AHIMA CCA COMPREHENSIVE EXAM UPDATED
QUESTIONS AND SOLUTIONS RATED A+
✔✔Reviewing the health record for missing signatures, missing medical reports, and
ensuring that all documents belong in the health record is an example of ______ review.
a. Quantitative
b. Qualitative
c. Statistical
d. Outcomes - ✔✔Correct Answer: A
HIM professional analyze medical records for any missing reports, forms, or required
signatures and deletions. This is a quantitative analysis of the medical record (Johns
2011, 409-410).
✔✔From the information provided, how many APCs would this patient have?
Billing Number Status Indicator CPT/HCPCS APC
998323 V 99285-25 0612
998324 T 25500 0044
998325 X 72050 0261
998326 S 72128 0283
998327 S 70450 0283
a. 1
b. 4
c. 5
d. 3 - ✔✔Correct Answer: C
Payment for separately paid APCs depends on the status indicator assigned to each
HCPCS code. This particular example allows separate payment on all five codes based
on separately paid status indicator assignment (Johns 2011, 330-332).
✔✔In a joint effort of the Department of Health and Human Services (DHHS), Office of
Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS), and
Administration on Aging (AOA), which program was released in 1995 to target fraud and
abuse among healthcare providers?
a. Operation Restore Trust
,b. Medicare Integrity Program
c. Tax Equity and Fiscal Responsibility Act (TEFRA)
d. Medicare and Medicaid Patient and Program Protection Act - ✔✔Correct Answer: A
In a joint effort of the Department of Health and Human Services (HHS), Office of
Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS), and
Administration on Aging (AOA), Operation Restore Trust was released in 1995 to target
fraud and abuse among healthcare providers (Casto and Layman 2011, 36).
✔✔A threat to data security is:
a. Encryption
b. Malware
c. Audit trail
d. Data quality - ✔✔Correct Answer: B
Computer viruses and other malware constitute a threat to data security (Johns 2011,
510).
✔✔The HIM department is planning to scan nonelectronic medical record
documentation. The project includes the scanning of health record documentation such
as history and physicals, physician orders, operative reports, and nursing notes. Which
of the following methods of scanning would be best to help HIM professionals monitor
the completeness of health records during a patient's hospitalization?
a. Ad hoc
b. Concurrent
c. Retrospective
d. Post-discharge - ✔✔Correct Answer: B
Concurrent review occurs on a continuing basis during a patient's stay (Johns 2011,
410).
✔✔This is a program unveiled in 1998 by the OIG that encourages healthcare providers
to report fraudulent conduct affecting Medicare, Medicaid, and other federal healthcare
programs.
a. World Health Organization
,b. Voluntary Disclosure Program
c. Compliance Disclosure Program
d. Fraud and Abuse Program - ✔✔Correct Answer: B
The Voluntary Disclosure program was introduced in 1998 by the OIG to encourage
healthcare providers to voluntarily report fraudulent conduct affecting federal payers
(Johns 2011, 358).
✔✔An epidural was given during labor. Subsequently, it was determined that the patient
would require a C-section for cephalopelvic disproportion because of obstructed labor.
Assign the correct ICD-9-CM diagnostic and CPT anesthesia codes. (Modifiers are not
used in this example.)
a. 660.11, 653.41, 64479
b. 660.11, 653.01, 01961
c. 660.11, 653.41, 01967, 01968
d. 660.11, 653.91, 01996 - ✔✔Correct Answer: C
The disproportion was specified as cephalopelvic; thus the correct ICD-9-CM code is
653.41. Two codes are required for anesthesia; one for the planned vaginal delivery
(01967) and an add-on code (01968) to describe anesthesia for cesarean delivery
following planned vaginal delivery converted to cesarean. An instructional note guides
the coder to use 01968 with 01967 (Schraffenberger 2012, 272-273; AMA 2012b, 52).
✔✔A patient was discharged with the following diagnoses: "Cerebral occlusion,
hemiparesis, and hypertension. The aphasia resolved before the patient was
discharged." Which of the following code assignments would be appropriate for this
case?
