AHIMA CCA Exam 2 Questions & Answers
1.Data security policies and procedures should be reviewed at least:
a. Semi-annually
b. Annually
c. Every two years
d. Quarterly
Answer B
All data security policies and procedures should be reviewed and
evaluated at least every year to make sure they are up-to-date and still
relevant to the organization (Johns 2011, 995).
2.If an orthopedic surgeon attempted to reduce a fracture but was
unsuccess- ful in obtaining acceptable alignment, what type of code should
be assigned for the procedure?
a. A "with manipulation" code
b. A "without manipulation" code
c. An unlisted procedure code
d. An E/M code only
, Answer A
The "with manipulation" code is used because the fracture was
manipulated, even if the manipulation did not result in clinical anatomic
alignment. See Musculoskeletal Guidelines, Definitions (AHIMA 2012a,
597).
3.What is the maximum number of diagnosis codes that can appear on
the UB-04 paper claim form locator 67 for a hospital inpatient principal
and secondary diagnoses?
a. 35
b. 25
c. 18
d. 9
Answer B
As of January 1, 2011, CMS allows a total of 25 ICD-9-CM diagnosis codes
(one principal and 24 additional diagnoses) for 837 Institutional claims
filing (Schraffen- berger 2012, 66).
4.A patient has two health insurance policies: Medicare and a
Medicare supplement. Which of the following statements is true?
,a. The patient receives any monies paid by the insurance companies over
and above the charges.
b. Monies paid to the healthcare provider cannot exceed charges.
c. The decision on which company is primary is based on remittance advice.
d. The patient should not have a Medicare supplement.
Answer B
The monies collected from third-party payers cannot be greater than the
amount of the provider's charges (Johns 2011, 343).
5.A hospital needs to know how much Medicare paid on a claim so they
can bill the secondary insurance. What should the hospital refer to?
a. Explanation of benefits
b. Medicare Summary Notice
c. Remittance advice
d. Coordination of benefits
Answer C
Remittance advice (RA) is sent to the provider to explain
payments made by third-party payers (Johns 2011, 346).
, 6.Which of the following threatens the "need-to-know" principle?
a. Backdating progress notes
b. Blanket authorization
c. HIPAA regulations
d. Surgical consent
Answer B
A blanket authorization is a common ethical problem when misused.
Patients often sign a blanket authorization, which authorizes the release
of information from that point forward, without understanding the
implications. The problem is the patient is not aware of what information
is being accessed (Johns 2011, 778-779).
7.A fee schedule is:
a. Developed by third-party payers and includes a list of healthcare
services, procedures, and charges associated with each
b. Developed by providers and includes a list of healthcare services
provided to a patient
c. Developed by third-party payers and includes a list of healthcare
services provided to a patient
d. Developed by providers and lists charge codes
1.Data security policies and procedures should be reviewed at least:
a. Semi-annually
b. Annually
c. Every two years
d. Quarterly
Answer B
All data security policies and procedures should be reviewed and
evaluated at least every year to make sure they are up-to-date and still
relevant to the organization (Johns 2011, 995).
2.If an orthopedic surgeon attempted to reduce a fracture but was
unsuccess- ful in obtaining acceptable alignment, what type of code should
be assigned for the procedure?
a. A "with manipulation" code
b. A "without manipulation" code
c. An unlisted procedure code
d. An E/M code only
, Answer A
The "with manipulation" code is used because the fracture was
manipulated, even if the manipulation did not result in clinical anatomic
alignment. See Musculoskeletal Guidelines, Definitions (AHIMA 2012a,
597).
3.What is the maximum number of diagnosis codes that can appear on
the UB-04 paper claim form locator 67 for a hospital inpatient principal
and secondary diagnoses?
a. 35
b. 25
c. 18
d. 9
Answer B
As of January 1, 2011, CMS allows a total of 25 ICD-9-CM diagnosis codes
(one principal and 24 additional diagnoses) for 837 Institutional claims
filing (Schraffen- berger 2012, 66).
4.A patient has two health insurance policies: Medicare and a
Medicare supplement. Which of the following statements is true?
,a. The patient receives any monies paid by the insurance companies over
and above the charges.
b. Monies paid to the healthcare provider cannot exceed charges.
c. The decision on which company is primary is based on remittance advice.
d. The patient should not have a Medicare supplement.
Answer B
The monies collected from third-party payers cannot be greater than the
amount of the provider's charges (Johns 2011, 343).
5.A hospital needs to know how much Medicare paid on a claim so they
can bill the secondary insurance. What should the hospital refer to?
a. Explanation of benefits
b. Medicare Summary Notice
c. Remittance advice
d. Coordination of benefits
Answer C
Remittance advice (RA) is sent to the provider to explain
payments made by third-party payers (Johns 2011, 346).
, 6.Which of the following threatens the "need-to-know" principle?
a. Backdating progress notes
b. Blanket authorization
c. HIPAA regulations
d. Surgical consent
Answer B
A blanket authorization is a common ethical problem when misused.
Patients often sign a blanket authorization, which authorizes the release
of information from that point forward, without understanding the
implications. The problem is the patient is not aware of what information
is being accessed (Johns 2011, 778-779).
7.A fee schedule is:
a. Developed by third-party payers and includes a list of healthcare
services, procedures, and charges associated with each
b. Developed by providers and includes a list of healthcare services
provided to a patient
c. Developed by third-party payers and includes a list of healthcare
services provided to a patient
d. Developed by providers and lists charge codes
