CCA Exam Flashcards

Q: How many questions are on the CCA exam?

The AHIMA CCA exam has 105 total questions: 90 scored questions and 15 pretest questions. The time limit is 2 hours, and the passing score is a 300 scaled score.

Q: What should CCA flashcards cover?

CCA flashcards should cover ICD-10-CM, ICD-10-PCS basics, CPT and HCPCS concepts, reimbursement, compliance, documentation, data quality, and coding workflow vocabulary.

Q: How long should I study for the CCA exam?

Most candidates should plan around 80-140 study hours, with more time if coding guidelines, anatomy, medical terminology, or reimbursement rules are new.

Question 1

What does the CCA credential validate?

Accepted Answer

Foundational coding and health information work: interpreting records, assigning codes, applying reimbursement rules, recognizing compliance risks, and protecting health data.

Question 2

CCA exam format

Accepted Answer

The CCA exam has scored questions and unscored pretest questions mixed together. Because pretest items are not identified, answer every question as if it counts.

Question 3

CCA passing score

Accepted Answer

CCA uses a scaled passing score of 300. Do not treat that as a fixed raw percentage; use domain practice results and timed accuracy to judge readiness.

Question 4

CCA retake planning

Accepted Answer

After an unsuccessful attempt, plan for a new application, a new fee, and at least a 30-day wait before the new application can be approved.

Question 5

Official source control

Accepted Answer

When exam facts or coding rules conflict, use the current AHIMA, Pearson VUE, official coding guideline, codebook, or payer source that controls the situation.

Question 6

Index-to-tabular workflow

Accepted Answer

Use the alphabetic index to start a search, then verify the code, notes, exclusions, sequencing rules, and required characters in the tabular list or table.

Question 7

Code to supported specificity

Accepted Answer

Choose the most specific code supported by documentation and the classification. Do not add laterality, acuity, episode, or relationship details that are not documented.

Question 8

Inpatient versus outpatient rules

Accepted Answer

The care setting changes the coding logic. Inpatient cases use principal-diagnosis and PCS concepts, while outpatient encounters often use first-listed diagnosis and CPT/HCPCS rules.

Question 9

Provider documentation boundary

Accepted Answer

Coders assign codes from provider documentation and official rules. Clinical clues can support a query, but they do not let the coder diagnose for the provider.

Question 10

Principal diagnosis

Accepted Answer

For inpatient reporting, the principal diagnosis is the condition established after study as chiefly responsible for the admission.

Question 11

First-listed diagnosis

Accepted Answer

For many outpatient encounters, report the diagnosis, condition, problem, or reason chiefly responsible for the service using outpatient coding rules.

Question 12

Combination code

Accepted Answer

A combination code captures linked concepts in one code, such as a condition with a manifestation or complication. Do not split the concepts unless instructions require more codes.

Question 13

Etiology and manifestation

Accepted Answer

When instructions identify an underlying cause and a manifestation, sequence the cause first and the manifestation second unless a specific guideline says otherwise.

Question 14

Uncertain diagnosis by setting

Accepted Answer

Inpatient discharge coding has specific rules for uncertain diagnoses. Outpatient coding generally does not report uncertain conditions as confirmed diagnoses.

Question 15

Sequela coding

Accepted Answer

A sequela is a residual effect after the acute phase has ended. Code the current residual condition and the appropriate sequela code when both are supported.

Question 16

Present on admission indicator

Accepted Answer

POA indicators show whether a condition was present when an inpatient admission began. They affect quality reporting, hospital-acquired condition review, and reimbursement integrity.

Question 17

ICD-10-PCS code structure

Accepted Answer

PCS codes use seven characters, with each character representing a defined axis such as section, body system, root operation, body part, approach, device, or qualifier.

Question 18

PCS root operation

Accepted Answer

The root operation describes the objective of the procedure. Choose it from what was actually done, not from a loose verb in the operative note.

Question 19

Resection versus excision

Accepted Answer

Resection means all of a body part was removed. Excision means only a portion was removed. The distinction depends on extent, not incision size.

Question 20

PCS approach

Accepted Answer

Approach describes how the body part was reached, such as open, percutaneous, percutaneous endoscopic, or through a natural or artificial opening.

Question 21

PCS device character

Accepted Answer

A PCS device is material or an appliance that remains after the procedure. Instruments, scopes, and temporary supplies used during the procedure are not device values.

Question 22

When CPT is used

Accepted Answer

CPT is commonly used for professional and outpatient procedures and services. Code selection depends on section guidelines, descriptors, parenthetical notes, and documentation.

Question 23

HCPCS Level II purpose

Accepted Answer

HCPCS Level II describes many supplies, drugs, durable medical equipment, ambulance services, and other items or services not fully captured by CPT.

