1
CCS CERTIFICATION PRACTICE EXAM
2026/2027 | CERTIFIED CODING SPECIALIST |
75 VERIFIED Q&A | DETAILED RATIONALES |
PASS GUARANTEED – A+ GRADED
SECTION 1: ICD-10-CM CODING GUIDELINES - Questions 1-12
Q1: ICD-10-CM Code Structure
The student is reviewing ICD-10-CM coding. What is the maximum number of characters in an ICD-
10-CM diagnosis code?
A. 5
B. 6
C. 7
D. 8
Correct Answer: C
Rationale: ICD-10-CM codes can be up to 7 characters in length. The first character is always a letter,
followed by numbers and possibly additional letters. The 7th character is used for episode of care or
laterality in certain chapters. [100% CORRECT]
Q2: Excludes1 Note
The student is reviewing coding guidelines. What does an Excludes1 note indicate?
A. The two conditions may be coded together
B. The two conditions cannot be coded together
C. The excluded code is optional
D. The excluded code is the primary diagnosis
Correct Answer: B
Rationale: Excludes1 means the two conditions are mutually exclusive. The code excluded should
never be used at the same time as the code above it. [100% CORRECT]
Q3: Signs and Symptoms
The student is reviewing coding guidelines. When should a sign or symptom code be used?
A. When the definitive diagnosis has been established
B. When the definitive diagnosis has not been established
,2
C. Always as a secondary code
D. Never
Correct Answer: B
Rationale: Signs and symptoms are coded when a definitive diagnosis has not been established.
Once a definitive diagnosis is made, the sign/symptom is not coded separately unless it is an integral
part of the disease. [100% CORRECT]
Q4: Combination Codes
The student is reviewing ICD-10-CM. What is a combination code?
A. A code that combines two diagnoses or a diagnosis with a manifestation
B. A code that combines two procedures
C. A code that combines a diagnosis and a procedure
D. A code that combines two body sites
Correct Answer: A
Rationale: Combination codes classify two diagnoses, a diagnosis with an associated secondary
process (manifestation), or a diagnosis with an associated complication. Only one code is needed.
[100% CORRECT]
Q5: Laterality
The student is reviewing ICD-10-CM. How is laterality coded in ICD-10-CM?
A. With a 5th character
B. With a 6th character
C. With a 7th character
D. With an additional code
Correct Answer: B
Rationale: Laterality (right, left, bilateral) is typically coded in the 6th character position for many
codes. The 7th character is used for episode of care. [100% CORRECT]
Q6: Neoplasm Coding
The student is reviewing neoplasm coding. When a patient is admitted for treatment of a primary
malignancy and a secondary malignancy, which is sequenced first?
A. The primary malignancy
B. The secondary malignancy
C. The malignancy most related to the reason for admission
D. Both are sequenced equally
Correct Answer: C
, 3
Rationale: When a patient is admitted for treatment of a malignancy, the code for the malignancy
being treated is sequenced first. If both are treated, the primary is usually sequenced first, but the
reason for admission guides sequencing. [100% CORRECT]
Q7: Diabetes Coding
The student is reviewing diabetes coding. How is diabetes coded when it is controlled by insulin?
A. As type 1 diabetes
B. As type 2 diabetes
C. As diabetes mellitus without complication
D. As secondary diabetes
Correct Answer: A
Rationale: In ICD-10-CM, diabetes is classified by type (type 1, type 2, etc.) and by the use of insulin.
If the patient requires insulin, it is coded as type 1 or type 2 with long-term use of insulin. The type is
determined by the physician. [100% CORRECT]
Q8: Pressure Ulcer Coding
The student is reviewing pressure ulcer coding. What is required to code a pressure ulcer in ICD-10-
CM?
A. Site and stage
B. Site and laterality
C. Site and depth
D. Site and cause
Correct Answer: A
Rationale: Pressure ulcer codes require the site and stage. If the stage is not documented, it cannot
be coded as a pressure ulcer unless specified by the physician. [100% CORRECT]
Q9: Fracture Coding
The student is reviewing fracture coding. What is the 7th character for a fracture when the patient is
receiving active treatment?
