CCA STUDY GUIDE 2026 EXAM QUESTIONS AND
SOLUTIONS RATED A+
✔✔Pt was admitted for abdominal pain with diarrhea and was diagnosed with infectious
gastroenteritis. Pt also has angina and COPD. Which of the following would be the
correct coding and sequencing for this case? - ✔✔Infectious gastroenteritis; COPD;
angina
✔✔Pt admitted with hx of prostate cancer and with mental confusion. Pt completed
radiation therapy for prostatic carcinoma 3 years ago and is status post a radical
resection of the prostate. CT scan of brain during current admission reveals metastasis.
Which of the following is the correct coding and sequencing for the current hospital
stay? - ✔✔Metastatic carcinoma of the brain; history of carcinoma of the prostate
✔✔According to UHDDS, which of the following is the definition of "other diagnoses"? -
✔✔Receives clinical eval or therapeutic tx or diagnostic procedures to extends the LOS
or increases nursing care and monitoring
✔✔Pt is admitted with abdominal pain and physician documents the discharge dx as
pancreatitis vs. noncalculus cholecystitis. Both dx are equally treated. The correct
coding/sequencing for this case would be: - ✔✔Sequence either pancreatitis or
noncalculus cholecystitis as PD
✔✔7yo pt admitted to ED for tx for shortness of breath and given epinephrine and
nebulizer tx. Shortness of breath and wheezing are unabated following tx. What
diagnosis should be suspected? - ✔✔Asthma with status asthmaticus since pt failed to
respond to therapy during attack. This is a life-threatening condition that requires
emergency care and likely hospitalization.
✔✔Pt is seen in ED for chest pain. After eval, it is suspected that pt may have
gastroesophageal reflux disease (GERD). Final dx was "rule out chest pain vs. GERD".
The correct ICD-10-CM is: - ✔✔Physician has uncertainty about GERD, so rather than
code a condition that potentially does not exist, it is best to code to the highest degree
of certainty which is the sign/symptom the pt exhibits = Chest pain, unspecified R07.9
✔✔Skin lesion was removed from pt's cheek in doctor's office and is documented as
"skin lesion" in health record. Before billing, pathology report returns with dx of basal
cell carcinoma. Which of the following action should the coding professional do for claim
submission? - ✔✔Code basal cell carcinoma since diagnostic tests interpreted by
physician and final report is available and this is a outpatient encounter. However, this is
different from inpatient rules regarding abnormal findings on test results.
✔✔Epidural given during labor and subsequently it was determined that pt would
require C-section for cephalopelvic disproportion due to obstructed labor. Assign correct
,ICD-10-CM dx and CPT anesthesia codes without modifiers: - ✔✔Cephalopelvic =
O65.4; two codes req for anesthesia: planned vaginal delivery = 01967 and add'l code
describing anesthesia for c-section following planned vaginal delivery converted to
cesarean = 01968 (instructional note guides coder to use 01968 with 01967)
✔✔Which of the following purpose and use goals does NOT apply to ICD-10-PCS? -
✔✔Improved collection of data about nursing care
✔✔Which of the following is NOT a way that ICD-10-CM improves coding accuracy? -
✔✔Increases cross-referencing
✔✔To help clarify terms that currently have overlapping meaning, ICD-10-PCS has
defined root operations. What is an example of the root operation of "Excision"? -
✔✔Partial nephrectomy: a portion of the body part is cut out or off, without replacement
✔✔When coding benign neoplasm of the breast, the section noted "D24 Benign
neoplasm of breast" directs coder to: - ✔✔Use category D24 for fibroadenoma of breast
✔✔Patient was discharged with the following dx: "Cerebral artery occlusion,
hemiparesis, and hypertension. The aphasia resolved before the pt was discharged."
Which of the following code assignment would be appropriate for this case? - ✔✔I66.9,
G81.90, R47.01, I10
✔✔Pt is admitted to hospital with shortness of breath and CHF. Pt subsequently
develops respiratory failure and undergoes intubation with ventilator management.
