1|Page
AHIMA CCS EXAM 2025 ACTUAL QUESTIONS WITH
VERIFIED COMPLETE SOLUTIONS/A+ SCORE
ASSURED
CPT defines a separate procedure as - (answers)Procedure considered an integral
part of a more major service
No combination code available - (answers)Use separate codes for hypertension
and acute renal failure
Documentation from the nursing staff or other allied health professionals' notes
can be used to provide specificity for code assignment for which of the following
diagnoses? - (answers)Body Mass Index (BMI)
POA Indicator - Y - (answers)Y-Yes, present at the time of inpatient admission
POA Indicator - N - (answers)N-No, not present at the time of inpatient admission
POA Indicator - U - (answers)U-Unknown, documentation is insufficient to
determine if condition is present on admission and you cannot speak to the
physician to figure it out
POA Indicator - W - (answers)W-Clinically undetermined, provider is unable to
clinically determine whether condition was present on admission or not
,2|Page
POA Indicator - E - (answers)E-Exempt, unreported/not used, some facilities will
leave these blank, others will use the letter "E"
Present on Admission Indicator (POA) - (answers)A Present On Admission (POA)
indicator is required on all diagnosis codes for the inpatient setting except for
admission. The indicator should be reported for principal diagnosis codes,
secondary diagnosis codes, Z-codes, and External cause injury codes.
The use of the outpatient code editor (OCE) is designed to: - (answers)Identify
incomplete and incorrect claims
Medicare's identification of medically necessary services is outlined in: -
(answers)Local Coverage Determinations (LCDs)
Medically unlikely edits are used to identify: - (answers)Maximum units of service
for a HCPCS code
National Correct Coding Initiative (NCCI) Edits are released how often? -
(answers)Quarterly
In 2000, CMS issued the final rule on the outpatient prospective payment system
(OPPS). The final rule: - (answers)Divided outpatient services into fixed payment
groups
, 3|Page
Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs)
are similar in that they are both: - (answers)Prospective payment systems
What are APCs? - (answers)APCs or "Ambulatory Payment Classifications" are the
government's method of paying facilities for outpatient services for the Medicare
program.
How do APCs work? - (answers)The payments are calculated by multiplying the
APCs relative weight by the OPPS conversion factor and then there is a minor
adjustment for geographic location.
APC Status Indicator - C - (answers)Inpatient Procedures, not paid under OPPS
APC Status Indicator - N - (answers)Items and Services Packaged into APC Rates
APC Status Indicator - S - (answers)Significant Procedure, Not Discounted When
Multiple
APC Status Indicator - T - (answers)Significant Procedure, Multiple Reduction
Applies
APC Status Indicator - V - (answers)Clinic or Emergency Department Visit
APC Status Indicator - X - (answers)Ancillary Services
AHIMA CCS EXAM 2025 ACTUAL QUESTIONS WITH
VERIFIED COMPLETE SOLUTIONS/A+ SCORE
ASSURED
CPT defines a separate procedure as - (answers)Procedure considered an integral
part of a more major service
No combination code available - (answers)Use separate codes for hypertension
and acute renal failure
Documentation from the nursing staff or other allied health professionals' notes
can be used to provide specificity for code assignment for which of the following
diagnoses? - (answers)Body Mass Index (BMI)
POA Indicator - Y - (answers)Y-Yes, present at the time of inpatient admission
POA Indicator - N - (answers)N-No, not present at the time of inpatient admission
POA Indicator - U - (answers)U-Unknown, documentation is insufficient to
determine if condition is present on admission and you cannot speak to the
physician to figure it out
POA Indicator - W - (answers)W-Clinically undetermined, provider is unable to
clinically determine whether condition was present on admission or not
,2|Page
POA Indicator - E - (answers)E-Exempt, unreported/not used, some facilities will
leave these blank, others will use the letter "E"
Present on Admission Indicator (POA) - (answers)A Present On Admission (POA)
indicator is required on all diagnosis codes for the inpatient setting except for
admission. The indicator should be reported for principal diagnosis codes,
secondary diagnosis codes, Z-codes, and External cause injury codes.
The use of the outpatient code editor (OCE) is designed to: - (answers)Identify
incomplete and incorrect claims
Medicare's identification of medically necessary services is outlined in: -
(answers)Local Coverage Determinations (LCDs)
Medically unlikely edits are used to identify: - (answers)Maximum units of service
for a HCPCS code
National Correct Coding Initiative (NCCI) Edits are released how often? -
(answers)Quarterly
In 2000, CMS issued the final rule on the outpatient prospective payment system
(OPPS). The final rule: - (answers)Divided outpatient services into fixed payment
groups
, 3|Page
Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs)
are similar in that they are both: - (answers)Prospective payment systems
What are APCs? - (answers)APCs or "Ambulatory Payment Classifications" are the
government's method of paying facilities for outpatient services for the Medicare
program.
How do APCs work? - (answers)The payments are calculated by multiplying the
APCs relative weight by the OPPS conversion factor and then there is a minor
adjustment for geographic location.
APC Status Indicator - C - (answers)Inpatient Procedures, not paid under OPPS
APC Status Indicator - N - (answers)Items and Services Packaged into APC Rates
APC Status Indicator - S - (answers)Significant Procedure, Not Discounted When
Multiple
APC Status Indicator - T - (answers)Significant Procedure, Multiple Reduction
Applies
APC Status Indicator - V - (answers)Clinic or Emergency Department Visit
APC Status Indicator - X - (answers)Ancillary Services
