CCA Domain 2 Exam Prep- 10th Edition
AHIMA-Graded A
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
In the Laboratory section of CPT, if a group of tests overlaps two or more panels, report
the panel that incorporates the greatest number of tests to fulfill the code definition.
What would a coding professional do with the remaining test codes that are not part of a
panel?
1. Report the remaining tests using individual test codes.
2. Do not report the remaining individual test codes.
3. Report only those test codes that are part of a panel.
, 4. Do not report a test code more than once regardless of whether the test was
performed twice. - ANSWER-Report the remaining tests using individual test codes.
The Office of Inspector General's (OIG) Compliance Program for Hospitals recommends
that hospitals appoint a chief compliance officer and _____.
1. Establish a compliance committee
2. Report their case mix annually
3. Monitor the fraud hotline
4. Assign CDI professionals to audit claims - ANSWER-Establish a compliance
committee
The front end of the revenue cycle management process does not include _____.
1. An enterprise-wide scheduling system
2. Claims appeals
3. An order tracking system
4. A financial function system - ANSWER-Claims appeals
What is the best reference tool for ICD-10-CM and ICD-10-PCS coding advice?
1. CMS Inpatient Prospective Payment System (IPPS)
2. ICD-10-CM and ICD-10-PCS Coding Guidelines
3. AHA's Coding Clinic for ICD-10-CM/PCS
4. National Correct Coding Initiative (NCCI) - ANSWER-AHA's Coding Clinic for ICD-10-
CM/PCS
CMS developed medically unlikely edits (MUEs) to prevent providers from billing units of
service greater than the norm would indicate. These MUEs were implemented on
January 1, 2007, and are applied to which code set?
1. ICD-10-PCS codes
2. HCPCS/CPT codes
3. ICD-10-CM codes
4. LOINC - ANSWER-HCPCS/CPT codes
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?
AHIMA-Graded A
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
In the Laboratory section of CPT, if a group of tests overlaps two or more panels, report
the panel that incorporates the greatest number of tests to fulfill the code definition.
What would a coding professional do with the remaining test codes that are not part of a
panel?
1. Report the remaining tests using individual test codes.
2. Do not report the remaining individual test codes.
3. Report only those test codes that are part of a panel.
, 4. Do not report a test code more than once regardless of whether the test was
performed twice. - ANSWER-Report the remaining tests using individual test codes.
The Office of Inspector General's (OIG) Compliance Program for Hospitals recommends
that hospitals appoint a chief compliance officer and _____.
1. Establish a compliance committee
2. Report their case mix annually
3. Monitor the fraud hotline
4. Assign CDI professionals to audit claims - ANSWER-Establish a compliance
committee
The front end of the revenue cycle management process does not include _____.
1. An enterprise-wide scheduling system
2. Claims appeals
3. An order tracking system
4. A financial function system - ANSWER-Claims appeals
What is the best reference tool for ICD-10-CM and ICD-10-PCS coding advice?
1. CMS Inpatient Prospective Payment System (IPPS)
2. ICD-10-CM and ICD-10-PCS Coding Guidelines
3. AHA's Coding Clinic for ICD-10-CM/PCS
4. National Correct Coding Initiative (NCCI) - ANSWER-AHA's Coding Clinic for ICD-10-
CM/PCS
CMS developed medically unlikely edits (MUEs) to prevent providers from billing units of
service greater than the norm would indicate. These MUEs were implemented on
January 1, 2007, and are applied to which code set?
1. ICD-10-PCS codes
2. HCPCS/CPT codes
3. ICD-10-CM codes
4. LOINC - ANSWER-HCPCS/CPT codes
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?
