CCS Exam Questions with Verified
Answers
Capitation - ANSWERSA specified amount of money paid to a health plan or doctor.
This is used to cover the cost of a health plan member's healthcare services for a
certain length of time.
Case management - ANSWERSThe ongoing, concurrent review performed by clinical
professionals to ensure the necessity and effectiveness of the clinical services being
provided to a patient.
Case-mix index (CMI): - ANSWERSThe average relative weight of all cases treated at a
given facility or by a given physician, which reflects the resource intensity or clinical
severity of a specific group in relation to the other groups in the classification system;
calculated by dividing the sum of the weights of diagnosis-related groups (DRGs) for
patients discharged during a given period divided by the total number of patients
discharged.
National Practitioner Data Bank - ANSWERScomprehensive database of health care
provider credentials
Healthcare Integrity and Protection Data Bank - ANSWERSa national data bank of
health care provider licensure and certification actions, participation exclusions, criminal
convictions, civil judgements, and other adjudicated actions
MEDPAR - ANSWERSfiles contain information for 100% of Medicare beneficiaries
using hospital inpatient services
Registries - ANSWERSfor example, tumor, cancer, HIV/AIDS, diabetes mellitus,
trauma, birth defects; run to collect histological data on disease progression
Disease index - ANSWERSlist of all diseases treated at one facility
Operation index - ANSWERSlist of all surgical procedures performed at one facility
MPI (Master Patient Index) - ANSWERSlist of all patients treated at one facility
GEM (General Equivalency Mapping) - ANSWERSused general equivalency mapping
to translate from one classification system to another
Hospital Compare/Nursing Home Compare - ANSWERSinformation on how well
hospitals provide recommended care to their patients
,Outcomes and Assessment Information Set (OASIS) - ANSWERScore assessment
data that measure adult outcomes of those receiving home health services
Uniform Ambulatory Care Data Set (UACDS) - ANSWERSspecific data elements
collected regarding patient care in ambulatory care settings
Uniform Hospital Discharge Data Set (UHDDS) - ANSWERSdata collected on all
hospital discharges
Abbreviated Injury Scale (AIS) - ANSWERSReflects nature of injury and severity (threat
to life) by body system
Abstracting - ANSWERSCompilation of pertinent information extracted from the
patient's record. Purpose is to make information from the patient's record readily
available for internal and external reporting needs - it supports secondary use of patient
data for registries, public reporting, and research.
Accession number - ANSWERSNumber used to identify the patient that is assigned to
the patient when the case is first entered into the registry
Accession registry - ANSWERSListing of patients in accession number order that
provides a way to monitor whether or not all cases have been entered into the registry
Agency for Healthcare Research and Quality (AHRQ) - ANSWERSMajor initiative is
Healthcare Cost and Utilization Project (HCUP)
American Medical Association (AMA) - ANSWERSPublishes CPT codes and updates
coding system annually
Attributes - ANSWERSData elements within an entity that become the column or field
names when the entity relationship diagram is implemented as a relational database
Basic interoperability - ANSWERSRelates to the ability to successfully transmit and
receive data from one computer to another
Cancer Committee - ANSWERSDesignated multidisciplinary body for administrative
oversight, development and review of cancer services at a facility
Cancer Registry - ANSWERSMost common type of registry that is in all hospitals over
the United States and it maintains data on all patients diagnosed and/or treated from
cancer at a particular facility
Cancer staging - ANSWERSProcess of determining the size and extent of spread of the
tumor throughout the body
,Case definition - ANSWERSMethod of determining criteria for cases that should be
included in a registry
Case finding - ANSWERSMethod of identifying patients who have been seen or treated
in a healthcare facility for the particular disease or condition of interest to the registry
Clinical classification - ANSWERSA clinical vocabulary, terminology, or nomenclature
that lists words or phrases with their meanings
Clinical terminology - ANSWERSA set of standardized terms and their synonyms that
record patient findings, circumstances, events, and interventions with sufficient detail to
support clinical care, decision support, outcomes research, and quality improvement
Clinical trial - ANSWERSFinal stages of a long and careful research process that tests
new types of medical care to see if they are safe
Clinical vocabulary - ANSWERSLists words or phrases with their meanings
Commission on Cancer of the American College of Surgeons - ANSWERSThis
organization has an approval process for cancer programs. Standards are published in
the Cancer Program Standards
Computer Assisted Coding (CAC) - ANSWERSTool intended to improve efficiency of
coding and claims submission process
Concurrent Coding - ANSWERSCompleted while patient is still admitted to the facility
CPT, Category II - ANSWERSused to report participation in Physician Quality Reporting
System (PQRS)
Current Dental Terminology (CDT) - ANSWERSA reference manual maintained and
updated annually by the American Dental Association (ADA) which includes codes on
Dental Procedures
Current Procedural Terminology (CPT) - ANSWERSProvides a uniform language that
accurately describes medical, surgical, and diagnostic services. It has become a widely
used standard for outpatient and ambulatory care procedural coding.
