Certified Coding Specialist (CCS) Exam
Preparation
Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs) are similar in
that they are both:
a. Determined by HCPCS codes
b. Focused on hospital outpatients
c. Focused on hospital inpatients
d. Prospective payment systems
d. Prospective payment systems
** Both are types of prospective payment systems (Casto and Forrestal 2015, 6).
A patient is treated for esophageal varices with hemorrhage due to cirrhosis. The diagnostic
codes that would be assigned are:
I85.01 Esophageal varices with bleeding
I85.11 Secondary esophageal varices with bleeding
K74.60 Unspecified cirrhosis of liver
d. K74.60, I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
**The patient has cirrhosis of the liver with resulting bleeding esophageal varices. Cirrhosis of
liver is sequenced first followed by the code for the bleeding esophageal varices (HHS 2017,
Section I.A.13, 11).
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:00
/
0:15
,Full screen
Brainpower
Read More
Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for each lobe of each
lung.
31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with
transbronchial lung biopsy(s), single lobe
31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with
transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)
31632 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when perf
Assign the code(s) for endoscopic sinusotomy with bilateral anterior ethmoidectomy.
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)
−50 Bilateral procedurea.
a. 31254
b. 31254-50
c. 31254, 31254
d. 31231
b. 31254-50
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)
−50 Bilateral procedurea.
** A code for the anterior ethmoidectomy is assigned and to denote the bilateral procedure, a
modifier of -50 is added (CPT Assistant Winter 1993, 23; Jan. 1997, 4; Sept. 1997, 10; Oct.
1997, 5; Dec. 2001, 6; May 2003, 5). The sinusotomy is not coded separately, as it is a
diagnostic procedure.
The most common language used for both data definition language and data manipulation
language is:
a. Unified modeling language
b. JAVA
c. Perl
d. Structured query language
d. Structured query language
** Structured query language (SQL) is used commonly for data language and data definitions
(Sharp 2016, 184).
,An ethmoidectomy removes infected tissue and bone in the ethmoid sinuses that blocks natural
drainage. The surgeon views your ethmoid sinuses with an endoscope, a thin flexible tube with
a very small camera and light at the end of it.
Documentation from the nursing or other allied health professionals' notes can be used to
establish which of the following diagnoses:
a. Body mass index (BMI)
b. Malnutrition
c. Aspiration pneumonia
d. Fatigue
a. Body mass index (BMI)
** The physician must establish the diagnosis—obesity or morbid obesity—and the additional
information can be pulled from ancillary documentation to establish the correct code assignment
for body mass index (BMI) (Leon-Chisen 2017, 168).
A 55-year-old patient has hypertensive heart disease with congestive heart failure. What code
would be assigned?
a. I15.8, Other secondary hypertension
b. I11.0, Hypertensive heart disease with heart failure and I50.9, Heart failure, unspecified
c. I50.9, Heart failure, unspecified and I15.0, Renovascular hypertension
d. N18.6, End stage renal disease
b. I11.0, Hypertensive heart disease with heart failure and I50.9, Heart failure, unspecified
** There is a cause and effect relationship established between the hypertension and the
congestive heart failure. A separate code for the congestive heart failure is assigned based on
the "code also" note (HHS 2017, Section I.C.9.a., 40).
A surgeon would like to undertake a research study on his patients with stage II malignant
melanoma of the back, who have undergone wide excision of the melanoma. What work
processes and associated software could be used to provide this information?
a. Obtain a summary of the cases from the cancer registry, import them into a spreadsheet, and
provide to the surgeon.
b. Obtain a summary of the cases from the chart completion software, import them into a
spreadsheet, and provide to the surgeon.
c
a. Obtain a summary of the cases from the cancer registry, import them into a spreadsheet, and
provide to the surgeon.
, **The cancer registry can be used to undertake studies in addition to reporting cases to a
central registry (Sharp and Madlock-Brown 2016, 173).
A facility located near a national park has a significant number of snake bites, and patients
receive treatment with antivenom in urgent-care settings. Sometimes a patient is admitted to the
hospital after several days. Can the urgent-care setting provide the hospital with a list of names
of patients treated with snake antivenom?
a. Only the names of patients who are admitted to the hospital can be requested if the physician
needs it for continuity of care, but an entire list of patients cannot
a. Only the names of patients who are admitted to the hospital can be requested if the physician
needs it for continuity of care, but an entire list of patients cannot be provided.
**Only records that are required for care or authorized by the patient can be released by the
urgent-care facility to the acute-care facility (Brodnik 2012, 225; Rinehart-Thompson 2016b,
243-247).
What diagnoses and procedures should be reported for recurrent left inguinal hernia with
laparoscopic repair?
K40.30 Unilateral inguinal hernia, with obstruction, without gangrene, not specified as recurrent
K40.31 Unilateral inguinal hernia, with obstruction, without gangrene, recurrent
K40.91 Unilateral inguinal hernia, without mention of obstruction or gangrene, recurrent
49520 Repair recurrent inguinal hernia, any age; reducible
49521 Repair recurrent inguinal hernia, any age; incarcerated
c. K40.91:Unilateral inguinal hernia, without mention of obstruction or gangrene, recurrent
49651:Laparoscopy, surgical; repair recurrent inguinal hernia
**The patient has a recurrent hernia without obstruction and this is captured in diagnosis code
K40.91 (Leon-Chisen 2017, 253; CPT Assistant Nov. 1999, 24; March 2000, 9).
.In order to accurately code a cardiac catheterization, what needs to be determined based on a
review of the documentation?
a. The approach and the side of the heart (chambers) into which the catheter was inserted
b. The approach, the side of the heart (chambers) into which the catheter was inserted, as well
as any additional procedures performed
c. The duration of the procedure
d. If there is documentation of the procedure in the medical record that stents are considered
