CCA Exam Questions PDoan with complete solutions 2023/2024
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CCA EPDoan
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CCA EPDoan
CCA Exam Questions PDoan with complete solutions 2023/2024
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 unde...
CCA Exam Questions PDoan with
complete solutions 2023/2024
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.
This person designs, implements, and maintains a program that ensures conformity to all types of
regulatory and voluntary accreditation requirements - ANSWER-Compliance officer
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