Certified Coding Associate (CCA) Domains 1–6 Practice Examination
2026-2027 VERSION
1. A patient is admitted with spotting. She had been treated two weeks previously for a
miscarriage with sepsis. The sepsis had resolved, and she is afebrile at this time. She is
treated with an aspiration dilation and curettage and products of conception are found.
Which of the following should be the principal diagnosis?
a. Miscarriage
b. Complications of spontaneous abortion with sepsis
c. Sepsis
d. Spontaneous abortion with sepsis - correct answer>>>a. Miscarriage
2. If a patient has an excision of a malignant lesion of the skin, the CPT code is
determined by the body area from which the excision occurs and which of the following?
a. Length of the lesion as described in the pathology report
b. Dimension of the specimen submitted as described in the pathology report
c. Width times the length of the lesion as described in the operative report
d. Diameter of the lesion as well as the most narrow margins required to adequately
excise the lesion described in the operative report - correct answer>>>d. Diameter of
the lesion as well as the most narrow margins required to adequately excise the lesion
described in the operative report
3. A patient is admitted to the hospital with shortness of breath and congestive heart
failure. The patient subsequently develops respiratory failure. The patient undergoes
intubation with ventilator management. Which of the following would be the correct
sequencing and coding of this case?
a. Congestive heart failure, respiratory failure, ventilator management
b. Respiratory failure, intubation, ventilator management
c. Respiratory failure, congestive heart failure, intubation, ventilator management
d. Shortness of breath, congestive heart failure, respiratory failure, ventilator
management - correct answer>>>a. Congestive heart failure, respiratory failure,
ventilator management
4. Which of the following is a standard terminology used to code medical procedures
and services?
a. CPT
b. HCPCS
c. ICD-10-PCS
d. SNOMED CT - correct answer>>>a. CPT
,5. What is the correct CPT code assignment for hysteroscopy with lysis of intrauterine
adhesions?
a. 58555, 58559
b. 58559
c. 58559, 58740
d. 58555, 58559, 58740 - correct answer>>>b. 58559
6. What is the correct CPT code assignment for destruction of internal hemorrhoids with
use of infrared coagulation?
a. 46255
b. 46930
c. 46260
d. 46945 - correct answer>>>b. 46930
7.00Identify the diagnosis code(s) for melanoma of skin of right shoulder.
a. D03.61, C43.61
b. C43.61
c. C43.60
d. D03.61 - correct answer>>>b. C43.61
8. A female patient is admitted for stress incontinence. A urethral suspension to
reposition the urethra via open approach is performed. Assign the correct ICD-10-CM
diagnosis and/or procedure codes.
a. N39.3, 0TJB8ZZ
b. N23, 0TSD0ZZ
c. N39.3, 0TSD0ZZ
d. R32, 0TSD4ZZ - correct answer>>>c. N39.3, 0TSD0ZZ
9. A patient is admitted to the hospital with abdominal pain. The principal diagnosis is
cholecystitis. The patient also has a history of hypertension and diabetes. In the DRG
prospective payment system, which of the following would determine the MDC
assignment for this patient?
a. Abdominal pain
b. Cholecystitis
c. Hypertension
d. Diabetes - correct answer>>>b. Cholecystitis
10. Reference codes 49491 through 49525 for inguinal hernia repair. Patient is 47 years
old. What is the correct code for an initial inguinal herniorrhaphy for incarcerated
hernia?
,a. 49496
b. 49501
c. 49507
d. 49521 - correct answer>>>c. 49507
11. A patient was admitted for abdominal pain with diarrhea and was diagnosed with
infectious gastroenteritis. The patient also has angina and chronic obstructive
pulmonary disease. Which of the following would be the correct coding and sequencing
for this case?
a. Abdominal pain; infectious gastroenteritis; chronic obstructive pulmonary disease;
angina
b. Infectious gastroenteritis; chronic obstructive pulmonary disease; angina
c. Gastroenteritis; abdominal pain; angina
d. Gastroenteritis; abdominal pain; diarrhea; chronic obstructive pulmonary disease;
angina - correct answer>>>b. Infectious gastroenteritis; chronic obstructive pulmonary
disease; angina
12. A 65-year-old female was admitted to the hospital. She was diagnosed with sepsis
secondary to Staphylococcus aureus and abdominal pain secondary to diverticulitis of
the colon. What is the correct code assignment?
