AHIMA CCA: Questions With Comprehensive Solutions
1.
Identify the CPT code for a 42-year-old diagnosed with ESRD who requires
home dialysis for the month of April.
a. 90965
b. 90964
c. 90966
d. 90970 Accurate Answer:- Correct Answer: C
Dialysis, end-stage renal disease. Code 90966 is for end-stage renal disease
(ESRD) related services for home dialysis per full month for patients 20 years
of age and older (Smith 2012, 227).
2.
Exceptions to the consent requirement include:
a. Medical emergencies
b. Provider discretion
c. Implied consent
d. Informed consent Accurate Answer:- Correct Answer: A
The law permits a presumption of consent during emergency situations,
regardless of whether the patient is an adult or minor (Brodnik et al. 2009,
99).
3.
An 80-year-old female is admitted with fever, lethargy, hypotension,
tachycardia, oliguria, and elevated WBC. The patient has more than 100,000
organisms of Escherichia coli per cc of urine. The attending physician
documents "urosepsis." How should the coder proceed to code this case?
,a. Code sepsis as the principal diagnosis with urinary tract infection due to E.
coli as secondary diagnosis.
b. Code urinary tract infection with sepsis as the principal diagnosis.
c. Query the physician to ask if the patient has septicemia because of the
symptomatology.
d. Query the physician to ask if the patient had septic shock so that this may be
used as the principal diagnosis. Accurate Answer:- Correct Answer: C
The term "urosepsis" is a nonspecific term. If that is the only term
documented, only code 599.0 should be assigned based on the default for the
term in the ICD-9-CM index, in addition to the code for the causal organism, if
known. Septicemia results from the entry of pathogens into the bloodstream.
Symptoms include spiking fever, chills, and skin eruptions in the form of
petechiae or purpura. Blood cultures are usually positive; however, a negative
culture does not exclude the diagnosis of septicemia. Several other clinical
indications and symptomology could indicate the diagnosis of septicemia.
Only the physician can diagnose the condition based on clinical indications.
Query the physician when the diagnosis is not clear to the coder
(Schraffenberger 2012, 79-81, 251).
4.
What is the correct CPT code assignment for destruction of internal
hemorrhoids with use of infrared coagulation?
a. 46255
b. 46930
c. 46260
d. 46945 Accurate Answer:- Correct Answer: B
Index main term: Destruction, hemorrhoid, thermal. Thermal includes
infrared coagulation (Kuehn 2012, 27, 163).
5.
,Identify the two-digit modifier that may be reported to indicate a physician
performed the postoperative management of a patient, but another physician
performed the surgical procedure.
a. -22
b. -54
c. -32
d. -55 Accurate Answer:- Correct Answer: D
Modifiers are appended to the code to provide more information or to alert
the payer that a payment change is required. Modifier -55 is used to identify
the physician provided only postoperative care services for a particular
procedure (Kuehn 2012, 292, 295).
6.
Which of the following organizations is responsible for updating the
procedure classification of ICD-9-CM?
a. Centers for Disease Control (CDC)
b. Centers for Medicare and Medicaid Services (CMS)
c. National Center for Health Statistics (NCHS)
d. World Health Organization (WHO) Accurate Answer:- Correct
Answer: B
NCHS is responsible for updating the diagnosis classification (Volumes 1 and
2), and CMS is responsible for updating the procedure classification (Volume
3) (Johns 2011, 239).
7.
Good encoding software should include ________ to ensure data quality.
a. Edit checks
, b. Voice recognition
c. Reimbursement technology
d. Passwords Accurate Answer:- Correct Answer: A
Good encoding software should include edit checks to ensure data quality
(Johns 2011, 270).
8.
Patient was admitted through the emergency department following a fall from
a ladder while painting an interior room in his house. He had contusions of the
scalp and face and an open fracture of the acetabulum. The fracture site was
debrided and the fracture was reduced by open procedure with an external
fixation device applied. Which is the correct code assignment?
a. 808.1, E881.0, E849.0, 79.25, 78.15
b. 808.1, 920, E881.0, E849.0, E000.8, E013.9, 79.25, 78.15, 79.65
c. 808.0, E881.0, E000.8, E013.9, 79.35, 79.65
d. 808.1, E881.0, E849.0, E013.9, 79.25, 78.15, 79.65 Accurate Answer:-
Correct Answer: B
The fracture is the principal diagnosis, with the contusions as a secondary
diagnosis. The fracture is what required the most treatment. Procedures for
the reduction, debridement, and external fixation device would all need to be
coded (Schraffenberger 2012, 354-355).
9.
A request for reconsideration of a denied claim for insurance coverage for
healthcare services is called a(n):
a. Breach
b. Exclusion
c. Appeal
1.