Question 24

Modifier purpose

Accepted Answer

Modifiers add reporting detail without changing the base code. They may identify laterality, distinct service, professional component, reduced service, or other payer-relevant circumstances.

Question 25

E/M level selection

Accepted Answer

Evaluation and management coding depends on the applicable CPT rules for the service type. Match the documented work to the allowed method rather than relying on habit.

Question 26

Medical necessity in CPT/HCPCS

Accepted Answer

A service can be technically coded correctly and still deny if the documented diagnosis, payer policy, or coverage rule does not support medical necessity.

Question 27

DRG reimbursement logic

Accepted Answer

Inpatient DRG assignment depends on principal diagnosis, significant secondary diagnoses, procedures, patient factors, discharge status, and complication or comorbidity logic.

Question 28

APC reimbursement logic

Accepted Answer

APCs are outpatient prospective payment groupings. They use outpatient codes, edits, packaging, status indicators, and payer rules rather than inpatient DRG logic.

Question 29

NCCI edits

Accepted Answer

NCCI edits identify code pairs that are not normally reported together. A modifier is appropriate only when documentation supports a distinct, allowed service.

Question 30

LCD and NCD use

Accepted Answer

Local and national coverage determinations help decide whether a service is covered and what diagnosis or documentation support is needed for payment.

Question 31

Denial review

Accepted Answer

A denial review compares the claim, codes, coverage rule, documentation, edits, and payer response. The goal is to find the correct fix, not just rebill faster.

Question 32

HCC risk adjustment

Accepted Answer

HCC work depends on complete, accurate, documented diagnoses that affect expected resource use. Unsupported or stale diagnoses should not be carried forward as current.

Question 33

Bundling risk

Accepted Answer

Bundling rules prevent separate payment for services considered part of a broader service. Unbundling is risky unless a rule and documentation support separate reporting.

Question 34

Quantitative record analysis

Accepted Answer

Quantitative analysis checks whether required record parts are present, complete, signed, and dated according to facility policy and legal requirements.

Question 35

Qualitative record analysis

Accepted Answer

Qualitative analysis reviews whether documentation is clear, consistent, clinically meaningful, and sufficient to support coding, care, billing, and reporting.

Question 36

Master patient index

Accepted Answer

The master patient index links a patient to the correct health records across encounters. Duplicate or overlaid records can cause coding, billing, and safety errors.

Question 37

Abstracting a health record

Accepted Answer

Abstraction pulls relevant facts such as diagnoses, procedures, dates, provider statements, discharge status, POA indicators, and required reporting elements.

Question 38

Release request review

Accepted Answer

Before fulfilling a documentation request, verify patient identity, requester authority, requested date range, requested content, and any privacy restrictions.

Question 39

Ethical code assignment

Accepted Answer

Assign codes accurately and completely from documentation and rules. Reimbursement pressure does not justify unsupported coding, omitted codes, or exaggerated severity.

Question 40

When to query a provider

Accepted Answer

Query when documentation is conflicting, ambiguous, incomplete, clinically unsupported, or missing specificity needed for accurate code assignment.

Question 41

Compliant query style

Accepted Answer

A compliant query is clear, neutral, supported by relevant clinical indicators, and allows the provider to give an answer other than the one the coder expects.

Question 42

Audit preparation

Accepted Answer

Strong audit preparation preserves the record trail: code rationale, source rule, documentation support, query history, claim data, and any correction steps.

Question 43

Chargemaster review

Accepted Answer

Chargemaster updates should connect codes, descriptions, prices, departments, payer edits, and documentation workflows so charges remain accurate and defensible.

Question 44

HIPAA minimum necessary

Accepted Answer

Use or disclose only the protected health information needed for the assigned task, unless an exception applies. Access should match the work purpose.

Question 45

Secure coding workspace

Accepted Answer

Protect records by locking screens, using strong credentials, avoiding shared passwords, securing printed material, and discussing patient information only in appropriate settings.

Question 46

Privacy incident response

Accepted Answer

If a privacy issue is suspected, follow policy, report through the correct channel, preserve facts, and avoid informal disclosure or cleanup that hides what happened.

Question 47

Data quality dimensions

Accepted Answer

Useful coded data should be accurate, complete, consistent, timely, and reliable. Weak data quality can affect reimbursement, reporting, research, and patient care.

Question 48

Encoder validation

Accepted Answer

Encoders help locate codes and rules, but the coder must still verify documentation, sequencing, edits, and final code selection.

Question 49

Computer-assisted coding

Accepted Answer

CAC can suggest codes from documentation, but it can miss context, accept copied terms, or overselect codes. Validate every suggestion before reporting it.

Question 50

Coding reports

Accepted Answer

Coding data reports can show productivity, denials, case mix, quality indicators, and error patterns. Review definitions before comparing teams, facilities, or time periods.

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