342.90 Hemiparesis affecting unspecified side
342.91 Hemiparesis affecting dominant side
342.92 Hemiparesis affecting nondominant side
434.90 Cerebral artery occlusion unspecified, without mention of cerebral infarction
434.91 Cerebral artery occlusion unspecified with cerebral infarction
401 Hypertension
401.0 Malignant hypertension
401.1 Benign hypertension
401.9 Unspecified hypertension
428.0 Congestive heart failure
784.3 Aphasia
, a. 434.91, 342.92, 784.3, 401
b. 434.90, 342.90, 784.3, 401.9
c. 434.90, 342.90, 401.9
d. 434.90, 342.90, 784.3, 401.0 - ✔✔Correct Answer: B
Code 434.91 is assigned when the diagnosis states stroke, cerebrovascular, or
cerebrovascular accident (CVA) without further specification. The health record should
be reviewed to make sure nothing more specific is available. Conditions resulting from
an acute cerebrovascular disease, such as aphasia or hemiplegia, should be coded as
well (Schraffenberger 2012, 198-199).
✔✔In developing a coding compliance program, which of the following would not be
ordinarily included as participants in coding compliance education?
a. Current coding personnel
b. Medical staff
c. Newly hired coding personnel
d. Nursing staff - ✔✔Correct Answer: D
All newly hired coding personnel should receive extensive training on the facility's and
HIM department's compliance programs. Education of the medical staff on
documentation is likewise important to the success of any compliance program (Johns
2011, 362).
✔✔A 7-year-old patient was admitted to the emergency department for treatment of
shortness of breath. The patient is given epinephrine and nebulizer treatments. The
shortness of breath and wheezing are unabated following treatment. What diagnosis
should be suspected?
a. Acute bronchitis
b. Acute bronchitis with chronic obstructive pulmonary disease
c. Asthma with status asthmaticus
d. Chronic obstructive asthma - ✔✔Correct Answer: C
A patient in status asthmaticus fails to respond to therapy administered during an
asthmatic attack. This is a life-threatening condition that requires emergency care and
likely hospitalization (Schraffenberger 2012, 222-223).
QUESTIONS AND SOLUTIONS RATED A+
✔✔Reviewing the health record for missing signatures, missing medical reports, and
ensuring that all documents belong in the health record is an example of ______ review.
a. Quantitative
b. Qualitative
c. Statistical
d. Outcomes - ✔✔Correct Answer: A
HIM professional analyze medical records for any missing reports, forms, or required
signatures and deletions. This is a quantitative analysis of the medical record (Johns
2011, 409-410).
✔✔From the information provided, how many APCs would this patient have?
Billing Number Status Indicator CPT/HCPCS APC
998323 V 99285-25 0612
998324 T 25500 0044
998325 X 72050 0261
998326 S 72128 0283
998327 S 70450 0283
a. 1
b. 4
c. 5
d. 3 - ✔✔Correct Answer: C
Payment for separately paid APCs depends on the status indicator assigned to each
HCPCS code. This particular example allows separate payment on all five codes based
on separately paid status indicator assignment (Johns 2011, 330-332).
✔✔In a joint effort of the Department of Health and Human Services (DHHS), Office of
Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS), and
Administration on Aging (AOA), which program was released in 1995 to target fraud and
abuse among healthcare providers?
a. Operation Restore Trust
,b. Medicare Integrity Program
c. Tax Equity and Fiscal Responsibility Act (TEFRA)
d. Medicare and Medicaid Patient and Program Protection Act - ✔✔Correct Answer: A
In a joint effort of the Department of Health and Human Services (HHS), Office of
Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS), and
Administration on Aging (AOA), Operation Restore Trust was released in 1995 to target
fraud and abuse among healthcare providers (Casto and Layman 2011, 36).
✔✔A threat to data security is:
a. Encryption
b. Malware
c. Audit trail
d. Data quality - ✔✔Correct Answer: B
Computer viruses and other malware constitute a threat to data security (Johns 2011,
510).
