CCA EVALUATION EXAM 2026 QUESTIONS AND
SOLUTIONS RATED A+
✔✔Your facility would like to improve physician documentation in order to allow
improved coding. As coding supervisor, you have found it very effective to provide the
physicians with - ✔✔feedback on specific instances when improved documentation
would improve coding.
✔✔NCCI stands for - ✔✔National Correct Coding Initiative.
✔✔While CAC systems are convenient, the codes they determine must be validated to
ensure accuracy. One method to do this would be - ✔✔a prospective audit.
✔✔The outpatient method for reimbursement from CMS for Medicare is -
✔✔Ambulatory Patient Classification (APC).
✔✔All of these are acceptable destruction methods when health records are no longer
required, EXCEPT - ✔✔deleting files from the server.
✔✔One excellent source to guide you to perform ethical coding is ________. -
✔✔AHIMA
✔✔Which of the following contains a list of coding edits developed by CMS in an effort
to promote correct coding nationwide and to prevent the inappropriate unbundling of
related services? - ✔✔National Correct Coding Initiative (NCCI)
✔✔Which of the following could influence a facility's case mix? - ✔✔accuracy of coding
changes in DRG weights
changes in the services offered by a facility
✔✔The patient was brought in by ambulance to the Emergency Department. An EKG
and bloodwork were completed, and the patient was discharged, with a
recommendation to see his cardiologist. The next day, the cardiologist admitted this
patient to the surgery ward to prepare for a valve replacement procedure. The EKG
performed in the ED the day before should - ✔✔be reported as an outpatient procedure.
✔✔The special form that plays the central role in planning and providing care at
nursing, psychiatric, and rehabilitation facilities is the - ✔✔interdisciplinary patient care
plan.
✔✔As part of a concurrent record review, you need to locate the initial plan of action
based on the attending physician's initial assessment of the patient. You can expect to
, find this documentation either within the body of the history and physical or in the -
✔✔doctor's admitting progress note.
✔✔If a claim is returned as denied or rejected due to an error, the best thing to do is -
✔✔correct the claim and resubmit in accordance with the third-party payer.
✔✔Which of the following is vital for determining why the reimbursement from an
insurance company is less than that was expected? - ✔✔the remittance advice
✔✔The most efficient way to determine the accurate DRG (Diagnosis Related Group) is
to utilize software known as - ✔✔a grouper.
✔✔Linking diagnosis codes to the CPT codes reported on a claim provides evidence of
- ✔✔medical necessity.
✔✔The purpose of the Correct Coding Initiative is to - ✔✔detect and prevent payment
for improperly coded services.
✔✔Ensuring that data have been modified or accessed only by individuals who are
authorized to do so is a function of data - ✔✔integrity.
✔✔DNR and DNI documents are all part of what are known as - ✔✔advance directives.
✔✔Medically Unlikely Edits (MUE) are a claims review looking for - ✔✔incorrect units of
service of any procedure, service, or treatment.
✔✔The practice of using a code that results in a higher payment to the provider than the
code that more accurately reflects the service provided is known as - ✔✔upcoding.
✔✔Your organization is sending confidential patient information across the Internet
using technology that will transform the original data into unintelligible code that can be
re-created by authorized users. This technique is called - ✔✔data encryption.
✔✔Which diagnosis should be listed first when sequencing inpatient codes using the
UHDDS? - ✔✔principal diagnosis
✔✔Diagnosis codes update every year on - ✔✔October 1.
✔✔The _______________ are the organizations that contract with Medicare to perform
reviews of medical records with the corresponding Medicare claims to detect and
correct improper payments. - ✔✔recovery audit contractors (RACs)
SOLUTIONS RATED A+
✔✔Your facility would like to improve physician documentation in order to allow
improved coding. As coding supervisor, you have found it very effective to provide the
physicians with - ✔✔feedback on specific instances when improved documentation
would improve coding.
✔✔NCCI stands for - ✔✔National Correct Coding Initiative.
✔✔While CAC systems are convenient, the codes they determine must be validated to
ensure accuracy. One method to do this would be - ✔✔a prospective audit.
✔✔The outpatient method for reimbursement from CMS for Medicare is -
✔✔Ambulatory Patient Classification (APC).
✔✔All of these are acceptable destruction methods when health records are no longer
required, EXCEPT - ✔✔deleting files from the server.
✔✔One excellent source to guide you to perform ethical coding is ________. -
✔✔AHIMA
✔✔Which of the following contains a list of coding edits developed by CMS in an effort
to promote correct coding nationwide and to prevent the inappropriate unbundling of
related services? - ✔✔National Correct Coding Initiative (NCCI)
✔✔Which of the following could influence a facility's case mix? - ✔✔accuracy of coding
changes in DRG weights
changes in the services offered by a facility
✔✔The patient was brought in by ambulance to the Emergency Department. An EKG
and bloodwork were completed, and the patient was discharged, with a
recommendation to see his cardiologist. The next day, the cardiologist admitted this
patient to the surgery ward to prepare for a valve replacement procedure. The EKG
performed in the ED the day before should - ✔✔be reported as an outpatient procedure.
✔✔The special form that plays the central role in planning and providing care at
nursing, psychiatric, and rehabilitation facilities is the - ✔✔interdisciplinary patient care
plan.
✔✔As part of a concurrent record review, you need to locate the initial plan of action
based on the attending physician's initial assessment of the patient. You can expect to
, find this documentation either within the body of the history and physical or in the -
✔✔doctor's admitting progress note.
✔✔If a claim is returned as denied or rejected due to an error, the best thing to do is -
✔✔correct the claim and resubmit in accordance with the third-party payer.
✔✔Which of the following is vital for determining why the reimbursement from an
insurance company is less than that was expected? - ✔✔the remittance advice
✔✔The most efficient way to determine the accurate DRG (Diagnosis Related Group) is
to utilize software known as - ✔✔a grouper.
✔✔Linking diagnosis codes to the CPT codes reported on a claim provides evidence of
- ✔✔medical necessity.
✔✔The purpose of the Correct Coding Initiative is to - ✔✔detect and prevent payment
for improperly coded services.
✔✔Ensuring that data have been modified or accessed only by individuals who are
authorized to do so is a function of data - ✔✔integrity.
✔✔DNR and DNI documents are all part of what are known as - ✔✔advance directives.
✔✔Medically Unlikely Edits (MUE) are a claims review looking for - ✔✔incorrect units of
service of any procedure, service, or treatment.
✔✔The practice of using a code that results in a higher payment to the provider than the
code that more accurately reflects the service provided is known as - ✔✔upcoding.
✔✔Your organization is sending confidential patient information across the Internet
using technology that will transform the original data into unintelligible code that can be
re-created by authorized users. This technique is called - ✔✔data encryption.
✔✔Which diagnosis should be listed first when sequencing inpatient codes using the
UHDDS? - ✔✔principal diagnosis
✔✔Diagnosis codes update every year on - ✔✔October 1.
✔✔The _______________ are the organizations that contract with Medicare to perform
reviews of medical records with the corresponding Medicare claims to detect and
correct improper payments. - ✔✔recovery audit contractors (RACs)