Current Procedural Terminology (CPT) Category II Codes - ANSWERSOptional codes
used for performance measurement reporting purposes
Current Procedural Terminology (CPT) Category III Codes - ANSWERSTemporary
codes that represent include medical technologies, services, and procedures that have
not yet been approved for general use by the FDA and are not otherwise covered by
CPT codes
, Data Elements for Emergency Department Systems (DEEDS) (Classification Systems
and Secondary Data Sources) - ANSWERSA standardization for the collection of data
from hospital-based emergency departments
Data modeling - ANSWERSProcess of determining the users' information needs and
identifying relationships among the data
Database management system (DBMS) - ANSWERSSoftware tools used to store,
analyze, modify, and access data
Diagnosis-Related Groups (DRG) - ANSWERSclassification of related diagnoses used
for determining level of reimbursement for inpatient services provided to Medicare
beneficiaries
Diagnostics and Statistics Manual (DSM) - ANSWERSA handbook published by the
American Psychiatric Association (APA) that is used by health care professionals as a
guide to properly diagnose mental disorders (most frequently used in behavioral/
psychiatric/ mental healthcare settings)
Disease index (Classification Systems and Secondary Data Sources) - ANSWERSan
ongoing list of all diseases and conditions treated within the facility
Encoder - ANSWERSAssigns diagnosis and procedure codes
Encounter - ANSWERSFace to face contact between a patient and health care provider
who assesses and treats the patient's condition
Entity - ANSWERSClass of objects that exist in the real world and have related
properties
Facility-based registry - ANSWERSRegistry that includes only cases from a particular
type of healthcare facility such as a hospital or clinic
Functional interoperability - ANSWERSRefers to sending messages between
computers with a shared understanding of the structure and format of the message
General Equivalency Mappings (GEMS) - ANSWERSTranslation dictionaries or
crosswalks of codes that can be used to roughly identify ICD-10-CM codes for their
ICD-9-CM equivalent (facilitate location of corresponding diagnosis codes between two
code sets)
Health Level Seven (HL7) - ANSWERSprivacy and security classification system for
interoperability
Answers
Capitation - ANSWERSA specified amount of money paid to a health plan or doctor.
This is used to cover the cost of a health plan member's healthcare services for a
certain length of time.
Case management - ANSWERSThe ongoing, concurrent review performed by clinical
professionals to ensure the necessity and effectiveness of the clinical services being
provided to a patient.
Case-mix index (CMI): - ANSWERSThe average relative weight of all cases treated at a
given facility or by a given physician, which reflects the resource intensity or clinical
severity of a specific group in relation to the other groups in the classification system;
calculated by dividing the sum of the weights of diagnosis-related groups (DRGs) for
patients discharged during a given period divided by the total number of patients
discharged.
National Practitioner Data Bank - ANSWERScomprehensive database of health care
provider credentials
Healthcare Integrity and Protection Data Bank - ANSWERSa national data bank of
health care provider licensure and certification actions, participation exclusions, criminal
convictions, civil judgements, and other adjudicated actions
MEDPAR - ANSWERSfiles contain information for 100% of Medicare beneficiaries
using hospital inpatient services
Registries - ANSWERSfor example, tumor, cancer, HIV/AIDS, diabetes mellitus,
trauma, birth defects; run to collect histological data on disease progression
Disease index - ANSWERSlist of all diseases treated at one facility
Operation index - ANSWERSlist of all surgical procedures performed at one facility
MPI (Master Patient Index) - ANSWERSlist of all patients treated at one facility
GEM (General Equivalency Mapping) - ANSWERSused general equivalency mapping
to translate from one classification system to another
Hospital Compare/Nursing Home Compare - ANSWERSinformation on how well
hospitals provide recommended care to their patients
,Outcomes and Assessment Information Set (OASIS) - ANSWERScore assessment
data that measure adult outcomes of those receiving home health services
Uniform Ambulatory Care Data Set (UACDS) - ANSWERSspecific data elements
collected regarding patient care in ambulatory care settings
Uniform Hospital Discharge Data Set (UHDDS) - ANSWERSdata collected on all
hospital discharges
Abbreviated Injury Scale (AIS) - ANSWERSReflects nature of injury and severity (threat
to life) by body system
Abstracting - ANSWERSCompilation of pertinent information extracted from the
patient's record. Purpose is to make information from the patient's record readily
available for internal and external reporting needs - it supports secondary use of patient
data for registries, public reporting, and research.
