CCA Exam Domain 2
Look at book on page 14 question 65
Given the following information, which of the following statements is correct?
A. In each MS-DRG the geometric mean is lower than the arithmetic mean.
b. In each MS-DRG the arithmetic mean is lower than the geometric mean.
c. The higher the number of patients in each MS-DRG, the greater the geometric mean for that MS-DRG.
d. The geometric means are lower in MS-DRGs that are associated with a CC or MCC. - ANSWER-A
The geometric mean LOS is defined as the total days of service, excluding any outliers or transfers,
divided by the total number of patients
Look at page 14 question 66
If another status T procedure were performed, how much would the facility receive for the second status
T procedure?
a. 0%
b. 50%
c. 75%
d. 100% - ANSWER-B
Multiple surgical procedures with payment status indicator T performed during the same operative
session are discounted. The highest-weighted procedure is fully reimbursed. All other procedures with
payment status indicator T are reimbursed at 50 percent.
67
Medical necessity for inpatient services does not always include:
,a. LCDs
b. Related monetary benefits to payers
c. Uniform written procedures for appeals
d. Concurrent review - ANSWER-A
There are not LCDs and NDCs for every type of procedure or service that could be provided for a patient
68
Which of the following types of hospitals are excluded from the Medicare inpatient prospective payment
system?
a. Children's
b. Rural
c. State supported
d. Tertiary - ANSWER-A
Psychiatric and rehabilitation hospitals, long-term care hospitals, children's hospitals, cancer hospitals,
and critical access hospitals are paid on the basis of reasonable cost, subject to payment limits per
discharge or under separate PPS
69
Diagnosis-related groups are organized into:
a. Case-mix classifications
b. Geographic practice cost indices
c. Major diagnostic categories
d. Resource-based relative values - ANSWER-C
Diagnosis -related groupings (DRGs) are classified by one of 25 major diagnostic categories (MDCs)
70
The Medicare program pays for health care services Social Security benefits for those age 65 and older,
permanently disabled people and those with:
, a. End stage renal disease
b. Military experience
c. Medicaid
d. Skilled nursing services - ANSWER-A
Medicare Part A is generally provided free of charge to individuals age 65 and over who are eligible for
Social Security. The coverage is provided to those with end-stage renal disease
71
Which of the following is not reimbursed according to the Medicare outpatient prospective payment
system?
a. CMHC partial hospitalization services
b. Critical access hospitals
c. Hospital outpatient departments
d. Vaccines provided by CORFs - ANSWER-B
Critical access hospitals are paid on a cost-based payment system and are not part of the prospective
payment system
72
Fee schedules are updated by third-party payers:
a. Annually
b. Monthly
c. Semiannually
d. Weekly - ANSWER-A
Third-party payers who reimburse providers on a fee-for-service basis generally update fee schedules on
an annual basis
73
Look at book on page 14 question 65
Given the following information, which of the following statements is correct?
A. In each MS-DRG the geometric mean is lower than the arithmetic mean.
b. In each MS-DRG the arithmetic mean is lower than the geometric mean.
c. The higher the number of patients in each MS-DRG, the greater the geometric mean for that MS-DRG.
d. The geometric means are lower in MS-DRGs that are associated with a CC or MCC. - ANSWER-A
The geometric mean LOS is defined as the total days of service, excluding any outliers or transfers,
divided by the total number of patients
Look at page 14 question 66
If another status T procedure were performed, how much would the facility receive for the second status
T procedure?
a. 0%
b. 50%
c. 75%
d. 100% - ANSWER-B
Multiple surgical procedures with payment status indicator T performed during the same operative
session are discounted. The highest-weighted procedure is fully reimbursed. All other procedures with
payment status indicator T are reimbursed at 50 percent.
67
Medical necessity for inpatient services does not always include:
,a. LCDs
b. Related monetary benefits to payers
c. Uniform written procedures for appeals
d. Concurrent review - ANSWER-A
There are not LCDs and NDCs for every type of procedure or service that could be provided for a patient
68
Which of the following types of hospitals are excluded from the Medicare inpatient prospective payment
system?
a. Children's
b. Rural
c. State supported
d. Tertiary - ANSWER-A
Psychiatric and rehabilitation hospitals, long-term care hospitals, children's hospitals, cancer hospitals,
and critical access hospitals are paid on the basis of reasonable cost, subject to payment limits per
discharge or under separate PPS
69
Diagnosis-related groups are organized into:
a. Case-mix classifications
b. Geographic practice cost indices
c. Major diagnostic categories
d. Resource-based relative values - ANSWER-C
Diagnosis -related groupings (DRGs) are classified by one of 25 major diagnostic categories (MDCs)
70
The Medicare program pays for health care services Social Security benefits for those age 65 and older,
permanently disabled people and those with:
, a. End stage renal disease
b. Military experience
c. Medicaid
d. Skilled nursing services - ANSWER-A
Medicare Part A is generally provided free of charge to individuals age 65 and over who are eligible for
Social Security. The coverage is provided to those with end-stage renal disease
71
Which of the following is not reimbursed according to the Medicare outpatient prospective payment
system?
a. CMHC partial hospitalization services
b. Critical access hospitals
c. Hospital outpatient departments
d. Vaccines provided by CORFs - ANSWER-B
Critical access hospitals are paid on a cost-based payment system and are not part of the prospective
payment system
72
Fee schedules are updated by third-party payers:
a. Annually
b. Monthly
c. Semiannually
d. Weekly - ANSWER-A
Third-party payers who reimburse providers on a fee-for-service basis generally update fee schedules on
an annual basis
73
