AHIMA CCS Exam Questions and
Answers (Verified)
CPT defines a separate procedure as - Answer -Procedure considered an integral part
of a more major service
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
APC Status Indicator - N - Answer -Items and Services Packaged into APC Rates
APC Status Indicator - S - Answer -Significant Procedure, Not Discounted When
Multiple
APC Status Indicator - T - Answer -Significant Procedure, Multiple Reduction Applies
APC Status Indicator - V - Answer -Clinic or Emergency Department Visit
APC Status Indicator - X - Answer -Ancillary Services
APC Status Indicator - Y - Answer -Non-Implantable Durable Medical Equipment
Medicare exerts control of provider reimbursement through adjustment of this
component of the resource-based relative value scale (RBRVS) - Answer -Conversion
factor
The process of collecting data elements from a source document is known as: - Answer
-Abstracting
, What piece of claims data from hospital A alerts a payer that the patient was transferred
to hospital B? - Answer -Discharge disposition
Admission source code used to identify a patient admitted to the facility from home: -
Answer -Non-Healthcare Facility
Admission source code used to identify a patient admitted to the facility from hospice
care: - Answer -Transfer from hospice
When a patient is transferred from an acute care facility to a skilled nursing home
facility, what abstracted data element can impact the DRG assignment? - Answer -
Discharge disposition
A complication or comorbidity - Answer -Hypernatremia - A high concentration of
sodium in the blood. Hypernatremia most often occurs in people who don't drink enough
water.
A major complication comorbidity: - Answer -Acute diastolic congestive heart failure
MCC - Answer -major complication or comorbidity
increases the use of medical and hospital expenses
CC - Answer -complication or comorbidity
Which condition meets the definition of comorbidity? - Answer -Hypertension
Myocardial Infarction - Answer -CPK elevation with MB enzymes elevated and the EKG
ST changes denote MI (myocardial infarction)
Coding a Cardiac Catheterization - Answer -Include:
the approach
the side of the heart into which catheter was inserted
note if any additional procedures were performed
Coding a Wound Closure - Answer -Include:
the site and length of the closure
the repair type: simple, intermediate, or complex
CHF - Answer -Congestive Heart Failure
Query - POA - Answer -Yes/No queries are permissible to establish POA status
Compliant queries include - Answer -Relevant clinical indicators
Query must: - Answer -Provide a concise presentation of facts and clinical indicators
Answers (Verified)
CPT defines a separate procedure as - Answer -Procedure considered an integral part
of a more major service
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
APC Status Indicator - N - Answer -Items and Services Packaged into APC Rates
APC Status Indicator - S - Answer -Significant Procedure, Not Discounted When
Multiple
APC Status Indicator - T - Answer -Significant Procedure, Multiple Reduction Applies
APC Status Indicator - V - Answer -Clinic or Emergency Department Visit
APC Status Indicator - X - Answer -Ancillary Services
APC Status Indicator - Y - Answer -Non-Implantable Durable Medical Equipment
Medicare exerts control of provider reimbursement through adjustment of this
component of the resource-based relative value scale (RBRVS) - Answer -Conversion
factor
The process of collecting data elements from a source document is known as: - Answer
-Abstracting
, What piece of claims data from hospital A alerts a payer that the patient was transferred
to hospital B? - Answer -Discharge disposition
Admission source code used to identify a patient admitted to the facility from home: -
Answer -Non-Healthcare Facility
Admission source code used to identify a patient admitted to the facility from hospice
care: - Answer -Transfer from hospice
When a patient is transferred from an acute care facility to a skilled nursing home
facility, what abstracted data element can impact the DRG assignment? - Answer -
Discharge disposition
A complication or comorbidity - Answer -Hypernatremia - A high concentration of
sodium in the blood. Hypernatremia most often occurs in people who don't drink enough
water.
A major complication comorbidity: - Answer -Acute diastolic congestive heart failure
MCC - Answer -major complication or comorbidity
increases the use of medical and hospital expenses
CC - Answer -complication or comorbidity
Which condition meets the definition of comorbidity? - Answer -Hypertension
Myocardial Infarction - Answer -CPK elevation with MB enzymes elevated and the EKG
ST changes denote MI (myocardial infarction)
Coding a Cardiac Catheterization - Answer -Include:
the approach
the side of the heart into which catheter was inserted
note if any additional procedures were performed
Coding a Wound Closure - Answer -Include:
the site and length of the closure
the repair type: simple, intermediate, or complex
CHF - Answer -Congestive Heart Failure
Query - POA - Answer -Yes/No queries are permissible to establish POA status
Compliant queries include - Answer -Relevant clinical indicators
Query must: - Answer -Provide a concise presentation of facts and clinical indicators
