CCS EXAM QUESTIONS AND ANSWERS (VERIFIED AND WELL
DETAILED ANSWERS GRADED ANSWERS) LATEST UPDATE 2025/2026
Assign code(s) for the following diagnosis: Congestive heart failure due to
hypertension.
I10Essential (primary) hypertension
I11.0Hypertensive heart disease with heart failure
I50.9Heart failure, unspecified
I50.23Acute on chronic systolic (congestive) heart failure
a. I10, I50.9
b. I11.0
c. I50.23, I10
d. I11.0, I50.9 -- CORRECT ANSWER- Correct Answer: D
Heart failure is assigned a combination code when a causal relationship is stated
(due to hypertension) or implied (hypertensive). Use an additional code to identify
the type of heart failure in those patients with heart failure (CMS 2020a, Section
I.C.9.a.1, 46-47).
A patient is seen for evaluation of a right orbital roof fracture. How should this be
coded?
S02.121AFracture of orbital roof, right side, initial encounter for closed fracture
S02.31XAFracture of orbital floor, right side, initial encounter for closed fracture
S02.92XAUnspecified fracture of facial bones, initial encounter for closed fracture
,S02.91XAUnspecified fracture of skull, initial encounter for closed fracture
a. S02.121A
b. S02.31XA
c. S02.92XA
d. S02.91XA -- CORRECT ANSWER- Correct Answer: A
Alphabetic Index for fracture, traumatic; orbit, orbital; roof guides the coder to
S02.12. Evaluation of a fracture is an example of active treatment which is
reported with 7th character "A" (Schraffenberger and Palkie 2020, 580-584).
Patient presents in the ER with thrombosis of a loop PTFE hemodialysis fistula
without mechanical complications. The physician performed a percutaneous
thrombectomy of the left brachial vein. Assign a facility code for this outpatient
procedure.
05CA3ZZExtirpation of matter from left brachial vein, percutaneous approach
36904Percutaneous transluminal mechanical thrombectomy and/or infusion for
thrombolysis, dialysis circuit, any method, including all imaging and radiological
supervision and interpretation, diagnostic angiography, fluoroscopic guidance,
catheter placement(s), and intraprocedural pharmacological thrombolytic
injection(s)
36832Revision, open, arteriovenous fistula; without thrombectomy, autogenous or
nonautogenous dialysis graft (separate procedure)
37184Primary percutaneous transluminal mechanical thrombectomy, noncoronary,
arterial or arterial bypass graft, including fluoroscopic guidance and intrapro --
CORRECT ANSWER- Correct Answer: B
This episode of care occurs in the ER which is an outpatient setting, therefore, a
CPT code should be used. CPT code 36904 correctly identifies the thrombectomy
procedure because it specifies the site of the thrombectomy as "dialysis circuit."
,36904 includes imaging guidance, diagnostic angiography, catheter placement, and
intraprocedural pharmacological thrombolytic injections" (Kirchoff 2009, 203).
Patient admitted for laparoscopic repair of right diaphragmatic hernia. Assign the
ICD-10-PCS procedure code for this surgery.
0BQT4ZZRepair diaphragm, percutaneous endoscopic approach
0BQT3ZZRepair diaphragm, percutaneous approach
0WQF4ZZRepair abdominal wall, percutaneous endoscopic approach
0BQT0ZZRepair diaphragm, open approach
a. 0BQT4ZZ
b. 0BQT3ZZ
c. 0WQF4ZZ
d. 0BQT0ZZ -- CORRECT ANSWER- Correct Answer: A
ICD-10-PCS code 0BQT4ZZ is the correct code based on the values for the body
part and approach. The correct body part is diaphragm and laparoscopy is reported
as a percutaneous endoscopic method of approach (Leon-Chisen 2020, 250-251).
A 23-year-old female is admitted for vaginal bleeding following a miscarriage two
weeks prior to this admission. She is afebrile at this time and is treated with an
aspiration dilation and curettage. Products of conception are found. Which of the
following should be the principal diagnosis?
a. O03.1, Delayed or excessive hemorrhage following incomplete spontaneous
abortion
b. O08.1, Delayed or excessive hemorrhage following ectopic and molar
pregnancy
, c. O03.6, Delayed or excessive hemorrhage following complete or unspecified
spontaneous abortion
d. O07.1, Delayed or excessive hemorrhage following failed attempted termination
of pregnancy -- CORRECT ANSWER- Correct Answer: A
A miscarriage is a spontaneous abortion. If the readmission is for the purpose of
dealing with retained products of conception, the spontaneous abortion is
incomplete; use a code from the O03 category (CMS 2020a, Section I.C.15.q., 68).
A patient presents to the emergency department with a fractured arm secondary to
a fall precipitated by syncope and ataxia. The patient undergoes a closed reduction
of the fracture in the emergency department and is then admitted for work up for
metastatic carcinoma secondary to ataxia and syncope in a patient with recent
history of lung cancer. The patient's work-up confirms recurrent lung carcinoma
metastatic to the brain.The principal diagnosis should be:
a. Fractured arm
b. Syncope
c. Metastatic carcinoma of the brain
d. Carcinoma of the lung -- CORRECT ANSWER- Correct Answer: C
According to the UHDDS definition, the principal diagnosis is "that condition
established after study to be chiefly responsible for occasioning the admission of
the patient to the hospital for care." In this case, metastatic carcinoma of the brain
is responsible for the patient's ataxia and syncope, which led to the fall (CMS
2020a, Section II, 107).
