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CCS Exam Prep NEW UPDATE 2026-2027
QUESTIONS AND DETAILED SOLUTIONS
Question: What services are paid under the outpatient prospective payment system (OPPS)? -
CORRECT ANSWER✔✔Outpatient hospital services
Question: What is assigned to CPT codes to indicate whether serv or procedure will be reimb
under the OPPS? - CORRECT ANSWER✔✔Payment status indicators
Question: DRGs and APCs are dissimilar in that: - CORRECT ANSWER✔✔There is only one MS-
DRG per inpatient visit with one or more APCs per outpatient visit
Question: Case mix is determined by - CORRECT ANSWER✔✔(MS-DRG x number of pts) then
add those number together
Question: Data accuracy is also referred to as: - CORRECT ANSWER✔✔Validity
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Question: A method that can be used to ensure validity of data in the database is: - CORRECT
ANSWER✔✔Edits
Question: Data consistency means that the data is: - CORRECT ANSWER✔✔Reliable
Question: 64yo female discharged w/final dx of acute renal failure and hypertension, so what
coding rule applies? - CORRECT ANSWER✔✔Use separate codes codes for hypertension and
acute renal failure since acute kidney failure is not the same as chronic kidney failure
Question: Quality Mgmt Director is working on phys reappt reports and needs to focus on all
phys who attended pts w/pneumonia during last quarter. She asks coder to get list of all
pneumonia pts who did not have an x-ray done during their stay. To perform this task efficiently,
the coder should do the following: - CORRECT ANSWER✔✔Obtain list of all pts who were dx'd
w/pneumonia, retrieve list of all pts who had an x-ray from charge master, compare both lists, id
pts who did not have an x-ray along w/phys responsible
Question: Blood usage review committee is trying to id phys who have ordered blood tranx
w/o following predetermined criteria during last quarter. How is this done most efficiently? -
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CORRECT ANSWER✔✔Obtain list of all blood transfusions given in facility during designated
quarter along w/ordering phys and lab values for RBC, import list into spreadsheet and filter
data using RBC predetermined values or lower in facility criteria for blood transfusions
Question: QI study showed maternity cases not being coded w/correct procedure code for
manually assisted vaginal delivery codes associated. What HIM software could be used to eval
this? - CORRECT ANSWER✔✔Billing and reimbursement abstracting system
Question: HIT for Economic and Clinical Health (HITECH) Act is providing incentives for: -
CORRECT ANSWER✔✔Meaningful use of certified EHR technology
Question: The use of standard protocols to enable different computer systems to communicate
is referred to as: - CORRECT ANSWER✔✔Interoperability
Question: Coding spvr concerned that pts dx'd w/carcinoid colon tumors were miscoded as
malignant during last 6mo. To address this situation, what work processes could be undertaken?
- CORRECT ANSWER✔✔Obtain case of malignant colon tumors from both cancer registry and
billing system, import both lists into spreadsheet and compare them. ID cases that are not in the
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tumor registry that are in the billing system and then manually review to ensure they are not
carcinoid tumors
Question: According to AHIMA Standards of Ethical Coding, "A coder should protect the
confidentiality of the health record at all time and refuse to access PHI not required for coding-
related activities." What is not considered coding-related activity? - CORRECT ANSWER✔✔Risk
analysis of medical record documentation
Question: According to AHIMA Standards of Ethical Coding, "A coder should protect the
confidentiality of the health record at all time and refuse to access PHI not required for coding-
related activities." What is considered coding-related activity? - CORRECT ANSWER✔✔Coding
quality evaluation, review of records assigned each day, completion of abstracting
Question: Routine computer back-up procedure is an example of security program that ensure
data loss does not occur and this type of control is: - CORRECT ANSWER✔✔Preventative
CCS Exam Prep NEW UPDATE 2026-2027
QUESTIONS AND DETAILED SOLUTIONS
Question: What services are paid under the outpatient prospective payment system (OPPS)? -
CORRECT ANSWER✔✔Outpatient hospital services
Question: What is assigned to CPT codes to indicate whether serv or procedure will be reimb
under the OPPS? - CORRECT ANSWER✔✔Payment status indicators
Question: DRGs and APCs are dissimilar in that: - CORRECT ANSWER✔✔There is only one MS-
DRG per inpatient visit with one or more APCs per outpatient visit
Question: Case mix is determined by - CORRECT ANSWER✔✔(MS-DRG x number of pts) then
add those number together
Question: Data accuracy is also referred to as: - CORRECT ANSWER✔✔Validity
, Page 2 of 96
Question: A method that can be used to ensure validity of data in the database is: - CORRECT
ANSWER✔✔Edits
Question: Data consistency means that the data is: - CORRECT ANSWER✔✔Reliable
Question: 64yo female discharged w/final dx of acute renal failure and hypertension, so what
coding rule applies? - CORRECT ANSWER✔✔Use separate codes codes for hypertension and
acute renal failure since acute kidney failure is not the same as chronic kidney failure
Question: Quality Mgmt Director is working on phys reappt reports and needs to focus on all
phys who attended pts w/pneumonia during last quarter. She asks coder to get list of all
pneumonia pts who did not have an x-ray done during their stay. To perform this task efficiently,
the coder should do the following: - CORRECT ANSWER✔✔Obtain list of all pts who were dx'd
w/pneumonia, retrieve list of all pts who had an x-ray from charge master, compare both lists, id
pts who did not have an x-ray along w/phys responsible
Question: Blood usage review committee is trying to id phys who have ordered blood tranx
w/o following predetermined criteria during last quarter. How is this done most efficiently? -
, Page 3 of 96
CORRECT ANSWER✔✔Obtain list of all blood transfusions given in facility during designated
quarter along w/ordering phys and lab values for RBC, import list into spreadsheet and filter
data using RBC predetermined values or lower in facility criteria for blood transfusions
Question: QI study showed maternity cases not being coded w/correct procedure code for
manually assisted vaginal delivery codes associated. What HIM software could be used to eval
this? - CORRECT ANSWER✔✔Billing and reimbursement abstracting system
Question: HIT for Economic and Clinical Health (HITECH) Act is providing incentives for: -
CORRECT ANSWER✔✔Meaningful use of certified EHR technology
Question: The use of standard protocols to enable different computer systems to communicate
is referred to as: - CORRECT ANSWER✔✔Interoperability
Question: Coding spvr concerned that pts dx'd w/carcinoid colon tumors were miscoded as
malignant during last 6mo. To address this situation, what work processes could be undertaken?
- CORRECT ANSWER✔✔Obtain case of malignant colon tumors from both cancer registry and
billing system, import both lists into spreadsheet and compare them. ID cases that are not in the
, Page 4 of 96
tumor registry that are in the billing system and then manually review to ensure they are not
carcinoid tumors
Question: According to AHIMA Standards of Ethical Coding, "A coder should protect the
confidentiality of the health record at all time and refuse to access PHI not required for coding-
related activities." What is not considered coding-related activity? - CORRECT ANSWER✔✔Risk
analysis of medical record documentation
Question: According to AHIMA Standards of Ethical Coding, "A coder should protect the
confidentiality of the health record at all time and refuse to access PHI not required for coding-
related activities." What is considered coding-related activity? - CORRECT ANSWER✔✔Coding
quality evaluation, review of records assigned each day, completion of abstracting
Question: Routine computer back-up procedure is an example of security program that ensure
data loss does not occur and this type of control is: - CORRECT ANSWER✔✔Preventative
