CCA Exam Preparation Domains 1, 2, 3, 4, 5, & 6
Practice Test 200 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) ALREADY GRADED A+
2025 NEW UPDATE
1. A patient is admitted with spotting. She had been treated two weeks previously for a
miscarriage with sepsis. The sepsis had resolved, and she is afebrile at this time. She is
treated with an aspiration dilation and curettage and products of conception are found.
Which of the following should be the principal diagnosis?
a. Miscarriage
b. Complications of spontaneous abortion with sepsis
c. Sepsis
d. Spontaneous abortion with sepsis - CORRECT ANSWER: a. Miscarriage
10. Reference codes 49491 through 49525 for inguinal hernia repair. Patient is 47 years
old. What is the correct code for an initial inguinal herniorrhaphy for incarcerated
hernia?
a. 49496
b. 49501
c. 49507
d. 49521 - CORRECT ANSWER: c. 49507
100. From the information provided, how many APCs would this patient have?
Billing Number Status Indicator CPT/HCPCS APC
,998323 V 99285-25 0612
998324 T 25500 0044
998325 X 72050 0261
998326 S 72128 0283
998327 S 70450 0283
a. 1
b. 4
c. 5
d. 3 - CORRECT ANSWER: c. 5
101. 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. - CORRECT ANSWER: d. A service provided solely for the convenience of
the insured, the insured's family, or the provider.
102. 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 precertify the necessity of inpatient services
b. Determine what services can be bundled
c. Pay only 80 percent of the inpatient bill
,d. Require the patient to pay 20 percent of the inpatient bill - CORRECT ANSWER: a.
Prospectively precertify the necessity of inpatient services
103. If a patient's total outpatient bill is $500, and the patient's healthcare insurance
plan pays 80 percent of the allowable charges, what is the amount owed by the patient?
a. $10
b. $40
c. $100
d. $400 - CORRECT ANSWER: c. $100
104. What system reimburses hospitals a predetermined amount for each Medicare
inpatient admission?
a. APR-DRG
b. DRG
c. APC
d. RUG - CORRECT ANSWER: b. DRG
105. Timely and correct reimbursement is dependent on:
a. Adjudication
b. Clean claims
c. Remittance advice
d. Actual charge - CORRECT ANSWER: b. Clean claims
106. When a provider accepts assignment, this means the:
, a. Patient authorizes payment to be made directly to the provider
b. Provider agrees to accept as payment in full the allowed charge from the fee
schedule
c. Balance billing is allowed on patient accounts, but at a limited rate
d. Participating provider receives a fee-for-service reimbursement - CORRECT
ANSWER: b. Provider agrees to accept as payment in full the allowed charge from the
fee schedule
107. Effective October 16, 2003, under the Administrative Simplification Compliance
section of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), all
healthcare providers must electronically submit claims to Medicare. Which is the
electronic format for hospital technical fees?
a. 837I
b. 837P
c. UB-04
d. 1500 - CORRECT ANSWER: a. 837I
108. Given the following information, which of the following statements is correct?
Weight Discharges Geometric Mean Arithmetic Mean
0.9757 10 4.1 5.0
0.7254 20 3.3 4.0
1.4327 10 5.4 6.7
1.0056 20 4.4 5.3
0.7316 10 3.5 4.1
a. In each MS-DRG the geometric mean is lower than the arithmetic mean.
b. In each MS-DRG the arithmetic mean is lower than the geometric mean.
Practice Test 200 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) ALREADY GRADED A+
2025 NEW UPDATE
1. A patient is admitted with spotting. She had been treated two weeks previously for a
miscarriage with sepsis. The sepsis had resolved, and she is afebrile at this time. She is
treated with an aspiration dilation and curettage and products of conception are found.
Which of the following should be the principal diagnosis?
a. Miscarriage
b. Complications of spontaneous abortion with sepsis
c. Sepsis
d. Spontaneous abortion with sepsis - CORRECT ANSWER: a. Miscarriage
10. Reference codes 49491 through 49525 for inguinal hernia repair. Patient is 47 years
old. What is the correct code for an initial inguinal herniorrhaphy for incarcerated
hernia?
a. 49496
b. 49501
c. 49507
d. 49521 - CORRECT ANSWER: c. 49507
100. From the information provided, how many APCs would this patient have?
Billing Number Status Indicator CPT/HCPCS APC
,998323 V 99285-25 0612
998324 T 25500 0044
998325 X 72050 0261
998326 S 72128 0283
998327 S 70450 0283
a. 1
b. 4
c. 5
d. 3 - CORRECT ANSWER: c. 5
101. 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. - CORRECT ANSWER: d. A service provided solely for the convenience of
the insured, the insured's family, or the provider.
102. 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 precertify the necessity of inpatient services
b. Determine what services can be bundled
c. Pay only 80 percent of the inpatient bill
,d. Require the patient to pay 20 percent of the inpatient bill - CORRECT ANSWER: a.
Prospectively precertify the necessity of inpatient services
103. If a patient's total outpatient bill is $500, and the patient's healthcare insurance
plan pays 80 percent of the allowable charges, what is the amount owed by the patient?
a. $10
b. $40
c. $100
d. $400 - CORRECT ANSWER: c. $100
104. What system reimburses hospitals a predetermined amount for each Medicare
inpatient admission?
a. APR-DRG
b. DRG
c. APC
d. RUG - CORRECT ANSWER: b. DRG
105. Timely and correct reimbursement is dependent on:
a. Adjudication
b. Clean claims
c. Remittance advice
d. Actual charge - CORRECT ANSWER: b. Clean claims
106. When a provider accepts assignment, this means the:
, a. Patient authorizes payment to be made directly to the provider
b. Provider agrees to accept as payment in full the allowed charge from the fee
schedule
c. Balance billing is allowed on patient accounts, but at a limited rate
d. Participating provider receives a fee-for-service reimbursement - CORRECT
ANSWER: b. Provider agrees to accept as payment in full the allowed charge from the
fee schedule
107. Effective October 16, 2003, under the Administrative Simplification Compliance
section of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), all
healthcare providers must electronically submit claims to Medicare. Which is the
electronic format for hospital technical fees?
a. 837I
b. 837P
c. UB-04
d. 1500 - CORRECT ANSWER: a. 837I
108. Given the following information, which of the following statements is correct?
Weight Discharges Geometric Mean Arithmetic Mean
0.9757 10 4.1 5.0
0.7254 20 3.3 4.0
1.4327 10 5.4 6.7
1.0056 20 4.4 5.3
0.7316 10 3.5 4.1
a. In each MS-DRG the geometric mean is lower than the arithmetic mean.
b. In each MS-DRG the arithmetic mean is lower than the geometric mean.
