CCA Exam Prep from AHIMA
2023
Mary Smith, RHIA, has been charged with the responsibility of designing a data
collection form to be used on admission
... [Show More] of a patient to the acute-care hospital in which
she works. The first resource that she should use is:
UHDDS
UACDS
MDS
ORYX - Answer-a
When the CCI editor flags that a comprehensive code and a component code are billed
together for the same beneficiary on the same date of service, Medicare will pay for:
The component code but not the comprehensive code
The comprehensive but not the component code
The comprehensive and the component codes
Neither the comprehensive nor the component codes - Answer-b
When clean claims are submitted, they can be adjudicated in many ways through
computer software automatically. Which statement is not one of the outcomes that can
occur as part of auto-adjudication?
Auto-pay
Auto-suspend
Auto-calculate
Auto-deny - Answer-c
Which of the following is not a way that ICD-10-CM improves coding accuracy?
Reduces sequencing problems by combining conditions into one code
Provides laterality options
Captures more details for injuries, diabetes, and postoperative complications
Increases cross-referencing - Answer-d
Which of the following organizations is responsible for updating the procedure
classification of ICD-10-PCS?
Centers for Disease Control (CDC)
Centers for Medicare and Medicaid Services (CMS)
National Center for Health Statistics (NCHS)
World Health Organization (WHO) - Answer-b
This program was initiated by the Balanced Budget Act of 1997 and allows states to
expand existing insurance programs to cover children up to age 19.
Children's State Medicare Program (CSMP)
State Children's Health Insurance Program (SCHIP)
Children's State Healthcare Alliance (CSHA)
Children's Aid to Healthcare (CAH) - Answer-b
Which of the following provides a complete description to patients about how PHI is
used in a healthcare facility?
Notice of Privacy Practices
Authorization
Consent for treatment
Minimum necessary - Answer-a
The National Correct Coding Initiative was developed to control improper coding leading
to inappropriate payment for:
Part A Medicare claims
Part B Medicare claims
Medicaid claims
Medicare and Medicaid claims - Answer-b
The National Correct Coding Initiative was developed to control improper coding leading
to inappropriate payment for:
Part A Medicare claims
Part B Medicare claims
Medicaid claims
Medicare and Medicaid claims - Answer-b
Which of the following software applications would be used to aid in the coding function
in a physician's office?
Grouper
Encoder
Pricer
Diagnosis calculator - Answer-b
What is the maximum number of diagnosis codes that can appear on the UB-04 paper
claim form locator 67 for a hospital inpatient principal and secondary diagnoses?
35
25
18
9 - Answer-b
CMS identified conditions that are not present on admission and could be "reasonably
preventable." Hospitals are not allowed to receive additional payment for these
conditions when the condition is present on admission. What are these conditions
called?
Conditions of Participation
Present on admission
Hospital-acquired conditions
Hospital-acquired infection - Answer-c
Which of the following materials is not documented in an emergency care record?
Patient's instructions at discharge
Time and means of the patient's arrival
Patient's complete medical history
Emergency care administered before arrival at the facility - Answer-c
Using uniform terminology is a way to improve:
Validity
Data timeliness
Audit trails
Data reliability - Answer-d
When the physician does not specify the method used to remove a lesion during an
endoscopy, what is the appropriate procedure?
Assign the removal by snare technique code.
Assign the removal by hot biopsy forceps code.
Assign the ablation code.
Query the physician as to the method used. - Answer-d
Which of the following is not reimbursed according to the Medicare outpatient
prospective payment system?
CMHC partial hospitalization services
Critical access hospitals
Hospital outpatient departments
Vaccines provided by CORFs - Answer-b
The technology commonly used for automated claims processing (sending bills directly
to third-party payers) is:
Optical character recognition
Bar coding
Neural networks
Electronic data interchange - Answer-d
Timely and correct reimbursement is dependent on:
Adjudication
Clean claims
Remittance advice
Actual charge - Answer-b
27. Which answer is not required for assignment of the MS-DRG?
Diagnoses and procedures (principal and secondary)
Attending and consulting physicians
Presence of major or other complications and comorbidities (MCC or CC)
Discharge disposition or status - Answer-b
In processing a bill under the Medicare outpatient prospective payment system (OPPS)
in which a patient had three surgical procedures performed during the same operative
session, which of the following would apply?
Bundling of services
Outlier adjustment
Pass-through payment
Discounting of procedures - Answer-d
In the laboratory section of CPT, if a group of tests overlaps two or more panels, report
the panel that incorporates the greatest number of tests to fulfill the code definition.
What would a coder do with the remaining test codes that are not part of a panel?
Report the remaining tests using individual test codes, according to CPT.
Do not report the remaining individual test codes.
Report only those test codes that are part of a panel.
Do not report a test code more than once regardless whether the test was performed
twice. - Answer-a
Which document directs an individual to bring originals or copies of records to court?
Summons
Subpoena
Subpoena duces tecum
Deposition - Answer-c
. Which of the following is not a function of the discharge summary?
Providing information about the patient's insurance coverage
Ensuring the continuity of future care
Providing information to support the activities of the medical staff review committee
Providing concise information that can be used to answer information requests -
Answer-a
The HIM department is planning to scan medical record documentation. The project
includes the scanning of documentation such as history and physicals, physician orders,
operative reports, and nursing notes. Which of the following methods of scanning would
be best to help HIM professionals monitor the completeness of health records during a
patient's hospitalization?
Ad hoc
Concurrent
Retrospective
Post discharge - Answer-b
The practice of assigning a diagnosis or procedure code specifically for the purpose of
obtaining a higher level of payment is called:
Billing
Unbundling
Upcoding
Unnecessary service - Answer-c
. Exceptions to the consent requirement include:
Medical emergencies
Provider discretion
Implied consent
Informed consent - Answer-a
One objective of the Balanced Budget Act (BBA) of 1997 was to:
Improve program integrity for Medicare by educating beneficiaries to report errors
noticed on their explanation of benefits (EOBs) to the Department of Health and Human
Services (HHS)
Improve the quality of care to its beneficiaries by increasing availability to healthcare
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