A female patient with hematochezia presents to the hospital outpatient surgery
department for a colonoscopy but the procedure was not performed due to elevated
blood pressure. What is the firstlisted diagnosis for this encounter?
a. Elevated blood pressure
b. Hematochezia
DETAILED ANSWERS GRADED ANSWERS) LATEST UPDATE 2025/2026
Assign code(s) for the following diagnosis: Congestive heart failure due to
hypertension.
I10Essential (primary) hypertension
I11.0Hypertensive heart disease with heart failure
I50.9Heart failure, unspecified
I50.23Acute on chronic systolic (congestive) heart failure
a. I10, I50.9
b. I11.0
c. I50.23, I10
d. I11.0, I50.9 -- CORRECT ANSWER- Correct Answer: D
Heart failure is assigned a combination code when a causal relationship is stated
(due to hypertension) or implied (hypertensive). Use an additional code to identify
the type of heart failure in those patients with heart failure (CMS 2020a, Section
I.C.9.a.1, 46-47).
A patient is seen for evaluation of a right orbital roof fracture. How should this be
coded?
S02.121AFracture of orbital roof, right side, initial encounter for closed fracture
S02.31XAFracture of orbital floor, right side, initial encounter for closed fracture
S02.92XAUnspecified fracture of facial bones, initial encounter for closed fracture
,S02.91XAUnspecified fracture of skull, initial encounter for closed fracture
a. S02.121A
b. S02.31XA
c. S02.92XA
d. S02.91XA -- CORRECT ANSWER- Correct Answer: A
Alphabetic Index for fracture, traumatic; orbit, orbital; roof guides the coder to
S02.12. Evaluation of a fracture is an example of active treatment which is
reported with 7th character "A" (Schraffenberger and Palkie 2020, 580-584).
Patient presents in the ER with thrombosis of a loop PTFE hemodialysis fistula
without mechanical complications. The physician performed a percutaneous
thrombectomy of the left brachial vein. Assign a facility code for this outpatient
procedure.
05CA3ZZExtirpation of matter from left brachial vein, percutaneous approach
36904Percutaneous transluminal mechanical thrombectomy and/or infusion for
thrombolysis, dialysis circuit, any method, including all imaging and radiological
supervision and interpretation, diagnostic angiography, fluoroscopic guidance,
catheter placement(s), and intraprocedural pharmacological thrombolytic
injection(s)
36832Revision, open, arteriovenous fistula; without thrombectomy, autogenous or
nonautogenous dialysis graft (separate procedure)
37184Primary percutaneous transluminal mechanical thrombectomy, noncoronary,
arterial or arterial bypass graft, including fluoroscopic guidance and intrapro --
CORRECT ANSWER- Correct Answer: B
This episode of care occurs in the ER which is an outpatient setting, therefore, a
CPT code should be used. CPT code 36904 correctly identifies the thrombectomy
procedure because it specifies the site of the thrombectomy as "dialysis circuit."
,36904 includes imaging guidance, diagnostic angiography, catheter placement, and
intraprocedural pharmacological thrombolytic injections" (Kirchoff 2009, 203).
Patient admitted for laparoscopic repair of right diaphragmatic hernia. Assign the
ICD-10-PCS procedure code for this surgery.
0BQT4ZZRepair diaphragm, percutaneous endoscopic approach
0BQT3ZZRepair diaphragm, percutaneous approach
0WQF4ZZRepair abdominal wall, percutaneous endoscopic approach
0BQT0ZZRepair diaphragm, open approach
a. 0BQT4ZZ
b. 0BQT3ZZ
c. 0WQF4ZZ
d. 0BQT0ZZ -- CORRECT ANSWER- Correct Answer: A
ICD-10-PCS code 0BQT4ZZ is the correct code based on the values for the body
part and approach. The correct body part is diaphragm and laparoscopy is reported
as a percutaneous endoscopic method of approach (Leon-Chisen 2020, 250-251).
A 23-year-old female is admitted for vaginal bleeding following a miscarriage two
weeks prior to this admission. She is afebrile at this time and is treated with an
aspiration dilation and curettage. Products of conception are found. Which of the
following should be the principal diagnosis?
a. O03.1, Delayed or excessive hemorrhage following incomplete spontaneous
abortion
b. O08.1, Delayed or excessive hemorrhage following ectopic and molar
pregnancy
, c. O03.6, Delayed or excessive hemorrhage following complete or unspecified
spontaneous abortion
d. O07.1, Delayed or excessive hemorrhage following failed attempted termination
of pregnancy -- CORRECT ANSWER- Correct Answer: A
A miscarriage is a spontaneous abortion. If the readmission is for the purpose of
dealing with retained products of conception, the spontaneous abortion is
incomplete; use a code from the O03 category (CMS 2020a, Section I.C.15.q., 68).
A patient presents to the emergency department with a fractured arm secondary to
a fall precipitated by syncope and ataxia. The patient undergoes a closed reduction
of the fracture in the emergency department and is then admitted for work up for
metastatic carcinoma secondary to ataxia and syncope in a patient with recent
history of lung cancer. The patient's work-up confirms recurrent lung carcinoma
metastatic to the brain.The principal diagnosis should be:
a. Fractured arm
b. Syncope
c. Metastatic carcinoma of the brain
d. Carcinoma of the lung -- CORRECT ANSWER- Correct Answer: C
According to the UHDDS definition, the principal diagnosis is "that condition
established after study to be chiefly responsible for occasioning the admission of
the patient to the hospital for care." In this case, metastatic carcinoma of the brain
is responsible for the patient's ataxia and syncope, which led to the fall (CMS
2020a, Section II, 107).
A female patient with hematochezia presents to the hospital outpatient surgery
department for a colonoscopy but the procedure was not performed due to elevated
blood pressure. What is the firstlisted diagnosis for this encounter?
a. Elevated blood pressure
b. Hematochezia
