CERTIFIED CODING ASSOCIATE (CCA) – QUESTIONS AND
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
Medical Terminology and Anatomy
ICD-10-CM Diagnosis Coding
ICD-10-PCS Procedure Coding
CPT and HCPCS Level II Coding
Healthcare Reimbursement Methodologies
Compliance, Privacy, and Regulatory Standards
Data Quality and Clinical Documentation Improvement
Healthcare Information Technology and Electronic Health
Records*
This comprehensive examination is designed to rigorously evaluate the
foundational knowledge and practical competencies required of
healthcare coding and information management professionals. The
primary purpose of the assessment is to measure a candidate's
technical proficiency in translating complex medical documentation into
standardized alphanumeric code sets used across global healthcare
systems. The evaluation thoroughly tests a wide array of skills,
including clinical terminology comprehension, precise application of
coding guidelines, sequencing rules, and regulatory compliance
standards. Utilizing a balanced mix of traditional multiple-choice items
and intricate clinical scenarios, the assessment challenges candidates
to demonstrate analytical thinking and real-world decision-making.
Emphasis is placed on navigating intricate medical records, resolving
documentation discrepancies, and ensuring accurate reimbursement
and ethical data stewardship within modern healthcare environments.
SECTION ONE: QUESTIONS 1–100
,A patient is admitted for acute systolic heart failure and
hypertensive chronic kidney disease stage 3. How should this
encounter be coded in ICD-10-CM?
A. I50.21, I12.9, N18.3
B. I11.0, I50.21, N18.3
C. I13.0, I50.21, N18.3
D. I13.2, I50.21, N18.3
🟢 C. I13.0, I50.21, N18.3
🔴 Explanation: According to ICD-10-CM official guidelines,
hypertension with heart involvement and chronic kidney disease
is classified using combination code category I13. When
hypertensive heart and chronic kidney disease are both present,
an additive link is assumed. Category I13 requires a secondary
code to identify the specific type of heart failure (I50.21) and the
stage of chronic kidney disease (N18.3).
Which regulatory body is primarily responsible for establishing
and maintaining the Healthcare Common Procedure Coding
System (HCPCS) Level II codes?
A. American Medical Association
B. Centers for Medicare and Medicaid Services
C. National Center for Health Statistics
D. World Health Organization
🟢 B. Centers for Medicare and Medicaid Services
🔴 Explanation: The Centers for Medicare and Medicaid Services
(CMS) oversees, updates, and maintains the HCPCS Level II
coding system, which is utilized primarily to identify products,
supplies, and services not included in CPT codes.
A patient undergoes an open excision of a benign lesion of the
scalp measuring 2.1 cm with intermediate closure. Which CPT
code combination is appropriate?
A. 11423, 12032
B. 11423 only
C. 11420, 12031
D. 11443, 12032
🟢 A. 11423, 12032
🔴 Explanation: CPT code 11423 represents the excision of a
,benign lesion, excluding malignant, on the scalp, neck, hands,
feet, or genitalia with a excised diameter of 2.1 to 3.0 cm.
Intermediate repair (12032) is separately reportable when
performing layered closure of wounds requiring intermediate
repair outside of simple superficial closure.
What is the primary purpose of a chargemaster (CDM) in a
hospital setting?
A. To track patient clinical outcomes over time
B. To manage physician credentialing and privileging
C. To maintain a centralized database of all hospital items,
services, and associated charges
D. To report vital statistics to state public health departments
🟢 C. To maintain a centralized database of all hospital items,
services, and associated charges
🔴 Explanation: The chargemaster serves as a comprehensive
financial management tool containing descriptions, internal
identifiers, and standard pricing for every item and service
provided to patients within a healthcare facility.
A patient presents with pneumonia due to Streptococcus
pneumoniae. What is the correct ICD-10-CM code assignment?
A. J18.9
B. J13
C. J15.9
D. J12.9
🟢 B. J13
🔴 Explanation: ICD-10-CM provides specific combination codes
for pneumonia caused by specific organisms. Pneumonia due to
Streptococcus pneumoniae is directly mapped to code J13.
Under HIPAA Privacy Rules, which of the following entities is
exempt from compliance regarding Protected Health Information?
A. Healthcare clearinghouses
B. Health insurance providers
C. Life insurers analyzing underwriting risk without healthcare
provider status
D. Healthcare providers transmitting electronic claims
🟢 C. Life insurers analyzing underwriting risk without healthcare
, provider status
🔴 Explanation: Life insurance companies generally operate
outside the scope of HIPAA covered entities unless they function
as healthcare providers or health plans, though they are subject
to separate state privacy laws.
Which CPT modifier indicates a significant, separately identifiable
evaluation and management service performed by the same
physician on the same day of a procedure?
A. Modifier 25
B. Modifier 59
C. Modifier 51
D. Modifier 24
🟢 A. Modifier 25
🔴 Explanation: Modifier 25 is appended to E/M services to report
a significant, separately identifiable evaluation and management
service above and beyond the usual pre-operative and post-
operative care associated with a procedure performed on the
same day.
A patient with type 2 diabetes mellitus develops diabetic
peripheral neuropathy. How is this properly sequenced and
coded?
A. E11.40, G63
B. G62.9, E11.9
C. E11.9, G62.9
D. E11.42
🟢 D. E11.42
🔴 Explanation: Type 2 diabetes mellitus with diabetic
polyneuropathy is represented by a specific combination code
(E11.42) that links the underlying metabolic condition with its
neurological manifestation, eliminating the need for a separate
manifestation code.
What does the acronym DRG stand for in hospital inpatient
reimbursement systems?
