CCS EXAM PREPARATION AND ANSWERS
A patient was admitted from the emergency department because of chest pain.
Following blood work, it was determined that the patient had elevated CK-MB enzymes.
The EKG shows nonspecific ST changes. What type of diagnosis might this indicate?
a) mitral valve stenosis
b) unstable angina
c) myocardial infarction
d) congestive heart failure - Answers -Myocardial infarction
A resident physician continually documents "CHF" without further clarification in patients
medical record. What is the most likely rationale for this documentation practice?
a) no problem exists with this documentation as CFH without further clarification is
acceptable
b) the reissue t is not qualified to make a more definitive determination of the type of
CHF
c) the resident lacks knowledge regarding the need for further clarification
d) there is not enough information to determine the type of CHF - Answers -The
residents lacks knowledge regarding the need for the further clarification
A a patient is scheduled for elective surgery for cataract removal of the left eye. The
operative report indicates the surgery on the right eye is performed with the use of
phacoemulsification and intraocular lens insertion. What discrepancy is noted in this
documentation?
a) the use of irrigation and aspiration is not mentioned
b) No mention of implantation of intraocular lens
c) No indication if general anesthesia was unsend
d) laterality is not in agreement - Answers -Laterality is not in agreement
A 12-year-old boy was seen in an ambulatory surgical center for pain in his right arm.
The x-ray showed fracture of ulna. Patient underwent closed reduction of fracture right
proximal ulna and an elbow-to-finger cast was applied. What diagnostic and procedure
codes should be assigned? - Answers -S52.101A, S52.001A, 0PSK0ZZ
A 75-year-old male patient was admitted from a nursing home with dehydration and
dysphagia due to a previous stroke. During hospitalization, the patient was rehydrated
and transferred back to the nursing home. What codes should be assigned? - Answers -
E86.0, I69.391, R13.10
Sepsis due to the presence of an indwelling urinary catheter with a positive blood
culture reflected in the progress notes as Staphylococcus aureus sepsis. What codes
should be assigned? - Answers -T83.511A, A41.01
A laparoscopic tubal ligation is completed. What is the correct CPT code assignment? -
Answers -58670
, Laparoscopy, surgical; with fulguration of oviducts (with or without transection)
A patient is admitted to an acute-care facility with chest pain. The patient was awakened
from sleep by the pain. This was the patient's first experience with chest pain. The
patient was given two nitroglycerin tablets in the emergency department. The chest pain
was not relieved, resulting in the diagnosis of new onset unstable angina. Serial
creatine phosphokinase was normal. Following a left cardiac catheterization with
fluoroscopic angiogram of multiple coronary arteries with low osmolar contrast, the
patient is found to have arteriosclerotic coronary artery disease. - Answers -I25.110,
4A023N7, B2111ZZ
Normal twin delivery at 30 weeks. Both babies were delivered vaginally and were
liveborn. What conditions should have codes assigned? - Answers -O60.14X1,
O60.14X2, O30.003, Z3A.30, Z37.2
A patient is admitted with metastatic carcinoma from breast to liver with previous
bilateral mastectomy and no reoccurrence at the primary site. In the progress note of
day three, the physician indicates that patient now has pneumonia and begins treatment
with an antibiotic that will be continued on discharge. What is the proper coding and
sequencing of this admission? - Answers -C78.7, J18.9, Z85.3, Z90.13
Patient admitted with syncope due to taking Valium in combination with an over-the-
counter antihistamine, taken as directed on the package
but without consulting a healthcare provider. What are the correct codes and
sequencing for this admission? - Answers -T42.4X1A, T45.0X1A, R55
A 50-year-old woman with a diagnosis of metastatic ovarian cancer to the pleura has an
outpatient thoracoscopic pleurodesis performed. What is the correct coding and
sequencing? - Answers -C78.2, C56.9, 32650
A patient with acute respiratory failure, hypertension, and congestive heart failure is
admitted for intubation and ventilation. The patient's heart failure is stable on current
medications. What are the correct diagnosis codes and sequencing? - Answers -J96.00,
I11.0, I50.9
A 34-year-old woman delivered a live-born, term baby boy (39 weeks) with macrosomia.
She had a hemorrhage following a low forceps delivery with episiotomy but prior to
expulsion of the placenta. What are the appropriate codes and sequencing for this
record? - Answers -O67.9, O36.63X0, Z37.0, Z3A.39, 10D07Z3, 0W8NXZZ
A 64-year-old female was discharged with the final diagnosis of acute
renal failure and hypertension. What coding guideline applies? - Answers -Use separate
codes for hypertension and acute renal failure.
A patient was discharged from observation following an outpatient surgery with the
following diagnoses: posterior subcapsular, mature, incipient, senile cataract right eye,
A patient was admitted from the emergency department because of chest pain.
