CERTIFIED CODING SPECIALIST (CCS)
EXAM PREPARATION QUESTIONS AND
ANSWERS A GRADED
Diagnostic-
relatedagroupsa(DRGs)aandaambulatoryapatientaclassificationsa(APCs)aareasimilarainathatath
eyaareaboth:
a.aDeterminedabyaHCPCSacodes
b.aFocusedaonahospitalaoutpatients
c.aFocusedaonahospitalainpatients
d.aProspectiveapaymentasystemsa-aans✔✔d.aProspectiveapaymentasystems
**aBothaareatypesaofaprospectiveapaymentasystemsa(CastoaandaForrestala2015,a6).
Aapatientaisatreatedaforaesophagealavaricesawithahemorrhageadueatoacirrhosis.aTheadiagnos
ticacodesathatawouldabeaassignedaare:
I85.01aEsophagealavaricesawithableeding
I85.11aSecondaryaesophagealavaricesawithableeding
K74.60aUnspecifiedacirrhosisaofalivera-aans✔✔d.aK74.60,aI85.11
K74.60:aUnspecifiedacirrhosisaofaliver
I85.11:Secondaryaesophagealavaricesawithableeding
**Theapatientahasacirrhosisaofathealiverawitharesultingableedingaesophagealavarices.aCirrhos
isaofaliveraisasequencedafirstafollowedabyatheacodeaforatheableedingaesophagealavaricesa(HH
Sa2017,aSectionaI.A.13,a11).
Assignatheacode(s)aforabronchoscopyawithabilateralatransbronchialabiopsyaforaeachalobeaofa
eachalung.
,31628aBronchoscopy,arigidaoraflexible,aincludingafluoroscopicaguidance,awhenaperformed;a
withatransbronchialalungabiopsy(s),asinglealobe
31629aBronchoscopy,arigidaoraflexible,aincludingafluoroscopicaguidance,awhenaperformed;a
withatransbronchialaneedleaaspirationabiopsy(s),atrachea,amainastemaand/
oralobarabronchus(i)
31632aBronchoscopy,arigidaoraflexible,aincludingafluoroscopicaguidance,awhenaperformed;a
withatransbronchialalungabiopsy(s),aeachaadditionalalobe
−50aBilateralaprocedurea-aans✔✔
Assignatheacode(s)aforaendoscopicasinusotomyawithabilateralaanterioraethmoidectomy.
31231aNasalaendoscopy,adiagnostic,aunilateralaorabilaterala(separateaprocedure)
31254aNasal/sinusaendoscopy,asurgical;awithaethmoidectomy,apartiala(anterior)
−50aBilateralaprocedurea.a
a.a31254
b.a31254-50
c.a31254,a31254
d.a31231a-aans✔✔b.a31254-50
31254aNasal/sinusaendoscopy,asurgical;awithaethmoidectomy,apartiala(anterior)
−50aBilateralaprocedurea.a
**aAacodeaforatheaanterioraethmoidectomyaisaassignedaandatoadenoteatheabilateralaprocedur
e,aaamodifieraofa-
50aisaaddeda(CPTaAssistantaWintera1993,a23;aJan.a1997,a4;aSept.a1997,a10;aOct.a1997,a5;a
Dec.a2001,a6;aMaya2003,a5).aTheasinusotomyaisanotacodedaseparately,aasaitaisaaadiagnostica
procedure.
Theamostacommonalanguageausedaforabothadataadefinitionalanguageaandadataamanipulatio
nalanguageais:
a.aUnifiedamodelingalanguage
b.aJAVA
c.aPerl
d.aStructuredaqueryalanguagea-aans✔✔d.aStructuredaqueryalanguage
**aStructuredaqueryalanguagea(SQL)aisausedacommonlyaforadataalanguageaandadataadefiniti
onsa(Sharpa2016,a184).
Anaethmoidectomyaremovesainfectedatissueaandaboneainatheaethmoidasinusesathatablocksa
naturaladrainage.aTheasurgeonaviewsayouraethmoidasinusesawithaanaendoscope,aaathinaflex
ibleatubeawithaaaveryasmallacameraaandalightaatatheaendaofait.a-aans✔✔
Documentationafromatheanursingaoraotheraalliedahealthaprofessionals'anotesacanabeausedato
aestablishawhichaofatheafollowingadiagnoses:
a.aBodyamassaindexa(BMI)
b.aMalnutrition
c.aAspirationapneumonia
,d.aFatiguea-aans✔✔a.aBodyamassaindexa(BMI)
**aTheaphysicianamustaestablishatheadiagnosis—obesityaoramorbidaobesity—
andatheaadditionalainformationacanabeapulledafromaancillaryadocumentationatoaestablishathe
acorrectacodeaassignment aforabodyamassaindexa(BMI)a(Leon-Chisena2017,a168).