a. A41.89, K57.92, R10.9
b. A41.01, K57.92
c. A41.89, K57.92, A49.01
d. A41.9, K57.92 - correct answer>>>b. A41.01, K57.92
13. Coding accuracy is anticipated to improve due to which ICD-10-CM enhancement?
a. Less combination codes
b. Increased cross referencing
c. Removal of laterality
d. Expanded codes that capture more detail - correct answer>>>d. Expanded codes
that capture more detail
14. Patient with flank pain was admitted and found to have a calculus of the kidney. A
ureteroscopy with placement of bilateral ureteral stents was performed to expand the
lumen so the stone could pass naturally. Assign the correct ICD-10-CM/PCS diagnosis
and procedure codes.
a. N20.0, N23, 0T788DZ
b. N23, N20.0, 0TC68ZZ, 0TC78ZZ
c. N20.0, 0T768DZ, 0T778DZ
d. N20.0, 0T788DZ - correct answer>>>d. N20.0, 0T788DZ
, 15. Code only a confirmed diagnosis of Zika virus (A92.5, Zika virus disease) as
documented by the provider. In this context, "confirmation" __________.
a. Does not require documentation of the type of test performed; the physician's
diagnostic statement that the condition is confirmed is sufficient
b. Requires the documentation of the type of test in addition to the physician's
diagnostic statement
c. Must be provided by the laboratory findings report
d. Requires that the Public Health Agency be contacted - correct answer>>>a. Does not
require documentation of the type of test performed; the physician's diagnostic
statement that the condition is confirmed is sufficient
16. 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. Asthma with status asthmaticus
17. A patient is admitted with acute exacerbation of COPD, chronic renal failure, and
hypertension.
a. J44.1, J44.9, I12.9, N18.9
b. J44.1, N18.9, I10
c. J44.9, N18.9, I10
d. J44.1, I12.9, N18.9 - correct answer>>>d. J44.1, I12.9, N18.9
18. What does the fourth character of an ICD-10-CM diagnosis code capture?
a. Anatomic site
b. Severity
c. Etiology
d. Supplemental information - correct answer>>>c. Etiology
19. Identify the diagnosis code(s) for carcinoma in situ of vocal cord.
a. D02.0
b. C32.0
c. D49.1
d. D14.1 - correct answer>>>a. D02.0
20. 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?
2026-2027 VERSION
1. A patient is admitted with spotting. She had been treated two weeks previously for a
miscarriage with sepsis. The sepsis had resolved, and she is afebrile at this time. She is
treated with an aspiration dilation and curettage and products of conception are found.
Which of the following should be the principal diagnosis?
a. Miscarriage
b. Complications of spontaneous abortion with sepsis
c. Sepsis
d. Spontaneous abortion with sepsis - correct answer>>>a. Miscarriage
2. If a patient has an excision of a malignant lesion of the skin, the CPT code is
determined by the body area from which the excision occurs and which of the following?
a. Length of the lesion as described in the pathology report
b. Dimension of the specimen submitted as described in the pathology report
c. Width times the length of the lesion as described in the operative report
d. Diameter of the lesion as well as the most narrow margins required to adequately
excise the lesion described in the operative report - correct answer>>>d. Diameter of
the lesion as well as the most narrow margins required to adequately excise the lesion
described in the operative report
3. A patient is admitted to the hospital with shortness of breath and congestive heart
failure. The patient subsequently develops respiratory failure. The patient undergoes
intubation with ventilator management. Which of the following would be the correct
sequencing and coding of this case?
a. Congestive heart failure, respiratory failure, ventilator management
b. Respiratory failure, intubation, ventilator management
c. Respiratory failure, congestive heart failure, intubation, ventilator management
d. Shortness of breath, congestive heart failure, respiratory failure, ventilator
management - correct answer>>>a. Congestive heart failure, respiratory failure,
ventilator management
4. Which of the following is a standard terminology used to code medical procedures
and services?
a. CPT
b. HCPCS
c. ICD-10-PCS
d. SNOMED CT - correct answer>>>a. CPT
,5. What is the correct CPT code assignment for hysteroscopy with lysis of intrauterine
adhesions?
a. 58555, 58559
b. 58559
c. 58559, 58740
d. 58555, 58559, 58740 - correct answer>>>b. 58559
6. What is the correct CPT code assignment for destruction of internal hemorrhoids with
use of infrared coagulation?
a. 46255
b. 46930
c. 46260
d. 46945 - correct answer>>>b. 46930
7.00Identify the diagnosis code(s) for melanoma of skin of right shoulder.
