certification EXAM, offered by the
American Health Information Management
Association (AHIMA) | Q&A WITH
RATIONALES - Pass AHIMA CCA CRAT on
Your First Try
1. 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?
A) National Correct Coding Initiative (NCCI)
B) Outpatient Code Editor (OCE)
C) Medicare Severity Diagnosis Related Groups (MS-
DRG)
D) Ambulatory Payment Classification (APC)
Correct answer: A
Rationale: The National Correct Coding Initiative
(NCCI) was developed by CMS to promote national
correct coding methodologies and to prevent
improper payment when procedure codes are
incorrectly unbundled or billed together when they
,should be considered part of a more comprehensive
code .
2. Which of the following could influence a facility's
case mix?
A) Accuracy of coding
B) Changes in DRG weights
C) Changes in the services offered by a facility
D) All of the above
Correct answer: D
Rationale: A facility's case mix is influenced by
multiple factors including the accuracy of coding
(which directly impacts DRG assignment), changes in
DRG weights (which affect reimbursement), and
changes in the types of services offered by the
facility .
3. A physician has come to the HIM department
because he wants a new smartphone to be able to
access patient records. This way he can enter orders
when he is outside of the hospital. The HIM
professional should direct the IT department to:
A) Encrypt the phone so access is protected
B) Disable all security features for ease of access
,C) Install social media applications for
communication
D) Remove all antivirus software
Correct answer: A
Rationale: To protect patient information, the
smartphone must be encrypted to secure data and
prevent unauthorized access. Encryption transforms
data into unintelligible code that can only be re-
created by authorized users .
4. You would expect to find documentation regarding
the assessment of an obstetric patient's lochia,
fundus, and perineum on the:
A) Postpartum record
B) Antepartum record
C) Intrapartum record
D) Newborn record
Correct answer: A
Rationale: The postpartum record contains
documentation of a mother's recovery after delivery,
including assessment of lochia (vaginal discharge),
fundus (uterine involution), and perineum (healing of
the birth canal) .
, 5. Procedure-to-Procedure (PTP) Edits review claims
for codes that report:
A) Procedures that cannot or should not be provided
to the same patient on the same day
B) Procedures that are always provided together
C) Procedures that are only performed in an inpatient
setting
D) Procedures that require prior authorization
Correct answer: A
Rationale: PTP edits are part of the NCCI and identify
pairs of procedure codes that should not be billed
together because one procedure is considered an
integral part of the other, or the procedures are
unlikely to be performed separately on the same
patient on the same day .
6. It is September 15th, and you have just received
the upcoming year's ICD-10-PCS code set updates.
The next step is to:
A) Put in a change ticket for the hospital's
chargemaster to be updated
B) Discard the updates without review
C) Immediately begin using the new codes
D) File the updates without action