AHIMA CCA ACTUAL 2026 TEST PAPER QUESTIONS
AND SOLUTIONS RATED A+
✔✔59.
What reimbursement system uses the Medicare fee schedule?
a. APCs
b. MS-DRGs
c. RBRVS
d. RUG-III - ✔✔Correct Answer: C
The resource-based relative value scale (RBRVS) system was implemented by CMS in
1992 for physicians' services such as office visits covered under Medicare Part B. The
system reimburses physicians according to a fee schedule based on predetermined
values assigned to specific services (Johns 2011, 326).
✔✔60.
The CIA of security includes confidentiality, data integrity, and data _____.
a. Accessibility
b. Authentication
c. Accuracy
d. Availability - ✔✔orrect Answer: D
Security measures not only provide for confidentiality, but data integrity and data
availability—the CIA of security (Johns 2011, 184).
✔✔61.
Valley High, a skilled nursing facility, wants to become certified to take part in federal
government reimbursement programs such as Medicare. What standards must the
facility meet in order to become certified for these programs?
a. Joint Commission Accreditation Standards
b. Accreditation Association for Ambulatory Healthcare Standards
c. Conditions of Participation
,d. Outcomes and Assessment Information Set - ✔✔Correct Answer: C
Participating organizations must follow the Medicare Conditions of Participation to
receive federal funds from the Medicare program for services rendered (Johns 2011,
61).
✔✔62.
What software will prompt the user through a variety of questions and choices based on
the clinical terminology entered to assist the coder in selecting the most appropriate
code?
a. Logic-based encoder
b. Automated code book
c. Speech recognition
d. Natural-language processing - ✔✔Correct Answer: A
Encoders come in two distinct categories: logic-based and automated codebook
formats. A logic-based encoder prompts the user through a variety of questions and
choices based on the clinical terminology entered. The coder selects the most accurate
code for a service or condition (and any possible complications or comorbidities). An
automated codebook provides screen views that resemble the actual format of the
coding system (LaTour and Eichenwald Maki 2010, 269).
✔✔63.
Which of the following is not a function of the discharge summary?
a. Providing information about the patient's insurance coverage
b. Ensuring the continuity of future care
c. Providing information to support the activities of the medical staff review committee
d. Providing concise information that can be used to answer information requests -
✔✔Correct Answer: A
The discharge summary provides an overview of the entire medical encounter to ensure
the continuity of future care by providing information to the patient's attending physician,
referring physician, and any consulting physicians, to provide information to support the
activities of the medical staff review committee and to provide concise information that
can be used to answer information requests from authorized individuals or entities
(Johns 2011, 78).
✔✔64.
, MS diagnostic-related groups are organized into:
a. Case-mix classifications
b. Geographic practice cost indices
c. Major diagnostic categories
d. Resource-based relative values - ✔✔Correct Answer: C
Major diagnostic categories (MDCs), of which there are 25. The principal diagnosis
determines the MDC assignment (Johns 2011, 322).
✔✔65.
Identify ICD-9-CM diagnosis code for atypical ductal hyperplasia.
a. 610.1
b. 610.4
c. 610.8
d. 610.9 - ✔✔Correct Answer: C
Use this code when the diagnosis is specified as a certain type of "benign mammary
dysplasia," and in this case, "ductal" hyperplasia. Index Hyperplasia, breast, ductal,
atypical (Schraffenberger 2012, 253).
✔✔66.
The Medical Record Committee is reviewing the privacy policies for a large outpatient
clinic. One of the members of the committee remarks that he feels the clinic's practice of
calling out a patient's full name in the waiting room is not in compliance with HIPAA
regulations and that only the patient's first name should be used. Other committee
members disagree with this assessment. What should the HIM director advise the
committee?
a. HIPAA does not allow a patient's name to be announced in a waiting room.
b. There is no HIPAA violation for announcing a patient's name, but the committee may
want to consider implementing practices that might reduce this practice.
c. HIPAA allows only the use of the patient's first name.
d. HIPAA requires that patients be given numbers and only the number be announced. -
✔✔Correct Answer: B
AND SOLUTIONS RATED A+
✔✔59.
