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Certified Coding Associate Exam Content Outline

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631 views2 pages

Certified Coding Associate Exam Content Outline

Uploaded by

chaitanya varma
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Certified Coding Associate (CCA) Exam Content Outline

Domain 1 – Clinical Classification Systems (30-34%)


Tasks:
1. Interpret healthcare data for code assignment
2. Incorporate clinical vocabularies and terminologies used in health information systems
3. Abstract pertinent information from medical records
4. Consult reference materials to facilitate code assignment
5. Apply inpatient coding guidelines
6. Apply outpatient coding guidelines
7. Apply physician coding guidelines
8. Assign inpatient codes
9. Assign outpatient codes
10. Assign physician codes
11. Sequence codes according to healthcare setting

Domain 2 – Reimbursement Methodologies (21-25%)


Tasks:
1. Sequence codes for optimal reimbursement
2. Link diagnoses and CPT® codes according to payer specific guidelines
3. Assign correct DRG
4. Assign correct APC
5. Evaluate NCCI edits
6. Reconcile NCCI edits
7. Validate medical necessity using LCD and NCD
8. Submit claim forms
9. Communicate with financial departments
10. Evaluate claim denials
11. Respond to claim denials
12. Resubmit denied claim to the payer source
13. Communicate with the physician to clarify documentation

Domain 3 – Health Records and Data Content (13-17%)


Tasks:
1. Retrieve medical records
2. Assemble medical records according to healthcare setting
3. Analyze medical records quantitatively for completeness
4. Analyze medical records qualitatively for deficiencies
5. Perform data abstraction
6. Request patient-specific documentation from other sources (ancillary depts., physician’s
office, etc.)
7. Retrieve patient information from master patient index
8. Educate providers on health data standards
9. Generate reports for data analysis
Domain 4 – Compliance (12-16%)
Tasks:
1. Identify discrepancies between coded data and supporting documentation
2. Validate that codes assigned by provider or electronic systems are supported by proper
documentation
3. Perform ethical coding
4. Clarify documentation through physician query
5. Research latest coding changes
6. Implement latest coding changes
7. Update fee/charge ticket based on latest coding changes
8. Educate providers on compliant coding
9. Assist in preparing the organization for external audits

Domain 5 – Information Technologies (6-10%)


Tasks:
1. Navigate throughout the EHR
2. Utilize encoding and grouping software
3. Utilize practice management and HIM systems
4. Utilize CAC software that automatically assigns codes based on electronic text
5. Validate the codes assigned by CAC software

Domain 6 – Confidentiality & Privacy (6-10%)


Tasks:
1. Ensure patient confidentiality
2. Educate healthcare staff on privacy and confidentiality issues
3. Recognize and report privacy issues/violations
4. Maintain a secure work environment
5. Utilize pass codes
6. Access only minimal necessary documents/information
7. Release patient-specific data to authorized individuals
8. Protect electronic documents through encryption
9. Transfer electronic documents through secure sites
10. Retain confidential records appropriately
11. Destroy confidential records appropriately

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