FREE Certified Coding Associate Knowledge Questions and Answers
A woman, age 66, suffers a spiral fractured right tibia while skiing. She undergoes an initial evaluation in the emergency room and is then hospitalized right away for an intramedullary implant procedure with Dr. Riva. She experiences an uncommon implant reaction during the first 24 hours of her recuperation in which the pressure inside her leg has risen dangerously high. She is swiftly readmitted to the operating room so that Dr. Riva can perform surgery to relieve the implant's pressure. What modifier is required for classifying this second surgery, according to your understanding of Medicare's global surgical package provisions?
Repeat procedures or services, whether performed by the same surgeon or a new one, are referred to as modifiers 76 and 77. This technique is not a follow-up to the medullary implant operation; rather, it is intended to reduce the difficulties that resulted from the initial procedure. We can assume that this second procedure was unexpected because the reaction is described as being uncommon. The same surgeon, Dr. Riva, who carried out the first procedure also carried out this second one. This is a good fit for modifier 78, which is characterized as a sudden return by the same surgeon to the operating or procedure room. Modifier 78 is the right response since modifier 79 cannot be used because it only indicates unrelated surgeries that have place during the global surgical package period.
A patient agrees to perhaps take on financial responsibility for a treatment or service that Medicare might refuse. What form does the patient need to complete?
Forms are not HIPAA or the Merit-Based Incentive Payment System (MIPS). CMS-1450 (or UB-04) is a typical billing form used to transmit patient claims to Medicare administrative contractors for services or interventions that automatically satisfy the "medically required" criterion for reimbursement. The right response is an Advance Beneficiary Notice of Non-Coverage (ABN), which is completed when a service or procedure might not fulfill this standard for "medically required."
Which of the following is an example of an external cause code?
External cause codes provide information about the cause of an injury, such as a car accident.
What ICD-10 code should be used to diagnose a malignant tumor in the upper inner quadrant of the right male breast?
Refer to the ICD-10 Table of Neoplasms to determine the proper diagnosis. There is a subcategory called "Upper-inner quadrant" under the heading "Breast." The base code C50.2- from the table would be the first step in determining the precise numeric code because this tumor is designated as being malignant. Due to the patient's gender designation, C50.211 and C50.411 are no longer applicable. Because the malignancy is in his right breast and upper-inner quadrant, the right response is C50.221 (versus being in his left breast and in the upper-outer quadrant, as described by C50.421).
What is the purpose of a query in medical coding?
A query is used to clarify ambiguous or incomplete documentation to ensure accurate coding.
What does "DRG" stand for in the context of medical coding and billing?
What does "DRG" stand for in the context of medical coding and billing?
A process that requires the precise movement of imaging tools and contrast material between numerous separate artery vessels is being carried out by a radiologist. Which CPT codebook appendix provides the greatest guidelines for choosing the right code for this procedure?
The Food and Drug Administration (FDA) has not yet approved a Category III code for widespread usage as a Category I code, hence they are only used for novel and developing medical technologies that are still being actively examined for their efficacy and safety. A category III code is superfluous and improper for vascular imaging, despite the fact that it can be extremely complex at times. The indexes of modifiers in Appendix A have no direct bearing on the coding of procedures involving vascular systems (but it could be indirectly related, depending on whether or not the procedure itself requires flagging for special circumstances). The demands of the coder would not be served by Appendix C, despite the fact that it is informative because it only deals with difficult scenarios in evaluation and management (E/M) coding. A highly trained coder is aware that the names and classifications of the vessels investigated during the same session have a significant impact on the code selection and code sequencing for vascular imaging. Therefore, it is crucial to pay close attention to detail. The response is in Appendix L.
Which of these groups is in charge of the CCA examination?
The organization responsible for the Certified Coding Associate (CCA) examination is the American Health Information Management Association (AHIMA).
Which of the following best describes the concept of "coding specificity"?
Coding specificity involves selecting the most accurate code that best reflects the details provided in the medical documentation.
What does CCS mean?
A certified Coding Specialist (CCS) is a professional credential in the field of health information management. CCS professionals are experts in medical coding, which involves translating medical diagnoses and procedures into codes that are used for billing and reimbursement purposes.
Which of the following is NOT a benefit of accurate medical coding?
Reduced need for physician documentation Explanation: Accurate medical coding requires appropriate physician documentation to support the codes assigned.
What does the abbreviation PHI mean?
PHI stands for protected health information in the medical field. PHI has several different parts, some of which are private, individual, and patient. The fact that this information is intended to be kept private across digital systems and interfaces is what counts most in the modern healthcare infrastructure, which is heavily based on information technology [IT]. Consequently, in order to safeguard patient privacy and confidentiality to the fullest extent possible, PHI is legally protected under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Any electronic sharing of PHI must therefore adhere to the "minimum necessary" criteria.
Which of the following is a part of the ICD-10-PCS code structure?
ICD-10-PCS codes have a structure of seven alphanumeric characters, representing various aspects of a medical procedure.
What is the main focus of outpatient coding?
Outpatient coding primarily involves coding for physician services and procedures that do not require an overnight stay.
Which of the following is a potential consequence of inaccurate medical coding?
Inaccurate medical coding can lead to compliance issues, billing errors, and financial penalties.
What is the primary goal of the CCA certification program?
The primary goal of the CCA certification program is to train and certify individuals as professional medical coders.