CERTIFIED CODING SPECIALIST
QUESTIONS AND ACCURATE
OPTIONS
What is the maximum number of APCs that may be assigned per encounter? ✅✅ANSW-unlimited
Each code in the HCPCS has been assigned a(n)________ that establishes how a service, procedure,
or item is paid in OPPS.A. Payment Status Indicator (SI)B. Outpatient Code Editor (OCE)C. Medicare
Summary Notice (MSN)D. Remittance advice (RA) ✅✅ANSW-Payment status indicator (SI)
Each code in the HCPCS has been assigned a payment status indicator that establishes how a service,
procedure, or item is paid in the OPPS.
What type of data is exemplified by the insured party's member identification number?
✅✅ANSW-Financial data
Two patients were given the same health record number. This is an example of a(n): ✅✅ANSW-
overlap
the ___ otherwise known as the ____, builds on the Anti-Kickback Statute and prohibits a physician
from referring patients to a business with which he or she or a member of the physician's
intermediate family has financial interests ✅✅ANSW-Physician Self-Referral Law
(Stark Law)
What does the Anti-Kickback Statute Prevent? ✅✅ANSW-Prohibits offering, paying, soliciting, or
receiving anything of value in induce or reward referrals or generate Federal health care program
business.
The Anti-Kickback Statute prohibits offering or accepting kickbacks intended to generate health care
business.
,Which of the following programs has been in place in hospitals for years and has been required by
the Medicare and Medicaid programs and accreditation standards? ✅✅ANSW-Quality
improvement
maintenance of the charge description master requires expertise in: ✅✅ANSW-coding, clinical
procedures, health record/clinical documentation, and billing regulations
CDM software is designed to..... ✅✅ANSW-The software is primarily designed to continuously
apply edits that point out compliance issues, validity of elements such as CPT codes and revenue
codes, and identification of items priced below national reimbursement levels.
The inpatient clinical documentation integrity process can be divided into three main functions:
✅✅ANSW-query for documentation clarification, physician education, and record review
Although computer assisted coding (CAC) is used mainly for coding of the health record for
reimbursement, another purpose is _____. ✅✅ANSW-Clinical documentation integrity
what does the acronym PHI stand for? ✅✅ANSW-protected health information
which of the following statements is true of the notice of privacy practices?a. it gives the covered
entity permission to sue information for treatment purposes
b. it gives the covered entity permission to use information for TPO purposes
c. it must be provided to every individual at the first time of contact or service with the covered
entity
d. it must be provided to the individual by the covered entity within 30 days after receipt of
treatment or service ✅✅ANSW-c. it must be provided to every individual at the first time of
contact or service with the covered entity
a valid authorization requires which of the following?
a. a statement that a notice of privacy practice has been provided
b. an expiration date or event
c. statement that patient understands their rights related to PHI
d. patient account number ✅✅ANSW-b. an expiration date or event
, The Final Rule that defines practices which constitute information blocking and authorizes the
Secretary of Health and Human Services (HHS) to identify reasonable and necessary activities that do
not constitute information blocking (referred to as "exceptions") is which of the following?
✅✅ANSW-Section 4004 of the 21st Century Cures Act
(The Information Blocking final rule eliminates intentional barriers to electronic health information
(EHI) exchange. This rule was designed to give patients greater control over their personal health
data and make it easier to share patient records between organizations and with patients.)
Is general anesthesia included in the surgical package? ✅✅ANSW-No (but local anesthesia usually
is)
The surgical package includes: ✅✅ANSW-surgical procedure performed; local infiltration (local
anesthesia); preoperative E/M services on day immediately prior to or on day of procedure;
immediate postoperative care; normal, uncomplicated postoperative care
special report ✅✅ANSW-Additional medical documentation required to confirm the need for the
use of unlisted, unusual, or newly adopted medical procedures.
include: nature, extent, need, time, effort, equipment
global surgery ✅✅ANSW-Global period—number of days associated with surgical package;
designated as 0, 10 (minor surgery), or 90 (major) days
When the words "separate procedure" appear after the descriptor of a code, you know which of the
following about that code? ✅✅ANSW-the procedure is not reported if it is performed with a
more major procedure of the same site
these are minor procedures that are reported only when they are the only services performed or
when they are performed with another major procedure that is unrelated
Integumentary abscess incision codes are used when only ✅✅ANSW-the skin and subcutaneous
tissues are incised
Musculoskeletal abscess incision codes are used when the incision ✅✅ANSW-is deeper than the
subcutaneous-to the fascia, muscle,tendons or other deep soft tissue
QUESTIONS AND ACCURATE
OPTIONS
What is the maximum number of APCs that may be assigned per encounter? ✅✅ANSW-unlimited
Each code in the HCPCS has been assigned a(n)________ that establishes how a service, procedure,
or item is paid in OPPS.A. Payment Status Indicator (SI)B. Outpatient Code Editor (OCE)C. Medicare
Summary Notice (MSN)D. Remittance advice (RA) ✅✅ANSW-Payment status indicator (SI)
Each code in the HCPCS has been assigned a payment status indicator that establishes how a service,
procedure, or item is paid in the OPPS.
