation codes (99242-99245, 99252-99255). For Medicare, the consulting physician reports an initial hospital care code (99221-99223) at the appropriate MDM level. High MDM with sepsis supports 99223.

8A critical care intensivist (internal medicine subspecialist) provides 75 minutes of critical care to a patient in the ICU with septic shock. Which CPT codes are reported?

A.99291 only

B.99291 x 2

C.99291 + 99292

D.99223 + 99292

Explanation: 99291 covers the first 30-74 minutes of critical care on a given date. 99292 is reported for each additional 30 minutes beyond the first 74. 75 minutes triggers one unit of 99292 (75 - 74 = 1 minute into the next 30-minute increment, but per CPT and CMS guidance, 99292 is reported for 75-104 minutes).

9An internist sees an established patient for management of stable hypertension only. Documentation: brief HPI, problem-focused exam, prescription refill (no change). Total time 12 minutes. Best code?

A.99211

B.99212

C.99213

D.99214

Explanation: 99212 is correct. One stable chronic condition is low MDM, and the visit also requires the physician to be present and personally address the patient. Time 10-19 minutes also supports 99212. Although Rx refill alone could push toward moderate, when documentation lacks the elements of moderate MDM and time supports 99212, the lower code is appropriate. Note: per 2021 MDM table, 1 stable chronic illness = low problem; without other moderate elements (data or risk), the visit may stay at 99212 if Rx management is not the focus.

10Under 2021 outpatient E/M MDM guidelines, what counts as a 'chronic illness with severe exacerbation, progression, or side effects of treatment'?

A.A stable chronic condition managed long-term

B.A chronic illness with acute exacerbation that poses a threat to life or bodily function

C.Any new acute illness

D.A self-limited or minor problem

Explanation: Per AMA 2021 E/M guidelines, a 'chronic illness with severe exacerbation, progression, or side effects of treatment' is one whose acute exacerbation, progression, or treatment side effects poses a threat to life or bodily function — supporting high complexity in the problems addressed column.

About the CIMC Exam

AAPC specialty credential for internal medicine coders. Validates expertise in office and inpatient E/M (heavy IM volume), chronic disease ICD-10-CM coding (with combination 'with' guideline for diabetes/HTN/CKD/HF), HCC risk adjustment (CMS-HCC v24/v28 transition), care management codes (CCM, TCM, AWV), and IM-specific procedures (joint injection, lumbar puncture, paracentesis).

Questions

150 scored questions

Time Limit

5 hours 40 minutes

Passing Score

70%

Exam Fee

$299 AAPC member (AAPC)

CIMC Exam Content Outline

30%

E/M Services for Internal Medicine

Office 99202-99215 (2021), inpatient/observation/consult 99221-99245 (2023)

20%

ICD-10-CM Chronic Disease Coding

I10/I11/I12/I13, E11.x DM with complications, J44.x COPD with exacerbation, N18.x CKD

15%

CPT IM Procedures

Joint injection 20600-20611, LP 62270, paracentesis, thoracentesis, spirometry

10%

Care Management and Coordination

CCM 99490/99491/99437/99439/99487/99489, TCM 99495/99496, AWV G0438/G0439, ACP 99497/99498

10%

HCC / Risk Adjustment

CMS-HCC v24/v28, MEAT criteria, annual capture of chronic conditions

15%

Modifiers, Compliance and Telehealth

25, 24, 33, 95 telehealth, MIPS measures (CMS122, CMS165), audit risks

How to Pass the CIMC 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

CIMC Study Tips from Top Performers

1Master 'with' guideline: ICD-10-CM presumes link unless documented otherwise. Diabetes with CKD = E11.22 + N18.x; HTN with CKD = I12.x; HTN with HF = I11.x; HTN with HF and CKD = I13.x (combined)

2Know CCM tier structure: 99490 (20 min clinical staff), 99491 (30 min MD/QHP), complex 99487/99489. AWV G0438 initial, G0439 subsequent

3Understand HCC capture: chronic conditions actively managed each YEAR with MEAT documentation; v24 mapping transitioning to v28 over 2024-2026

4Master MIPS measures common to IM: CMS122 A1c >9% (poor control — inverse measure), CMS165 BP control HTN, CMS134 BP screening

Frequently Asked Questions

What is the ICD-10-CM 'with' guideline?

Per Section I.A.15 of ICD-10-CM Official Guidelines: when the alphabetic index lists conditions joined by 'with' or 'in', a relationship between them is presumed even WITHOUT explicit documentation linking them. Example: diabetes 'with' chronic kidney disease — code E11.22 (T2DM with CKD) + N18.x even if the documentation doesn't say 'diabetic CKD.' Provider documentation can refute the link.

What is HCC risk adjustment?

Hierarchical Condition Categories (HCC) drive CMS Medicare Advantage risk-adjusted payments. CMS-HCC model (v24 transitioning to v28 over 2024-2026) maps ICD-10-CM codes to HCC categories based on resource utilization. Each HCC carries a Risk Adjustment Factor (RAF) score. Annual recapture is required — chronic conditions actively managed each calendar year must be documented and coded with MEAT criteria (Monitor, Evaluate, Assess, Treat).

What is Chronic Care Management?

CCM compensates non-face-to-face management of patients with 2+ chronic conditions expected to last ≥12 months. 99490 = 20 min/mo by clinical staff; 99439 = each addt'l 20 min by clinical staff; 99491 = 30 min by physician/QHP; 99437 = each addt'l 30 min by physician/QHP. Complex CCM 99487 (60 min initial)/99489 (each addt'l 30 min) requires moderate-to-high MDM and care plan establishment.