1|Page
AHIMA CCA EXAM 2 LATEST 2025 ACTUAL EXAM WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS (100% VERIFIED
ANSWERS) |ALREADY GRADED A+| ||PROFESSOR VERIFIED||
||BRANDNEW!!!||
What is the maximum number of procedure codes that can appear on a
UB-04 institutional claim form via electronic transmission?
a. 6
b. 9
c. 15
d. 25 - ANSWER-Correct Answer: D
Effective January 1, 2011, CMS allows a total of 25 ICD-9-CM
procedure codes for 837 Institutional claims filing (Schraffenberger
2012, 66).
What are possible "add-on" payments that a hospital could receive in
addition to the basic Medicare DRG payment?
a. Additional payments may be made for locum tenens, increased
emergency room services, stays over the average length of stay, and cost
outlier cases.
b. Additional payments may be made to critical access hospitals, for higher-
than-normal volumes, unexpected hospital emergencies, and cost outlier
cases.
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c. Additional payments may be made for increased emergency room
services, critical access hospitals, increased labor costs, and cost outlier
cases.
d. Additional payments may be made to disproportionate share hospitals
for indirect medical education, new technologies, and cost outlier cases. -
ANSWER-Correct Answer: D
Medicare provides for additional payment for other factors related to a
particular hospital's business. If the hospital treats a high percentage
of low-income patients, it receives a percentage add-on payment
applied to the MS-DRG adjusted base payment rate. This add-on
payment, known as the disproportionate share hospital (DSH)
adjustment, provides for a percentage increase in Medicare payments
to hospitals that qualify under either of two statutory formulas
designed to identify hospitals that serve these areas. Hospitals that
have approved teaching hospitals also receive a percentage add-on
payment for each Medicare discharged paid under IPPS, known as the
indirect medical education (IME) adjustment. The percentage varies,
depending on the ratio of residents to beds. Additional payments are
made for new technologies or medical services that have been
approved for special add-on payments. Finally, the costs incurred by
a hospital for a Medicare beneficiary are evaluated to determine
whether the hospital is eligible for an additional payment as an outlier
case. This additional payment is designed to protect the hospital from
,3|Page
large financial losses due to unusually expensive cases
(Schraffenberger 2012, 471-473).
What is the name of the national program to detect and correct improper
payments in the Medicare Fee-for-Service (FFS) program?
a. Medicare administrative contractors (MACs)
b. Recovery audit contractors (RACs)
c. Comprehensive error rate testing (CERT)
d. Fiscal intermediaries (FIs) - ANSWER-Correct Answer: B
Congress directed HHS to conduct a three-year demonstration project
using RACs to detect and correct improper payments in the Medicare
traditional fee-for-service program. Congress further required HHS to
make the RAC program permanent and nationwide by January 1, 2010
(Schraffenberger 2012, 475).
Identify the correct ICD-9-CM diagnosis code(s) and sequence for a patient
with disseminated candidiasis secondary to AIDS-like syndrome.
a. 042, 112.5, V01.79
b. 112.5, 042
c. 042, 112.5, V08
d. 042, 112.5 - ANSWER-Correct Answer: D
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Only confirmed cases of HIV infection/illness are reported whether
inpatient or outpatient. 042, Human immunodeficiency virus [HIV]
disease. Patients with HIV-related illness should be coded to category
042, which includes AIDS, AIDS-like syndrome, AIDS-related complex,
and symptomatic HIV infection (Hazelwood and Venable 2012, 89-90).
What is the name of the organization that develops the billing form that
hospitals are required to use?
a. American Academy of Billing Forms (AABF)
b. National Uniform Billing Committee (NUBC)
c. National Uniform Claims Committee (NUCC)
d. American Billing and Claims Academy (ABCA) - ANSWER-Correct
Answer: B
The NUBC was established with the goal of developing an acceptable,
uniform bill that would consolidate the numerous billing forms
hospitals were required to use (Schraffenberger 2012, 65).
