CCS Practice Exam: Verified Questions &
Answers – Certified Coding Specialist (AHIMA)
Exam Prep with Detailed Rationales
Complete Q&A with Rationales for CCS
Certification Success
SECTION A: CODING KNOWLEDGE & SKILLS – ICD-10-CM
(Questions 1-35)
Question 1
A patient is admitted with acute exacerbation of chronic
obstructive pulmonary disease (COPD) with acute bronchitis. The
physician documents "acute exacerbation of COPD with acute
bronchitis." What is the correct ICD-10-CM code assignment?
A) J44.0 (COPD with acute lower respiratory infection)
B) J44.1 (COPD with acute exacerbation, unspecified)
C) J44.9 (COPD, unspecified)
D) J20.9 (Acute bronchitis, unspecified)
,Answer: A) J44.0 (COPD with acute lower respiratory infection)
Rationale: ICD-10-CM guideline I.C.10.a.5 states that COPD
with acute bronchitis is coded to J44.0. The combination code
captures both the chronic condition and the acute lower
respiratory infection. This is a crucial concept for the CCS exam:
when a combination code exists, it must be used rather than
coding the conditions separately. Incorrect (C) would be for
unspecified COPD without acute infection; (D) would miss the
underlying COPD which is the primary condition; (B) is for acute
exacerbation without specific lower respiratory infection .
Question 2
A patient with type 2 diabetes mellitus is admitted with diabetic
ketoacidosis. The physician documents "diabetic ketoacidosis due
to type 2 diabetes." What is the correct ICD-10-CM code
assignment?
A) E11.10 (Type 2 diabetes mellitus with ketoacidosis, with coma)
B) E11.9 (Type 2 diabetes mellitus without complications)
C) E11.65 (Type 2 diabetes mellitus with hyperglycemia)
D) E10.10 (Type 1 diabetes mellitus with ketoacidosis)
,Answer: A) E11.10 (Type 2 diabetes mellitus with ketoacidosis,
with coma)
Rationale: ICD-10-CM requires combination codes for diabetes
with manifestations. Ketoacidosis is coded as a manifestation of
diabetes. E11.10 is used for type 2 diabetes with ketoacidosis.
Note that the 5th character indicates whether coma is present; if
the documentation does not specify coma, E11.10 is still
appropriate as it represents "with ketoacidosis" (the 5th
character 0 indicates no coma). The code E10.10 is for type 1
diabetes, not type 2. E11.9 would be for uncomplicated
diabetes, which is incorrect when ketoacidosis is documented .
Question 3
A patient is admitted with sepsis due to a urinary tract infection
(UTI). The physician documents "sepsis due to E. coli UTI." How
should the ICD-10-CM codes be sequenced?
A) A41.51 (Sepsis due to Escherichia coli [E. coli]), N39.0 (Urinary
tract infection, site not specified)
B) N39.0, A41.51
C) A41.9 (Sepsis, unspecified organism), N39.0
D) R65.20 (Severe sepsis without septic shock), A41.51
, Answer: A) A41.51 (Sepsis due to Escherichia coli [E. coli]),
N39.0 (Urinary tract infection, site not specified)
Rationale: ICD-10-CM guideline I.C.1.d.1 states that sepsis due
to a localized infection should be coded first to the sepsis code
(A41.51), followed by the code for the localized infection
(N39.0). The sequencing is sepsis first, then the underlying
infection. This is a high-yield concept for the CCS exam. If the
provider documents severe sepsis, an additional code for severe
sepsis (R65.20 or R65.21) would be added, but R65.20 alone
would not capture the underlying infection. Sequencing correctly
is essential for DRG assignment and severity capture .
Question 4
A pregnant patient at 32 weeks gestation is admitted with
preeclampsia. The physician documents "preeclampsia." What is
the correct ICD-10-CM code?