Which of the following would be the correct sequencing and coding of this case? -
✔✔CHF, respiratory failure, ventilator management (Acute respiratory failure may be
assigned as a PD depending on the circumstances of the InPT admission; because the
respiratory failure occurred after admission, it is listed as a secondary dx and the CHF is
listed first.)
✔✔Physician correctly prescribes Coumadin and the pt takes the Coumadin as
prescribed, but develops hematuria as a result. Which of the following is the correct
coding? - ✔✔Hematuria; adverse reaction to Coumadin
✔✔Pt is admitted to chest pain with cardiac dysrhythmia to Hospital A, then found to
have acute STEMI with atrial fibrillation. After AF was controlled and pt stabilized, pt is
transferred to Hospital B for a CABG X3. Coumadin therapy and monitoring for the AF
continued at Hospital B. What is the proper coding and sequencing for both hospitals? -
✔✔Hospital A: I21.19, I48.91; Hospital B: I21.19, I48.91, 021209W (Encounters
occurring while the MI is equal to, or less than, 4 wks. old, including transfers to another
acute setting or postacute setting, and pt req continued care for MI, codes from
category I21 may continue to be reported
, ✔✔Pt is admitted to hospital with abdominal pain and PD is cholecystitis. Pt also has
history of hypertension and DM. In DRG-PPS, which would determine the MDC
assignment for this pt? - ✔✔Cholecystitis, since PD determines the MDC assignment
✔✔Pt was admitted to hospital with symptoms of a stroke and secondary diagnoses of
COPD and hypertension. Pt was subsequently discharged from hospital with PD of
cerbral vascular accident and secondary diagnoses of catheter-associated urinary tract
infection, COPD, and hypertension. Which should NOT be tagged as POA? -
✔✔Catheter-associated urinary tract infection
✔✔What is a condition that arise during hospitalization? - ✔✔Complication
✔✔65 yo female was admitted to hospital and diagnosed with sepsis secondary to
Staphylococcus aureus and abdominal pain secondary to diverticulitis of the colon.
What is the correct code assignment? - ✔✔A41.01 - Sepsis, due to Staph. aureus
K57.92 - Diverticulitis
✔✔Patient had carcinoma of anterior bladder wall fulgurated 3 years ago and returns
yearly for cystoscopy to recheck for bladder tumor. Patient is currently admitted for a
routine check. A small recurring malignancy is found and fulgurated during the
cystoscopy procedure. What is the correct code assignment - ✔✔C67.3 - Neoplasm,
bladder, wall, anterior, malignancy 0T5B8ZZ - Fulguration (see Destruction), Bladder,
via Natural or Artificial Opening Endoscopic, No device or qualifier
✔✔Pt with dx of ventral hernia is admitted to undergo laparotomy with ventral hernia
repair and undergoes an incision in the abdominal wall, then develops bradycardia.
Surgeon does not indicate that it is a complication of surgery. The operative site is
closed without the repair of the hernia. What is the correct code assignment? -
✔✔K43.9 - Hernia, ventral
R00.1 - Bradycardia
Z53.09 - Procedure, not done, because of, contraindication
OWJF0ZZ - Inspection, abdominal wall, open, no device or qualifier (assigned to the
extent of the procedure, not the full laparotomy)
✔✔Codes used to assign a dx to a pt seeking health services but not necessarily sick: -
✔✔Z codes
✔✔Pt admitted through ED following fall from a ladder with painting an interior bathroom
in his farmhouse and had contusions of the scalp and face, and displaced open fracture
of anterior wall of rt acetabulum. Fracture site was excisionally debrided and fracture
was reduced by open procedure with internal fixation device inserted. What is correct
code assignment? - ✔✔S32.411B - Fracture, traumatic, acetabulum, wall, anterior,
displaced,right, initial encounter, open fracture
S00.03XA - Contusion, scalp, X place mark, initial encounter
SOLUTIONS RATED A+
✔✔Pt was admitted for abdominal pain with diarrhea and was diagnosed with infectious
gastroenteritis. Pt also has angina and COPD. Which of the following would be the
correct coding and sequencing for this case? - ✔✔Infectious gastroenteritis; COPD;
angina
✔✔Pt admitted with hx of prostate cancer and with mental confusion. Pt completed
radiation therapy for prostatic carcinoma 3 years ago and is status post a radical
resection of the prostate. CT scan of brain during current admission reveals metastasis.
