CCA 1 Domain 2: Reimbursement
Methodolgies ACTUAL QUESTIONS AND
CORRECT ANSWERS
HCPCS/ CPT codes - CORRECT ANSWERS CMS developed medically unlikely edits
(MUEs) to prevent providers from billing units of services greater than the norm would indicate.
These MUEs were implemented on January 1, 2007, and are applied to which code set?
Unbundling - CORRECT ANSWERS There are several codes to describe a colonoscopy.
CPT code 45378 describes the most basic colonoscopy without additional services. Additional
codes in the colonoscopy section of CPT further define removal of foreign body (45379) and
biopsy, single or multiple (45379) or biopsy code (45380) would violate which rule?
AHA's Coding Clinic for ICD-9-CM - CORRECT ANSWERS What is the best reference
tool to receive ICD-9-CM coding advice?
Report the remaining tests using individual test codes according to CPT. - CORRECT
ANSWERS In the laboratory section of CPT, if a group of tests overlaps two or more
panels, report the panel that incorporates the greater number of tests to fulfill the code definition.
What would a coder do with the remaining test codes that are not part of a panel?
National Correct Coding Initiative (NCCI) - CORRECT ANSWERS What did the Centers
of Medicare and Medicaid Services develop to promote national correct coding methodologies
and to control improper coding leading to inappropriate payment in Part B claims?
HHRGs, Home health resource groups - CORRECT ANSWERS Which classification
system is in place to reimburse home health agencies?
Methodolgies ACTUAL QUESTIONS AND
CORRECT ANSWERS
HCPCS/ CPT codes - CORRECT ANSWERS CMS developed medically unlikely edits
(MUEs) to prevent providers from billing units of services greater than the norm would indicate.
These MUEs were implemented on January 1, 2007, and are applied to which code set?
Unbundling - CORRECT ANSWERS There are several codes to describe a colonoscopy.
CPT code 45378 describes the most basic colonoscopy without additional services. Additional
codes in the colonoscopy section of CPT further define removal of foreign body (45379) and
biopsy, single or multiple (45379) or biopsy code (45380) would violate which rule?
AHA's Coding Clinic for ICD-9-CM - CORRECT ANSWERS What is the best reference
tool to receive ICD-9-CM coding advice?
Report the remaining tests using individual test codes according to CPT. - CORRECT
ANSWERS In the laboratory section of CPT, if a group of tests overlaps two or more
panels, report the panel that incorporates the greater number of tests to fulfill the code definition.
What would a coder do with the remaining test codes that are not part of a panel?
National Correct Coding Initiative (NCCI) - CORRECT ANSWERS What did the Centers
of Medicare and Medicaid Services develop to promote national correct coding methodologies
and to control improper coding leading to inappropriate payment in Part B claims?
HHRGs, Home health resource groups - CORRECT ANSWERS Which classification
system is in place to reimburse home health agencies?
