CCS Exam Study Questions With
Complete solutions
malicious |software |- |CORRECT |ANSWER✔✔-backdoor
A |female |patient |is |diagnosed |with |congestive |heart |failure. |Which |of |the |following |will |
increase |the |MS-DRG |weight |if |present |on |admission?
Atrial |fibrillation
Stage |III |pressure |ulcer
Blood |loss |anemia
Coronary |artery |disease |- |CORRECT |ANSWER✔✔-Stage |III |pressure |ulcer
MS-DRG |291 |(weight |= |01.5010) |for |congestive |heart |failure |with |stage |III |pressure |ulcer |
would |optimize |the |MS-DRG. |MS-DRG |293 |(weight |= |0. |6756) |is |assigned |for |congestive |heart |
failure |alone, |with |atrial |fibrillation, |with |blood |loss |anemia, |and |with |coronary |artery |disease |
all |remain |the |same |(Medicare |Grouper |Version |29-10/11)
A |70-year-old |patient |was |admitted |with |pneumonia. |The |history |and |physical |documented |
that |the |patient |has |a |history |of |diabetes, |hypertension, |and |migraine |headache |about |10 |
years |ago |without |recurrence. |The |patient |was |administered |IV |antibiotics, |metformin, |and |
Altace |during |the |hospitalization. |Which |conditions |would |be |reported |at |the |time |of |
discharge? |- |CORRECT |ANSWER✔✔-Pneumonia, |diabetes, |and |hypertension
A |patient |is |admitted |for |chest |pain. |The |patient |was |stabilized |and |discharged. |In |a |
subsequent |admission, |the |patient |was |admitted |as |an |outpatient |for |a |left |heart |
catheterization, |coronary |arteriography |using |two |catheters |and |left |ventricular |angiography. |
,The |patient |was |found |to |have |arteriosclerotic |heart |disease. |The |patient |has |no |history |of |
cardiac |surgery. |The |appropriate |sequencing |of |ICD-9 |and |CPT |codes |for |the |outpatient |
catheterization |would |be:
411.1-Intermediate |coronary |syndrome |(unstable |angina)
413.9- |Other |and |unspecified |angina |pectoris
414.00-Coronary |atherosclerosis |of |unspecified |type |of |vessel, |native |or |graft
414.01-Coronary |atherosclerosis |of |native |coronary |artery
786.50-Chest |pain, |unspecified
93452-Left |heart |catheterization |including |intraprocedural |injection(s) |for |left |ventriculography,
|imaging |supervision |and |interpretation, |when |performed
93453-Combined |right |and |left |heart |- |CORRECT |ANSWER✔✔-414.01, |93458
Code |414.01 |is |assigned |to |show |coronary |artery |disease |in |a |native |coronary |artery |and |is |
used |when |a |patient |has |coronary |artery |disease |and |no |history |of |coronary |bypass |graft |
(CABG) |surgery |(Schraffenberger |2012, |190-192). |Code |93458 |includes |intraprocedural |
injection(s) |for |left |ventricular/left |atrial |angiography, |imaging |supervision, |and |interpretation |
when |performed |(AMA |CPT |Professional |Edition |2013, |Cardiac |Catheterization |Guidelines, |500-
503).
According |to |CPT, |an |endoscopy |that |is |undertaken |to |the |level |of |the |midtransverse |colon |
would |be |coded |as |a |- |CORRECT |ANSWER✔✔-colonoscopy
,A |chest |x-ray |done |to |evaluate |a |chronic |cough |revealed |a |asymptomatic |compression |fracture
|of |a |lumbar |vertebrae. |No |further |evaluation |was |undertaken. |The |coder |should:
Not |assign |a |code |for |an |acute |condition |but |assign |a |code |for |chronic |compression |fracture
Assign |a |code |for |pathologic |lumbar |compression |fracture
Assign |a |code |for |acute |traumatic |vertebral |fracture
Not |assign |a |code |for |this |condition |- |CORRECT |ANSWER✔✔-Not |assign |a |code |for |this |
condition
Do |not |assign |a |code |for |this |condition |because |this |is |a |frequent |condition |in |the |elderly, |is |
asymptomatic, |and |there |is |no |documentation |of |treating |the |condition |so |it |should |not |be |
coded |(Brown |2012, |33).