A. Diagnostic Resource Group
B. Data Related Governance
C. Diagnosis-Related Group
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
Medical Terminology and Anatomy
ICD-10-CM Diagnosis Coding
ICD-10-PCS Procedure Coding
CPT and HCPCS Level II Coding
Healthcare Reimbursement Methodologies
Compliance, Privacy, and Regulatory Standards
Data Quality and Clinical Documentation Improvement
Healthcare Information Technology and Electronic Health
Records*
This comprehensive examination is designed to rigorously evaluate the
foundational knowledge and practical competencies required of
healthcare coding and information management professionals. The
primary purpose of the assessment is to measure a candidate's
technical proficiency in translating complex medical documentation into
standardized alphanumeric code sets used across global healthcare
systems. The evaluation thoroughly tests a wide array of skills,
including clinical terminology comprehension, precise application of
coding guidelines, sequencing rules, and regulatory compliance
standards. Utilizing a balanced mix of traditional multiple-choice items
and intricate clinical scenarios, the assessment challenges candidates
to demonstrate analytical thinking and real-world decision-making.
Emphasis is placed on navigating intricate medical records, resolving
documentation discrepancies, and ensuring accurate reimbursement
and ethical data stewardship within modern healthcare environments.
SECTION ONE: QUESTIONS 1–100
,A patient is admitted for acute systolic heart failure and
hypertensive chronic kidney disease stage 3. How should this
encounter be coded in ICD-10-CM?
A. I50.21, I12.9, N18.3
B. I11.0, I50.21, N18.3
C. I13.0, I50.21, N18.3
D. I13.2, I50.21, N18.3
🟢 C. I13.0, I50.21, N18.3
🔴 Explanation: According to ICD-10-CM official guidelines,
hypertension with heart involvement and chronic kidney disease
is classified using combination code category I13. When
hypertensive heart and chronic kidney disease are both present,
an additive link is assumed. Category I13 requires a secondary
code to identify the specific type of heart failure (I50.21) and the
stage of chronic kidney disease (N18.3).
Which regulatory body is primarily responsible for establishing
and maintaining the Healthcare Common Procedure Coding
System (HCPCS) Level II codes?
A. American Medical Association
B. Centers for Medicare and Medicaid Services
C. National Center for Health Statistics
D. World Health Organization
🟢 B. Centers for Medicare and Medicaid Services
🔴 Explanation: The Centers for Medicare and Medicaid Services
(CMS) oversees, updates, and maintains the HCPCS Level II
coding system, which is utilized primarily to identify products,
supplies, and services not included in CPT codes.
A patient undergoes an open excision of a benign lesion of the
scalp measuring 2.1 cm with intermediate closure. Which CPT
code combination is appropriate?
A. 11423, 12032
B. 11423 only
C. 11420, 12031
D. 11443, 12032
🟢 A. 11423, 12032
🔴 Explanation: CPT code 11423 represents the excision of a
,benign lesion, excluding malignant, on the scalp, neck, hands,
feet, or genitalia with a excised diameter of 2.1 to 3.0 cm.
Intermediate repair (12032) is separately reportable when
performing layered closure of wounds requiring intermediate
repair outside of simple superficial closure.
What is the primary purpose of a chargemaster (CDM) in a
hospital setting?
A. To track patient clinical outcomes over time
B. To manage physician credentialing and privileging
C. To maintain a centralized database of all hospital items,
services, and associated charges
D. To report vital statistics to state public health departments
🟢 C. To maintain a centralized database of all hospital items,
services, and associated charges
🔴 Explanation: The chargemaster serves as a comprehensive
financial management tool containing descriptions, internal
identifiers, and standard pricing for every item and service
provided to patients within a healthcare facility.
A patient presents with pneumonia due to Streptococcus
pneumoniae. What is the correct ICD-10-CM code assignment?
A. J18.9
B. J13
C. J15.9
D. J12.9
🟢 B. J13
🔴 Explanation: ICD-10-CM provides specific combination codes
for pneumonia caused by specific organisms. Pneumonia due to
Streptococcus pneumoniae is directly mapped to code J13.
Under HIPAA Privacy Rules, which of the following entities is
exempt from compliance regarding Protected Health Information?
A. Healthcare clearinghouses
B. Health insurance providers
C. Life insurers analyzing underwriting risk without healthcare
provider status
D. Healthcare providers transmitting electronic claims
🟢 C. Life insurers analyzing underwriting risk without healthcare
, provider status
🔴 Explanation: Life insurance companies generally operate
outside the scope of HIPAA covered entities unless they function
as healthcare providers or health plans, though they are subject
to separate state privacy laws.
Which CPT modifier indicates a significant, separately identifiable
evaluation and management service performed by the same
physician on the same day of a procedure?
A. Modifier 25
B. Modifier 59
C. Modifier 51
D. Modifier 24
🟢 A. Modifier 25
🔴 Explanation: Modifier 25 is appended to E/M services to report
a significant, separately identifiable evaluation and management
service above and beyond the usual pre-operative and post-
operative care associated with a procedure performed on the
same day.
A patient with type 2 diabetes mellitus develops diabetic
peripheral neuropathy. How is this properly sequenced and
coded?
A. E11.40, G63
B. G62.9, E11.9
C. E11.9, G62.9
D. E11.42
🟢 D. E11.42
🔴 Explanation: Type 2 diabetes mellitus with diabetic
polyneuropathy is represented by a specific combination code
(E11.42) that links the underlying metabolic condition with its
neurological manifestation, eliminating the need for a separate
manifestation code.
What does the acronym DRG stand for in hospital inpatient
reimbursement systems?
A. Diagnostic Resource Group
B. Data Related Governance
C. Diagnosis-Related Group
