FREE Certified Coding Associate Clinical Questions and Answers

Question 1

The following are the names of the most recent Medicare claims processing payment contract entities:

Accepted Answer

Medicare administrative contractors (MACs)

Answer

Medicare Administrative Contractors (MACs) are private healthcare insurers that have been awarded a contract by the Centers for Medicare & Medicaid Services (CMS) to process Medicare Part A and Part B (and Durable Medical Equipment) claims. They serve as the primary contact for providers and handle claims processing, payment, and other administrative functions for specific geographic regions. They replaced the previous system of fiscal intermediaries and carriers.

Question 2

Determine the punctuation mark that is used to augment any additional words or explanatory information that may or may not be included in the ICD-9-CM coding statement of diagnosis or procedure. The case's code number is unaffected by the punctuation. The punctuation is used in all three volumes of ICD-9-CM and is regarded as a nonessential modifer.

Accepted Answer

Parentheses ( )

Answer

In ICD-9-CM, parentheses ( ) are used to enclose nonessential modifiers. These are supplementary words or explanatory information that may or may not be present in the diagnostic statement but do not affect the code assignment. They provide additional detail without changing the fundamental meaning of the code.

Question 3

The following entities have established messaging standards for electronic data interchange in healthcare:

Accepted Answer

HL7

Answer

HL7 (Health Level Seven International) is a not-for-profit organization that develops international standards for the transfer of clinical and administrative data between healthcare software applications. Its standards are widely used for electronic data interchange in healthcare, facilitating interoperability and communication between different systems.

Question 4

The Joint Commission's ORYX program and HEDIS are both made to gather data for .

Accepted Answer

Performance improvement programs

Answer

Both The Joint Commission's ORYX program and HEDIS (Healthcare Effectiveness Data and Information Set) are designed to collect and report data on the quality of healthcare services. This data is then used to evaluate and drive performance improvement initiatives within healthcare organizations. Their goal is to enhance patient care, safety, and efficiency by identifying areas for improvement.

Question 5

Written or oral authorization to move forward with caution is categorized as:

Accepted Answer

Informed consent

Answer

Informed consent is a legal and ethical principle that requires a healthcare provider to obtain permission from a patient before performing a medical procedure or treatment. This authorization must be given after the patient has received and understood all relevant information, including the nature of the procedure, its risks, benefits, and alternatives. It signifies a patient's autonomous decision-making regarding their care.

Certified Coding Associate Exam Practice Test

Certified Coding Associate Exam Practice Test

FREE Certified Coding Associate Clinical Questions and Answers