CCS EXAM PREP QUESTIONS AND
CORRECT ANSWERS
Principal diagnosis is an initial episode of an anterior wall MI, so which procedure would increase
DRG: ventilator, central venous catheter insertion, right heart cardiac cath, or transbronchial lung
biopsy? ✅✅ANSW-Transbronchial lung biopsy carries a DRG of 282, weight 00.7736, and the MI
alone carries a DRG of 264, weight 02.6674
Modifier -50 is only used when? ✅✅ANSW-When it pertains to paired organs only
According to UHDDS, what is the definition of a secondary diagnosis? ✅✅ANSW-Received clinical
evaluation, therapeutic treatment, further evaluation, extends the LOS, increases nursing monitoring
and care
When case reads "This patient is seen today to insert an intrathecal pump for pain management due
to...carcinoma...", then: ✅✅ANSW-PD is neoplasm related pain (acute) (chronic)
Definition of intrathecal? ✅✅ANSW-occurring within or administered into the spinal theca;
"intrathecal injection"
Metastatic means: ✅✅ANSW-the cancer traveled FROM initial area TO another; if the cancer is
being described as "metastatic", then it is the secondary cancer due to spreading from primary site
Metastasis means: ✅✅ANSW-the development of secondary malignant growths at a distance
from a primary site of cancer
What is a cutaneous abscess? ✅✅ANSW-a localized collection of pus in the skin and may occur
on any skin surface; symptoms and signs are pain and a tender and firm or fluctuant swelling;
diagnosis is usually obvious by examination; treatment is incision and drainage
When case reads "...sustained blisters on the bottoms of her feet...proceeded to become infected..."
then: ✅✅ANSW-Code cutaneous abscess first, L02.XXX, then ulcer second, L97.XXX in addition to
whatever else needs coding
,What is cellulitis? ✅✅ANSW-an infection within the skin and the area just beneath it; the skin is
red and tender.
What are APC status indicators for payment? ✅✅ANSW-G, H, K,P, R, S, T, U, X, AND V
What does APC status indicator N mean? ✅✅ANSW-That there is no specific payment for that
APC because the procedure payment is included in another APC
Patient undergoes colonoscopy with endometrial biopsy, so how is this coded? ✅✅ANSW-Two
codes would be used since the endometrial biopsy is an add-on code with specific directions in CPT
to use this code in conjunction with the colonoscopy code.
Who publishes CPT? ✅✅ANSW-AMA, American Medical Association
When was CPT initially developed and for what reason? ✅✅ANSW-Developed in 1966 it was
designed to meet the reporting and communication needs of Physicians
When was CPT adopted for application to the Medicare reimbursement system? ✅✅ANSW-1983
and since that time CPT has been widely used as the standard for outpatient and Ambulatory Care
procedural coding and reimbursement
When is the new edition of the CPT published? ✅✅ANSW-Annually
How often are Category II codes implemented and released? ✅✅ANSW-As needed throughout
the year; these updates can be obtained by accessing the AMA website and entering the term
"category II codes" into the site's search engine
How often are category III codes updated? ✅✅ANSW-Semi-annually on January 1st and July 1st
via the AMA's CPT website
What are the two levels of codes in hcpcs? ✅✅ANSW-Level 1 which is based on the current
edition of CPT and level 2 which is made up of the national codes that represent the medical supplies
/ services not included in CPT
,How often are hcpcs Level II codes updated? ✅✅ANSW-Annually for use by January 1
Database utilize data models and data dictionaries which are both defined how? ✅✅ANSW-Data
models provides the conceptual and graphical framework that define the entity and its attributes,
and data dictionaries provides details on each data element.
What are parts of the coding compliance plan? ✅✅ANSW-*Regular internal audits
*Audits performed by objective external reviewers
*Sharing and discussing results with coding staff
What is not a part of the coding compliance plan? ✅✅ANSW-Coding audits performed by payers
45 yo female with chronic ulcerative enterocolitis and steroid induced osteoporosis due to long-term
steroid use is coded how? ✅✅ANSW-K51.00 - Ulcerative pancolitis without complications
M81.8 - other osteoporosis without current pathological fracture
T38.0X5A - Adverse effects of glucocorticoids and synthetic analogues, initial encounter
Z79.52 - Long term (current) use of systemic steroids
What are the parts of an information system? ✅✅ANSW-*Data
*People
*Processes
*Hardware
*Software
*Communications technology
What are names of drugs used for the management of Parkinson's disease? ✅✅ANSW-*Sinemet
*Sinemet CR
*Parcopa
*Carbidopa-levodopa
75 yo woman with history of severe Parkinson's disease due to dehydration and severe diarrhea.
