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CERTIFIED CODING SPECIALIST EXAM
PREP /CCS EXAM 2 LATEST VERSIONS
2025/2026 AND PRACTICE QUESTIONS
(VERSION A AND B) COMPLETE
500 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
A coder reviews a medical record and determines that a code Medicare has
designated as "unacceptable principal diagnosis" is the correct code to assign.
What should the coder do?
a. Assign another code from the history and physical as the principal diagnosis
b. Assign the code even though the insurer may not pay the claim
c. Use a comorbidity as the principal diagnosis
d. Assign a code from the outpatient visit prior to admission - CORRECT
ANSWER ✔✔- b. Assign the code even though the insurer may not pay the claim
**While Medicare may specify that a given condition is not acceptable, if that
condition is what is documented, the coder has no other option but to code
what is documented even though the insurer may not pay the claim (Leon-
Chisen 2017, 39-40).
A 35-year-old woman has hypertension with acute renal failure and stage 3 chronic
kidney disease. What code would be assigned?
a. N17.9, Acute kidney failure, unspecified
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b. I13.2, Hypertensive heart and chronic kidney disease with heart failure and with
stage 5 chronic kidney disease, or end stage renal disease
c. I50.9, Heart failure, unspecified
d. N17.9, Acute kidney failure, unspecified and I12.9, Hypertensive chronic kidney
disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic
kidney disease and N18.3, Chronic kidney disease, stage 3 (moderate) -
CORRECT ANSWER ✔✔- d. N17.9, Acute kidney failure, unspecified and I12.9,
Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney
disease, or unspecified chronic kidney disease and N18.3, Chronic kidney disease,
stage 3 (moderate)
**Code the hypertension with stage 3 chronic kidney disease. In this case,
both hypertension and chronic kidney disease are documented and a
combination code is used. Also the code for the stage 3 chronic kidney disease
must be assigned due to the "code also" note. The acute renal failure is
identified with a separate code (HHS 2017, Section I.C.9.a., 40; HHS 2017,
Section I.C.14.a., 53).
What diagnoses and procedures should be reported for recurrent left inguinal
hernia with laparoscopic repair?
K40.30 Unilateral inguinal hernia, with obstruction, without gangrene, not
specified as recurrent
K40.31 Unilateral inguinal hernia, with obstruction, without gangrene, recurrent
K40.91 Unilateral inguinal hernia, without mention of obstruction or gangrene,
recurrent
49520 Repair recurrent inguinal hernia, any age; reducible
49521 Repair recurrent inguinal hernia, any age; incarcerated or strangulated
49651 Laparoscopy, surgical; repair recurrent inguinal hernia
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a. K40.91, 49520
b. K40.31, 49521
c. K40.91, 49651
d. K40.30, 49520 - CORRECT ANSWER ✔✔- c. K40.91:Unilateral inguinal
hernia, without mention of obstruction or gangrene, recurrent
49651:Laparoscopy, surgical; repair recurrent inguinal hernia
**The patient has a recurrent hernia without obstruction and this is captured in
diagnosis code K40.91 (Leon-Chisen 2017, 253; CPT Assistant Nov. 1999, 24;
March 2000, 9).
Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs)
are similar in that they are both:
a. Determined by HCPCS codes
b. Focused on hospital outpatients
c. Focused on hospital inpatients
d. Prospective payment systems - CORRECT ANSWER ✔✔- d. Prospective
payment systems
** Both are types of prospective payment systems (Casto and Forrestal 2015,
6).
A patient is treated for esophageal varices with hemorrhage due to cirrhosis. The
diagnostic codes that would be assigned are:
I85.01 Esophageal varices with bleeding
I85.11 Secondary esophageal varices with bleeding
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K74.60 Unspecified cirrhosis of liver - CORRECT ANSWER ✔✔- d. K74.60,
I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
**The patient has cirrhosis of the liver with resulting bleeding esophageal
varices. Cirrhosis of liver is sequenced first followed by the code for the
bleeding esophageal varices (HHS 2017, Section I.A.13, 11).
Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for each
lobe of each lung.
31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial lung biopsy(s), single lobe
31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial needle aspiration biopsy(s), trachea, main stem
and/or lobar bronchus(i)
31632 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial lung biopsy(s), each additional lobe
−50 Bilateral procedure - CORRECT ANSWER ✔✔-
Assign the code(s) for endoscopic sinusotomy with bilateral anterior
ethmoidectomy.
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)
−50 Bilateral procedurea.
