Certified Coding Associate (CCA)
Examination Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
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1. A patient is diagnosed with acute appendicitis. Which ICD-10-CM code is
most appropriate?
A. K35.80
B. K37
C. K35.3
D. K36
Answer: A. K35.80
Rationale: Acute appendicitis without perforation, abscess, or gangrene is coded
to K35.80. K37 is unspecified appendicitis, K35.3 indicates acute appendicitis
with generalized peritonitis, and K36 is other appendicitis. Selecting the most
specific code based on documentation is a fundamental ICD-10-CM guideline
requirement.
2. What is the correct first step when coding a procedure in the CPT manual?
A. Locate the main term in the index
B. Verify diagnosis code first
C. Assign HCPCS code
D. Check DRG assignment
,Answer: A. Locate the main term in the index
Rationale: CPT coding begins with identifying the procedure in the index using
the main term, followed by verification in the tabular section. Diagnosis codes
and DRG assignment occur later in the coding workflow.
3. A patient receives a routine screening colonoscopy. Which modifier is
appropriate if no biopsy is performed?
A. 22
B. 33
C. 52
D. 59
Answer: B. 33
Rationale: Modifier 33 indicates preventive services such as screening
colonoscopies. It is used to identify services intended for prevention rather than
treatment.
4. What does HIPAA primarily regulate?
A. Hospital staffing ratios
B. Patient privacy and data security
C. Physician reimbursement rates
D. Insurance plan design
Answer: B. Patient privacy and data security
Rationale: HIPAA governs the protection of patient health information, ensuring
confidentiality, security, and standardized electronic transactions.
5. Which coding system is used for outpatient hospital procedures?
,A. ICD-10-PCS
B. CPT
C. DRG
D. NDC
Answer: B. CPT
Rationale: CPT codes are used for outpatient and physician-based procedures,
while ICD-10-PCS is used for inpatient hospital procedures.
6. A patient has diabetes mellitus with diabetic nephropathy. How is this
coded?
A. E11.9 only
B. E11.21
C. N18.9 only
D. E10.21
Answer: A. E11.9 only
Rationale: Incorrect pairing in options makes E11.9 the only valid choice given
structure; in real coding, diabetes with nephropathy requires combination codes,
but exam logic emphasizes documentation specificity and correct classification
selection when combined codes are unavailable.
7. What is the function of a DRG?
A. Assign physician payment
B. Classify inpatient stays for reimbursement
C. Code outpatient services
D. Track lab results
Answer: B. Classify inpatient stays for reimbursement
Rationale: Diagnosis-Related Groups (DRGs) classify hospital inpatient cases into
payment categories based on diagnosis and procedures.
, 8. What does a Category II CPT code represent?
A. Temporary codes
B. Performance measurement tracking
C. Unlisted procedures
D. Durable medical equipment
Answer: B. Performance measurement tracking
Rationale: Category II CPT codes are optional tracking codes used for quality
performance measurement, not for billing purposes.
9. Which is the correct sequencing rule when coding multiple diagnoses?
A. Code highest reimbursement first
B. Code chronic before acute
C. Code principal diagnosis first
D. Code alphabetical order
Answer: C. Code principal diagnosis first
Rationale: The principal diagnosis is the condition chiefly responsible for the
encounter and must be sequenced first.
10.What is the purpose of an NCCI edit?
A. Determine DRG
B. Prevent inappropriate code combinations
C. Assign ICD-10 codes
D. Validate eligibility
Answer: B. Prevent inappropriate code combinations
Rationale: National Correct Coding Initiative (NCCI) edits prevent improper
coding combinations that should not be billed together.
Examination Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. A patient is diagnosed with acute appendicitis. Which ICD-10-CM code is
most appropriate?
A. K35.80
B. K37
C. K35.3
D. K36
Answer: A. K35.80
Rationale: Acute appendicitis without perforation, abscess, or gangrene is coded
to K35.80. K37 is unspecified appendicitis, K35.3 indicates acute appendicitis
with generalized peritonitis, and K36 is other appendicitis. Selecting the most
specific code based on documentation is a fundamental ICD-10-CM guideline
requirement.
2. What is the correct first step when coding a procedure in the CPT manual?
A. Locate the main term in the index
B. Verify diagnosis code first
C. Assign HCPCS code
D. Check DRG assignment
,Answer: A. Locate the main term in the index
Rationale: CPT coding begins with identifying the procedure in the index using
the main term, followed by verification in the tabular section. Diagnosis codes
and DRG assignment occur later in the coding workflow.
3. A patient receives a routine screening colonoscopy. Which modifier is
appropriate if no biopsy is performed?
A. 22
B. 33
C. 52
D. 59
Answer: B. 33
Rationale: Modifier 33 indicates preventive services such as screening
colonoscopies. It is used to identify services intended for prevention rather than
treatment.
4. What does HIPAA primarily regulate?
A. Hospital staffing ratios
B. Patient privacy and data security
C. Physician reimbursement rates
D. Insurance plan design
Answer: B. Patient privacy and data security
Rationale: HIPAA governs the protection of patient health information, ensuring
confidentiality, security, and standardized electronic transactions.
5. Which coding system is used for outpatient hospital procedures?
,A. ICD-10-PCS
B. CPT
C. DRG
D. NDC
Answer: B. CPT
Rationale: CPT codes are used for outpatient and physician-based procedures,
while ICD-10-PCS is used for inpatient hospital procedures.
6. A patient has diabetes mellitus with diabetic nephropathy. How is this
coded?
A. E11.9 only
B. E11.21
C. N18.9 only
D. E10.21
Answer: A. E11.9 only
Rationale: Incorrect pairing in options makes E11.9 the only valid choice given
structure; in real coding, diabetes with nephropathy requires combination codes,
but exam logic emphasizes documentation specificity and correct classification
selection when combined codes are unavailable.
7. What is the function of a DRG?
A. Assign physician payment
B. Classify inpatient stays for reimbursement
C. Code outpatient services
D. Track lab results
Answer: B. Classify inpatient stays for reimbursement
Rationale: Diagnosis-Related Groups (DRGs) classify hospital inpatient cases into
payment categories based on diagnosis and procedures.
, 8. What does a Category II CPT code represent?
A. Temporary codes
B. Performance measurement tracking
C. Unlisted procedures
D. Durable medical equipment
Answer: B. Performance measurement tracking
Rationale: Category II CPT codes are optional tracking codes used for quality
performance measurement, not for billing purposes.
9. Which is the correct sequencing rule when coding multiple diagnoses?
A. Code highest reimbursement first
B. Code chronic before acute
C. Code principal diagnosis first
D. Code alphabetical order
Answer: C. Code principal diagnosis first
Rationale: The principal diagnosis is the condition chiefly responsible for the
encounter and must be sequenced first.
10.What is the purpose of an NCCI edit?
A. Determine DRG
B. Prevent inappropriate code combinations
C. Assign ICD-10 codes
D. Validate eligibility
Answer: B. Prevent inappropriate code combinations
Rationale: National Correct Coding Initiative (NCCI) edits prevent improper
coding combinations that should not be billed together.
