CCA EXAM 2023/2024 | Que &Answ
Name the 4 Cooperating Parties for ICD-9-CM Answer- 1) AHIMA, 2) AHA-American Hospital Association, 3) CMS-Centers for Medicare and Medicaid, and 4) NCHS-National Center for Health Statistics
CCA EXAM 2023/2024 | Que &Answ
Name the 4 Cooperating Parties for ICD-9-CM Answer- 1) AHIMA, 2) AHA-American Hospital
Association, 3) CMS-Centers for Medicare and Medicaid, and 4) NCHS-National Center for Health
Statistics
What is a POA Indicator? Answer- The POA-Present on Admission Indicator is used to differentiate
between conditions present at the time of admission and conditions that develop during an inpatient
admission. The POA Indicator applies to diagnosis codes for claims involving inpatient admissions to
acute care hospitals and other facilities. POA - developed by the Cooperating Parties.
What organization is responsible for updating the diagnosis classification (Volumes 1 & 2) for ICD-9-CM?
Answer- Volumes 1 & 2 of the ICD-9-CM are updated by NCHS-National Center for Health Statistics.
What organization is responsible for updating the procedure classification (Volume 3) for ICD-9-CM?
Answer- Volume 3 of the ICD-9-CM is updated by CMS-Centers for Medicaid and Medicare.
Which classification level of ICD-9-CM codes is the most specific? Answer- The "sub-classification" level
is the most specific level of coding in ICD-9-CM (5-digit codes).
What are the levels of ICD-9-CM codes called? Answer- Category>Subcategory (4-digit)>Sub-
classification (5-digit)
How many digits are in the Subcategory Level of ICD-9-CM codes? Answer- There are 4 digits at the
Subcategory Level of ICD-9-CM codes.
Please describe E Codes. Answer- E Codes classify environmental events and circumstances as the cause
of an injury, poisoning, or other adverse effect.
Please describe V Codes. Answer- V Codes are diagnosis codes that indicate a REASON for the
healthcare encounter.
,Please give brief description of Volume I of the ICD-9-CM Volumes. Answer- Volume I of the ICD-9-CM
contains the TABULAR INDEX - a numerical listing of codes that represent diseases and injuries.
Please give a brief description of Volume 2 of the ICD-9-CM Volumes. Answer- Volume 2 of the ICD-9-
CM contains the ALPHABETIC INDEX to Diseases and Injuries (You should always trust this index).
Please give a brief description of Volume 3 of the ICD-9-CM Volumes. Answer- Volume 3 of the ICD-9-
CM contains the TABULAR and ALPHABETIC INDEX to Procedures.
Which item is not a purpose of the ICD-9-CM: A)-used in the evaluation of medical care planning for
healthcare delivery systems, B)-used in the collection of data about nursing care, C)-used to facilitate
data storage and retrieval, or D)-used as the basis of epidemiological research Answer- Collection of
data about nursing care is not a purpose of the ICD-9-CM.
Which item is not one of the purposes of ICD-9-CM: A)-reporting of diagnoses by physicians, B)-
classification of mortality for statistical purposes, C)-the identification of supplies, products & services
provided to patients, or D)-classification of morbidity for statistical purposes Answer- The identification
of supplies, products & services provided to patients is NOT on of the purposes of ICD-9-CM.
Please define "complication". Answer- A complication is a secondary condition that arises during
hospitalization and is thought to increase the LOS-Length of Stay by at least one day for approximately
75% of patients.
Please define "comorbidity". Answer- Comorbidity is a pre-existing condition that because of its
presence with a specific diagnosis will likely cause an increase in the patient's length of stay in the
hospital.
Please define "principal diagnosis". Answer- Principal diagnosis is the condition established, after study,
to be chiefly responsible for occasioning the admission to the patient for the hospital. The principal
diagnosis is NOT the admitting diagnosis, but the diagnosis found after workup, or even after surgery
that proves to the be reason for admission.
State the criteria of a "Significant Procedure". Answer- 1- Surgical in Nature, 2-Carries a procedural risk,
3- Carries an anesthetic risk, 4- Requires specialized training
,Which volume of ICD-9-CM contains the numerical listing of codes that represent diseases and injuries?
Answer- Volume I - the Tablular List contains the numerical listing of codes that represent diseases and
injuries.
What ICD-9-CM codes are always alphanumeric? Answer- V Codes are always alphanumeric.
