Certified Coding Specialist – Physician-Based (CCS-P) Exam Prep 2026 Updated Practice Questions, Comprehensive Physician Coding Review, Verified Answers, Detailed Rationales, Success Workbook

Certified Coding Specialist – Physician-Based (CCS-P)
Exam Prep 2026 Updated Practice Questions,
Comprehensive Physician Coding Review, Verified Answers,
Detailed Rationales, Success Workbook

The exam covers five domains:

Domain Weight

1. Diagnosis Coding (ICD-10-CM) 24–26%

2. Procedure Coding (CPT/HCPCS) 28–32%

3. Research 6–10%

4. Compliance 18–22%

5. Revenue Cycle 14–18%

Sources: AHIMA CCS-P Exam Content Outline (Effective 05/01/2024)


DOMAIN 1: DIAGNOSIS CODING (ICD-10-CM) (24–26%)


1. A 45-year-old male is seen for a routine annual physical. During the visit,
the provider documents "essential hypertension" that is well-controlled on
medication. What ICD-10-CM code should be assigned?
A) I10
B) I10
C) I15.9
D) Z00.00
Answer: B) I10

,Rationale: Essential (primary) hypertension is coded to I10. There is no distinction
in ICD-10-CM for controlled versus uncontrolled hypertension; both are coded to
I10 unless a specific hypertensive crisis or secondary hypertension is documented.
Z00.00 (D) is the code for a routine annual physical, but the encounter is not solely
for the physical—the hypertension is being addressed, so the diagnosis code I10 is
appropriate.


2. A patient with Type 2 diabetes mellitus is seen for a follow-up visit. The
provider documents that the patient's diabetes is "in remission." What ICD-
10-CM code should be assigned?
A) E11.9
B) E11.A
C) Z86.39
D) E11.65
Answer: B) E11.A
Rationale: For FY 2026, a new code E11.A was introduced for Type 2 diabetes in
remission. This code should be used when the provider documents that the patient's
diabetes is in remission. E11.9 (A) is for Type 2 diabetes without complications
and does not capture remission status. Z86.39 (C) is a personal history code for
other endocrine, nutritional, and metabolic diseases, not for active diabetes in
remission.


3. A 68-year-old patient with known HIV is seen for a routine follow-up. The
provider documents "HIV, asymptomatic." The patient is not on
antiretroviral therapy. What is the correct ICD-10-CM code?
A) B20
B) Z21
C) B20 + Z21
D) R75
Answer: B) Z21
Rationale: Z21 (Asymptomatic human immunodeficiency virus [HIV] infection
status) is assigned when the patient is HIV positive but has no symptoms or HIV-
related conditions. B20 (A) is assigned only when the patient has symptomatic

,HIV or an HIV-related condition. The provider's documentation of "asymptomatic"
clearly indicates Z21. R75 (D) is for inconclusive HIV test results.


4. A patient presents with chest pain that the provider documents as "atypical
chest pain." The provider rules out cardiac causes. What ICD-10-CM code
should be assigned?
A) I20.9
B) R07.89
C) R07.9
D) I10
Answer: B) R07.89
Rationale: R07.89 (Other chest pain) is the correct code for atypical chest pain
when a specific cause has not been identified. I20.9 (A) is for angina pectoris,
which would require a confirmed diagnosis. R07.9 (C) is for unspecified chest
pain, but "atypical chest pain" is more specifically classified to R07.89. I10 (D) is
for hypertension.


5. A patient is being seen for a follow-up after a stroke. The provider
documents "history of cerebrovascular accident without residual deficits."
What ICD-10-CM code should be assigned?
A) I63.9
B) Z86.73
C) I69.30
D) G81.9
Answer: B) Z86.73
Rationale: Z86.73 (Personal history of transient ischemic attack [TIA], and
cerebrovascular disease without residual deficits) is the correct code when the
patient has a history of CVA but no current residual deficits. I63.9 (A) is for a
current (acute) cerebral infarction. I69.30 (C) is for late effects of cerebral
infarction with unspecified cognitive deficits. G81.9 (D) is for hemiplegia, which
would indicate a residual deficit.

, 6. A patient is seen for a well-child visit. The provider documents "encounter
for routine child health examination with abnormal findings." What ICD-10-
CM code is assigned for this encounter?
A) Z00.121
B) Z00.129
C) Z00.00
D) Z02.0
Answer: B) Z00.129
Rationale: Z00.129 (Encounter for routine child health examination with abnormal
findings) is assigned when a routine well-child visit reveals abnormal
findings. Z00.121 (A) is for a routine child health examination with abnormal
findings, but the 7th character "1" indicates a specific age group
(child). Z00.00 (C) is for a routine adult physical. Z02.0 (D) is for an encounter for
examination for admission to educational institution.


7. A patient with chronic kidney disease (CKD) stage 3 due to diabetes
mellitus is seen for a follow-up. What ICD-10-CM codes should be assigned?
A) N18.3
B) E11.22
C) E11.22, N18.3
D) N18.9, E11.9
Answer: C) E11.22, N18.3
Rationale: When CKD is due to diabetes, ICD-10-CM guidelines require
sequencing the diabetes code first, followed by the CKD code. E11.22 (Type 2
diabetes mellitus with diabetic nephropathy) and N18.3 (Chronic kidney disease,
stage 3) should be assigned, with E11.22 sequenced first as the underlying
etiology. N18.3 alone (A) misses the etiology, and E11.22 alone (B) misses the
CKD stage.


8. A patient is seen for an exacerbation of COPD. The provider documents
"acute exacerbation of chronic obstructive pulmonary disease." The patient
also has a history of tobacco dependence. What ICD-10-CM codes should be
assigned?