What is the basic formula for calculating each MS-DRG hospital payment?
a. Hospital payment = DRG relative weight × hospital base rate
b. Hospital payment = DRG relative weight × hospital base rate − 1
AHIMA CCA EXAM 2 LATEST 2025 ACTUAL EXAM WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS (100% VERIFIED
ANSWERS) |ALREADY GRADED A+| ||PROFESSOR VERIFIED||
||BRANDNEW!!!||
What is the maximum number of procedure codes that can appear on a
UB-04 institutional claim form via electronic transmission?
a. 6
b. 9
c. 15
d. 25 - ANSWER-Correct Answer: D
Effective January 1, 2011, CMS allows a total of 25 ICD-9-CM
procedure codes for 837 Institutional claims filing (Schraffenberger
2012, 66).
What are possible "add-on" payments that a hospital could receive in
addition to the basic Medicare DRG payment?
a. Additional payments may be made for locum tenens, increased
emergency room services, stays over the average length of stay, and cost
outlier cases.
b. Additional payments may be made to critical access hospitals, for higher-
than-normal volumes, unexpected hospital emergencies, and cost outlier
cases.
,2|Page
c. Additional payments may be made for increased emergency room
services, critical access hospitals, increased labor costs, and cost outlier
cases.
d. Additional payments may be made to disproportionate share hospitals
for indirect medical education, new technologies, and cost outlier cases. -
ANSWER-Correct Answer: D
Medicare provides for additional payment for other factors related to a
particular hospital's business. If the hospital treats a high percentage
of low-income patients, it receives a percentage add-on payment
applied to the MS-DRG adjusted base payment rate. This add-on
payment, known as the disproportionate share hospital (DSH)
adjustment, provides for a percentage increase in Medicare payments
to hospitals that qualify under either of two statutory formulas
designed to identify hospitals that serve these areas. Hospitals that
have approved teaching hospitals also receive a percentage add-on
payment for each Medicare discharged paid under IPPS, known as the
indirect medical education (IME) adjustment. The percentage varies,
depending on the ratio of residents to beds. Additional payments are
made for new technologies or medical services that have been
approved for special add-on payments. Finally, the costs incurred by
a hospital for a Medicare beneficiary are evaluated to determine
whether the hospital is eligible for an additional payment as an outlier
case. This additional payment is designed to protect the hospital from
,3|Page
large financial losses due to unusually expensive cases
(Schraffenberger 2012, 471-473).
What is the name of the national program to detect and correct improper
payments in the Medicare Fee-for-Service (FFS) program?
a. Medicare administrative contractors (MACs)
b. Recovery audit contractors (RACs)
c. Comprehensive error rate testing (CERT)
d. Fiscal intermediaries (FIs) - ANSWER-Correct Answer: B
Congress directed HHS to conduct a three-year demonstration project
using RACs to detect and correct improper payments in the Medicare
traditional fee-for-service program. Congress further required HHS to
make the RAC program permanent and nationwide by January 1, 2010
(Schraffenberger 2012, 475).
Identify the correct ICD-9-CM diagnosis code(s) and sequence for a patient
with disseminated candidiasis secondary to AIDS-like syndrome.
a. 042, 112.5, V01.79
b. 112.5, 042
c. 042, 112.5, V08
d. 042, 112.5 - ANSWER-Correct Answer: D
, 4|Page
Only confirmed cases of HIV infection/illness are reported whether
inpatient or outpatient. 042, Human immunodeficiency virus [HIV]
disease. Patients with HIV-related illness should be coded to category
042, which includes AIDS, AIDS-like syndrome, AIDS-related complex,
and symptomatic HIV infection (Hazelwood and Venable 2012, 89-90).
What is the name of the organization that develops the billing form that
hospitals are required to use?
a. American Academy of Billing Forms (AABF)
b. National Uniform Billing Committee (NUBC)
c. National Uniform Claims Committee (NUCC)
d. American Billing and Claims Academy (ABCA) - ANSWER-Correct
Answer: B
The NUBC was established with the goal of developing an acceptable,
uniform bill that would consolidate the numerous billing forms
hospitals were required to use (Schraffenberger 2012, 65).
What is the basic formula for calculating each MS-DRG hospital payment?
a. Hospital payment = DRG relative weight × hospital base rate
b. Hospital payment = DRG relative weight × hospital base rate − 1