What reimbursement system uses the Medicare fee schedule?
a. APCs
b. MS-DRGs
c. RBRVS
d. RUG-III - ✔✔Correct Answer: C
The resource-based relative value scale (RBRVS) system was implemented by CMS in
1992 for physicians' services such as office visits covered under Medicare Part B. The
system reimburses physicians according to a fee schedule based on predetermined
values assigned to specific services (Johns 2011, 326).
✔✔60.
The CIA of security includes confidentiality, data integrity, and data _____.
a. Accessibility
b. Authentication
c. Accuracy
d. Availability - ✔✔orrect Answer: D
Security measures not only provide for confidentiality, but data integrity and data
availability—the CIA of security (Johns 2011, 184).
✔✔61.
Valley High, a skilled nursing facility, wants to become certified to take part in federal
government reimbursement programs such as Medicare. What standards must the
facility meet in order to become certified for these programs?
a. Joint Commission Accreditation Standards
b. Accreditation Association for Ambulatory Healthcare Standards
c. Conditions of Participation
,d. Outcomes and Assessment Information Set - ✔✔Correct Answer: C
Participating organizations must follow the Medicare Conditions of Participation to
receive federal funds from the Medicare program for services rendered (Johns 2011,
61).
✔✔62.
What software will prompt the user through a variety of questions and choices based on
the clinical terminology entered to assist the coder in selecting the most appropriate
code?
a. Logic-based encoder
b. Automated code book
c. Speech recognition
d. Natural-language processing - ✔✔Correct Answer: A
Encoders come in two distinct categories: logic-based and automated codebook
formats. A logic-based encoder prompts the user through a variety of questions and
choices based on the clinical terminology entered. The coder selects the most accurate
code for a service or condition (and any possible complications or comorbidities). An
automated codebook provides screen views that resemble the actual format of the
coding system (LaTour and Eichenwald Maki 2010, 269).
✔✔63.
Which of the following is not a function of the discharge summary?
a. Providing information about the patient's insurance coverage
b. Ensuring the continuity of future care
c. Providing information to support the activities of the medical staff review committee
d. Providing concise information that can be used to answer information requests -
✔✔Correct Answer: A
The discharge summary provides an overview of the entire medical encounter to ensure
the continuity of future care by providing information to the patient's attending physician,
referring physician, and any consulting physicians, to provide information to support the
activities of the medical staff review committee and to provide concise information that
can be used to answer information requests from authorized individuals or entities
(Johns 2011, 78).
✔✔64.
, MS diagnostic-related groups are organized into:
a. Case-mix classifications
b. Geographic practice cost indices
c. Major diagnostic categories
d. Resource-based relative values - ✔✔Correct Answer: C
Major diagnostic categories (MDCs), of which there are 25. The principal diagnosis
determines the MDC assignment (Johns 2011, 322).
✔✔65.
Identify ICD-9-CM diagnosis code for atypical ductal hyperplasia.
a. 610.1
b. 610.4
c. 610.8
d. 610.9 - ✔✔Correct Answer: C
Use this code when the diagnosis is specified as a certain type of "benign mammary
dysplasia," and in this case, "ductal" hyperplasia. Index Hyperplasia, breast, ductal,
atypical (Schraffenberger 2012, 253).
✔✔66.
The Medical Record Committee is reviewing the privacy policies for a large outpatient
clinic. One of the members of the committee remarks that he feels the clinic's practice of
calling out a patient's full name in the waiting room is not in compliance with HIPAA
regulations and that only the patient's first name should be used. Other committee
members disagree with this assessment. What should the HIM director advise the
committee?
a. HIPAA does not allow a patient's name to be announced in a waiting room.
b. There is no HIPAA violation for announcing a patient's name, but the committee may
want to consider implementing practices that might reduce this practice.
c. HIPAA allows only the use of the patient's first name.
d. HIPAA requires that patients be given numbers and only the number be announced. -
✔✔Correct Answer: B