a. D03.61, C43.61
b. C43.61
c. C43.60
d. D03.61 - correct answer>>>b. C43.61
8. A female patient is admitted for stress incontinence. A urethral suspension to
reposition the urethra via open approach is performed. Assign the correct ICD-10-CM
diagnosis and/or procedure codes.
a. N39.3, 0TJB8ZZ
b. N23, 0TSD0ZZ
c. N39.3, 0TSD0ZZ
d. R32, 0TSD4ZZ - correct answer>>>c. N39.3, 0TSD0ZZ
9. A patient is admitted to the hospital with abdominal pain. The principal diagnosis is
cholecystitis. The patient also has a history of hypertension and diabetes. In the DRG
prospective payment system, which of the following would determine the MDC
assignment for this patient?
a. Abdominal pain
b. Cholecystitis
c. Hypertension
d. Diabetes - correct answer>>>b. Cholecystitis
10. Reference codes 49491 through 49525 for inguinal hernia repair. Patient is 47 years
old. What is the correct code for an initial inguinal herniorrhaphy for incarcerated
hernia?
,a. 49496
b. 49501
c. 49507
d. 49521 - correct answer>>>c. 49507
11. A patient was admitted for abdominal pain with diarrhea and was diagnosed with
infectious gastroenteritis. The patient also has angina and chronic obstructive
pulmonary disease. Which of the following would be the correct coding and sequencing
for this case?
a. Abdominal pain; infectious gastroenteritis; chronic obstructive pulmonary disease;
angina
b. Infectious gastroenteritis; chronic obstructive pulmonary disease; angina
c. Gastroenteritis; abdominal pain; angina
d. Gastroenteritis; abdominal pain; diarrhea; chronic obstructive pulmonary disease;
angina - correct answer>>>b. Infectious gastroenteritis; chronic obstructive pulmonary
disease; angina
12. A 65-year-old female was admitted to the hospital. She was diagnosed with sepsis
secondary to Staphylococcus aureus and abdominal pain secondary to diverticulitis of
the colon. What is the correct code assignment?
a. A41.89, K57.92, R10.9
b. A41.01, K57.92
c. A41.89, K57.92, A49.01
d. A41.9, K57.92 - correct answer>>>b. A41.01, K57.92
13. Coding accuracy is anticipated to improve due to which ICD-10-CM enhancement?
a. Less combination codes
b. Increased cross referencing
c. Removal of laterality
d. Expanded codes that capture more detail - correct answer>>>d. Expanded codes
that capture more detail
14. Patient with flank pain was admitted and found to have a calculus of the kidney. A
ureteroscopy with placement of bilateral ureteral stents was performed to expand the
lumen so the stone could pass naturally. Assign the correct ICD-10-CM/PCS diagnosis
and procedure codes.
a. N20.0, N23, 0T788DZ
b. N23, N20.0, 0TC68ZZ, 0TC78ZZ
c. N20.0, 0T768DZ, 0T778DZ
d. N20.0, 0T788DZ - correct answer>>>d. N20.0, 0T788DZ
, 15. Code only a confirmed diagnosis of Zika virus (A92.5, Zika virus disease) as
documented by the provider. In this context, "confirmation" __________.
a. Does not require documentation of the type of test performed; the physician's
diagnostic statement that the condition is confirmed is sufficient
b. Requires the documentation of the type of test in addition to the physician's
diagnostic statement
c. Must be provided by the laboratory findings report
d. Requires that the Public Health Agency be contacted - correct answer>>>a. Does not
require documentation of the type of test performed; the physician's diagnostic
statement that the condition is confirmed is sufficient
16. 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. Asthma with status asthmaticus
17. A patient is admitted with acute exacerbation of COPD, chronic renal failure, and
hypertension.
a. J44.1, J44.9, I12.9, N18.9
b. J44.1, N18.9, I10
c. J44.9, N18.9, I10
d. J44.1, I12.9, N18.9 - correct answer>>>d. J44.1, I12.9, N18.9
18. What does the fourth character of an ICD-10-CM diagnosis code capture?
a. Anatomic site
b. Severity
c. Etiology
d. Supplemental information - correct answer>>>c. Etiology
19. Identify the diagnosis code(s) for carcinoma in situ of vocal cord.
a. D02.0
b. C32.0
c. D49.1
d. D14.1 - correct answer>>>a. D02.0
20. 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?