CERTIFIED CODING SPECIALIST EXAM
PREP /CCS EXAM 2 LATEST VERSIONS
2025/2026 AND PRACTICE QUESTIONS
(VERSION A AND B) COMPLETE
500 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
A coder reviews a medical record and determines that a code Medicare has
designated as "unacceptable principal diagnosis" is the correct code to assign.
What should the coder do?
a. Assign another code from the history and physical as the principal diagnosis
b. Assign the code even though the insurer may not pay the claim
c. Use a comorbidity as the principal diagnosis
d. Assign a code from the outpatient visit prior to admission - CORRECT
ANSWER ✔✔- b. Assign the code even though the insurer may not pay the claim
**While Medicare may specify that a given condition is not acceptable, if that
condition is what is documented, the coder has no other option but to code
what is documented even though the insurer may not pay the claim (Leon-
Chisen 2017, 39-40).
A 35-year-old woman has hypertension with acute renal failure and stage 3 chronic
kidney disease. What code would be assigned?
a. N17.9, Acute kidney failure, unspecified
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b. I13.2, Hypertensive heart and chronic kidney disease with heart failure and with
stage 5 chronic kidney disease, or end stage renal disease
c. I50.9, Heart failure, unspecified
d. N17.9, Acute kidney failure, unspecified and I12.9, Hypertensive chronic kidney
disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic
kidney disease and N18.3, Chronic kidney disease, stage 3 (moderate) -
CORRECT ANSWER ✔✔- d. N17.9, Acute kidney failure, unspecified and I12.9,
Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney
disease, or unspecified chronic kidney disease and N18.3, Chronic kidney disease,
stage 3 (moderate)
**Code the hypertension with stage 3 chronic kidney disease. In this case,
both hypertension and chronic kidney disease are documented and a
combination code is used. Also the code for the stage 3 chronic kidney disease
must be assigned due to the "code also" note. The acute renal failure is
identified with a separate code (HHS 2017, Section I.C.9.a., 40; HHS 2017,
Section I.C.14.a., 53).
What diagnoses and procedures should be reported for recurrent left inguinal
hernia with laparoscopic repair?
K40.30 Unilateral inguinal hernia, with obstruction, without gangrene, not
specified as recurrent
K40.31 Unilateral inguinal hernia, with obstruction, without gangrene, recurrent
K40.91 Unilateral inguinal hernia, without mention of obstruction or gangrene,
recurrent
49520 Repair recurrent inguinal hernia, any age; reducible
49521 Repair recurrent inguinal hernia, any age; incarcerated or strangulated
49651 Laparoscopy, surgical; repair recurrent inguinal hernia
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a. K40.91, 49520
b. K40.31, 49521
c. K40.91, 49651
d. K40.30, 49520 - CORRECT ANSWER ✔✔- c. K40.91:Unilateral inguinal
hernia, without mention of obstruction or gangrene, recurrent
49651:Laparoscopy, surgical; repair recurrent inguinal hernia
**The patient has a recurrent hernia without obstruction and this is captured in
diagnosis code K40.91 (Leon-Chisen 2017, 253; CPT Assistant Nov. 1999, 24;
March 2000, 9).
Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs)
are similar in that they are both:
a. Determined by HCPCS codes
b. Focused on hospital outpatients
c. Focused on hospital inpatients
d. Prospective payment systems - CORRECT ANSWER ✔✔- d. Prospective
payment systems
** Both are types of prospective payment systems (Casto and Forrestal 2015,
6).
A patient is treated for esophageal varices with hemorrhage due to cirrhosis. The
diagnostic codes that would be assigned are:
I85.01 Esophageal varices with bleeding
I85.11 Secondary esophageal varices with bleeding
, 4|Page
K74.60 Unspecified cirrhosis of liver - CORRECT ANSWER ✔✔- d. K74.60,
I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
**The patient has cirrhosis of the liver with resulting bleeding esophageal
varices. Cirrhosis of liver is sequenced first followed by the code for the
bleeding esophageal varices (HHS 2017, Section I.A.13, 11).
Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for each
lobe of each lung.
31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial lung biopsy(s), single lobe
31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial needle aspiration biopsy(s), trachea, main stem
and/or lobar bronchus(i)
31632 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when
performed; with transbronchial lung biopsy(s), each additional lobe
−50 Bilateral procedure - CORRECT ANSWER ✔✔-
Assign the code(s) for endoscopic sinusotomy with bilateral anterior
ethmoidectomy.
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)
−50 Bilateral procedurea.
