CCS Provider Queries Practice Questions
Provider Queries makes up 5 of every 50 questions on a Tigertest CCS practice test. Here are 10 of the 20 questions on it, each with the answer and the reason.
Updated by the Tigertest team. Weighted to the AHIMA CCS Exam Content Outline. Original questions on coding guidelines and concepts; not affiliated with AHIMA.
1. A query is appropriate when documentation is:
- A.Signed by a resident
- B.Conflicting or incomplete
- C.Clear and fully consistent
- D.Lengthy but complete
Answer: B. Queries clarify documentation that is conflicting, incomplete, ambiguous or imprecise. When the record is clear, no query is needed.
2. A query should not be sent when:
- A.Two notes disagree
- B.An organism is unclear
- C.A diagnosis is missing
- D.Documentation is clear
Answer: D. Queries are not used to question a provider's clear, consistent documentation or to ask about every possible diagnosis. They are for documentation that needs clarification.
3. An open-ended query asks the provider to:
- A.Answer in their own words
- B.Sign a preset diagnosis
- C.Choose yes or no only
- D.Choose from a set list
Answer: A. An open-ended query presents the clinical indicators and asks a question the provider answers in their own words, with no options to choose from.
4. Clinical indicators in a query should come from:
- A.National averages
- B.The coder's experience
- C.The patient's health record
- D.A payer's criteria list
Answer: C. Queries cite the clinical indicators in the patient's record, such as lab results, vital signs and treatment, so the provider can respond from the facts of the case.
5. A query that brings up a diagnosis with no supporting indicators in the record is:
- A.Open-ended
- B.Concurrent
- C.Leading
- D.Compliant
Answer: C. A query that introduces information not supported by the record, or points the provider to a particular answer, is leading and noncompliant.
6. A yes/no query may NOT be used to:
- A.Obtain a new diagnosis
- B.Resolve a conflict
- C.Confirm a cause and effect
- D.Confirm POA status
Answer: A. Yes/no queries are not used when only clinical indicators exist and the diagnosis has not been documented. They may establish POA status, resolve conflicts and confirm a cause-and-effect link.
7. When a query is made verbally, the person asking should:
- A.Repeat it a week later
- B.Keep no record of it
- C.Code from the conversation
- D.Document it in writing
Answer: D. Verbal queries must be documented in the same way as written ones, including the clinical indicators and the question, and the provider's answer must still be documented in the record.
8. Whether a completed query form is kept as part of the legal health record is set by:
- A.The patient's wishes
- B.Facility policy
- C.The payer's contract
- D.The coding manager
Answer: B. Organizations decide by policy whether queries are part of the permanent legal record or kept as a business record. Either way, the provider's answer must be in the health record.
9. After discharge, a provider answers a query. The answer is usually added to the record as:
- A.A coding note
- B.An addendum
- C.A sticky note
- D.An email only
Answer: B. A retrospective query response is documented by the provider as an addendum, often to the discharge summary or the relevant progress note.
10. A provider does not answer a query. The next step is to:
- A.Drop it with no record
- B.Ask the payer to decide
- C.Code the queried diagnosis
- D.Escalate per policy
Answer: D. Organizations should have an escalation policy, for example to a physician advisor, for queries that go unanswered or are disputed. The coder does not assign the diagnosis without an answer.
Practice all 20 provider queries questions, and the rest of the 200-question bank, in the free CCS training sets. Questions you miss come back until you have mastered them.
Start practicingFree to start. No account needed.