CCS Exam Preparation, Domain 4:
Regulatory Compliance Exam Questions And
Answers
After consulting with a physician, a coding supervisor has issued an
internal policy stating that all bedside debridement be coded as
excisional. Is this an ethical practice for a coding professional to
follow? Why or why not?
A. Yes, physician guidance provided basis for the policy.
B. Yes, coding professionals must follow internal policies of the
facilities where they are employed.
C. No, coding supervisors cannot make internal policies without
approval of administration.
D. No, internal policies cannot conflict with requirements provided
in coding guidelines, conventions, and so on. - - -
correct answer ✅D. No, internal policies cannot conflict with
requirements provided in coding guidelines, conventions, and so
on.
Ethical Coding Guideline 1.2 states that internal policies may not
conflict with the coding rules, conventions, guidelines, etc. of the
,CCS Exam Preparation, Domain 4:
Regulatory Compliance Exam Questions And
Answers
coding classifications nor with any official coding advice (AHIMA
House of Delegates 2016).
The coding supervisor is concerned that patients diagnosed with
carcinoid colon tumors were miscoded as malignant during the last
six months. To address this situation, what work processes could be
undertaken?
A. Obtain the cases of carcinoid colon tumors from the cancer
registry, obtain the cases of malignant colon tumors from the billing
system, import both lists into a spreadsheet, and compare them.
The cases in the cancer registry but not coded as carcinoid in the
billing system are likely malignant and should be manually
reviewed.
B. Compare the cases from the chart completion software with the
billing software. Identify the cases that are not in the billing system.
These cases should be manually reviewed to ensure they are not
carcinoid tumors.
C. Obtain the cases of malignant colon tumors from both the cancer
registry and the billing system; import both lists into a spreadsheet
,CCS Exam Preparation, Domain 4:
Regulatory Compliance Exam Questions And
Answers
and compare them. Identify - - -
correct answer ✅C. Obtain the cases of malignant colon tumors
from both the cancer registry and the billing system; import both
lists into a spreadsheet and compare them. Identify the cases that
are not in the tumor registry but are coded as malignant in the
billing system. These cases should be manually reviewed to ensure
they are not carcinoid tumors.
The diagnostic index can be used with the cancer registry data to
undertake data quality analysis (Johns 2020, 85).
The patient was admitted for prostate carcinoma. This was treated
with radiation. A member of the medical staff who was not
associated with the patient's care requests to see the patient's
health record. What should the coding professional do?
A. Provide the record to the physician.
B. Report the incident to hospital security.
C. Ask the physician to come back when the supervisor gets back.
D. Explain that providing the record would violate the privacy policy
---
, CCS Exam Preparation, Domain 4:
Regulatory Compliance Exam Questions And
Answers
correct answer ✅D. Explain that providing the record would
violate the privacy policy
This question relates to the need-to-know principle. The medical
staff member who is not associated with the patient's care does not
need to see that patient's record (Hamilton 2020, 669-670).
Under which of the following circumstances does a healthcare
entity lose a potential increase in reimbursement when a hospital-
acquired condition (HAC) is coded without a POA indicator of "Y"?
A. When the HAC is the only CC/MCC on the account
B. When the HAC is listed as the principal diagnosis
C. When the HAC is coded along with a surgical procedure
D. When the HAC is the only diagnosis listed - - -
correct answer ✅A. When the HAC is the only CC/MCC on the
account
It is only in the circumstance when the HAC is the only CC/MCC on
the patient's account, and does not carry a POA indicator of Y, will
there be a loss of an opportunity to capture additional
reimbursement (Casto and White 2021, 85).
Regulatory Compliance Exam Questions And
Answers
After consulting with a physician, a coding supervisor has issued an
internal policy stating that all bedside debridement be coded as
excisional. Is this an ethical practice for a coding professional to
follow? Why or why not?
A. Yes, physician guidance provided basis for the policy.
B. Yes, coding professionals must follow internal policies of the
facilities where they are employed.
C. No, coding supervisors cannot make internal policies without
approval of administration.
D. No, internal policies cannot conflict with requirements provided
in coding guidelines, conventions, and so on. - - -
correct answer ✅D. No, internal policies cannot conflict with
requirements provided in coding guidelines, conventions, and so
on.
Ethical Coding Guideline 1.2 states that internal policies may not
conflict with the coding rules, conventions, guidelines, etc. of the
,CCS Exam Preparation, Domain 4:
Regulatory Compliance Exam Questions And
Answers
coding classifications nor with any official coding advice (AHIMA
House of Delegates 2016).
The coding supervisor is concerned that patients diagnosed with
carcinoid colon tumors were miscoded as malignant during the last
six months. To address this situation, what work processes could be
undertaken?
A. Obtain the cases of carcinoid colon tumors from the cancer
registry, obtain the cases of malignant colon tumors from the billing
system, import both lists into a spreadsheet, and compare them.
The cases in the cancer registry but not coded as carcinoid in the
billing system are likely malignant and should be manually
reviewed.
B. Compare the cases from the chart completion software with the
billing software. Identify the cases that are not in the billing system.
These cases should be manually reviewed to ensure they are not
carcinoid tumors.
C. Obtain the cases of malignant colon tumors from both the cancer
registry and the billing system; import both lists into a spreadsheet
,CCS Exam Preparation, Domain 4:
Regulatory Compliance Exam Questions And
Answers
and compare them. Identify - - -
correct answer ✅C. Obtain the cases of malignant colon tumors
from both the cancer registry and the billing system; import both
lists into a spreadsheet and compare them. Identify the cases that
are not in the tumor registry but are coded as malignant in the
billing system. These cases should be manually reviewed to ensure
they are not carcinoid tumors.
The diagnostic index can be used with the cancer registry data to
undertake data quality analysis (Johns 2020, 85).
The patient was admitted for prostate carcinoma. This was treated
with radiation. A member of the medical staff who was not
associated with the patient's care requests to see the patient's
health record. What should the coding professional do?
A. Provide the record to the physician.
B. Report the incident to hospital security.
C. Ask the physician to come back when the supervisor gets back.
D. Explain that providing the record would violate the privacy policy
---
, CCS Exam Preparation, Domain 4:
Regulatory Compliance Exam Questions And
Answers
correct answer ✅D. Explain that providing the record would
violate the privacy policy
This question relates to the need-to-know principle. The medical
staff member who is not associated with the patient's care does not
need to see that patient's record (Hamilton 2020, 669-670).
Under which of the following circumstances does a healthcare
entity lose a potential increase in reimbursement when a hospital-
acquired condition (HAC) is coded without a POA indicator of "Y"?
A. When the HAC is the only CC/MCC on the account
B. When the HAC is listed as the principal diagnosis
C. When the HAC is coded along with a surgical procedure
D. When the HAC is the only diagnosis listed - - -
correct answer ✅A. When the HAC is the only CC/MCC on the
account
It is only in the circumstance when the HAC is the only CC/MCC on
the patient's account, and does not carry a POA indicator of Y, will
there be a loss of an opportunity to capture additional
reimbursement (Casto and White 2021, 85).
