CCA PREPARATION DOMAIN 2 EXAM
WITH QUESTIONS AND 100% CORRECT
ANSWERS 2025 UPDATE APPROVED BY
EXPERT.
In a managed fee-for-service arrangement, which of the following would be used as a cost-
control process for inpatient surgical services?
a. Prospectively pre-certify the necessity of inpatient services
b. Determine what services can be bundled
c. Pay only 80% of the inpatient bill
d. Require the patient to pay 20% of the inpatient bill - ANS a. Prospectively pre-certify the
necessity of inpatient services
The government sponsored supplemental medical insurance that covers physicians and surgeons
services, emergency department, outpatient clinic, labs and physical therapy is:
a. Medicaid
b. Medicare Part B
c. Medicare Part A
d. Medicare Part D - ANS b. Medicare Part B
What is one way that physicians can prevent or minimize potentially abusive or fraudulent
activities?
a. Developing a compliance plan
b. Upcoding
c. Unbundling
d. Billing for noncovered services - ANS a. Developing a compliance plan
Who is the guarantor?
a. The patient who is an inpatient
b. The person responsible for the bill, such as a parent
c. The person who bills the patient, such as the Medicare biller
d. The patient who is an outpatient - ANS b. The person responsible for the bill, such as a parent
A coding audit shows that an inpatient coder is using multiple codes that describe the individual
components of a procedure rather than using a single code that describes all the steps of the
procedure performed. Which of the following should be done in this case?
a. Require all coders to implement this practice
b. Report the practice to the OIG
c. Counsel the coder and stop the practice immediately
, d. Put the coder on unpaid leave of absence - ANS c. Counsel the coder and stop the practice
immediately
Which of the following types of hospitals are excluded from the Medicare inpatient
prospective payment system?
a. Children's
b. Rural
c. State supported
d. Tertiary - ANS a. Children's
Which of the following would a health record technician use to perform the billing
function for a physician's office? a. CMS-1500
b. UB-04
c. UB-92
d. CMS 1450 - ANS a. CMS-1500
Medicare's newest claims processing payment contract entities are referred to as ________.
a. Recovery audit contractors (RACs)
b. Medicare administrative contractors (MACs)
c. Fiscal intermediaries (FIs)
d. Office of Inspector General contractors (OIGCs) - ANS b. Medicare administrative
contractors (MACs)
What statement is not reflective of meeting medical necessity requirements?
a. A service or supply provided for the diagnosis, treatment, cure, or relief of a health
condition, illness, injury, or disease.
b. A service or supply provided that is not experimental, investigational, or cosmetic in
purpose.
c. A service provided that is necessary for and appropriate to the diagnosis, treatment, cure,
or relief of a health condition, illness, injury, disease, or its symptoms.
d. A service provided solely for the convenience of the insured, the insured's family, or the
provider. - ANS d. A service provided solely for the convenience of the insured, the insured's
family, or the provider.
Timely and correct reimbursement is dependent on: a.
Adjudication
b. Clean claims
c. Remittance advice
d. Actual charge - ANS b. Clean claims
Which of the following is not reimbursed according to the Medicare outpatient
prospective payment system?
a. CMHC partial hospitalization services
WITH QUESTIONS AND 100% CORRECT
ANSWERS 2025 UPDATE APPROVED BY
EXPERT.
In a managed fee-for-service arrangement, which of the following would be used as a cost-
control process for inpatient surgical services?
a. Prospectively pre-certify the necessity of inpatient services
b. Determine what services can be bundled
c. Pay only 80% of the inpatient bill
d. Require the patient to pay 20% of the inpatient bill - ANS a. Prospectively pre-certify the
necessity of inpatient services
The government sponsored supplemental medical insurance that covers physicians and surgeons
services, emergency department, outpatient clinic, labs and physical therapy is:
a. Medicaid
b. Medicare Part B
c. Medicare Part A
d. Medicare Part D - ANS b. Medicare Part B
What is one way that physicians can prevent or minimize potentially abusive or fraudulent
activities?
a. Developing a compliance plan
b. Upcoding
c. Unbundling
d. Billing for noncovered services - ANS a. Developing a compliance plan
Who is the guarantor?
a. The patient who is an inpatient
b. The person responsible for the bill, such as a parent
c. The person who bills the patient, such as the Medicare biller
d. The patient who is an outpatient - ANS b. The person responsible for the bill, such as a parent
A coding audit shows that an inpatient coder is using multiple codes that describe the individual
components of a procedure rather than using a single code that describes all the steps of the
procedure performed. Which of the following should be done in this case?
a. Require all coders to implement this practice
b. Report the practice to the OIG
c. Counsel the coder and stop the practice immediately
, d. Put the coder on unpaid leave of absence - ANS c. Counsel the coder and stop the practice
immediately
Which of the following types of hospitals are excluded from the Medicare inpatient
prospective payment system?
a. Children's
b. Rural
c. State supported
d. Tertiary - ANS a. Children's
Which of the following would a health record technician use to perform the billing
function for a physician's office? a. CMS-1500
b. UB-04
c. UB-92
d. CMS 1450 - ANS a. CMS-1500
Medicare's newest claims processing payment contract entities are referred to as ________.
a. Recovery audit contractors (RACs)
b. Medicare administrative contractors (MACs)
c. Fiscal intermediaries (FIs)
d. Office of Inspector General contractors (OIGCs) - ANS b. Medicare administrative
contractors (MACs)
What statement is not reflective of meeting medical necessity requirements?
a. A service or supply provided for the diagnosis, treatment, cure, or relief of a health
condition, illness, injury, or disease.
b. A service or supply provided that is not experimental, investigational, or cosmetic in
purpose.
c. A service provided that is necessary for and appropriate to the diagnosis, treatment, cure,
or relief of a health condition, illness, injury, disease, or its symptoms.
d. A service provided solely for the convenience of the insured, the insured's family, or the
provider. - ANS d. A service provided solely for the convenience of the insured, the insured's
family, or the provider.
Timely and correct reimbursement is dependent on: a.
Adjudication
b. Clean claims
c. Remittance advice
d. Actual charge - ANS b. Clean claims
Which of the following is not reimbursed according to the Medicare outpatient
prospective payment system?
a. CMHC partial hospitalization services
