AHIMA CCA FINAL PAPER 2026
SOLVED QUESTIONS VERIFIED
ANSWERS 100 PERCENT CORRECT
FULL STUDY SHEET
◉ 2. All of the following should be part of the core areas of a coding
compliance plan except:
a. physician query process
b. correct use of encoder software
c. coding diagnoses supported by medical record documentation
d. tracking length of stay. Answer: d. tracking length of stay
tracking length of stay is part of the hospital utilization review
committee function
◉ 3. Common forms of fraud and abuse include all of the following
except:
a. upcoding
b. unbundling or "exploding" charges
c. refilling claims after denials
d. billing for services not furnished to patients. Answer: c. refilling
claims after denials
, refilling claims after denial is not possible because denied claims must
be appealed and is not a factor in controlling fraud and abuse.
◉ 4. What is the primary use of the case-mix index?
a. benchmark of emergency room levels
b. defines how a hospital compares to peers and whether the facility is
at risk
c. audit of APCS and the comparison to same-size hospitals
d. a tool for the coding manager to compare coder productivity.
Answer: b. defines how a hospital compares to peers and whether the
facility is at risk
BENCHMARKING or PEER COMPARISON helps a manager to know how
his or her team has performed compared to peers. This include
whether the case-mix index level puts the facility at risk.
◉ 5. 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
SOLVED QUESTIONS VERIFIED
ANSWERS 100 PERCENT CORRECT
FULL STUDY SHEET
◉ 2. All of the following should be part of the core areas of a coding
compliance plan except:
a. physician query process
b. correct use of encoder software
c. coding diagnoses supported by medical record documentation
d. tracking length of stay. Answer: d. tracking length of stay
tracking length of stay is part of the hospital utilization review
committee function
◉ 3. Common forms of fraud and abuse include all of the following
except:
a. upcoding
b. unbundling or "exploding" charges
c. refilling claims after denials
d. billing for services not furnished to patients. Answer: c. refilling
claims after denials
, refilling claims after denial is not possible because denied claims must
be appealed and is not a factor in controlling fraud and abuse.
◉ 4. What is the primary use of the case-mix index?
a. benchmark of emergency room levels
b. defines how a hospital compares to peers and whether the facility is
at risk
c. audit of APCS and the comparison to same-size hospitals
d. a tool for the coding manager to compare coder productivity.
Answer: b. defines how a hospital compares to peers and whether the
facility is at risk
BENCHMARKING or PEER COMPARISON helps a manager to know how
his or her team has performed compared to peers. This include
whether the case-mix index level puts the facility at risk.
◉ 5. 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