✔✔The HIM department is planning to scan nonelectronic medical record
documentation. The project includes the scanning of health record documentation such
as history and physicals, physician orders, operative reports, and nursing notes. Which
of the following methods of scanning would be best to help HIM professionals monitor
the completeness of health records during a patient's hospitalization?
a. Ad hoc
b. Concurrent
c. Retrospective
d. Post-discharge - ✔✔Correct Answer: B
Concurrent review occurs on a continuing basis during a patient's stay (Johns 2011,
410).
✔✔This is a program unveiled in 1998 by the OIG that encourages healthcare providers
to report fraudulent conduct affecting Medicare, Medicaid, and other federal healthcare
programs.
a. World Health Organization
,b. Voluntary Disclosure Program
c. Compliance Disclosure Program
d. Fraud and Abuse Program - ✔✔Correct Answer: B
The Voluntary Disclosure program was introduced in 1998 by the OIG to encourage
healthcare providers to voluntarily report fraudulent conduct affecting federal payers
(Johns 2011, 358).
✔✔An epidural was given during labor. Subsequently, it was determined that the patient
would require a C-section for cephalopelvic disproportion because of obstructed labor.
Assign the correct ICD-9-CM diagnostic and CPT anesthesia codes. (Modifiers are not
used in this example.)
a. 660.11, 653.41, 64479
b. 660.11, 653.01, 01961
c. 660.11, 653.41, 01967, 01968
d. 660.11, 653.91, 01996 - ✔✔Correct Answer: C
The disproportion was specified as cephalopelvic; thus the correct ICD-9-CM code is
653.41. Two codes are required for anesthesia; one for the planned vaginal delivery
(01967) and an add-on code (01968) to describe anesthesia for cesarean delivery
following planned vaginal delivery converted to cesarean. An instructional note guides
the coder to use 01968 with 01967 (Schraffenberger 2012, 272-273; AMA 2012b, 52).
✔✔A patient was discharged with the following diagnoses: "Cerebral occlusion,
hemiparesis, and hypertension. The aphasia resolved before the patient was
discharged." Which of the following code assignments would be appropriate for this
case?
342.90 Hemiparesis affecting unspecified side
342.91 Hemiparesis affecting dominant side
342.92 Hemiparesis affecting nondominant side
434.90 Cerebral artery occlusion unspecified, without mention of cerebral infarction
434.91 Cerebral artery occlusion unspecified with cerebral infarction
401 Hypertension
401.0 Malignant hypertension
401.1 Benign hypertension
401.9 Unspecified hypertension
428.0 Congestive heart failure
784.3 Aphasia
, a. 434.91, 342.92, 784.3, 401
b. 434.90, 342.90, 784.3, 401.9
c. 434.90, 342.90, 401.9
d. 434.90, 342.90, 784.3, 401.0 - ✔✔Correct Answer: B
Code 434.91 is assigned when the diagnosis states stroke, cerebrovascular, or
cerebrovascular accident (CVA) without further specification. The health record should
be reviewed to make sure nothing more specific is available. Conditions resulting from
an acute cerebrovascular disease, such as aphasia or hemiplegia, should be coded as
well (Schraffenberger 2012, 198-199).
✔✔In developing a coding compliance program, which of the following would not be
ordinarily included as participants in coding compliance education?
a. Current coding personnel
b. Medical staff
c. Newly hired coding personnel
d. Nursing staff - ✔✔Correct Answer: D
All newly hired coding personnel should receive extensive training on the facility's and
HIM department's compliance programs. Education of the medical staff on
documentation is likewise important to the success of any compliance program (Johns
2011, 362).
✔✔A 7-year-old patient was admitted to the emergency department for treatment of
shortness of breath. The patient is given epinephrine and nebulizer treatments. The
shortness of breath and wheezing are unabated following treatment. What diagnosis
should be suspected?
a. Acute bronchitis
b. Acute bronchitis with chronic obstructive pulmonary disease
c. Asthma with status asthmaticus
d. Chronic obstructive asthma - ✔✔Correct Answer: C
A patient in status asthmaticus fails to respond to therapy administered during an
asthmatic attack. This is a life-threatening condition that requires emergency care and
likely hospitalization (Schraffenberger 2012, 222-223).