Aa55-year-
oldapatientahasahypertensiveaheartadiseaseawithacongestiveaheartafailure.aWhatacodeawoul
dabeaassigned?
a.aI15.8,aOtherasecondaryahypertension
b.aI11.0,aHypertensiveaheartadiseaseawithaheartafailureaandaI50.9,aHeartafailure,aunspecifie
d
c.aI50.9,aHeartafailure,aunspecifiedaandaI15.0,aRenovascularahypertension
d.aN18.6,aEndastagearenaladiseasea-
aans✔✔b.aI11.0,aHypertensiveaheartadiseaseawithaheartafailureaandaI50.9,aHeartafailure,aun
specified
**aThereaisaaacauseaandaeffectarelationshipaestablishedabetweenatheahypertensionaandathea
congestiveaheartafailure.aAaseparateacodeaforatheacongestiveaheartafailureaisaassignedabas
edaonathea"codeaalso"anotea(HHSa2017,aSectionaI.C.9.a.,a40).
AasurgeonawouldalikeatoaundertakeaaaresearchastudyaonahisapatientsawithastageaIIamalignan
tamelanomaaofatheaback,awhoahaveaundergoneawideaexcisionaofatheamelanoma.aWhatawork
aprocessesaandaassociatedasoftwareacouldabeausedatoaprovideathisainformation?
a.aObtainaaasummaryaofatheacasesafromatheacanceraregistry,aimportathemaintoaaaspreadshe
et,aandaprovideatoatheasurgeon.
b.aObtainaaasummaryaofatheacasesafromatheachartacompletionasoftware,aimportathemaintoaaa
spreadsheet,aandaprovideatoatheasurgeon.
c.aObtainaaasummaryaofatheacasesafromatheamasterapatientaindex,aimportathemaintoaaasprea
dsheet,aandaprovideatoatheasurgeon.
d.aObtainaaasummaryaofatheacasesafromatheatranscriptionatrackingasoftware,aimportathemain
toaaaspreadsheet,aandaprovideatoatheasurgeon.a-
aans✔✔a.aObtainaaasummaryaofatheacasesafromatheacanceraregistry,aimportathemaintoaaaspr
eadsheet,aandaprovideatoatheasurgeon.
**Theacanceraregistryacanabeausedatoaundertakeastudiesainaadditionatoareportingacasesatoaaa
centralaregistrya(SharpaandaMadlock-Browna2016,a173).
Aafacilityalocatedanearaaanationalaparkahasaaasignificantanumberaofasnakeabites,aandapatient
sareceiveatreatmentawithaantivenomainaurgent-
careasettings.aSometimesaaapatientaisaadmittedatoatheahospitalaafteraseveraladays.aCanathea
urgent-
careasettingaprovideatheahospitalawithaaalistaofanamesaofapatientsatreatedawithasnakeaantive
nom?
, a.aOnlyatheanamesaofapatientsawhoaareaadmittedatoatheahospitalacanabearequestedaifatheaph
ysiciananeedsaitaforacontinuityaofacare,abutaanaentirealistaofapatientsacannotabeaprovided.
b.aAalistaofanamesacouldabeaprovided.
c.aNoainformationacanabeaobtainedaunderaanyacircumstances.
d.aAalistaofapatientsamayabeaavailableaafteraconsultationawithatheanationalaparkaranger.a-
aans✔✔a.aOnlyatheanamesaofapatients awhoaareaadmitted atoatheahospitalacanabearequestedai
fatheaphysiciananeedsaitaforacontinuityaofacare,abutaanaentirealistaofapatientsacannotabeaprovid
ed.
**Onlyarecordsathataarearequiredaforacareaoraauthorizedabyatheapatientacanabeareleasedabyat
heaurgent-careafacilityatoatheaacute-careafacilitya(Brodnika2012,a225;aRinehart-
Thompsona2016b,a243-247).
Whatadiagnosesaandaproceduresashouldabeareportedaforarecurrentaleftainguinalaherniaawitha
laparoscopicarepair?
K40.30aUnilateralainguinalahernia,awithaobstruction,awithoutagangrene,anotaspecifiedaasarec
urrent
K40.31aUnilateralainguinalahernia,awithaobstruction,awithoutagangrene,arecurrent
K40.91aUnilateralainguinalahernia,awithoutamentionaofaobstructionaoragangrene,arecurrent
49520aRepairarecurrentainguinalahernia,aanyaage;areducible
49521aRepairarecurrentainguinalahernia,aanyaage;aincarceratedaorastrangulated
49651aLaparoscopy,asurgical;arepairarecurrentainguinalahernia
a.aK40.91,a49520
b.aK40.31,a49521
c.aK40.91,a49651
d.aK40.30,a49520a-
aans✔✔c.aK40.91:Unilateral ainguinalahernia,awithoutamentionaofaobstructionaoragangrene,ar
ecurrent
49651:Laparoscopy,asurgical;arepairarecurrentainguinalahernia
**Theapatientahasaaarecurrentaherniaawithoutaobstructionaandathisaisacapturedainadiagnosisa
codeaK40.91a(Leon-Chisena2017,a253;aCPTaAssistantaNov.a1999,a24;aMarcha2000,a9).
.Inaorderatoaaccuratelyacodeaaacardiacacatheterization,awhataneedsatoabeadeterminedabase
daonaaareviewaofatheadocumentation?
a.aTheaapproachaandatheasideaofatheahearta(chambers)aintoawhichatheacatheterawasainserte
d
b.aTheaapproach,atheasideaofatheahearta(chambers)aintoawhichatheacatheterawasainserted,aa
sawellaasaanyaadditionalaproceduresaperformed
c.aTheadurationaofatheaprocedure