AHIMA CCA EXAM EVALUATION QUESTIONS AND
SOLUTIONS RATED A+
✔✔17.
Identify the ICD-9-CM diagnostic code for other specified aplastic anemia secondary to
chemotherapy.
a. 284.9
b. 284.89
c. 285.9
d. 285.22 - ✔✔Correct Answer: B
Index Anemia, aplastic, due to, antineoplastic chemotherapy. A coder should always
assign the most specific type of anemia. Anemia due to chemotherapy is often aplastic
(Schraffenberger 2012, 133-135 ).
✔✔18.
When the physician does not specify the method used to remove a lesion during an
endoscopy, what is the appropriate procedure?
a. Assign the removal by snare technique code.
b. Assign the removal by hot biopsy forceps code.
c. Assign the ablation code.
d. Query the physician as to the method used. - ✔✔Correct Answer: D
It is not appropriate for the coder to assume the removal was done by either snare or
hot biopsy forceps. The ablation code is only assigned when a lesion is completely
destroyed and no specimen is retrieved. The coding professional must query the
physician to assign the appropriate code (AHIMA 2012a, 607).
✔✔19.
What is the best reference tool to determine how CPT codes should be assigned?
a. Local coverage determination from Medicare
b. American Medical Association's CPT Assistant newsletter
c. American Hospital Association's Coding Clinic
,d. CMS website - ✔✔Correct Answer: B
CPT Assistant provides additional CPT coding guidance on how to assign a CPT code
by providing intent on the use of the code and explanation of parenthetical instructions.
The American Medical Association publishes the guidance monthly (AMA 2012b).
✔✔20.
Identify the appropriate ICD-9-CM diagnosis code(s) for right and left bundle branch
block.
a. 426.3, 426.4
b. 426.53
c. 426.4, 426.53
d. 426.52 - ✔✔Correct Answer: B
Index Block, left, with right bundle branch block. Right and left bundle branch block is
inclusive of one code. It is inappropriate to assign a code for right (426.4) and left
(426.3) bundle branch block when a combination code includes both the right and left
(Schraffenberger 2012, 201-207).
✔✔21.
A software interface is a:
a. Device to enter data
b. Protocol for describing data
c. Program to exchange data
d. Standard vocabulary - ✔✔Correct Answer: C
A software interface is a computer program that allows different applications to
communicate and exchange data (Johns 2011, 137).
✔✔22.
What did the Centers of Medicare and Medicaid Services develop to promote national
correct coding methodologies and to control improper coding leading to inappropriate
payment in Part B claims?
a. Outpatient Perspective Payment System (OPPS)
b. National Correct Coding Initiative (NCCI)
,c. Ambulatory Payment Classifications (APCs)
d. Comprehensive Outpatient Rehab Facilities (CORFs) - ✔✔Correct Answer: B
CMS developed the NCCI to control improper coding practices leading to inappropriate
payments in Part B claims (CMS 2012a).
✔✔23.
Identify the appropriate diagnostic and/or procedure ICD-9-CM code(s) for
reprogramming of a cardiac pacemaker.
a. V53.31
b. 37.85
c. V53.02
d. V53.31, 37.85 - ✔✔Correct Answer: A
Index Fitting (of) pacemaker (cardiac). No procedure code exists in ICD-9-CM to
describe reprogramming (Schraffenberger 2012, 204-205).
✔✔24.
Which of the following hospitals are excluded from the Medicare acute-care prospective
payment system?
a. Children's
b. Small community
c. Tertiary
d. Trauma - ✔✔Correct Answer: A
Children's hospitals are excluded from PPS because the PPS diagnosis-related groups
do not accurately account for the resource costs for the types of patients treated (Johns
2011, 321).
✔✔25.
Which of the following programs has been in place in hospitals for years and has been
required by the Medicare and Medicaid programs and accreditation standards?
a. Internal DRG audits
b. Peer review
, c. Managed care
d. Quality improvement - ✔✔Correct Answer: D
Quality improvement (QI) programs have been in place in hospitals for years and have
been required by the Medicare/Medicaid programs and accreditation standards. QI
programs have covered medical staff as well as nursing and other departments or
processes (LaTour and Eichenwald Maki 2010, 33).
✔✔26.
Identify the code for a patient with a closed transcervical fracture of the epiphysis.
a. 820.09
b. 820.02
c. 820.03
d. 820.01 - ✔✔Correct Answer: D
Index Fracture, femur, epiphysis, capital. Fifth digits are required for further
classification of a specific condition. Many publishers include special symbols and/or
color highlighting to identify codes that require a fourth or fifth digit (Schraffenberger
2012, 7).
✔✔27.
What is the best source of documentation to determine the size of a removed malignant
lesion?
a. Pathology report
b. Post-acute care unit record
c. Operative report
d. Physical examination - ✔✔Correct Answer: C
The total size of a removed lesion, including margins, is needed for accurate coding.
This information is best provided in the operative report. The pathology report typically
provides the specimen size rather than the size of the excised lesion. Because the
specimen tends to shrink, this is not an accurate measurement (Kuehn 2012, 110-111).
✔✔28.
