AHIMA CCS COMPREHENSIVE EXAM PREP
QUESTIONS AND SOLUTIONS VERIFIED
STUDY RESOURCE
●● No combination code available
Answer: Use separate codes for hypertension and acute renal failure
●● 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?
Answer: Body Mass Index (BMI)
●● POA Indicator - Y
Answer: Y-Yes, present at the time of inpatient admission
●● POA Indicator - N
Answer: N-No, not present at the time of inpatient admission
●● POA Indicator - U
Answer: U-Unknown, documentation is insufficient to determine if
condition is present on admission and you cannot speak to the physician
to figure it out
,●● POA Indicator - W
Answer: W-Clinically undetermined, provider is unable to clinically
determine whether condition was present on admission or not
●● POA Indicator - E
Answer: E-Exempt, unreported/not used, some facilities will leave these
blank, others will use the letter "E"
●● Present on Admission Indicator (POA)
Answer: A Present On Admission (POA) indicator is required on all
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.
●● The use of the outpatient code editor (OCE) is designed to:
Answer: Identify incomplete and incorrect claims
●● Medicare's identification of medically necessary services is outlined
in:
Answer: Local Coverage Determinations (LCDs)
●● Medically unlikely edits are used to identify:
Answer: Maximum units of service for a HCPCS code
, ●● National Correct Coding Initiative (NCCI) Edits are released how
often?
Answer: Quarterly
●● In 2000, CMS issued the final rule on the outpatient prospective
payment system (OPPS). The final rule:
Answer: Divided outpatient services into fixed payment groups
●● Diagnostic-related groups (DRGs) and ambulatory patient
classifications (APCs) are similar in that they are both:
Answer: Prospective payment systems
●● What are APCs?
Answer: APCs or "Ambulatory Payment Classifications" are the
government's method of paying facilities for outpatient services for the
Medicare program.
●● How do APCs work?
Answer: 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.
●● APC Status Indicator - C
Answer: Inpatient Procedures, not paid under OPPS
QUESTIONS AND SOLUTIONS VERIFIED
STUDY RESOURCE
●● No combination code available
Answer: Use separate codes for hypertension and acute renal failure
●● 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?
Answer: Body Mass Index (BMI)
●● POA Indicator - Y
Answer: Y-Yes, present at the time of inpatient admission
●● POA Indicator - N
Answer: N-No, not present at the time of inpatient admission
●● POA Indicator - U
Answer: U-Unknown, documentation is insufficient to determine if
condition is present on admission and you cannot speak to the physician
to figure it out
,●● POA Indicator - W
Answer: W-Clinically undetermined, provider is unable to clinically
determine whether condition was present on admission or not
●● POA Indicator - E
Answer: E-Exempt, unreported/not used, some facilities will leave these
blank, others will use the letter "E"
●● Present on Admission Indicator (POA)
Answer: A Present On Admission (POA) indicator is required on all
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.
●● The use of the outpatient code editor (OCE) is designed to:
Answer: Identify incomplete and incorrect claims
●● Medicare's identification of medically necessary services is outlined
in:
Answer: Local Coverage Determinations (LCDs)
●● Medically unlikely edits are used to identify:
Answer: Maximum units of service for a HCPCS code
, ●● National Correct Coding Initiative (NCCI) Edits are released how
often?
Answer: Quarterly
●● In 2000, CMS issued the final rule on the outpatient prospective
payment system (OPPS). The final rule:
Answer: Divided outpatient services into fixed payment groups
●● Diagnostic-related groups (DRGs) and ambulatory patient
classifications (APCs) are similar in that they are both:
Answer: Prospective payment systems
●● What are APCs?
Answer: APCs or "Ambulatory Payment Classifications" are the
government's method of paying facilities for outpatient services for the
Medicare program.
●● How do APCs work?
Answer: 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.
●● APC Status Indicator - C
Answer: Inpatient Procedures, not paid under OPPS
