Certified Coding Specialist (CCS) Question and
Answer [2026] | UPDATED ACTUAL Exam | A+
Verified
• The patient was admitted from the emergency department because of chest pain.
Following blood work, it was determined that the patient had elevated CPKs and
MB enzymes. The EKG shows nonspecific ST changes.
What type of diagnosis might this indicate?
a. Unstable angina
b. Myocardial infarction
c. Congestive heart failure
d. Mitral valve stenosis -✓✓ b
The CPK elevation with MB enzymes elevated and the EKG ST changes denote a
possible Ml (Leon-Chisen 2013, 386-387).
• A patient is admitted and diagnosed with fever and urinary burning. The
discharge diagnosis· is Escherichia coli, urinary tract infection.
Which of the following represents the correct diagnoses and appropriate sequence
of those conditions?
a. Fever, urinary burning, urosepsis
b. Fever, urinary burning, sepsis
c. Escherichia coli, urinary tract infection
d. Urinary tract infection, Escherichia coli -✓✓ d
Symptoms are not coded when a definitive diagnosis is present on discharge. The
patient discharge diagnosis of urinary tract infection. The organism (E. coli) is
coded with a seco diagnosis code (B96.20) which is to be added as an additional
code to identify the bacterial agent (HHS 2014, Section II.A., 98).
,• A patient was admitted with heart failure within one week of a heart transplant.
Due to the timing, the coder thought that it may represent a postoperative
transplant rejection following heart transplant.
What action(s) should the coding staff take?
a. Query the physician.
b. Assign the codes for the postoperative transplant rejection.
c. Assign only the code for the transplant rejection.
d. Assign only the code for heart failure. -✓✓ a
When the documentation is not clear regarding a potential complication, it is
appropriate query the physician (HHS 2014, Section I.B.16, 16; Leon-Chisen 2013,
43-44).
• A patient is admitted to a psychiatric unit of an acute-care facility. The patient
experienced the following symptoms almost every day for the last month: loss of
interest or pleasure in most or all activities, which is a change from her prior level
of functioning. She has also gained 15 lbs, has difficulty falling asleep, feels
fatigued, and has difficulty making decisions.
What potential diagnosis most closely fits the patient's overall symptoms?
a. Insomnia
b. Major depression
c. Reye's syndrome
d. Bipolar disorder -✓✓ b
, The symptoms provided are indicative of a depressive disorder (Leon-Chisen
2013, 175).
• Inpatient:
Admission for inguinal hernia repair. This 30-year-old patient has acquired
immunodeficiency syndrome (AIDS) but is not symptomatic at this time due to
medication regimen. The procedure performed was a right indirect inguinal
herniorrhaphy via open approach. -✓✓ ICD-10-CM: K40.90, B20,
ICD-10-PCS: OYQ50ZZ (Schraffenberger 2013, 82-84,252)
• Inpatient:
A 75-year-old male patient was admitted from a nursing home with dehydration
and dysphagia due to a previous stroke. During hospitalization the patient was
rehydrated and transferred back to the nursing home. -✓✓ ICD-10-CM: E86.0,
I69.391
(Schraffenberger 2013, 131, 209-210).
Stroke= cerebral infarction
• Inpatient:
A patient is admitted to an acute care facility for detoxification from alcohol and
barbiturate intoxication with chronic alcoholism and barbiturate abuse. The patient
also has cirrhosis of the liver due to alcoholism. -✓✓ ICD-10-CM: F10.229,
F13.129, K70.30,
Answer [2026] | UPDATED ACTUAL Exam | A+
Verified
• The patient was admitted from the emergency department because of chest pain.
Following blood work, it was determined that the patient had elevated CPKs and
MB enzymes. The EKG shows nonspecific ST changes.
What type of diagnosis might this indicate?
a. Unstable angina
b. Myocardial infarction
c. Congestive heart failure
d. Mitral valve stenosis -✓✓ b
The CPK elevation with MB enzymes elevated and the EKG ST changes denote a
possible Ml (Leon-Chisen 2013, 386-387).
• A patient is admitted and diagnosed with fever and urinary burning. The
discharge diagnosis· is Escherichia coli, urinary tract infection.
Which of the following represents the correct diagnoses and appropriate sequence
of those conditions?
a. Fever, urinary burning, urosepsis
b. Fever, urinary burning, sepsis
c. Escherichia coli, urinary tract infection
d. Urinary tract infection, Escherichia coli -✓✓ d
Symptoms are not coded when a definitive diagnosis is present on discharge. The
patient discharge diagnosis of urinary tract infection. The organism (E. coli) is
coded with a seco diagnosis code (B96.20) which is to be added as an additional
code to identify the bacterial agent (HHS 2014, Section II.A., 98).
,• A patient was admitted with heart failure within one week of a heart transplant.
Due to the timing, the coder thought that it may represent a postoperative
transplant rejection following heart transplant.
What action(s) should the coding staff take?
a. Query the physician.
b. Assign the codes for the postoperative transplant rejection.
c. Assign only the code for the transplant rejection.
d. Assign only the code for heart failure. -✓✓ a
When the documentation is not clear regarding a potential complication, it is
appropriate query the physician (HHS 2014, Section I.B.16, 16; Leon-Chisen 2013,
43-44).
• A patient is admitted to a psychiatric unit of an acute-care facility. The patient
experienced the following symptoms almost every day for the last month: loss of
interest or pleasure in most or all activities, which is a change from her prior level
of functioning. She has also gained 15 lbs, has difficulty falling asleep, feels
fatigued, and has difficulty making decisions.
What potential diagnosis most closely fits the patient's overall symptoms?
a. Insomnia
b. Major depression
c. Reye's syndrome
d. Bipolar disorder -✓✓ b
, The symptoms provided are indicative of a depressive disorder (Leon-Chisen
2013, 175).
• Inpatient:
Admission for inguinal hernia repair. This 30-year-old patient has acquired
immunodeficiency syndrome (AIDS) but is not symptomatic at this time due to
medication regimen. The procedure performed was a right indirect inguinal
herniorrhaphy via open approach. -✓✓ ICD-10-CM: K40.90, B20,
ICD-10-PCS: OYQ50ZZ (Schraffenberger 2013, 82-84,252)
• Inpatient:
A 75-year-old male patient was admitted from a nursing home with dehydration
and dysphagia due to a previous stroke. During hospitalization the patient was
rehydrated and transferred back to the nursing home. -✓✓ ICD-10-CM: E86.0,
I69.391
(Schraffenberger 2013, 131, 209-210).
Stroke= cerebral infarction
• Inpatient:
A patient is admitted to an acute care facility for detoxification from alcohol and
barbiturate intoxication with chronic alcoholism and barbiturate abuse. The patient
also has cirrhosis of the liver due to alcoholism. -✓✓ ICD-10-CM: F10.229,
F13.129, K70.30,
