CCA Exam Questions Pdoan Questions
And Answers With Verified Solutions
100% Correct!!!
Which organization updates the procedure classification of ICD-10-PCS -
ANSWER✔✔CMS
What does the 4th character of an ICD-10-CM diagnosis code capture? -
ANSWER✔✔Etiology
True or false: Critical access hospitals are reimbursed under Medicare's outpatient
prospective payment system. - ANSWER✔✔False. They are paid based on a cost-
based payment system.
If the placement of a catheter is billed along with an infusion on the same day of
service for an outpatient beneficiary, what will Medicare pay for? -
ANSWER✔✔The infusion procedure. The insertion of the catheter is integral to
the procedure and not coded separately.
What is the goal of a coding compliance program? - ANSWER✔✔To prevent
accusations of fraud and abuse
What would be the best way for a hospital to determine whether POA indicators
for the conditions selected by CMS are having a negative impact on
reimbursement? - ANSWER✔✔Identify all records for a period having these
indicators for these conditions and determine if these conditions are the only
secondary diagnoses present that will lead to higher payment.
In a fee-for-service arrangement, what would be a cost control process for
inpatient surgery? - ANSWER✔✔Prospectively precertify the necessity of the
surgery
True or false: The outpatient claims editor generates denials of outpatient claims.
- ANSWER✔✔False. An outpatient claims editor does not exist.
What is the electronic format for hospital technical fees? - ANSWER✔✔8371
, What process determines how a claim will be reimbursed based on the insurance
benefit - ANSWER✔✔Adjudication
What is not one of the outcomes of auto-adjudication by computer software? -
ANSWER✔✔Auto-calculate. The software can auto-pay, auto-suspend, or auto-
deny
Which agency develops an annual work plan that delineates the target areas for
Medicare that will be monitored in a given year? - ANSWER✔✔Office of Inspector
General
What is the defining characteristic of an integrated health record? -
ANSWER✔✔Components are arranged in chronological order
What is the purpose of physician's orders? - ANSWER✔✔Document instructions
to other parties involved in providing patient care
Which program was released in 1995 to target fraud and abuse among healthcare
providers? - ANSWER✔✔Operation Restore Trust
Which resource can managers use to discover current areas of compliance? -
ANSWER✔✔OIG Workplan
What is the term for a record of all transactions that is maintained and reviewed
for unauthorized access? - ANSWER✔✔Audit trail
Performance counseling usually begins with what? - ANSWER✔✔Counseling or
verbal warning
Healthcare facilities have written standards of conduct and policies and
procedures that address fraud as well as audits to monitor compliance. What
should a compliance officer also ensure are in place? - ANSWER✔✔Establishment
of a hotline to receive complaints and adoption of procedures to protect
whistleblowers from retaliation.
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