Which volume of ICD-9-CM contains the Tabular and Alphabetic Index of Porcedures? Answer- Volume
3 of the ICD-9-CM contains the Tabluar LIst and Alphabetic Index of Procedures.
What is the standard terminology used to code medical procedures and services? Answer- CPT is a
comprehensive listing of terms and codes for reporting diagnostic and therapeutic procedures and
medical services.
According to CPT, a repair of a laceration that includes retention sutures would be considered what type
of closure? Answer- Complex Closure would describe the repair of wounds requiring more than layered
closure, namely, scar revision, debridement, extensive undermining, stents, or retention sutures.
A 7-year old patient was admitted to ER for treatment of shortness of breath. Patient was give
epinephrine and nebulizer treatments. The shortness of breath and wheezing are unabated following
treatment. What diagnosis should be suspected? [epineprhine-adrenaline hormone secreted by the
medulla of the adrenal glands - when injected treats vasoldilation by increasing blood flow] Answer-
Status Asthmaticus: fails to respond to therapy administered during an asthmatic attack. This is a life-
threatening conditions that requires emergency care and likely hospitalization. (Schraffenberger)
How is the CPT code determined for an excision of a malignant lesion of the skin? Answer- The CPT
code for an excision of a malignant lesion of the skin by the body area from which the excision occurs
and by measuring the greatest clinical diameter of the apparent lesion plus that margin required for
complete excision (lesion diameter + the most narrow margins required = the excised diameter).
Patient admitted for spotting. Patient had been treated 2 weeks prior for a miscarriage with sepsis.
Sepsis has resolved and she is afrebrile [having no fever] at this time. Patient is treated with an aspiration
dilation and curettage. Products of conception are found. What is the principal diagnosis? Answer-
Miscarriage: subsequent [later] admissions for retained products of conception following a spontaneous
or legally induced abortion are assigned the appropriate code from Catogory 634, spontaneous abortion,
or 635, legally induced abortion, with a fifth digit of "1" (incomplete). This advise is appropriate even
when the patient was discharged previously with a discharge diagnosis of complete abortion.
, What is a condition that arises during hospitalization? Answer- Complication
What codes are used to assign a diagnosis to a patient who is seeking healthcare services but is no
necessarily sick? Answer- V Codes are diagnosis codes and indicate a reason for healthcare encounter.
What is the 2-digit modifier that may be reported to indicate a physician performed the postoperative
management of a patient, but another physician performed the surgical procedure? Answer- Modifier -
55 is used to identify the physician provided ONLY postoperative care services for a particular procedure.
[modifiers are appended to the code to provide more information or to alert the payer that a payment
change is required.]
What does an encoder do for a coder? Answer- An encoder takes a coder through a series of questions
an choices called a logic based encoder. The logic based encoder prompts the user through a variety of
questions and choices based on the terminology entered. The coder selects the most accurate colde for
a service or condition (and any possible complications or comorbidities).
Patient admitted for abdominal pain with diarrhea and diagnosed with infectious gastroenteritis. Patient
also has angina and chronic obstruction pulmonary disease. What is the correct coding and sequence for
this case? Answer- Infectious gastroenteritis; chronic obstructive pulmonary disease; angina - Patients
can have several chronic conditions that co-exist at the time of their admision and qualify as additional
disgnoses. [the codes for the symptoms "abdominal pain", "diarrhea", "vomiting", or "abdominal
cramps" - signs, symptoms, and ill-defined conditions are not to be used as the Principal Diagnosis when
a related definitive diagnosis has been established. *Chapter 16 CPT Codebook*
Patient admitted with history of prostate cancer and with mental confusion. Patient completed radiation
therapy for prostatic carcinoma 3 years prior and is status post a radical resection of the prostate. A CT
Scan of the brain during the current admission reveals metastasis. What is the correct coding and
sequencing for this case? Answer- Metastastic carcinoma of the brain; History of carcinoma of the
prostate - for a FORMER malignancy a code from Category V10, personal history of a malignant
neoplasm should be used to indicate the former site of malignancy [when a primary malignancy has
been previously excised or eradicated from its site and there is NO further treatment directed to that site
& no evidence of any existing primary malignancy]. The mention of extension, invasion, or metastatic to
another site is coded as a secondary malignant neoplasm to that site. The secondary site may be the
principal, with the V10 code used as a secondary code. (Shcraffenberger)
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