CCA Practice Exam (2 Versions) Latest Updated 2025
Questions and Verified Answers (Updated File from
Trusted Totur), GUARANTEED PASS!!!
Unbundling - :answers :-reducing the bundle of services that comes with the basic
product
NCCI auto payments are based on - :answers :-analysis of standard medical & surgical
practices
ncci PURPOSE - :answers :-Denials of outpatient claims, ensure proper CPT & HCPCS
coding for Medicare B
OCE - :answers :-Outpatient Code Editor
OCE purpose - :answers :-set rules for combinations of codes that are correct and rep
the services provided
VPB - :answers :-value based purchasing
VPB purpose - :answers :-programs link quality to reimbursement
Pre-MDC assignment for MS-DRG is based on - :answers :-ICD-10-PCS
Medicare Advantage - :answers :-provides expanded coverage including HMO, PPO,
special needs, Medical savings account
RVU - :answers :-Relative Value Unit
,RVU dues - :answers :-assigned to each code to provide a value that correlates to the
payment in resources, time, intensity, and expenses, and malpractice
What systems reimburse hospitals on a set amount for Medicare inpatient admission -
:answers :-MS-DRG
What represents the average resources required to care for patients whose admission
falls into an MS-DRG - :answers :-Relative Weight
What code set under OPPS is APC system primarily based for outpatient procedures and
services including devices, drugs, and other covered items - :answers :-CPT/HCPCS
Hard Coding - :answers :-Use of the charge description master to code directly to the
claim bypassing the staff
soft coding - :answers :-process of assigning specific codes or values to certain data
elements within a healthcare system or software.
Encoder coding - :answers :-A software that selects medical codes based on a set of
terminology
Natural Language Processing coding - :answers :-transforming medical coding by
automating the extraction of billable information from medical records and translating
it into standardized codes used for billing
ACO - :answers :-Accountable Care Organization
CMS-HCC - :answers :-Centers for Medicare & Medicaid Services-Hierarchical
Condition Category
,CMS-HCC purpose - :answers :-CMS implemented to provide fair and accurate
payments while rewarding efficiency and high-quality are for Medicare
MS-DRG is not influenced by the absence or presence - :answers :-CCs/MCCs
CMS require health records to be maintained for - :answers :-at least 5 years
Objective information - :answers :-measured or observed by healthcare provider
Quantitative analysis - :answers :-A review of the health record to determine its
completeness and accuracy
Qualitative analysis - :answers :-a review of the health record to ensure that standards
are met and to determine the adequacy of entries documenting the quality of care
Integrated health record is arranged - :answers :-Strict chronological order
OIG - :answers :-Office of Inspector General
OIG purpose - :answers :-Investigates & prosecutes people who overbill Medicare,
develops an annual plan to target areas to monitor
ORT - :answers :-Operation Restore Trust
ORT purpose - :answers :-released in 1995 to target fraud and abuse among
healthcare provider
HL7 - :answers :-Health Level 7
, HL7 purpose - :answers :-developed messaging standards for electronic data
interchange in healthcare
Valid Authorization - :answers :-description of the information to be used or
disclosed,
Audit Trail - :answers :-A record of all transactions in the computer system is
maintained and reviewed for instances of unauthorized access
Issues compliance program guidance - :answers :-OIG
CDM - :answers :-Charge Description Master
CDM task - :answers :-coordinator tasks include planning of payment systems, rules
of incorporation of CMS rule changes into the CDM
QIO - :answers :-Quality Improvement Organization and enforcement
QIO Purpose - :answers :-Created in 2009 by HHS/DOJ to prevent waste, fraud
abuse, reduce healthcare costs, and improve quality and care to Medicare patient
MMA - :answers :-Medicare Modernization Act
MMA purpose - :answers :-Created in 03 to make CMS to make a Medicare payment
recovery demonstration project
RAC - :answers :-Recovery Audit Contractor
RAC purpose - :answers :-from MMA monitor suspicious and improper activity under
& overpayments of Medicare
Questions and Verified Answers (Updated File from
Trusted Totur), GUARANTEED PASS!!!
