AHIMA CCS Exam Prep
Study online at https://quizlet.com/_hwsaxm
1. CPT defines a separate procedure as: Procedure considered an integral part of a more major
service
2. No combination code available: Use separate codes for hypertension and acute renal failure
3. 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?: Body Mass Index (BMI)
4. POA Indicator - Y: Y-Yes, present at the time of inpatient admission
5. POA Indicator - N: N-No, not present at the time of inpatient admission
6. POA Indicator - U: U-Unknown, documentation is insufficient to determine if condition is present on
admission and you cannot speak to the physician to figure it out
7. POA Indicator - W: W-Clinically undetermined, provider is unable to clinically determine whether condition
was present on admission or not
8. POA Indicator - E: E-Exempt, unreported/not used, some facilities will leave these blank, others will use the
letter "E"
9. Present on Admission Indicator (POA): A Present On Admission (POA) indicator is required on al
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.
10. The use of the outpatient code editor (OCE) is designed to:: Identify incomplete and
incorrect claims
11. Medicare's identification of medically necessary services is outlined in:: Local
Coverage Determinations (LCDs)
12. Medically unlikely edits are used to identify:: Maximum units of service for a HCPCS code
13. National Correct Coding Initiative (NCCI) Edits are released how often?: Quar-
terly
14. In 2000, CMS issued the final rule on the outpatient prospective payment
system (OPPS). The final rule:: Divided outpatient services into fixed payment groups
15. Diagnostic-related groups (DRGs) and ambulatory patient classifications
(APCs) are similar in that they are both:: Prospective payment systems
16. What are APCs?: APCs or "Ambulatory Payment Classifications" are the government's method of paying
facilities for outpatient services for the Medicare program.
17. How do APCs work?: 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.
1/7
, AHIMA CCS Exam Prep
Study online at https://quizlet.com/_hwsaxm
18. APC Status Indicator - C: Inpatient Procedures, not paid under OPPS
19. APC Status Indicator - N: Items and Services Packaged into APC Rates
20. APC Status Indicator - S: Significant Procedure, Not Discounted When Multiple
21. APC Status Indicator - T: Significant Procedure, Multiple Reduction Applies
22. APC Status Indicator - V: Clinic or Emergency Department Visit
23. APC Status Indicator - X: Ancillary Services
24. APC Status Indicator - Y: Non-Implantable Durable Medical Equipment
25. Medicare exerts control of provider reimbursement through adjustment of
this component of the resource-based relative value scale (RBRVS): Conversion factor
26. The process of collecting data elements from a source document is known
as:: Abstracting
27. What piece of claims data from hospital A alerts a payer that the patient was
transferred to hospital B?: Discharge disposition
28. Admission source code used to identify a patient admitted to the facility from
home:: Non-Healthcare Facility
29. Admission source code used to identify a patient admitted to the facility from
hospice care:: Transfer from hospice
30. When a patient is transferred from an acute care facility to a skilled nursing
home facility, what abstracted data element can impact the DRG assignment?-
: Discharge disposition
31. A complication or comorbidity: Hypernatremia - A high concentration of sodium in the blood.
Hypernatremia most often occurs in people who don't drink enough water.
32. A major complication comorbidity:: Acute diastolic congestive heart failure
33. MCC: major complication or comorbidity
increases the use of medical and hospital expenses
34. CC: complication or comorbidity
35. Which condition meets the definition of comorbidity?: Hypertension
36. Myocardial Infarction: CPK elevation with MB enzymes elevated and the EKG ST changes denote MI
(myocardial infarction)
37. Coding a Cardiac Catheterization: Include:
the approach
2/7
Study online at https://quizlet.com/_hwsaxm
1. CPT defines a separate procedure as: Procedure considered an integral part of a more major
service
2. No combination code available: Use separate codes for hypertension and acute renal failure
3. 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?: Body Mass Index (BMI)
4. POA Indicator - Y: Y-Yes, present at the time of inpatient admission
5. POA Indicator - N: N-No, not present at the time of inpatient admission
6. POA Indicator - U: U-Unknown, documentation is insufficient to determine if condition is present on
admission and you cannot speak to the physician to figure it out
7. POA Indicator - W: W-Clinically undetermined, provider is unable to clinically determine whether condition
was present on admission or not
8. POA Indicator - E: E-Exempt, unreported/not used, some facilities will leave these blank, others will use the
letter "E"
9. Present on Admission Indicator (POA): A Present On Admission (POA) indicator is required on al
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.
10. The use of the outpatient code editor (OCE) is designed to:: Identify incomplete and
incorrect claims
11. Medicare's identification of medically necessary services is outlined in:: Local
Coverage Determinations (LCDs)
12. Medically unlikely edits are used to identify:: Maximum units of service for a HCPCS code
13. National Correct Coding Initiative (NCCI) Edits are released how often?: Quar-
terly
14. In 2000, CMS issued the final rule on the outpatient prospective payment
system (OPPS). The final rule:: Divided outpatient services into fixed payment groups
15. Diagnostic-related groups (DRGs) and ambulatory patient classifications
(APCs) are similar in that they are both:: Prospective payment systems
16. What are APCs?: APCs or "Ambulatory Payment Classifications" are the government's method of paying
facilities for outpatient services for the Medicare program.
17. How do APCs work?: 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.
1/7
, AHIMA CCS Exam Prep
Study online at https://quizlet.com/_hwsaxm
18. APC Status Indicator - C: Inpatient Procedures, not paid under OPPS
19. APC Status Indicator - N: Items and Services Packaged into APC Rates
20. APC Status Indicator - S: Significant Procedure, Not Discounted When Multiple
21. APC Status Indicator - T: Significant Procedure, Multiple Reduction Applies
22. APC Status Indicator - V: Clinic or Emergency Department Visit
23. APC Status Indicator - X: Ancillary Services
24. APC Status Indicator - Y: Non-Implantable Durable Medical Equipment
25. Medicare exerts control of provider reimbursement through adjustment of
this component of the resource-based relative value scale (RBRVS): Conversion factor
26. The process of collecting data elements from a source document is known
as:: Abstracting
27. What piece of claims data from hospital A alerts a payer that the patient was
transferred to hospital B?: Discharge disposition
28. Admission source code used to identify a patient admitted to the facility from
home:: Non-Healthcare Facility
29. Admission source code used to identify a patient admitted to the facility from
hospice care:: Transfer from hospice
30. When a patient is transferred from an acute care facility to a skilled nursing
home facility, what abstracted data element can impact the DRG assignment?-
: Discharge disposition
31. A complication or comorbidity: Hypernatremia - A high concentration of sodium in the blood.
Hypernatremia most often occurs in people who don't drink enough water.
32. A major complication comorbidity:: Acute diastolic congestive heart failure
33. MCC: major complication or comorbidity
increases the use of medical and hospital expenses
34. CC: complication or comorbidity
35. Which condition meets the definition of comorbidity?: Hypertension
36. Myocardial Infarction: CPK elevation with MB enzymes elevated and the EKG ST changes denote MI
(myocardial infarction)
37. Coding a Cardiac Catheterization: Include:
the approach
2/7
