AHIMA CCA EXAM PREP 2026/2027 – CERTIFIED CODING ASSOCIATE STUDY
GUIDE, PRACTICE QUESTIONS & TEST REVIEW
Mary Smith, RHIA, has been charged with the responsibility of designing a data collection form to be
used on admission of a patient to the acute-care hospital in which she works. The first resource that she
should use is:
UHDDS
UACDS
MDS
ORYX - correct 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 - correct 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 - correct 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 - correct 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) - correct 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) - correct 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 - correct 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 - correct 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 - correct 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 - correct 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 - correct 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 - correct 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 - correct answer ✔✔c
Using uniform terminology is a way to improve:
Validity
Data timeliness
Audit trails
, Data reliability - correct 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. - correct 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 - correct 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 - correct answer ✔✔d
Timely and correct reimbursement is dependent on:
Adjudication
Clean claims
Remittance advice
Actual charge - correct 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)
GUIDE, PRACTICE QUESTIONS & TEST REVIEW
Mary Smith, RHIA, has been charged with the responsibility of designing a data collection form to be
used on admission of a patient to the acute-care hospital in which she works. The first resource that she
should use is:
UHDDS
UACDS
MDS
ORYX - correct 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 - correct 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 - correct 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 - correct 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) - correct 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) - correct 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 - correct 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 - correct 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 - correct 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 - correct 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 - correct 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 - correct 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 - correct answer ✔✔c
Using uniform terminology is a way to improve:
Validity
Data timeliness
Audit trails
, Data reliability - correct 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. - correct 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 - correct 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 - correct answer ✔✔d
Timely and correct reimbursement is dependent on:
Adjudication
Clean claims
Remittance advice
Actual charge - correct 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)