Which of the following is the correct coding and sequencing for the current hospital
stay? - ✔✔Metastatic carcinoma of the brain; history of carcinoma of the prostate
✔✔According to UHDDS, which of the following is the definition of "other diagnoses"? -
✔✔Receives clinical eval or therapeutic tx or diagnostic procedures to extends the LOS
or increases nursing care and monitoring
✔✔Pt is admitted with abdominal pain and physician documents the discharge dx as
pancreatitis vs. noncalculus cholecystitis. Both dx are equally treated. The correct
coding/sequencing for this case would be: - ✔✔Sequence either pancreatitis or
noncalculus cholecystitis as PD
✔✔7yo pt admitted to ED for tx for shortness of breath and given epinephrine and
nebulizer tx. Shortness of breath and wheezing are unabated following tx. What
diagnosis should be suspected? - ✔✔Asthma with status asthmaticus since pt failed to
respond to therapy during attack. This is a life-threatening condition that requires
emergency care and likely hospitalization.
✔✔Pt is seen in ED for chest pain. After eval, it is suspected that pt may have
gastroesophageal reflux disease (GERD). Final dx was "rule out chest pain vs. GERD".
The correct ICD-10-CM is: - ✔✔Physician has uncertainty about GERD, so rather than
code a condition that potentially does not exist, it is best to code to the highest degree
of certainty which is the sign/symptom the pt exhibits = Chest pain, unspecified R07.9
✔✔Skin lesion was removed from pt's cheek in doctor's office and is documented as
"skin lesion" in health record. Before billing, pathology report returns with dx of basal
cell carcinoma. Which of the following action should the coding professional do for claim
submission? - ✔✔Code basal cell carcinoma since diagnostic tests interpreted by
physician and final report is available and this is a outpatient encounter. However, this is
different from inpatient rules regarding abnormal findings on test results.
✔✔Epidural given during labor and subsequently it was determined that pt would
require C-section for cephalopelvic disproportion due to obstructed labor. Assign correct
,ICD-10-CM dx and CPT anesthesia codes without modifiers: - ✔✔Cephalopelvic =
O65.4; two codes req for anesthesia: planned vaginal delivery = 01967 and add'l code
describing anesthesia for c-section following planned vaginal delivery converted to
cesarean = 01968 (instructional note guides coder to use 01968 with 01967)
✔✔Which of the following purpose and use goals does NOT apply to ICD-10-PCS? -
✔✔Improved collection of data about nursing care
✔✔Which of the following is NOT a way that ICD-10-CM improves coding accuracy? -
✔✔Increases cross-referencing
✔✔To help clarify terms that currently have overlapping meaning, ICD-10-PCS has
defined root operations. What is an example of the root operation of "Excision"? -
✔✔Partial nephrectomy: a portion of the body part is cut out or off, without replacement
✔✔When coding benign neoplasm of the breast, the section noted "D24 Benign
neoplasm of breast" directs coder to: - ✔✔Use category D24 for fibroadenoma of breast
✔✔Patient was discharged with the following dx: "Cerebral artery occlusion,
hemiparesis, and hypertension. The aphasia resolved before the pt was discharged."
Which of the following code assignment would be appropriate for this case? - ✔✔I66.9,
G81.90, R47.01, I10
✔✔Pt is admitted to hospital with shortness of breath and CHF. Pt subsequently
develops respiratory failure and undergoes intubation with ventilator management.