A |patient |is |admitted |with |hypotension |due |to |dobutamine |taken, |administered, |and |
prescribed |correctly. |How |should |this |be |coded? |- |CORRECT |ANSWER✔✔-Code |458.2, |
Iatrogenic |hypotension, |should |be |assigned |to |describe |this |condition. |This |code |should |be |
assigned |when |hypotension |develops |as |a |result |of |any |type |of |medical |care. |Assign |code |
E941.2, |Sympathomimetics |(adrenergics), |to |indicate |that |it |is |an |adverse |effect |of |the |drug
MS-DRG |assignment |is |based |on |information |that |includes |- |CORRECT |ANSWER✔✔-Diagnoses |
(principal |and |secondary); |Surgical |procedures |(principal |and |secondary; |Discharge |disposition |
or |status; |Presence |of |major |or |other |complications |and |comorbidities |(MCC |or |CC |as |
secondary |diagnosis)
These |elements |are |used |to |determine |the |MS-DRG) |MS-DRG |assignment |goes |through |four |
steps: |- |CORRECT |ANSWER✔✔-Pre-MDC |assignments, |MDC |determination, |Medical/surgical |
determination, |and |refinement
, If |a |patient |has |an |excision |of |a |malignant |lesion |of |the |skin, |the |CPT |code |is |determined |by |
the |body |area |from |which |the |excision |occurs |and |the |- |CORRECT |ANSWER✔✔-Diameter |of |
the |lesion |as |well |as |the |margins |excised |as |described |in |the |operative |report
The |operative |report |should |be |reviewed |for |the |body |part |involved |with |the |lesion. |The |total |
size |of |the |excised |area, |including |margins, |is |needed |for |accurate |coding. |The |pathology |
report |typically |provides |the |specimen |size |rather |than |the |lesion |or |excised |size. |Because |the |
specimen |tends |to |shrink, |this |is |not |an |accurate |measurement |according |to |the |intent |of |the |
code |assignment
The |case-mix |index |for |the |information |provided |above |is:
MS-DRG |Weight |Number |of |Patients
MS-DRG |193, |Simple |pneumonia |and |pleurisy |age |>17 |w/ |CC; |
WEIGHT |3.0; |# |of |patients |10
MS-DRG |195, |Simple |pneumonia |without |MCC |or |CC
2.0; |10
MS-DRG |192, |Chronic |obstructive |pulmonary |disease |w/o |CC
1.0; |10 |- |CORRECT |ANSWER✔✔-2.0
The |case |mix |is |defined |as |a |methods |of |grouping |patients. |MS-DRGs |are |often |used |to |
determine |case |mix |in |hospitals. |The |case-mix |index |is |the |average |MS-DRG |weight |based |on |
the |specific |patient |group |and |is |determined |by |multiplying |the |DRG |weights |by |the |number |
of |patients |and |then |divided |by |the |total |number |of |patients: |30 |+ |20 |+ |10 |= |60 |/ |30 |= |2.0
75-year-old |woman |is |admitted |to |the |hospital |after |tripping |and |falling |at |home. |She |
underwent |an |open |reduction |with |internal |fixation |of |the |femur. |Which |of |the |following |
Complete solutions
malicious |software |- |CORRECT |ANSWER✔✔-backdoor
A |female |patient |is |diagnosed |with |congestive |heart |failure. |Which |of |the |following |will |
increase |the |MS-DRG |weight |if |present |on |admission?
Atrial |fibrillation
Stage |III |pressure |ulcer
Blood |loss |anemia
Coronary |artery |disease |- |CORRECT |ANSWER✔✔-Stage |III |pressure |ulcer
MS-DRG |291 |(weight |= |01.5010) |for |congestive |heart |failure |with |stage |III |pressure |ulcer |
would |optimize |the |MS-DRG. |MS-DRG |293 |(weight |= |0. |6756) |is |assigned |for |congestive |heart |
failure |alone, |with |atrial |fibrillation, |with |blood |loss |anemia, |and |with |coronary |artery |disease |
all |remain |the |same |(Medicare |Grouper |Version |29-10/11)
A |70-year-old |patient |was |admitted |with |pneumonia. |The |history |and |physical |documented |
that |the |patient |has |a |history |of |diabetes, |hypertension, |and |migraine |headache |about |10 |
years |ago |without |recurrence. |The |patient |was |administered |IV |antibiotics, |metformin, |and |
Altace |during |the |hospitalization. |Which |conditions |would |be |reported |at |the |time |of |
discharge? |- |CORRECT |ANSWER✔✔-Pneumonia, |diabetes, |and |hypertension
A |patient |is |admitted |for |chest |pain. |The |patient |was |stabilized |and |discharged. |In |a |
subsequent |admission, |the |patient |was |admitted |as |an |outpatient |for |a |left |heart |
catheterization, |coronary |arteriography |using |two |catheters |and |left |ventricular |angiography. |
,The |patient |was |found |to |have |arteriosclerotic |heart |disease. |The |patient |has |no |history |of |
cardiac |surgery. |The |appropriate |sequencing |of |ICD-9 |and |CPT |codes |for |the |outpatient |
catheterization |would |be:
411.1-Intermediate |coronary |syndrome |(unstable |angina)
413.9- |Other |and |unspecified |angina |pectoris
414.00-Coronary |atherosclerosis |of |unspecified |type |of |vessel, |native |or |graft
414.01-Coronary |atherosclerosis |of |native |coronary |artery
786.50-Chest |pain, |unspecified
93452-Left |heart |catheterization |including |intraprocedural |injection(s) |for |left |ventriculography,
|imaging |supervision |and |interpretation, |when |performed
93453-Combined |right |and |left |heart |- |CORRECT |ANSWER✔✔-414.01, |93458
Code |414.01 |is |assigned |to |show |coronary |artery |disease |in |a |native |coronary |artery |and |is |
used |when |a |patient |has |coronary |artery |disease |and |no |history |of |coronary |bypass |graft |
(CABG) |surgery |(Schraffenberger |2012, |190-192). |Code |93458 |includes |intraprocedural |
injection(s) |for |left |ventricular/left |atrial |angiography, |imaging |supervision, |and |interpretation |
when |performed |(AMA |CPT |Professional |Edition |2013, |Cardiac |Catheterization |Guidelines, |500-
503).
