AHIMA CCS Exam Prep

AHIMA CCS Exam Prep
i i i




CPTidefinesiaiseparateiprocedureiasi-i

i ✅Procedureiconsideredianiintegralipartiofiaimoreimajoriservice



Noicombinationicodeiavailablei-i

i ✅Useiseparateicodesiforihypertensioniandiacuteirenalifailure



Documentationifromitheinursingistaffioriotherialliedihealthiprofessionals'inotesicanibeiuseditoiprovideis
pecificityiforicodeiassignmentiforiwhichiofitheifollowingidiagnoses?i-i

i ✅BodyiMassiIndexi(BMI)



POAiIndicatori-iYi-i

i ✅Y-Yes,ipresentiatitheitimeiofiinpatientiadmission



POAiIndicatori-iNi-i

i ✅N-No,inotipresentiatitheitimeiofiinpatientiadmission



POAiIndicatori-iUi-i

✅U-
i

Unknown,idocumentationiisiinsufficientitoidetermineiificonditioniisipresentioniadmissioniandiyouicanno
tispeakitoitheiphysicianitoifigureiitiout



POAiIndicatori-iWi-i

✅W-
i

Clinicallyiundetermined,iprovideriisiunableitoiclinicallyidetermineiwhethericonditioniwasipresentioniad
missioniorinot



POAiIndicatori-iEi-i

i ✅E-Exempt,iunreported/notiused,isomeifacilitiesiwillileaveitheseiblank,iothersiwilliuseitheiletteri"E"



PresentioniAdmissioniIndicatori(POA)i-i

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, ✅AiPresentiOniAdmissioni(POA)iindicatoriisirequiredioniallidiagnosisicodesiforitheiinpatientisettingiexc
i

eptiforiadmission.iTheiindicatorishouldibeireportediforiprincipalidiagnosisicodes,isecondaryidiagnosisico
des,iZ-codes,iandiExternalicauseiinjuryicodes.



Theiuseiofitheioutpatienticodeieditori(OCE)iisidesignedito:i-i

i ✅Identifyiincompleteiandiincorrecticlaims



Medicare'siidentificationiofimedicallyinecessaryiservicesiisioutlinediin:i-i

i ✅LocaliCoverageiDeterminationsi(LCDs)



Medicallyiunlikelyieditsiareiuseditoiidentify:i-i

i ✅MaximumiunitsiofiserviceiforiaiHCPCSicode



NationaliCorrectiCodingiInitiativei(NCCI)iEditsiareireleasedihowioften?i-i

i ✅Quarterly



Ini2000,iCMSiissueditheifinaliruleionitheioutpatientiprospectiveipaymentisystemi(OPPS).iTheifinalirule:i-i

i ✅Dividedioutpatientiservicesiintoifixedipaymentigroups



Diagnostic-
relatedigroupsi(DRGs)iandiambulatoryipatienticlassificationsi(APCs)iareisimilariinithatitheyiareiboth:i-i

i ✅Prospectiveipaymentisystems



WhatiareiAPCs?i-i

✅APCsiori"AmbulatoryiPaymentiClassifications"iareitheigovernment'simethodiofipayingifacilitiesiforio
i

utpatientiservicesiforitheiMedicareiprogram.



HowidoiAPCsiwork?i-i

✅TheipaymentsiareicalculatedibyimultiplyingitheiAPCsirelativeiweightibyitheiOPPSiconversionifactoria
i

ndithenithereiisiaiminoriadjustmentiforigeographicilocation.



APCiStatusiIndicatori-iCi-i


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