Identify the CPT code for a 42-year-old diagnosed with ESRD who requires
home dialysis for the month of April.
a. 90965
b. 90964
c. 90966
d. 90970 Accurate Answer:- Correct Answer: C
Dialysis, end-stage renal disease. Code 90966 is for end-stage renal disease
(ESRD) related services for home dialysis per full month for patients 20 years
of age and older (Smith 2012, 227).
2.
Exceptions to the consent requirement include:
a. Medical emergencies
b. Provider discretion
c. Implied consent
d. Informed consent Accurate Answer:- Correct Answer: A
The law permits a presumption of consent during emergency situations,
regardless of whether the patient is an adult or minor (Brodnik et al. 2009,
99).
3.
An 80-year-old female is admitted with fever, lethargy, hypotension,
tachycardia, oliguria, and elevated WBC. The patient has more than 100,000
organisms of Escherichia coli per cc of urine. The attending physician
documents "urosepsis." How should the coder proceed to code this case?
,a. Code sepsis as the principal diagnosis with urinary tract infection due to E.
coli as secondary diagnosis.
b. Code urinary tract infection with sepsis as the principal diagnosis.
c. Query the physician to ask if the patient has septicemia because of the
symptomatology.
d. Query the physician to ask if the patient had septic shock so that this may be
used as the principal diagnosis. Accurate Answer:- Correct Answer: C
The term "urosepsis" is a nonspecific term. If that is the only term
documented, only code 599.0 should be assigned based on the default for the
term in the ICD-9-CM index, in addition to the code for the causal organism, if
known. Septicemia results from the entry of pathogens into the bloodstream.
Symptoms include spiking fever, chills, and skin eruptions in the form of
petechiae or purpura. Blood cultures are usually positive; however, a negative
culture does not exclude the diagnosis of septicemia. Several other clinical
indications and symptomology could indicate the diagnosis of septicemia.
Only the physician can diagnose the condition based on clinical indications.
Query the physician when the diagnosis is not clear to the coder
(Schraffenberger 2012, 79-81, 251).
4.
What is the correct CPT code assignment for destruction of internal
hemorrhoids with use of infrared coagulation?
a. 46255
b. 46930
c. 46260
d. 46945 Accurate Answer:- Correct Answer: B
Index main term: Destruction, hemorrhoid, thermal. Thermal includes
infrared coagulation (Kuehn 2012, 27, 163).
5.
,Identify the two-digit modifier that may be reported to indicate a physician
performed the postoperative management of a patient, but another physician
performed the surgical procedure.
a. -22
b. -54
c. -32
d. -55 Accurate Answer:- Correct Answer: D
Modifiers are appended to the code to provide more information or to alert
the payer that a payment change is required. Modifier -55 is used to identify
the physician provided only postoperative care services for a particular
procedure (Kuehn 2012, 292, 295).
6.
Which of the following organizations is responsible for updating the
procedure classification of ICD-9-CM?
a. Centers for Disease Control (CDC)
b. Centers for Medicare and Medicaid Services (CMS)
c. National Center for Health Statistics (NCHS)
d. World Health Organization (WHO) Accurate Answer:- Correct
Answer: B
NCHS is responsible for updating the diagnosis classification (Volumes 1 and
2), and CMS is responsible for updating the procedure classification (Volume
3) (Johns 2011, 239).
7.
Good encoding software should include ________ to ensure data quality.
a. Edit checks
, b. Voice recognition
c. Reimbursement technology
d. Passwords Accurate Answer:- Correct Answer: A
Good encoding software should include edit checks to ensure data quality
(Johns 2011, 270).
8.
Patient was admitted through the emergency department following a fall from
a ladder while painting an interior room in his house. He had contusions of the
scalp and face and an open fracture of the acetabulum. The fracture site was
debrided and the fracture was reduced by open procedure with an external
fixation device applied. Which is the correct code assignment?
a. 808.1, E881.0, E849.0, 79.25, 78.15
b. 808.1, 920, E881.0, E849.0, E000.8, E013.9, 79.25, 78.15, 79.65
c. 808.0, E881.0, E000.8, E013.9, 79.35, 79.65
d. 808.1, E881.0, E849.0, E013.9, 79.25, 78.15, 79.65 Accurate Answer:-
Correct Answer: B
The fracture is the principal diagnosis, with the contusions as a secondary
diagnosis. The fracture is what required the most treatment. Procedures for
the reduction, debridement, and external fixation device would all need to be
coded (Schraffenberger 2012, 354-355).
9.
A request for reconsideration of a denied claim for insurance coverage for
healthcare services is called a(n):
a. Breach
b. Exclusion
c. Appeal
