CCS EXAMINATION SOLUTIONS GUIDE 2026
FULL ANSWERS GRADED A+
◍ CPT Assistant. Answer: provides official guidance in CPT coding
published by the AMA
◍ A barrier to wide spread use of automated code assignments is.
Answer: poor quality of documentation
◍ When should coders assign codes from lab reports alone. Answer:
Never. If findings are out of normal range and the physician has
ordered additional testing or treatment; consult with the physician as
to whether the Dx should be added or if an abnormal finding should
be listed.
◍ 4 cooperating parties of ICD-9 and responsibilities of each.
Answer: NCHS (national center for health statistics): maintaines dx
classifications in Vol 1&2
CMS: maintains procedural classification in Vol 3
AHIMA & AHA: give advice & assistance on coding guidelines in
conjunction with health information management practitioners,
physicians, & other users of ICD-9
,◍ When can code 99291 (E/M critical care) be used in place of a
medical visit or ER code. Answer: When the patient meets the
definition of critical care and receives outpatient care on the same day
◍ limiting charge. Answer: this is the amount a NON PAR Medicare
provider can collect from a patient in excess of 15% over the NON
PAR Medicare approved amount.
◍ When does CMS send the payment directly to the patient. Answer:
when a NON PAR provider does not accept assignment
◍ hard coding. Answer: refers to CPT/HCPCS codes that appear in
the hospitals chargemaster and will be included automatically on the
patient's bill.
◍ CAC- computer assisted coding. Answer: AHIMA defines as the
use of computer software that automatically generates a set of medical
codes for review , validation, and use based upon the documentation
provided by the various providers of healthcare.
◍ modifier: A1-principle physical of record. Answer: required for
patients covered by Medicare when reporting Initial Hospital Service
codes
◍ POMR- PROBLEM ORIENTED MEDICAL RECORD. Answer:
Organized by problem number
, Database: history and physical
Problem List: titles, numbers, dates of problems..."Table of Contents"
of the record
Initial Plan: describes diagnostic, therapeutic, and patient education
plans
Progress Note: documents the progress of a patient throughout the
episode of care
Discharge Note/ Transfer Note: summarizes episode of care and
current status of patient
◍ Cost Sharing Provision of Health Ins.. Answer: formulary for drugs
co-pay
benefit limitations
◍ Common Complication of Labor and Delivery. Answer: forceps or
vacuum extractor delivery without mention of indication
renal sphincter tear, not associated with 3rd degree peritoneal
laceration
trauma to perineum and vulva during delivery
FULL ANSWERS GRADED A+
◍ CPT Assistant. Answer: provides official guidance in CPT coding
published by the AMA
◍ A barrier to wide spread use of automated code assignments is.
Answer: poor quality of documentation
◍ When should coders assign codes from lab reports alone. Answer:
Never. If findings are out of normal range and the physician has
ordered additional testing or treatment; consult with the physician as
to whether the Dx should be added or if an abnormal finding should
be listed.
◍ 4 cooperating parties of ICD-9 and responsibilities of each.
Answer: NCHS (national center for health statistics): maintaines dx
classifications in Vol 1&2
CMS: maintains procedural classification in Vol 3
AHIMA & AHA: give advice & assistance on coding guidelines in
conjunction with health information management practitioners,
physicians, & other users of ICD-9
,◍ When can code 99291 (E/M critical care) be used in place of a
medical visit or ER code. Answer: When the patient meets the
definition of critical care and receives outpatient care on the same day
◍ limiting charge. Answer: this is the amount a NON PAR Medicare
provider can collect from a patient in excess of 15% over the NON
PAR Medicare approved amount.
◍ When does CMS send the payment directly to the patient. Answer:
when a NON PAR provider does not accept assignment
◍ hard coding. Answer: refers to CPT/HCPCS codes that appear in
the hospitals chargemaster and will be included automatically on the
patient's bill.
◍ CAC- computer assisted coding. Answer: AHIMA defines as the
use of computer software that automatically generates a set of medical
codes for review , validation, and use based upon the documentation
provided by the various providers of healthcare.
◍ modifier: A1-principle physical of record. Answer: required for
patients covered by Medicare when reporting Initial Hospital Service
codes
◍ POMR- PROBLEM ORIENTED MEDICAL RECORD. Answer:
Organized by problem number
, Database: history and physical
Problem List: titles, numbers, dates of problems..."Table of Contents"
of the record
Initial Plan: describes diagnostic, therapeutic, and patient education
plans
Progress Note: documents the progress of a patient throughout the
episode of care
Discharge Note/ Transfer Note: summarizes episode of care and
current status of patient
◍ Cost Sharing Provision of Health Ins.. Answer: formulary for drugs
co-pay
benefit limitations
◍ Common Complication of Labor and Delivery. Answer: forceps or
vacuum extractor delivery without mention of indication
renal sphincter tear, not associated with 3rd degree peritoneal
laceration
trauma to perineum and vulva during delivery
