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CCA Exam with Questions Solved 100% Correct
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CCA Exam with Questions Solved 100% Correct
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CCA Exam with Questions Solved 100%Correct
An 8-year-old male hemophiliac is admitted with acute blood loss anemia due to uncontrolled
bleeding. He is given clotting factor and six units of whole blood. Which of the following
diagnosis and procedure ICD-9-CM codes would be correct?
a. 286.0, 99.06, 99.03
b. 285.1, 286.0, 99.06, 99.03
c. 286.0, 285.1, 99.06, 99.03
d. 285.1, 99.06, 99.03 - ✔✔Correct Answer: B.
The anemia code 285.1 would be coded as the principal diagnosis. In accordance with the
UHDDS definition for principal diagnosis, the anemia (not the hemophilia), is the reason for
admission and sequenced as the principal diagnosis (CMS 2010c, Section II, 96; AHIMA 2012a,
646).
The patient was admitted with increasing shortness of breath, weakness, and nonproductive
cough. Treatment included oxygen therapy. Final diagnoses listed as acute respiratory
insufficiency and acute exacerbation of chronic obstructive pulmonary disease (COPD). Which
of the following is the correct ICD-9-CM diagnostic code assignment?
a. 491.21
b. 491.21, 518.82
c. 518.81, 491.21
d. 518.82, 491.21 - ✔✔Correct Answer: A.
Acute respiratory insufficiency is an integral part of COPD and is therefore not coded
separately. The patient had acute respiratory insufficiency and not acute respiratory failure
(AHIMA 2012a, 682).
,What term is used for retrospective cash payments paid by the patient for services rendered by
a provider?
a. Fee-for-service
b. Deductible
c. Retrospective
d. Prospective - ✔✔Correct Answer: A.
Patient paid cash for services on a retrospective fee-for-service basis, which meant the patient
was expected to pay the healthcare provider after a service was rendered (Johns 2011, 291).
In which of the following payment systems is the amount of payment determined before the
service is delivered?
a. Fee-for-service
b. Per diem
c. Prospective
d. Retrospective - ✔✔Correct Answer: C.
In a prospective payment system (PPS), the exact amount of the payment is determined before
the service is delivered (Johns 2011, 315).
Which of the following is a prospective payment system implemented for payment of acute
hospital inpatient services?
a. APC
b. DRG
c. OPPS
d. RBRVS - ✔✔Correct Answer: C.
In 1983, CMS implemented a PPS for inpatient hospital care provided to Medicare beneficiaries.
The PPS methodology is called diagnosis-related groups (DRGs) (Johns 2011, 319).
,The inpatient prospective payment system for MS-DRG assignment begins with the:
a. Principal diagnosis
b. Primary diagnosis
c. Secondary diagnosis
d. Surgical procedure - ✔✔Correct Answer: A.
To determine the appropriate MS-DRG, a claim for a healthcare encounter is first classified into
one of the 25 major diagnostic categories, or MDCs. The principal diagnosis determines the
MDC assignment (Johns 2011, 322-323).
The present on admission (POA) indicator is a requirement for
a. Inpatient Medicare claims submitted by acute care hospitals
b. Inpatient Medicare and Medicaid claims submitted by hospitals
c. Medicare claims submitted by all entities
d. Inpatient skilled nursing facility Medicare claims - ✔✔Correct Answer: A.
The POA indicator applies to diagnosis codes for claims involving inpatient admission to acute-
care hospitals or other facilities, as required by law or regulation for public health reporting
(Schraffenberger 2012, 58; CMS 2011c, 97-102; Johns 2011, 325).
The National Correct Coding Initiative was developed to control improper coding leading to
inappropriate payment for:
a. Part A Medicare claims
b. Part B Medicare claims
c. Medicaid claims
d. Medicare and Medicaid claims - ✔✔Correct Answer: B.
, CMS implemented the National Correct Coding Initiative (NCCI) in 1996 to develop correct
coding methodologies to improve the appropriate payment of Medicare Part B claims (Johns
2011, 347).
Code 87900, infectious agent drug susceptibility phenotype prediction using regularly updated
genotypic bioinformatics, is used in the management of patients with what disease?
a. Cancer patients on toxic chemotherapy agents
b. HIV patients on antiretroviral therapy
c. Tuberculosis patients on rifampin therapy
d. Organ transplant patients on immunosuppressive therapy - ✔✔Correct Answer: B.
CPT code 87900 for infectious agent drug susceptibility phenotype prediction using regularly
updated genotypic bioinformatics is used in the management of HIV patients on antiretroviral
therapy (AMA 2012b, 442).
Identify the CPT procedure code(s) and correct modifier for a thyroid stimulating hormone
(TSH) when medical necessity is not met and the patient signs a required waiver of liability
signifying the patient will be responsible for payment if the test is not covered by Medicare.
Another name for waiver of liability is Advance Beneficiary Notice (ABN).
a. 84443-GA
b. 80418-GA
c. 84443-GY
d. 80418-GY - ✔✔Correct Answer: A.
Index Thyroid simulating hormone, 80418, 80438-80440, 84443. Code 84443 is the correct code
for a TSH while the rest of the codes are panels including several tests. Modifier -GA is listed in
the front cover of the CPT Professional Edition and signifies the patient was given a notice of
non-coverage also known as waiver of liability or ABN (AMA 2012b, 427; CMS 2010d; CMS
2010e).
GA- Waiver of Liability Statement Issued as Required by Payer Policy, Individual Case- Use this
modifier to report when you issue a mandatory ABN for a service as required and it is on file.
You do not need to submit a copy of the ABN, but you must have it available on request.
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