CCS EXAM PREP COMPREHENSIVE EXAM|COMPLETE
STUDY GUIDE WITH 100% ACCURATE QUESTIONS &
ANSWERS | ACE EVERY TEST | GUARANTEED
EXCELLENCE.
The use of the outpatient code editor (OCE) is designed to: Answer: Identify incomplete or
incorrect claims
Medicare's identification of medically necessary services is outlined in: Answer: Local
coverage determinations
National Correct Coding Initiative (NCCI) are released how often? Answer: Quarterly
In 2000, the CMS issued the final rule on the outpatient prospective payment system. The final
rule: Answer: Divided outpatient services into fixed payment groups
DRG's and ambulatory patient classifications are similar in that they are both: Answer:
Prospective payment systems
Medicare exerts control of provider reimbursement through adjustment of this component of
the resource-based relative value scale Answer: Conversion factor
The process of collecting data elements from a source document is known as: Answer:
Abstracting
What piece of claims data from Hospital A alerts a payer that the patient was transferred to
Hospital B? Answer: Discharge disposition
Which of the following is considered a complication or comorbidity? Answer: Hypernatremia
Multiple choice queries must supply how many choices in order to be compliant? Answer: No
specific number
Compliant queries include which of the following? Answer: Relevant clinical indicators
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, Authentication of health record entries means to: Answer: Prove authorship of documents
The requirements for documentation and record completion (such as H&P's, discharge
summaries, and consultations) as well as penalties for non-adherence must be specified in:
Answer: Medical staff bylaws
Generally, data quality is defined as: Answer: Ensuring the accuracy and completeness of an
organization's data
Which type of conditions are always considered present on admission? Answer: Congenital
A patient is admitted for seizures. What is the appropriate POA for the external cause code of
W06.XXA assigned because the patient fell out of bed during a seizure in the ER? Answer: Y
The outpatient code editor (OCE) has all of the following types of edits except: Answer: Valid
diagnosis code edits
Determining medical necessity for outpatient services include all of the following except:
Answer: Requiring new HCPCS codes be developed to replace codes in the CPT code book
The National Correct Coding Initiative (NCCI) Edits apply to services billed by: Answer: The
same provider, for same beneficiary, on same date of service
If the principle diagnosis is an initial anterior wall myocardial infarction, which procedure will
result in the highest MS-DRG assignment? Answer: Transbronchial lung biopsy
Medicare payment to physicians for services rendered is made under the: Answer: Resource-
based Relative Value Scale
Inpatient procedures are coded with Answer: ICD-10-PCS
Under the inpatient prospective payment system (IPPS), what can be used to measure the cost
of care for inpatients? Answer: Case-mix index
The abstracting of this data element has an impact on the DRG reimbursement: Answer:
Discharge disposition
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
STUDY GUIDE WITH 100% ACCURATE QUESTIONS &
ANSWERS | ACE EVERY TEST | GUARANTEED
EXCELLENCE.
The use of the outpatient code editor (OCE) is designed to: Answer: Identify incomplete or
incorrect claims
Medicare's identification of medically necessary services is outlined in: Answer: Local
coverage determinations
National Correct Coding Initiative (NCCI) are released how often? Answer: Quarterly
In 2000, the CMS issued the final rule on the outpatient prospective payment system. The final
rule: Answer: Divided outpatient services into fixed payment groups
DRG's and ambulatory patient classifications are similar in that they are both: Answer:
Prospective payment systems
Medicare exerts control of provider reimbursement through adjustment of this component of
the resource-based relative value scale Answer: Conversion factor
The process of collecting data elements from a source document is known as: Answer:
Abstracting
What piece of claims data from Hospital A alerts a payer that the patient was transferred to
Hospital B? Answer: Discharge disposition
Which of the following is considered a complication or comorbidity? Answer: Hypernatremia
Multiple choice queries must supply how many choices in order to be compliant? Answer: No
specific number
Compliant queries include which of the following? Answer: Relevant clinical indicators
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, Authentication of health record entries means to: Answer: Prove authorship of documents
The requirements for documentation and record completion (such as H&P's, discharge
summaries, and consultations) as well as penalties for non-adherence must be specified in:
Answer: Medical staff bylaws
Generally, data quality is defined as: Answer: Ensuring the accuracy and completeness of an
organization's data
Which type of conditions are always considered present on admission? Answer: Congenital
A patient is admitted for seizures. What is the appropriate POA for the external cause code of
W06.XXA assigned because the patient fell out of bed during a seizure in the ER? Answer: Y
The outpatient code editor (OCE) has all of the following types of edits except: Answer: Valid
diagnosis code edits
Determining medical necessity for outpatient services include all of the following except:
Answer: Requiring new HCPCS codes be developed to replace codes in the CPT code book
The National Correct Coding Initiative (NCCI) Edits apply to services billed by: Answer: The
same provider, for same beneficiary, on same date of service
If the principle diagnosis is an initial anterior wall myocardial infarction, which procedure will
result in the highest MS-DRG assignment? Answer: Transbronchial lung biopsy
Medicare payment to physicians for services rendered is made under the: Answer: Resource-
based Relative Value Scale
Inpatient procedures are coded with Answer: ICD-10-PCS
Under the inpatient prospective payment system (IPPS), what can be used to measure the cost
of care for inpatients? Answer: Case-mix index
The abstracting of this data element has an impact on the DRG reimbursement: Answer:
Discharge disposition
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
