MASTERING THE AHIMA CCS EXAM 2025: YOUR ULTIMATE GUIDE TO CERTIFIED CODING SUCCESS
CPT defines a separate procedure as - Precise Answer ✔✔Procedure
considered an integral part of a more major service
No combination code available - Precise Answer ✔✔Use separate codes
for hypertension and acute renal failure
Documentation from the nursing staff or other allied health
professionals' notes can be used to provide specificity for code
assignment for which of the following diagnoses? - Precise Answer
✔✔Body Mass Index (BMI)
POA Indicator - Y - Precise Answer ✔✔Y-Yes, present at the time of
inpatient admission
POA Indicator - N - Precise Answer ✔✔N-No, not present at the time of
inpatient admission
POA Indicator - U - Precise Answer ✔✔U-Unknown, documentation is
insufficient to determine if condition is present on admission and you
cannot speak to the physician to figure it out
POA Indicator - W - Precise Answer ✔✔W-Clinically undetermined,
provider is unable to clinically determine whether condition was present
on admission or not
,POA Indicator - E - Precise Answer ✔✔E-Exempt, unreported/not used,
some facilities will leave these blank, others will use the letter "E"
Present on Admission Indicator (POA) - Precise Answer ✔✔A Present
On Admission (POA) indicator is required on all diagnosis codes for the
inpatient setting except for admission. The indicator should be reported
for principal diagnosis codes, secondary diagnosis codes, Z-codes, and
External cause injury codes.
The use of the outpatient code editor (OCE) is designed to: - Precise
Answer ✔✔Identify incomplete and incorrect claims
Medicare's identification of medically necessary services is outlined in: -
Precise Answer ✔✔Local Coverage Determinations (LCDs)
Medically unlikely edits are used to identify: - Precise Answer
✔✔Maximum units of service for a HCPCS code
National Correct Coding Initiative (NCCI) Edits are released how often?
- Precise Answer ✔✔Quarterly
In 2000, CMS issued the final rule on the outpatient prospective
payment system (OPPS). The final rule: - Precise Answer ✔✔Divided
outpatient services into fixed payment groups
, Diagnostic-related groups (DRGs) and ambulatory patient classifications
(APCs) are similar in that they are both: - Precise Answer
✔✔Prospective payment systems
What are APCs? - Precise Answer ✔✔APCs or "Ambulatory Payment
Classifications" are the government's method of paying facilities for
outpatient services for the Medicare program.
How do APCs work? - Precise Answer ✔✔The payments are calculated
by multiplying the APCs relative weight by the OPPS conversion factor
and then there is a minor adjustment for geographic location.
APC Status Indicator - C - Precise Answer ✔✔Inpatient Procedures, not
paid under OPPS
APC Status Indicator - N - Precise Answer ✔✔Items and Services
Packaged into APC Rates
APC Status Indicator - S - Precise Answer ✔✔Significant Procedure,
Not Discounted When Multiple
APC Status Indicator - T - Precise Answer ✔✔Significant Procedure,
Multiple Reduction Applies
APC Status Indicator - V - Precise Answer ✔✔Clinic or Emergency
Department Visit
CPT defines a separate procedure as - Precise Answer ✔✔Procedure
considered an integral part of a more major service
No combination code available - Precise Answer ✔✔Use separate codes
for hypertension and acute renal failure
Documentation from the nursing staff or other allied health
professionals' notes can be used to provide specificity for code
assignment for which of the following diagnoses? - Precise Answer
✔✔Body Mass Index (BMI)
POA Indicator - Y - Precise Answer ✔✔Y-Yes, present at the time of
inpatient admission
POA Indicator - N - Precise Answer ✔✔N-No, not present at the time of
inpatient admission
POA Indicator - U - Precise Answer ✔✔U-Unknown, documentation is
insufficient to determine if condition is present on admission and you
cannot speak to the physician to figure it out
POA Indicator - W - Precise Answer ✔✔W-Clinically undetermined,
provider is unable to clinically determine whether condition was present
on admission or not
,POA Indicator - E - Precise Answer ✔✔E-Exempt, unreported/not used,
some facilities will leave these blank, others will use the letter "E"
Present on Admission Indicator (POA) - Precise Answer ✔✔A Present
On Admission (POA) indicator is required on all diagnosis codes for the
inpatient setting except for admission. The indicator should be reported
for principal diagnosis codes, secondary diagnosis codes, Z-codes, and
External cause injury codes.
The use of the outpatient code editor (OCE) is designed to: - Precise
Answer ✔✔Identify incomplete and incorrect claims
Medicare's identification of medically necessary services is outlined in: -
Precise Answer ✔✔Local Coverage Determinations (LCDs)
Medically unlikely edits are used to identify: - Precise Answer
✔✔Maximum units of service for a HCPCS code
National Correct Coding Initiative (NCCI) Edits are released how often?
- Precise Answer ✔✔Quarterly
In 2000, CMS issued the final rule on the outpatient prospective
payment system (OPPS). The final rule: - Precise Answer ✔✔Divided
outpatient services into fixed payment groups
, Diagnostic-related groups (DRGs) and ambulatory patient classifications
(APCs) are similar in that they are both: - Precise Answer
✔✔Prospective payment systems
What are APCs? - Precise Answer ✔✔APCs or "Ambulatory Payment
Classifications" are the government's method of paying facilities for
outpatient services for the Medicare program.
How do APCs work? - Precise Answer ✔✔The payments are calculated
by multiplying the APCs relative weight by the OPPS conversion factor
and then there is a minor adjustment for geographic location.
APC Status Indicator - C - Precise Answer ✔✔Inpatient Procedures, not
paid under OPPS
APC Status Indicator - N - Precise Answer ✔✔Items and Services
Packaged into APC Rates
APC Status Indicator - S - Precise Answer ✔✔Significant Procedure,
Not Discounted When Multiple
APC Status Indicator - T - Precise Answer ✔✔Significant Procedure,
Multiple Reduction Applies
APC Status Indicator - V - Precise Answer ✔✔Clinic or Emergency
Department Visit