Which of the following definitions best describes the concept of confidentiality?
a. The right of individuals to control access to their personal health information
SOLUTIONS RATED A+
✔✔17.
Identify the ICD-9-CM diagnostic code for other specified aplastic anemia secondary to
chemotherapy.
a. 284.9
b. 284.89
c. 285.9
d. 285.22 - ✔✔Correct Answer: B
Index Anemia, aplastic, due to, antineoplastic chemotherapy. A coder should always
assign the most specific type of anemia. Anemia due to chemotherapy is often aplastic
(Schraffenberger 2012, 133-135 ).
✔✔18.
When the physician does not specify the method used to remove a lesion during an
endoscopy, what is the appropriate procedure?
a. Assign the removal by snare technique code.
b. Assign the removal by hot biopsy forceps code.
c. Assign the ablation code.
d. Query the physician as to the method used. - ✔✔Correct Answer: D
It is not appropriate for the coder to assume the removal was done by either snare or
hot biopsy forceps. The ablation code is only assigned when a lesion is completely
destroyed and no specimen is retrieved. The coding professional must query the
physician to assign the appropriate code (AHIMA 2012a, 607).
✔✔19.
What is the best reference tool to determine how CPT codes should be assigned?
a. Local coverage determination from Medicare
b. American Medical Association's CPT Assistant newsletter
c. American Hospital Association's Coding Clinic
,d. CMS website - ✔✔Correct Answer: B
CPT Assistant provides additional CPT coding guidance on how to assign a CPT code
by providing intent on the use of the code and explanation of parenthetical instructions.
The American Medical Association publishes the guidance monthly (AMA 2012b).
✔✔20.
Identify the appropriate ICD-9-CM diagnosis code(s) for right and left bundle branch
block.
a. 426.3, 426.4
b. 426.53
c. 426.4, 426.53
d. 426.52 - ✔✔Correct Answer: B
Index Block, left, with right bundle branch block. Right and left bundle branch block is
inclusive of one code. It is inappropriate to assign a code for right (426.4) and left
(426.3) bundle branch block when a combination code includes both the right and left
(Schraffenberger 2012, 201-207).
✔✔21.
A software interface is a:
a. Device to enter data
b. Protocol for describing data
c. Program to exchange data
d. Standard vocabulary - ✔✔Correct Answer: C
A software interface is a computer program that allows different applications to
communicate and exchange data (Johns 2011, 137).
✔✔22.
What did the Centers of Medicare and Medicaid Services develop to promote national
correct coding methodologies and to control improper coding leading to inappropriate
payment in Part B claims?
a. Outpatient Perspective Payment System (OPPS)
b. National Correct Coding Initiative (NCCI)
,c. Ambulatory Payment Classifications (APCs)
d. Comprehensive Outpatient Rehab Facilities (CORFs) - ✔✔Correct Answer: B
CMS developed the NCCI to control improper coding practices leading to inappropriate
payments in Part B claims (CMS 2012a).
✔✔23.
Identify the appropriate diagnostic and/or procedure ICD-9-CM code(s) for
reprogramming of a cardiac pacemaker.
a. V53.31
b. 37.85
c. V53.02
d. V53.31, 37.85 - ✔✔Correct Answer: A
Index Fitting (of) pacemaker (cardiac). No procedure code exists in ICD-9-CM to
describe reprogramming (Schraffenberger 2012, 204-205).
✔✔24.
Which of the following hospitals are excluded from the Medicare acute-care prospective
payment system?
a. Children's
b. Small community
c. Tertiary
d. Trauma - ✔✔Correct Answer: A
Children's hospitals are excluded from PPS because the PPS diagnosis-related groups
do not accurately account for the resource costs for the types of patients treated (Johns
2011, 321).
✔✔25.
Which of the following programs has been in place in hospitals for years and has been
required by the Medicare and Medicaid programs and accreditation standards?
a. Internal DRG audits
b. Peer review
, c. Managed care
d. Quality improvement - ✔✔Correct Answer: D
Quality improvement (QI) programs have been in place in hospitals for years and have
been required by the Medicare/Medicaid programs and accreditation standards. QI
programs have covered medical staff as well as nursing and other departments or
processes (LaTour and Eichenwald Maki 2010, 33).
✔✔26.
Identify the code for a patient with a closed transcervical fracture of the epiphysis.
a. 820.09
b. 820.02
c. 820.03
d. 820.01 - ✔✔Correct Answer: D
Index Fracture, femur, epiphysis, capital. Fifth digits are required for further
classification of a specific condition. Many publishers include special symbols and/or
color highlighting to identify codes that require a fourth or fifth digit (Schraffenberger
2012, 7).
✔✔27.
What is the best source of documentation to determine the size of a removed malignant
lesion?
a. Pathology report
b. Post-acute care unit record
c. Operative report
d. Physical examination - ✔✔Correct Answer: C
The total size of a removed lesion, including margins, is needed for accurate coding.
This information is best provided in the operative report. The pathology report typically
provides the specimen size rather than the size of the excised lesion. Because the
specimen tends to shrink, this is not an accurate measurement (Kuehn 2012, 110-111).
✔✔28.
Which of the following definitions best describes the concept of confidentiality?
a. The right of individuals to control access to their personal health information
