CCA Domain 2 Exam Prep- 10th Edition
AHIMA CORRECT 100%
Which of the following software applications would be used to aid in the coding function in a physician's
office?
1. Grouper
2. Encoder
3. Pricer
4. Diagnosis calculator - ANSWER Encoder
In fiscal year 2008, Medicare revamped the inpatient payment system to incorporate three severity
levels. The grouping is known as _____.
1. AP-DRGs
2. RBRVS
3. MS-DRGs
4. APR-DRGs - ANSWER MS-DRGs
The healthcare program for active duty members of the military and other qualified family members is
_____.
1. Children's Health Insurance Program (CHIP)
2. Veterans Insurance
3. Tricare
4. Workers' compensation - ANSWER Tricare
An electrolyte panel (80051) in the Laboratory section of CPT consists of tests for carbon dioxide
(82374), chloride (82435), potassium (84132), and sodium (84295). If each of the component codes are
reported and billed individually on a claim form, this would be a form of _____.
1. Optimizing
2. Unbundling
, 3. Sequencing
4. Classifying - ANSWER Unbundling
Several key principles require appropriate physician documentation to secure payment from the insurer.
Which of the following fails to impact payment based on physician responsibility?
1. The health record should be complete and legible.
2. The rationale for ordering diagnostic and other ancillary services should be documented or easily
inferred.
3. The charges and services should be documented on the itemized bill.
4. The patient's progress and response to treatment and any revision in the treatment plan and
diagnoses should be documented. - ANSWER The charges and services should be documented on the
itemized bill.
Which of the following does not need to be included in the documentation of each patient encounter to
secure payment from the insurer?
1. The reason for the encounter and the patient's relevant history, physical examination, and prior
diagnostic test results
2. A patient assessment, clinical impression, or diagnosis
3. A plan of care
4. The identity of the patient's nearest relative and emergency contact number - ANSWER The identity of
the patient's nearest relative and emergency contact number
2 Medicare pts were hospitalized w/ bacterial pneumonia. 1 pt was hospitalized for 3 days, and the other
pt was hospitalized for 30 days. Both cases result in the same MS-DRG with different lengths of stay.
Which of the following most closely describes how the hospital will be reimbursed?
1. The hospital will receive the same MS-DRG for both pts but additional reimbursement will be allowed
for the pt who stayed 30 days because the length of stay was greater than the geometric length of stay
for this MS-DRG.
2. The hospital will receive the same reimbursement for the same MS-DRG regardless of the length of
stay.
3. The hospital can appeal the payment for the pt who was in the hospital for 30 days because the cost
of care was significantly higher than the average length of stay for the MS-DRG payment.
4. The hospital will receive a day outlier for the pt who was hospitalized for 30 days. - ANSWER The
hospital will receive the same reimbursement for the same MS-DRG regardless of the length of stay.
AHIMA CORRECT 100%
Which of the following software applications would be used to aid in the coding function in a physician's
office?
1. Grouper
2. Encoder
3. Pricer
4. Diagnosis calculator - ANSWER Encoder
In fiscal year 2008, Medicare revamped the inpatient payment system to incorporate three severity
levels. The grouping is known as _____.
1. AP-DRGs
2. RBRVS
3. MS-DRGs
4. APR-DRGs - ANSWER MS-DRGs
The healthcare program for active duty members of the military and other qualified family members is
_____.
1. Children's Health Insurance Program (CHIP)
2. Veterans Insurance
3. Tricare
4. Workers' compensation - ANSWER Tricare
An electrolyte panel (80051) in the Laboratory section of CPT consists of tests for carbon dioxide
(82374), chloride (82435), potassium (84132), and sodium (84295). If each of the component codes are
reported and billed individually on a claim form, this would be a form of _____.
1. Optimizing
2. Unbundling
, 3. Sequencing
4. Classifying - ANSWER Unbundling
Several key principles require appropriate physician documentation to secure payment from the insurer.
Which of the following fails to impact payment based on physician responsibility?
1. The health record should be complete and legible.
2. The rationale for ordering diagnostic and other ancillary services should be documented or easily
inferred.
3. The charges and services should be documented on the itemized bill.
4. The patient's progress and response to treatment and any revision in the treatment plan and
diagnoses should be documented. - ANSWER The charges and services should be documented on the
itemized bill.
Which of the following does not need to be included in the documentation of each patient encounter to
secure payment from the insurer?
1. The reason for the encounter and the patient's relevant history, physical examination, and prior
diagnostic test results
2. A patient assessment, clinical impression, or diagnosis
3. A plan of care
4. The identity of the patient's nearest relative and emergency contact number - ANSWER The identity of
the patient's nearest relative and emergency contact number
2 Medicare pts were hospitalized w/ bacterial pneumonia. 1 pt was hospitalized for 3 days, and the other
pt was hospitalized for 30 days. Both cases result in the same MS-DRG with different lengths of stay.
Which of the following most closely describes how the hospital will be reimbursed?
1. The hospital will receive the same MS-DRG for both pts but additional reimbursement will be allowed
for the pt who stayed 30 days because the length of stay was greater than the geometric length of stay
for this MS-DRG.
2. The hospital will receive the same reimbursement for the same MS-DRG regardless of the length of
stay.
3. The hospital can appeal the payment for the pt who was in the hospital for 30 days because the cost
of care was significantly higher than the average length of stay for the MS-DRG payment.
4. The hospital will receive a day outlier for the pt who was hospitalized for 30 days. - ANSWER The
hospital will receive the same reimbursement for the same MS-DRG regardless of the length of stay.