Following blood work, it was determined that the patient had elevated CK-MB enzymes.
The EKG shows nonspecific ST changes. What type of diagnosis might this indicate?
a) mitral valve stenosis
b) unstable angina
c) myocardial infarction
d) congestive heart failure - Answers -Myocardial infarction
A resident physician continually documents "CHF" without further clarification in patients
medical record. What is the most likely rationale for this documentation practice?
a) no problem exists with this documentation as CFH without further clarification is
acceptable
b) the reissue t is not qualified to make a more definitive determination of the type of
CHF
c) the resident lacks knowledge regarding the need for further clarification
d) there is not enough information to determine the type of CHF - Answers -The
residents lacks knowledge regarding the need for the further clarification
A a patient is scheduled for elective surgery for cataract removal of the left eye. The
operative report indicates the surgery on the right eye is performed with the use of
phacoemulsification and intraocular lens insertion. What discrepancy is noted in this
documentation?
a) the use of irrigation and aspiration is not mentioned
b) No mention of implantation of intraocular lens
c) No indication if general anesthesia was unsend
d) laterality is not in agreement - Answers -Laterality is not in agreement
A 12-year-old boy was seen in an ambulatory surgical center for pain in his right arm.
The x-ray showed fracture of ulna. Patient underwent closed reduction of fracture right
proximal ulna and an elbow-to-finger cast was applied. What diagnostic and procedure
codes should be assigned? - Answers -S52.101A, S52.001A, 0PSK0ZZ
A 75-year-old male patient was admitted from a nursing home with dehydration and
dysphagia due to a previous stroke. During hospitalization, the patient was rehydrated
and transferred back to the nursing home. What codes should be assigned? - Answers -
E86.0, I69.391, R13.10
Sepsis due to the presence of an indwelling urinary catheter with a positive blood
culture reflected in the progress notes as Staphylococcus aureus sepsis. What codes
should be assigned? - Answers -T83.511A, A41.01
A laparoscopic tubal ligation is completed. What is the correct CPT code assignment? -
Answers -58670
, Laparoscopy, surgical; with fulguration of oviducts (with or without transection)
A patient is admitted to an acute-care facility with chest pain. The patient was awakened
from sleep by the pain. This was the patient's first experience with chest pain. The
patient was given two nitroglycerin tablets in the emergency department. The chest pain
was not relieved, resulting in the diagnosis of new onset unstable angina. Serial
creatine phosphokinase was normal. Following a left cardiac catheterization with
fluoroscopic angiogram of multiple coronary arteries with low osmolar contrast, the
patient is found to have arteriosclerotic coronary artery disease. - Answers -I25.110,
4A023N7, B2111ZZ
Normal twin delivery at 30 weeks. Both babies were delivered vaginally and were
liveborn. What conditions should have codes assigned? - Answers -O60.14X1,
O60.14X2, O30.003, Z3A.30, Z37.2
A patient is admitted with metastatic carcinoma from breast to liver with previous
bilateral mastectomy and no reoccurrence at the primary site. In the progress note of
day three, the physician indicates that patient now has pneumonia and begins treatment
with an antibiotic that will be continued on discharge. What is the proper coding and
sequencing of this admission? - Answers -C78.7, J18.9, Z85.3, Z90.13
Patient admitted with syncope due to taking Valium in combination with an over-the-
counter antihistamine, taken as directed on the package
but without consulting a healthcare provider. What are the correct codes and
sequencing for this admission? - Answers -T42.4X1A, T45.0X1A, R55
A 50-year-old woman with a diagnosis of metastatic ovarian cancer to the pleura has an
outpatient thoracoscopic pleurodesis performed. What is the correct coding and
sequencing? - Answers -C78.2, C56.9, 32650
A patient with acute respiratory failure, hypertension, and congestive heart failure is
admitted for intubation and ventilation. The patient's heart failure is stable on current
medications. What are the correct diagnosis codes and sequencing? - Answers -J96.00,
I11.0, I50.9
A 34-year-old woman delivered a live-born, term baby boy (39 weeks) with macrosomia.
She had a hemorrhage following a low forceps delivery with episiotomy but prior to
expulsion of the placenta. What are the appropriate codes and sequencing for this
record? - Answers -O67.9, O36.63X0, Z37.0, Z3A.39, 10D07Z3, 0W8NXZZ
A 64-year-old female was discharged with the final diagnosis of acute
renal failure and hypertension. What coding guideline applies? - Answers -Use separate
codes for hypertension and acute renal failure.
A patient was discharged from observation following an outpatient surgery with the
following diagnoses: posterior subcapsular, mature, incipient, senile cataract right eye,