A) O14.9 (Preeclampsia, unspecified)
B) O14.90 (Preeclampsia, unspecified, trimester unspecified)
C) O11.9 (Pre-existing hypertension with preeclampsia)
D) O15.9 (Eclampsia, unspecified)
Answers – Certified Coding Specialist (AHIMA)
Exam Prep with Detailed Rationales
Complete Q&A with Rationales for CCS
Certification Success
SECTION A: CODING KNOWLEDGE & SKILLS – ICD-10-CM
(Questions 1-35)
Question 1
A patient is admitted with acute exacerbation of chronic
obstructive pulmonary disease (COPD) with acute bronchitis. The
physician documents "acute exacerbation of COPD with acute
bronchitis." What is the correct ICD-10-CM code assignment?
A) J44.0 (COPD with acute lower respiratory infection)
B) J44.1 (COPD with acute exacerbation, unspecified)
C) J44.9 (COPD, unspecified)
D) J20.9 (Acute bronchitis, unspecified)
,Answer: A) J44.0 (COPD with acute lower respiratory infection)
Rationale: ICD-10-CM guideline I.C.10.a.5 states that COPD
with acute bronchitis is coded to J44.0. The combination code
captures both the chronic condition and the acute lower
respiratory infection. This is a crucial concept for the CCS exam:
when a combination code exists, it must be used rather than
coding the conditions separately. Incorrect (C) would be for
unspecified COPD without acute infection; (D) would miss the
underlying COPD which is the primary condition; (B) is for acute
exacerbation without specific lower respiratory infection .
Question 2
A patient with type 2 diabetes mellitus is admitted with diabetic
ketoacidosis. The physician documents "diabetic ketoacidosis due
to type 2 diabetes." What is the correct ICD-10-CM code
assignment?
A) E11.10 (Type 2 diabetes mellitus with ketoacidosis, with coma)
B) E11.9 (Type 2 diabetes mellitus without complications)
C) E11.65 (Type 2 diabetes mellitus with hyperglycemia)
D) E10.10 (Type 1 diabetes mellitus with ketoacidosis)
,Answer: A) E11.10 (Type 2 diabetes mellitus with ketoacidosis,
with coma)
Rationale: ICD-10-CM requires combination codes for diabetes
with manifestations. Ketoacidosis is coded as a manifestation of
diabetes. E11.10 is used for type 2 diabetes with ketoacidosis.
Note that the 5th character indicates whether coma is present; if
the documentation does not specify coma, E11.10 is still
appropriate as it represents "with ketoacidosis" (the 5th
character 0 indicates no coma). The code E10.10 is for type 1
diabetes, not type 2. E11.9 would be for uncomplicated
diabetes, which is incorrect when ketoacidosis is documented .
Question 3
A patient is admitted with sepsis due to a urinary tract infection
(UTI). The physician documents "sepsis due to E. coli UTI." How
should the ICD-10-CM codes be sequenced?
A) A41.51 (Sepsis due to Escherichia coli [E. coli]), N39.0 (Urinary
tract infection, site not specified)
B) N39.0, A41.51
C) A41.9 (Sepsis, unspecified organism), N39.0
D) R65.20 (Severe sepsis without septic shock), A41.51
, Answer: A) A41.51 (Sepsis due to Escherichia coli [E. coli]),
N39.0 (Urinary tract infection, site not specified)
Rationale: ICD-10-CM guideline I.C.1.d.1 states that sepsis due
to a localized infection should be coded first to the sepsis code
(A41.51), followed by the code for the localized infection
(N39.0). The sequencing is sepsis first, then the underlying
infection. This is a high-yield concept for the CCS exam. If the
provider documents severe sepsis, an additional code for severe
sepsis (R65.20 or R65.21) would be added, but R65.20 alone
would not capture the underlying infection. Sequencing correctly
is essential for DRG assignment and severity capture .
Question 4
A pregnant patient at 32 weeks gestation is admitted with
preeclampsia. The physician documents "preeclampsia." What is
the correct ICD-10-CM code?
A) O14.9 (Preeclampsia, unspecified)
B) O14.90 (Preeclampsia, unspecified, trimester unspecified)
C) O11.9 (Pre-existing hypertension with preeclampsia)
D) O15.9 (Eclampsia, unspecified)