According |to |CPT, |an |endoscopy |that |is |undertaken |to |the |level |of |the |midtransverse |colon |
would |be |coded |as |a |- |CORRECT |ANSWER✔✔-colonoscopy
,A |chest |x-ray |done |to |evaluate |a |chronic |cough |revealed |a |asymptomatic |compression |fracture
|of |a |lumbar |vertebrae. |No |further |evaluation |was |undertaken. |The |coder |should:
Not |assign |a |code |for |an |acute |condition |but |assign |a |code |for |chronic |compression |fracture
Assign |a |code |for |pathologic |lumbar |compression |fracture
Assign |a |code |for |acute |traumatic |vertebral |fracture
Not |assign |a |code |for |this |condition |- |CORRECT |ANSWER✔✔-Not |assign |a |code |for |this |
condition
Do |not |assign |a |code |for |this |condition |because |this |is |a |frequent |condition |in |the |elderly, |is |
asymptomatic, |and |there |is |no |documentation |of |treating |the |condition |so |it |should |not |be |
coded |(Brown |2012, |33).
A |patient |is |admitted |with |hypotension |due |to |dobutamine |taken, |administered, |and |
prescribed |correctly. |How |should |this |be |coded? |- |CORRECT |ANSWER✔✔-Code |458.2, |
Iatrogenic |hypotension, |should |be |assigned |to |describe |this |condition. |This |code |should |be |
assigned |when |hypotension |develops |as |a |result |of |any |type |of |medical |care. |Assign |code |
E941.2, |Sympathomimetics |(adrenergics), |to |indicate |that |it |is |an |adverse |effect |of |the |drug
MS-DRG |assignment |is |based |on |information |that |includes |- |CORRECT |ANSWER✔✔-Diagnoses |
(principal |and |secondary); |Surgical |procedures |(principal |and |secondary; |Discharge |disposition |
or |status; |Presence |of |major |or |other |complications |and |comorbidities |(MCC |or |CC |as |
secondary |diagnosis)
These |elements |are |used |to |determine |the |MS-DRG) |MS-DRG |assignment |goes |through |four |
steps: |- |CORRECT |ANSWER✔✔-Pre-MDC |assignments, |MDC |determination, |Medical/surgical |
determination, |and |refinement
, If |a |patient |has |an |excision |of |a |malignant |lesion |of |the |skin, |the |CPT |code |is |determined |by |
the |body |area |from |which |the |excision |occurs |and |the |- |CORRECT |ANSWER✔✔-Diameter |of |
the |lesion |as |well |as |the |margins |excised |as |described |in |the |operative |report
The |operative |report |should |be |reviewed |for |the |body |part |involved |with |the |lesion. |The |total |
size |of |the |excised |area, |including |margins, |is |needed |for |accurate |coding. |The |pathology |
report |typically |provides |the |specimen |size |rather |than |the |lesion |or |excised |size. |Because |the |
specimen |tends |to |shrink, |this |is |not |an |accurate |measurement |according |to |the |intent |of |the |
code |assignment
The |case-mix |index |for |the |information |provided |above |is:
MS-DRG |Weight |Number |of |Patients
MS-DRG |193, |Simple |pneumonia |and |pleurisy |age |>17 |w/ |CC; |
WEIGHT |3.0; |# |of |patients |10
MS-DRG |195, |Simple |pneumonia |without |MCC |or |CC
2.0; |10
MS-DRG |192, |Chronic |obstructive |pulmonary |disease |w/o |CC
1.0; |10 |- |CORRECT |ANSWER✔✔-2.0
The |case |mix |is |defined |as |a |methods |of |grouping |patients. |MS-DRGs |are |often |used |to |
determine |case |mix |in |hospitals. |The |case-mix |index |is |the |average |MS-DRG |weight |based |on |
the |specific |patient |group |and |is |determined |by |multiplying |the |DRG |weights |by |the |number |
of |patients |and |then |divided |by |the |total |number |of |patients: |30 |+ |20 |+ |10 |= |60 |/ |30 |= |2.0
75-year-old |woman |is |admitted |to |the |hospital |after |tripping |and |falling |at |home. |She |
underwent |an |open |reduction |with |internal |fixation |of |the |femur. |Which |of |the |following |
