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Exam (elaborations)

AHIMA CCS Exam Prep 2024/2025 already graded A+

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AHIMA CCS Exam Prep 2024/2025 already graded A+

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  • April 16, 2024
  • 8
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
  • ahima ccs
  • AHIMA CCS
  • AHIMA CCS
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Ashley96
AHIMA CCS Exam Prep

CPT defines a separate procedure as - ANSProcedure considered an integral part of a more
major service

No combination code available - ANSUse 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? - ANSBody Mass
Index (BMI)

POA Indicator - Y - ANSY-Yes, present at the time of inpatient admission

POA Indicator - N - ANSN-No, not present at the time of inpatient admission

POA Indicator - U - ANSU-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 - ANSW-Clinically undetermined, provider is unable to clinically determine
whether condition was present on admission or not

POA Indicator - E - ANSE-Exempt, unreported/not used, some facilities will leave these blank,
others will use the letter "E"

Present on Admission Indicator (POA) - ANSA 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: - ANSIdentify incomplete and
incorrect claims

Medicare's identification of medically necessary services is outlined in: - ANSLocal Coverage
Determinations (LCDs)

Medically unlikely edits are used to identify: - ANSMaximum units of service for a HCPCS code

National Correct Coding Initiative (NCCI) Edits are released how often? - ANSQuarterly

In 2000, CMS issued the final rule on the outpatient prospective payment system (OPPS). The
final rule: - ANSDivided outpatient services into fixed payment groups

, Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs) are similar in
that they are both: - ANSProspective payment systems

What are APCs? - ANSAPCs or "Ambulatory Payment Classifications" are the government's
method of paying facilities for outpatient services for the Medicare program.

How do APCs work? - ANSThe 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 - ANSInpatient Procedures, not paid under OPPS

APC Status Indicator - N - ANSItems and Services Packaged into APC Rates

APC Status Indicator - S - ANSSignificant Procedure, Not Discounted When Multiple

APC Status Indicator - T - ANSSignificant Procedure, Multiple Reduction Applies

APC Status Indicator - V - ANSClinic or Emergency Department Visit

APC Status Indicator - X - ANSAncillary Services

APC Status Indicator - Y - ANSNon-Implantable Durable Medical Equipment

Medicare exerts control of provider reimbursement through adjustment of this component of the
resource-based relative value scale (RBRVS) - ANSConversion factor

The process of collecting data elements from a source document is known as: - ANSAbstracting

What piece of claims data from hospital A alerts a payer that the patient was transferred to
hospital B? - ANSDischarge disposition

Admission source code used to identify a patient admitted to the facility from home: -
ANSNon-Healthcare Facility

Admission source code used to identify a patient admitted to the facility from hospice care: -
ANSTransfer 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? - ANSDischarge disposition

A complication or comorbidity - ANSHypernatremia - A high concentration of sodium in the
blood. Hypernatremia most often occurs in people who don't drink enough water.

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