Unbundling - :answers :-reducing the bundle of services that comes with the basic
product
NCCI auto payments are based on - :answers :-analysis of standard medical & surgical
practices
ncci PURPOSE - :answers :-Denials of outpatient claims, ensure proper CPT & HCPCS
coding for Medicare B
OCE - :answers :-Outpatient Code Editor
OCE purpose - :answers :-set rules for combinations of codes that are correct and rep
the services provided
VPB - :answers :-value based purchasing
VPB purpose - :answers :-programs link quality to reimbursement
Pre-MDC assignment for MS-DRG is based on - :answers :-ICD-10-PCS
Medicare Advantage - :answers :-provides expanded coverage including HMO, PPO,
special needs, Medical savings account
RVU - :answers :-Relative Value Unit
,RVU dues - :answers :-assigned to each code to provide a value that correlates to the
payment in resources, time, intensity, and expenses, and malpractice
What systems reimburse hospitals on a set amount for Medicare inpatient admission -
:answers :-MS-DRG
What represents the average resources required to care for patients whose admission
falls into an MS-DRG - :answers :-Relative Weight
What code set under OPPS is APC system primarily based for outpatient procedures and
services including devices, drugs, and other covered items - :answers :-CPT/HCPCS
Hard Coding - :answers :-Use of the charge description master to code directly to the
claim bypassing the staff
soft coding - :answers :-process of assigning specific codes or values to certain data
elements within a healthcare system or software.
Encoder coding - :answers :-A software that selects medical codes based on a set of
terminology
Natural Language Processing coding - :answers :-transforming medical coding by
automating the extraction of billable information from medical records and translating
it into standardized codes used for billing
ACO - :answers :-Accountable Care Organization
CMS-HCC - :answers :-Centers for Medicare & Medicaid Services-Hierarchical
Condition Category
,CMS-HCC purpose - :answers :-CMS implemented to provide fair and accurate
payments while rewarding efficiency and high-quality are for Medicare
MS-DRG is not influenced by the absence or presence - :answers :-CCs/MCCs
CMS require health records to be maintained for - :answers :-at least 5 years
Objective information - :answers :-measured or observed by healthcare provider
Quantitative analysis - :answers :-A review of the health record to determine its
completeness and accuracy
Qualitative analysis - :answers :-a review of the health record to ensure that standards
are met and to determine the adequacy of entries documenting the quality of care
Integrated health record is arranged - :answers :-Strict chronological order
OIG - :answers :-Office of Inspector General
OIG purpose - :answers :-Investigates & prosecutes people who overbill Medicare,
develops an annual plan to target areas to monitor
ORT - :answers :-Operation Restore Trust
ORT purpose - :answers :-released in 1995 to target fraud and abuse among
healthcare provider
HL7 - :answers :-Health Level 7
, HL7 purpose - :answers :-developed messaging standards for electronic data
interchange in healthcare
Valid Authorization - :answers :-description of the information to be used or
disclosed,
Audit Trail - :answers :-A record of all transactions in the computer system is
maintained and reviewed for instances of unauthorized access
Issues compliance program guidance - :answers :-OIG
CDM - :answers :-Charge Description Master
CDM task - :answers :-coordinator tasks include planning of payment systems, rules
of incorporation of CMS rule changes into the CDM
QIO - :answers :-Quality Improvement Organization and enforcement
QIO Purpose - :answers :-Created in 2009 by HHS/DOJ to prevent waste, fraud
abuse, reduce healthcare costs, and improve quality and care to Medicare patient
MMA - :answers :-Medicare Modernization Act
MMA purpose - :answers :-Created in 03 to make CMS to make a Medicare payment
recovery demonstration project
RAC - :answers :-Recovery Audit Contractor
RAC purpose - :answers :-from MMA monitor suspicious and improper activity under
& overpayments of Medicare