What type of data is exemplified by the insured party's member identification number?
✅✅ANSW-Financial data
Two patients were given the same health record number. This is an example of a(n): ✅✅ANSW-
overlap
the ___ otherwise known as the ____, builds on the Anti-Kickback Statute and prohibits a physician
from referring patients to a business with which he or she or a member of the physician's
intermediate family has financial interests ✅✅ANSW-Physician Self-Referral Law
(Stark Law)
What does the Anti-Kickback Statute Prevent? ✅✅ANSW-Prohibits offering, paying, soliciting, or
receiving anything of value in induce or reward referrals or generate Federal health care program
business.
The Anti-Kickback Statute prohibits offering or accepting kickbacks intended to generate health care
business.
,Which of the following programs has been in place in hospitals for years and has been required by
the Medicare and Medicaid programs and accreditation standards? ✅✅ANSW-Quality
improvement
maintenance of the charge description master requires expertise in: ✅✅ANSW-coding, clinical
procedures, health record/clinical documentation, and billing regulations
CDM software is designed to..... ✅✅ANSW-The software is primarily designed to continuously
apply edits that point out compliance issues, validity of elements such as CPT codes and revenue
codes, and identification of items priced below national reimbursement levels.
The inpatient clinical documentation integrity process can be divided into three main functions:
✅✅ANSW-query for documentation clarification, physician education, and record review
Although computer assisted coding (CAC) is used mainly for coding of the health record for
reimbursement, another purpose is _____. ✅✅ANSW-Clinical documentation integrity
what does the acronym PHI stand for? ✅✅ANSW-protected health information
which of the following statements is true of the notice of privacy practices?a. it gives the covered
entity permission to sue information for treatment purposes
b. it gives the covered entity permission to use information for TPO purposes
c. it must be provided to every individual at the first time of contact or service with the covered
entity
d. it must be provided to the individual by the covered entity within 30 days after receipt of
treatment or service ✅✅ANSW-c. it must be provided to every individual at the first time of
contact or service with the covered entity
a valid authorization requires which of the following?
a. a statement that a notice of privacy practice has been provided
b. an expiration date or event
c. statement that patient understands their rights related to PHI
d. patient account number ✅✅ANSW-b. an expiration date or event
, The Final Rule that defines practices which constitute information blocking and authorizes the
Secretary of Health and Human Services (HHS) to identify reasonable and necessary activities that do
not constitute information blocking (referred to as "exceptions") is which of the following?
✅✅ANSW-Section 4004 of the 21st Century Cures Act
(The Information Blocking final rule eliminates intentional barriers to electronic health information
(EHI) exchange. This rule was designed to give patients greater control over their personal health
data and make it easier to share patient records between organizations and with patients.)
Is general anesthesia included in the surgical package? ✅✅ANSW-No (but local anesthesia usually
is)
The surgical package includes: ✅✅ANSW-surgical procedure performed; local infiltration (local
anesthesia); preoperative E/M services on day immediately prior to or on day of procedure;
immediate postoperative care; normal, uncomplicated postoperative care
special report ✅✅ANSW-Additional medical documentation required to confirm the need for the
use of unlisted, unusual, or newly adopted medical procedures.
include: nature, extent, need, time, effort, equipment
global surgery ✅✅ANSW-Global period—number of days associated with surgical package;
designated as 0, 10 (minor surgery), or 90 (major) days
When the words "separate procedure" appear after the descriptor of a code, you know which of the
following about that code? ✅✅ANSW-the procedure is not reported if it is performed with a
more major procedure of the same site
these are minor procedures that are reported only when they are the only services performed or
when they are performed with another major procedure that is unrelated
Integumentary abscess incision codes are used when only ✅✅ANSW-the skin and subcutaneous
tissues are incised
Musculoskeletal abscess incision codes are used when the incision ✅✅ANSW-is deeper than the
subcutaneous-to the fascia, muscle,tendons or other deep soft tissue