Which of the following would be the correct sequencing and coding of this case? -
✔✔CHF, respiratory failure, ventilator management (Acute respiratory failure may be
assigned as a PD depending on the circumstances of the InPT admission; because the
respiratory failure occurred after admission, it is listed as a secondary dx and the CHF is
listed first.)
✔✔Physician correctly prescribes Coumadin and the pt takes the Coumadin as
prescribed, but develops hematuria as a result. Which of the following is the correct
coding? - ✔✔Hematuria; adverse reaction to Coumadin
✔✔Pt is admitted to chest pain with cardiac dysrhythmia to Hospital A, then found to
have acute STEMI with atrial fibrillation. After AF was controlled and pt stabilized, pt is
transferred to Hospital B for a CABG X3. Coumadin therapy and monitoring for the AF
continued at Hospital B. What is the proper coding and sequencing for both hospitals? -
✔✔Hospital A: I21.19, I48.91; Hospital B: I21.19, I48.91, 021209W (Encounters
occurring while the MI is equal to, or less than, 4 wks. old, including transfers to another
acute setting or postacute setting, and pt req continued care for MI, codes from
category I21 may continue to be reported
, ✔✔Pt is admitted to hospital with abdominal pain and PD is cholecystitis. Pt also has
history of hypertension and DM. In DRG-PPS, which would determine the MDC
assignment for this pt? - ✔✔Cholecystitis, since PD determines the MDC assignment
✔✔Pt was admitted to hospital with symptoms of a stroke and secondary diagnoses of
COPD and hypertension. Pt was subsequently discharged from hospital with PD of
cerbral vascular accident and secondary diagnoses of catheter-associated urinary tract
infection, COPD, and hypertension. Which should NOT be tagged as POA? -
✔✔Catheter-associated urinary tract infection
✔✔What is a condition that arise during hospitalization? - ✔✔Complication
✔✔65 yo female was admitted to hospital and diagnosed with sepsis secondary to
Staphylococcus aureus and abdominal pain secondary to diverticulitis of the colon.
What is the correct code assignment? - ✔✔A41.01 - Sepsis, due to Staph. aureus
K57.92 - Diverticulitis
✔✔Patient had carcinoma of anterior bladder wall fulgurated 3 years ago and returns
yearly for cystoscopy to recheck for bladder tumor. Patient is currently admitted for a
routine check. A small recurring malignancy is found and fulgurated during the
cystoscopy procedure. What is the correct code assignment - ✔✔C67.3 - Neoplasm,
bladder, wall, anterior, malignancy 0T5B8ZZ - Fulguration (see Destruction), Bladder,
via Natural or Artificial Opening Endoscopic, No device or qualifier
✔✔Pt with dx of ventral hernia is admitted to undergo laparotomy with ventral hernia
repair and undergoes an incision in the abdominal wall, then develops bradycardia.
Surgeon does not indicate that it is a complication of surgery. The operative site is
closed without the repair of the hernia. What is the correct code assignment? -
✔✔K43.9 - Hernia, ventral
R00.1 - Bradycardia
Z53.09 - Procedure, not done, because of, contraindication
OWJF0ZZ - Inspection, abdominal wall, open, no device or qualifier (assigned to the
extent of the procedure, not the full laparotomy)
✔✔Codes used to assign a dx to a pt seeking health services but not necessarily sick: -
✔✔Z codes
✔✔Pt admitted through ED following fall from a ladder with painting an interior bathroom
in his farmhouse and had contusions of the scalp and face, and displaced open fracture
of anterior wall of rt acetabulum. Fracture site was excisionally debrided and fracture
was reduced by open procedure with internal fixation device inserted. What is correct
code assignment? - ✔✔S32.411B - Fracture, traumatic, acetabulum, wall, anterior,
displaced,right, initial encounter, open fracture
S00.03XA - Contusion, scalp, X place mark, initial encounter
