CCA Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

Type 2 diabetes mellitus: Diabetes is a chronic comorbidity that was treated during the stay, so it is a secondary diagnosis, not the reason for admission.

Essential hypertension: Hypertension is also a managed comorbidity and is coded as a secondary diagnosis.

Intertrochanteric fracture of the right femur: Correct. Under UHDDS, the principal diagnosis is the condition established after study to be chiefly responsible for the admission: the hip fracture.

The fall at home (external cause): External cause codes describe how an injury happened and can never be sequenced as the principal diagnosis.

Principal diagnosis = the condition, after study, chiefly responsible for occasioning the admission. External cause codes are always secondary.

Answer: B

Write off the ECG, since tests done at preventive visits are never covered: The ECG was ordered for a documented symptom, so it can be covered when correctly linked.

Correct the ECG pointer to diagnosis B and submit a corrected claim: Correct. The pointer must link each service to the diagnosis that justifies it; linking the ECG to chest pain supports medical necessity.

Add a more serious cardiac diagnosis so the ECG meets coverage rules: Adding an undocumented diagnosis to get paid is fraudulent coding.

Bill the ECG to the patient without an ABN, since Medicare denied it: Without a valid ABN obtained beforehand, the patient generally cannot be billed for a medical necessity denial.

On the CMS-1500, item 24E pointers link each line to the diagnosis in item 21 that justifies it; fix linkage errors and resubmit per payer rules.

Answer: D

An overlay: An overlay occurs when two different patients share one medical record number, mixing their information.

An overlap: An overlap is when one patient has numbers in two different facilities or systems of an enterprise.

A record amendment: An amendment is a patient-requested or provider correction to content, not an identity error.

A duplicate record: Correct. One patient with two or more medical record numbers in the same facility's MPI is a duplicate; it must be merged per policy.

Duplicate = one patient, two MRNs (same facility). Overlay = two patients, one MRN. Overlap = one patient, MRNs in multiple facilities of an enterprise.

Answer: C

Correct her coding habits going forward and leave the paid claim alone: A known overpayment must be addressed; ignoring it violates ethical coding standards and Medicare overpayment rules.

Contact the payer directly and promise a refund from her department: Refunds and payer communication go through the organization's established compliance and billing processes.

Report the error to her supervisor or compliance so it can be corrected: Correct. Coders must report and help correct errors; the organization then corrects the claim and returns any overpayment.

Ask the physician to add documentation so the procedure is supported: Requesting documentation of a service that did not happen is falsification of the record.

Ethical coding: report errors through the compliance process; identified overpayments must be refunded. Never alter documentation to fit codes.

Answer: A

Verify the code against the Tabular List, guidelines and the record: Correct. Encoders are tools; the coder remains responsible for confirming the code is supported by documentation and follows official conventions and guidelines.

Accept the suggestion, since encoder logic already applies the guidelines: Encoders can produce errors from wrong prompt answers or outdated logic; unreviewed acceptance is not compliant.

Accept the code that yields the highest-paying MS-DRG in the grouper: Choosing codes for payment rather than documentation is unethical upcoding.

Send every encoder code to the physician to approve before billing: Physicians are queried for documentation questions, not routine approval of each code.

Encoders and groupers support, but never replace, the coder's professional judgment and verification against official sources.

Answer: C

Review the earlier visit to make sure the current coding is complete: The prior behavioral health visit is not needed to code the current stay; opening it exceeds minimum necessary.

Ask the friend about the earlier visit to clarify the documentation: Discussing the record with the patient outside the job role is a confidentiality breach.

Code only the current stay using the information needed for that task: Correct. HIPAA's minimum necessary standard limits workforce access to what the job requires; follow facility policy on reassigning cases involving acquaintances.

Print the record to finish coding at home where there is more privacy: Removing PHI from the facility without authorization violates security policies.

Access only the minimum necessary PHI for your assigned task, regardless of curiosity or personal connection.