A. A (initial encounter)
B. D (subsequent encounter)
C. S (sequela)
D. Not applicable
Correct Answer: A
Rationale: For fractures, the 7th character A is used for initial encounter (active treatment). D is for
subsequent encounter (healing/completed treatment). S is for sequela. [100% CORRECT]
CCS CERTIFICATION PRACTICE EXAM
2026/2027 | CERTIFIED CODING SPECIALIST |
75 VERIFIED Q&A | DETAILED RATIONALES |
PASS GUARANTEED – A+ GRADED
SECTION 1: ICD-10-CM CODING GUIDELINES - Questions 1-12
Q1: ICD-10-CM Code Structure
The student is reviewing ICD-10-CM coding. What is the maximum number of characters in an ICD-
10-CM diagnosis code?
A. 5
B. 6
C. 7
D. 8
Correct Answer: C
Rationale: ICD-10-CM codes can be up to 7 characters in length. The first character is always a letter,
followed by numbers and possibly additional letters. The 7th character is used for episode of care or
laterality in certain chapters. [100% CORRECT]
Q2: Excludes1 Note
The student is reviewing coding guidelines. What does an Excludes1 note indicate?
A. The two conditions may be coded together
B. The two conditions cannot be coded together
C. The excluded code is optional
D. The excluded code is the primary diagnosis
Correct Answer: B
Rationale: Excludes1 means the two conditions are mutually exclusive. The code excluded should
never be used at the same time as the code above it. [100% CORRECT]
Q3: Signs and Symptoms
The student is reviewing coding guidelines. When should a sign or symptom code be used?
A. When the definitive diagnosis has been established
B. When the definitive diagnosis has not been established
,2
C. Always as a secondary code
D. Never
Correct Answer: B
Rationale: Signs and symptoms are coded when a definitive diagnosis has not been established.
Once a definitive diagnosis is made, the sign/symptom is not coded separately unless it is an integral
part of the disease. [100% CORRECT]
Q4: Combination Codes
The student is reviewing ICD-10-CM. What is a combination code?
A. A code that combines two diagnoses or a diagnosis with a manifestation
B. A code that combines two procedures
C. A code that combines a diagnosis and a procedure
D. A code that combines two body sites
Correct Answer: A
Rationale: Combination codes classify two diagnoses, a diagnosis with an associated secondary
process (manifestation), or a diagnosis with an associated complication. Only one code is needed.
[100% CORRECT]
Q5: Laterality
The student is reviewing ICD-10-CM. How is laterality coded in ICD-10-CM?
A. With a 5th character
B. With a 6th character
C. With a 7th character
D. With an additional code
Correct Answer: B
Rationale: Laterality (right, left, bilateral) is typically coded in the 6th character position for many
codes. The 7th character is used for episode of care. [100% CORRECT]
Q6: Neoplasm Coding
The student is reviewing neoplasm coding. When a patient is admitted for treatment of a primary
malignancy and a secondary malignancy, which is sequenced first?
A. The primary malignancy
B. The secondary malignancy
C. The malignancy most related to the reason for admission
D. Both are sequenced equally
Correct Answer: C
, 3
Rationale: When a patient is admitted for treatment of a malignancy, the code for the malignancy
being treated is sequenced first. If both are treated, the primary is usually sequenced first, but the
reason for admission guides sequencing. [100% CORRECT]
Q7: Diabetes Coding
The student is reviewing diabetes coding. How is diabetes coded when it is controlled by insulin?
A. As type 1 diabetes
B. As type 2 diabetes
C. As diabetes mellitus without complication
D. As secondary diabetes
Correct Answer: A
Rationale: In ICD-10-CM, diabetes is classified by type (type 1, type 2, etc.) and by the use of insulin.
If the patient requires insulin, it is coded as type 1 or type 2 with long-term use of insulin. The type is
determined by the physician. [100% CORRECT]
Q8: Pressure Ulcer Coding
The student is reviewing pressure ulcer coding. What is required to code a pressure ulcer in ICD-10-
CM?
A. Site and stage
B. Site and laterality
C. Site and depth
D. Site and cause
Correct Answer: A
Rationale: Pressure ulcer codes require the site and stage. If the stage is not documented, it cannot
be coded as a pressure ulcer unless specified by the physician. [100% CORRECT]
Q9: Fracture Coding
The student is reviewing fracture coding. What is the 7th character for a fracture when the patient is
receiving active treatment?
A. A (initial encounter)
B. D (subsequent encounter)
C. S (sequela)
D. Not applicable
Correct Answer: A
Rationale: For fractures, the 7th character A is used for initial encounter (active treatment). D is for
subsequent encounter (healing/completed treatment). S is for sequela. [100% CORRECT]
