CCS Exam Prep- Questions With Insightful
Solutions
The use of the outpatient code editor (OCE) is designed to: Correct
Answer - Identify incomplete or incorrect claims
Medicare's identification of medically necessary services is outlined in:
Correct Answer - Local coverage determinations
National Correct Coding Initiative (NCCI) are released how often? Correct
Answer - Quarterly
In 2000, the CMS issued the final rule on the outpatient prospective payment
system. The final rule: Correct Answer - Divided outpatient services into
fixed payment groups
DRG's and ambulatory patient classifications are similar in that they are both:
Correct Answer - Prospective payment systems
Medicare exerts control of provider reimbursement through adjustment of
this component of the resource-based relative value scale Correct Answer
- Conversion factor
The process of collecting data elements from a source document is known as:
Correct Answer - Abstracting
What piece of claims data from Hospital A alerts a payer that the patient was
transferred to Hospital B? Correct Answer - Discharge disposition
Which of the following is considered a complication or comorbidity?
Correct Answer - Hypernatremia
Multiple choice queries must supply how many choices in order to be
compliant? Correct Answer - No specific number
, Compliant queries include which of the following? Correct Answer -
Relevant clinical indicators
Authentication of health record entries means to: Correct Answer -
Prove authorship of documents
The requirements for documentation and record completion (such as H&P's,
discharge summaries, and consultations) as well as penalties for non-
adherence must be specified in: Correct Answer - Medical staff bylaws
Generally, data quality is defined as: Correct Answer - Ensuring the
accuracy and completeness of an organization's data
The Joint Commission considers management that supports decision making
to be important for safety and quality. What kind of management supports
decision making? Correct Answer -
Which type of conditions are always considered present on admission?
Correct Answer - Congenital
A patient is admitted for seizures. What is the appropriate POA for the
external cause code of W06.XXA assigned because the patient fell out of bed
during a seizure in the ER? Correct Answer - Y
The outpatient code editor (OCE) has all of the following types of edits except:
Correct Answer - Valid diagnosis code edits
Determining medical necessity for outpatient services include all of the
following except: Correct Answer - Requiring new HCPCS codes be
developed to replace codes in the CPT code book
The National Correct Coding Initiative (NCCI) Edits apply to services billed by:
Correct Answer - The same provider, for same beneficiary, on same date of
service
If the principle diagnosis is an initial anterior wall myocardial infarction,
which procedure will result in the highest MS-DRG assignment? Correct
Answer - Transbronchial lung biopsy
Solutions
The use of the outpatient code editor (OCE) is designed to: Correct
Answer - Identify incomplete or incorrect claims
Medicare's identification of medically necessary services is outlined in:
Correct Answer - Local coverage determinations
National Correct Coding Initiative (NCCI) are released how often? Correct
Answer - Quarterly
In 2000, the CMS issued the final rule on the outpatient prospective payment
system. The final rule: Correct Answer - Divided outpatient services into
fixed payment groups
DRG's and ambulatory patient classifications are similar in that they are both:
Correct Answer - Prospective payment systems
Medicare exerts control of provider reimbursement through adjustment of
this component of the resource-based relative value scale Correct Answer
- Conversion factor
The process of collecting data elements from a source document is known as:
Correct Answer - Abstracting
What piece of claims data from Hospital A alerts a payer that the patient was
transferred to Hospital B? Correct Answer - Discharge disposition
Which of the following is considered a complication or comorbidity?
Correct Answer - Hypernatremia
Multiple choice queries must supply how many choices in order to be
compliant? Correct Answer - No specific number
, Compliant queries include which of the following? Correct Answer -
Relevant clinical indicators
Authentication of health record entries means to: Correct Answer -
Prove authorship of documents
The requirements for documentation and record completion (such as H&P's,
discharge summaries, and consultations) as well as penalties for non-
adherence must be specified in: Correct Answer - Medical staff bylaws
Generally, data quality is defined as: Correct Answer - Ensuring the
accuracy and completeness of an organization's data
The Joint Commission considers management that supports decision making
to be important for safety and quality. What kind of management supports
decision making? Correct Answer -
Which type of conditions are always considered present on admission?
Correct Answer - Congenital
A patient is admitted for seizures. What is the appropriate POA for the
external cause code of W06.XXA assigned because the patient fell out of bed
during a seizure in the ER? Correct Answer - Y
The outpatient code editor (OCE) has all of the following types of edits except:
Correct Answer - Valid diagnosis code edits
Determining medical necessity for outpatient services include all of the
following except: Correct Answer - Requiring new HCPCS codes be
developed to replace codes in the CPT code book
The National Correct Coding Initiative (NCCI) Edits apply to services billed by:
Correct Answer - The same provider, for same beneficiary, on same date of
service
If the principle diagnosis is an initial anterior wall myocardial infarction,
which procedure will result in the highest MS-DRG assignment? Correct
Answer - Transbronchial lung biopsy
