CERTIFIED CODING SPECIALIST 3 COMPLETE
STUDY GUIDE 2026
◉ Examples of carcinoma in situ. Answer: Intraepithelial infiltrating
◉ The patient was admitted from the emergency department
because of chest pain. Following blood work, it was determined that
the patient had elevated CPKs and MB enzymes. The EKG shows
nonspecific ST changes.
What type of diagnosis might this indicate?
a. Unstable angina
b. Myocardial infarction
c. Congestive heart failure
d. Mitral valve stenosis. Answer: b
The CPK elevation with MB enzymes elevated and the EKG ST
changes denote a possible Ml (Leon-Chisen 2013, 386-387).
◉ A patient is admitted and diagnosed with fever and urinary
burning. The discharge diagnosis· is Escherichia coli, urinary tract
infection.
,Which of the following represents the correct diagnoses and
appropriate sequence of those conditions?
a. Fever, urinary burning, urosepsis
b. Fever, urinary burning, sepsis
c. Escherichia coli, urinary tract infection
d. Urinary tract infection, Escherichia coli. Answer: d
Symptoms are not coded when a definitive diagnosis is present on
discharge. The patient discharge diagnosis of urinary tract infection.
The organism (E. coli) is coded with a seco diagnosis code (B96.20)
which is to be added as an additional code to identify the bacterial
agent (HHS 2014, Section II.A., 98).
◉ A patient was admitted with heart failure within one week of a
heart transplant. Due to the timing, the coder thought that it may
represent a postoperative transplant rejection following heart
transplant.
What action(s) should the coding staff take?
a. Query the physician.
b. Assign the codes for the postoperative transplant rejection.
c. Assign only the code for the transplant rejection.
d. Assign only the code for heart failure.. Answer: a
, When the documentation is not clear regarding a potential
complication, it is appropriate query the physician (HHS 2014,
Section I.B.16, 16; Leon-Chisen 2013, 43-44).
◉ A patient is admitted to a psychiatric unit of an acute-care facility.
The patient experienced the following symptoms almost every day
for the last month: loss of interest or pleasure in most or all
activities, which is a change from her prior level of functioning. She
has also gained 15 lbs, has difficulty falling asleep, feels fatigued, and
has difficulty making decisions.
What potential diagnosis most closely fits the patient's overall
symptoms?
a. Insomnia
b. Major depression
c. Reye's syndrome
d. Bipolar disorder. Answer: b
The symptoms provided are indicative of a depressive disorder
(Leon-Chisen 2013, 175).
◉ Inpatient:
Admission for inguinal hernia repair. This 30-year-old patient has
acquired immunodeficiency syndrome (AIDS) but is not
symptomatic at this time due to medication regimen. The procedure
STUDY GUIDE 2026
◉ Examples of carcinoma in situ. Answer: Intraepithelial infiltrating
◉ The patient was admitted from the emergency department
because of chest pain. Following blood work, it was determined that
the patient had elevated CPKs and MB enzymes. The EKG shows
nonspecific ST changes.
What type of diagnosis might this indicate?
a. Unstable angina
b. Myocardial infarction
c. Congestive heart failure
d. Mitral valve stenosis. Answer: b
The CPK elevation with MB enzymes elevated and the EKG ST
changes denote a possible Ml (Leon-Chisen 2013, 386-387).
◉ A patient is admitted and diagnosed with fever and urinary
burning. The discharge diagnosis· is Escherichia coli, urinary tract
infection.
,Which of the following represents the correct diagnoses and
appropriate sequence of those conditions?
a. Fever, urinary burning, urosepsis
b. Fever, urinary burning, sepsis
c. Escherichia coli, urinary tract infection
d. Urinary tract infection, Escherichia coli. Answer: d
Symptoms are not coded when a definitive diagnosis is present on
discharge. The patient discharge diagnosis of urinary tract infection.
The organism (E. coli) is coded with a seco diagnosis code (B96.20)
which is to be added as an additional code to identify the bacterial
agent (HHS 2014, Section II.A., 98).
◉ A patient was admitted with heart failure within one week of a
heart transplant. Due to the timing, the coder thought that it may
represent a postoperative transplant rejection following heart
transplant.
What action(s) should the coding staff take?
a. Query the physician.
b. Assign the codes for the postoperative transplant rejection.
c. Assign only the code for the transplant rejection.
d. Assign only the code for heart failure.. Answer: a
, When the documentation is not clear regarding a potential
complication, it is appropriate query the physician (HHS 2014,
Section I.B.16, 16; Leon-Chisen 2013, 43-44).
◉ A patient is admitted to a psychiatric unit of an acute-care facility.
The patient experienced the following symptoms almost every day
for the last month: loss of interest or pleasure in most or all
activities, which is a change from her prior level of functioning. She
has also gained 15 lbs, has difficulty falling asleep, feels fatigued, and
has difficulty making decisions.
What potential diagnosis most closely fits the patient's overall
symptoms?
a. Insomnia
b. Major depression
c. Reye's syndrome
d. Bipolar disorder. Answer: b
The symptoms provided are indicative of a depressive disorder
(Leon-Chisen 2013, 175).
◉ Inpatient:
Admission for inguinal hernia repair. This 30-year-old patient has
acquired immunodeficiency syndrome (AIDS) but is not
symptomatic at this time due to medication regimen. The procedure
