CCS exam practice
Chronic kidney disease stage 5 - ANSCode to N18.6 (ESRD) and dialysis status Z99.2
Severe sepsis - ANSUnderlying infection + R65.2
Septic shock - ANSUnderlying infection + R65.1
Nosocomial infections - ANSAdditional code of Y95
HIV infections - ANSCode only confirmed cases (diagnosis sufficient)
Sequencing HIV codes - ANSAdmitted for HIV- B20
A/D unrelated- unrelated first then B20
Asymptomatic HIV- Z21
Inconclusive HIV- R75
Previously diagnosed- B20
HIV in pregnancy- O98.7
Asymptomatic HIV in pregnancy- O98.7 + Z21
Encounters for testing of HIV- Z11.4
Return visit for negative test results- Z71.7
Labor pneumonia - ANSHas a unique category
Respiratory condition occurring in more than one place - ANSCoded to the lower anatomic
location
Respiratory condition - ANSCode exposure to tobacco
Gastrointestinal term hemmorrhage - ANSMeans ulcers
Gastrointestinal term bleeding - ANSMeans gastritis, duodenitis, diverticulosis, diverticulitis
Delivery and pregnancy - ANS5th or 6th digit represents trimester
Trimesters - ANS1- less than 14 wks
2- less than 28 wks, more than 14
3- 28 wks thru delivery
Delivery chart codes should include - ANSa) Delivery diagnosis code
b) Outcome of delivery
c)Weeks of gestation
, d) Procedure code
Normal delivery code - ANSO80
Weeks of gestation code - ANSZ3A
Complications of ectopic pregnancy and abortions - ANSRequire additional codes
Anemia - ANSCode also the cause
Code first the poisoning and under-dosing of medications
If associated with malignancy, code malignancy first
MI documented as nontransmural or subendocardial with a site provided - ANSCode as a
subenocardial MI
Subsequent MI within 4 weeks of initial - ANSCode from I22 and I21
Primary site of neoplasm - ANSIs where the cancer arises
Secondary neoplasm - ANSWhen cancer leaves the original site
Morphology can lead to primary site - ANSFor example: renal cell carcinoma arises in the
kidney
Steps for coding neoplasms - ANS1. Look up morphology
2. No primary site code- use neoplasm table
3. If the term metastatic is used assume these are secondary sites:
Bones, brain, diaphragm, heart, liver, lymph nodes, mediastinum, meninges, peritoneum,
pleura, retroperitoneum, spinal cord, and sites from C76
Injuries and burns - ANSUse code from ch. 20 to indicate cause of injury
Burns on different body parts - ANSUse only the degree of greatest severity along with the
additional codes for burns of other anatomic sites
Adverse effect of a drug - ANSAllergic reaction
Cumulative effect
Hypersensitivity
Idiosyncratic reaction
Paradoxical reaction
Synergistic
Poisoning - ANSAdministered, taken or prescribed incorrectly
Alcohol in conjunction with a drug
Chronic kidney disease stage 5 - ANSCode to N18.6 (ESRD) and dialysis status Z99.2
Severe sepsis - ANSUnderlying infection + R65.2
Septic shock - ANSUnderlying infection + R65.1
Nosocomial infections - ANSAdditional code of Y95
HIV infections - ANSCode only confirmed cases (diagnosis sufficient)
Sequencing HIV codes - ANSAdmitted for HIV- B20
A/D unrelated- unrelated first then B20
Asymptomatic HIV- Z21
Inconclusive HIV- R75
Previously diagnosed- B20
HIV in pregnancy- O98.7
Asymptomatic HIV in pregnancy- O98.7 + Z21
Encounters for testing of HIV- Z11.4
Return visit for negative test results- Z71.7
Labor pneumonia - ANSHas a unique category
Respiratory condition occurring in more than one place - ANSCoded to the lower anatomic
location
Respiratory condition - ANSCode exposure to tobacco
Gastrointestinal term hemmorrhage - ANSMeans ulcers
Gastrointestinal term bleeding - ANSMeans gastritis, duodenitis, diverticulosis, diverticulitis
Delivery and pregnancy - ANS5th or 6th digit represents trimester
Trimesters - ANS1- less than 14 wks
2- less than 28 wks, more than 14
3- 28 wks thru delivery
Delivery chart codes should include - ANSa) Delivery diagnosis code
b) Outcome of delivery
c)Weeks of gestation
, d) Procedure code
Normal delivery code - ANSO80
Weeks of gestation code - ANSZ3A
Complications of ectopic pregnancy and abortions - ANSRequire additional codes
Anemia - ANSCode also the cause
Code first the poisoning and under-dosing of medications
If associated with malignancy, code malignancy first
MI documented as nontransmural or subendocardial with a site provided - ANSCode as a
subenocardial MI
Subsequent MI within 4 weeks of initial - ANSCode from I22 and I21
Primary site of neoplasm - ANSIs where the cancer arises
Secondary neoplasm - ANSWhen cancer leaves the original site
Morphology can lead to primary site - ANSFor example: renal cell carcinoma arises in the
kidney
Steps for coding neoplasms - ANS1. Look up morphology
2. No primary site code- use neoplasm table
3. If the term metastatic is used assume these are secondary sites:
Bones, brain, diaphragm, heart, liver, lymph nodes, mediastinum, meninges, peritoneum,
pleura, retroperitoneum, spinal cord, and sites from C76
Injuries and burns - ANSUse code from ch. 20 to indicate cause of injury
Burns on different body parts - ANSUse only the degree of greatest severity along with the
additional codes for burns of other anatomic sites
Adverse effect of a drug - ANSAllergic reaction
Cumulative effect
Hypersensitivity
Idiosyncratic reaction
Paradoxical reaction
Synergistic
Poisoning - ANSAdministered, taken or prescribed incorrectly
Alcohol in conjunction with a drug