Accession number - ANSWERSNumber used to identify the patient that is assigned to
the patient when the case is first entered into the registry
Accession registry - ANSWERSListing of patients in accession number order that
provides a way to monitor whether or not all cases have been entered into the registry
Agency for Healthcare Research and Quality (AHRQ) - ANSWERSMajor initiative is
Healthcare Cost and Utilization Project (HCUP)
American Medical Association (AMA) - ANSWERSPublishes CPT codes and updates
coding system annually
Attributes - ANSWERSData elements within an entity that become the column or field
names when the entity relationship diagram is implemented as a relational database
Basic interoperability - ANSWERSRelates to the ability to successfully transmit and
receive data from one computer to another
Cancer Committee - ANSWERSDesignated multidisciplinary body for administrative
oversight, development and review of cancer services at a facility
Cancer Registry - ANSWERSMost common type of registry that is in all hospitals over
the United States and it maintains data on all patients diagnosed and/or treated from
cancer at a particular facility
Cancer staging - ANSWERSProcess of determining the size and extent of spread of the
tumor throughout the body
,Case definition - ANSWERSMethod of determining criteria for cases that should be
included in a registry
Case finding - ANSWERSMethod of identifying patients who have been seen or treated
in a healthcare facility for the particular disease or condition of interest to the registry
Clinical classification - ANSWERSA clinical vocabulary, terminology, or nomenclature
that lists words or phrases with their meanings
Clinical terminology - ANSWERSA set of standardized terms and their synonyms that
record patient findings, circumstances, events, and interventions with sufficient detail to
support clinical care, decision support, outcomes research, and quality improvement
Clinical trial - ANSWERSFinal stages of a long and careful research process that tests
new types of medical care to see if they are safe
Clinical vocabulary - ANSWERSLists words or phrases with their meanings
Commission on Cancer of the American College of Surgeons - ANSWERSThis
organization has an approval process for cancer programs. Standards are published in
the Cancer Program Standards
Computer Assisted Coding (CAC) - ANSWERSTool intended to improve efficiency of
coding and claims submission process
Concurrent Coding - ANSWERSCompleted while patient is still admitted to the facility
CPT, Category II - ANSWERSused to report participation in Physician Quality Reporting
System (PQRS)
Current Dental Terminology (CDT) - ANSWERSA reference manual maintained and
updated annually by the American Dental Association (ADA) which includes codes on
Dental Procedures
Current Procedural Terminology (CPT) - ANSWERSProvides a uniform language that
accurately describes medical, surgical, and diagnostic services. It has become a widely
used standard for outpatient and ambulatory care procedural coding.
Current Procedural Terminology (CPT) Category II Codes - ANSWERSOptional codes
used for performance measurement reporting purposes
Current Procedural Terminology (CPT) Category III Codes - ANSWERSTemporary
codes that represent include medical technologies, services, and procedures that have
not yet been approved for general use by the FDA and are not otherwise covered by
CPT codes
, Data Elements for Emergency Department Systems (DEEDS) (Classification Systems
and Secondary Data Sources) - ANSWERSA standardization for the collection of data
from hospital-based emergency departments
Data modeling - ANSWERSProcess of determining the users' information needs and
identifying relationships among the data
Database management system (DBMS) - ANSWERSSoftware tools used to store,
analyze, modify, and access data
Diagnosis-Related Groups (DRG) - ANSWERSclassification of related diagnoses used
for determining level of reimbursement for inpatient services provided to Medicare
beneficiaries
Diagnostics and Statistics Manual (DSM) - ANSWERSA handbook published by the
American Psychiatric Association (APA) that is used by health care professionals as a
guide to properly diagnose mental disorders (most frequently used in behavioral/
psychiatric/ mental healthcare settings)
Disease index (Classification Systems and Secondary Data Sources) - ANSWERSan
ongoing list of all diseases and conditions treated within the facility
Encoder - ANSWERSAssigns diagnosis and procedure codes
Encounter - ANSWERSFace to face contact between a patient and health care provider
who assesses and treats the patient's condition
Entity - ANSWERSClass of objects that exist in the real world and have related
properties
Facility-based registry - ANSWERSRegistry that includes only cases from a particular
type of healthcare facility such as a hospital or clinic
Functional interoperability - ANSWERSRefers to sending messages between
computers with a shared understanding of the structure and format of the message
General Equivalency Mappings (GEMS) - ANSWERSTranslation dictionaries or
crosswalks of codes that can be used to roughly identify ICD-10-CM codes for their
ICD-9-CM equivalent (facilitate location of corresponding diagnosis codes between two
code sets)
Health Level Seven (HL7) - ANSWERSprivacy and security classification system for
interoperability