Earlier this year, she was found to have esophageal reflux by upper GI series and CHF. She
, accidentally took 2 does of Sinemet each day. She is admitted for rehydration and for evaluation and
treatment of diarrhea. Her CHF, hypertension, and stage V CKD are stable. What is coded? (page 229
in CCS Exam Prep book) ✅✅ANSW-T42.8X1A - Poisoning by antiparkinsonism drugs and other
central muscle-tone depressants, accidental (unintentional), initial encounter
E86.0 - Dehydration
R19.7 - Diarrhea, unspecified
G20 - Parkinson's disease
K21.9 - Gastro-esphageal reflux disease without esophagitis
I12.0 - Hypertensive CKD with state 5 CKD or ESRD
I50.9 - Heart failure, unspecified
N18.5 - CKD, stage 5
62 yo man with progressive painful blurring of vision due to aphakic bullous keratopathy with
moderate stage glaucoma in left eye. He has undergone previous Molteno implant with poor vision
and pain due to ruptured bulla. Pt is admitted for transplant, vitrectomy and lens implantation at
this time. He has angina, COPD, and underwent prostatectomy 6 years ago for prostatic carcinoma.
What is coded? (page 141 CCS Exam prep book) ✅✅ANSW-H18.12 - Bullous keratopathy, left eye
H27.02 - Aphakia, left
H40.10X2 - Unspecified open-angle glaucoma, moderate stage
H20.13 - Chronic iridocyclitis, bilateral
I20.9 - Angina
J44.9 - COPD, unspecified
65750-LT - Keraoplasty, corneal transplant); penetrating (in aphakia)
66985-LT - Insertion of intraocular lens prosthesis (secondary implant), not associated with
concurrent cataract removal
67010-LT - Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal
removal with mechanical vitrectomy
Name the pacemaker devices that each have a unique ICD-10-PCS code: ✅✅ANSW-Single
chamber rate responsive, (insert code here)
Dual chamber, (insert code here)
When coding a documented ventilator associated pneumonia, VAP, what codes should be assigned?
✅✅ANSW-The specific code for ventilator associated pneumonia is coded first, and the organism
code, if known, is coded as secondary
CORRECT ANSWERS
Principal diagnosis is an initial episode of an anterior wall MI, so which procedure would increase
DRG: ventilator, central venous catheter insertion, right heart cardiac cath, or transbronchial lung
biopsy? ✅✅ANSW-Transbronchial lung biopsy carries a DRG of 282, weight 00.7736, and the MI
alone carries a DRG of 264, weight 02.6674
Modifier -50 is only used when? ✅✅ANSW-When it pertains to paired organs only
According to UHDDS, what is the definition of a secondary diagnosis? ✅✅ANSW-Received clinical
evaluation, therapeutic treatment, further evaluation, extends the LOS, increases nursing monitoring
and care
When case reads "This patient is seen today to insert an intrathecal pump for pain management due
to...carcinoma...", then: ✅✅ANSW-PD is neoplasm related pain (acute) (chronic)
Definition of intrathecal? ✅✅ANSW-occurring within or administered into the spinal theca;
"intrathecal injection"
Metastatic means: ✅✅ANSW-the cancer traveled FROM initial area TO another; if the cancer is
being described as "metastatic", then it is the secondary cancer due to spreading from primary site
Metastasis means: ✅✅ANSW-the development of secondary malignant growths at a distance
from a primary site of cancer
What is a cutaneous abscess? ✅✅ANSW-a localized collection of pus in the skin and may occur
on any skin surface; symptoms and signs are pain and a tender and firm or fluctuant swelling;
diagnosis is usually obvious by examination; treatment is incision and drainage
When case reads "...sustained blisters on the bottoms of her feet...proceeded to become infected..."
then: ✅✅ANSW-Code cutaneous abscess first, L02.XXX, then ulcer second, L97.XXX in addition to
whatever else needs coding
,What is cellulitis? ✅✅ANSW-an infection within the skin and the area just beneath it; the skin is
red and tender.
What are APC status indicators for payment? ✅✅ANSW-G, H, K,P, R, S, T, U, X, AND V
What does APC status indicator N mean? ✅✅ANSW-That there is no specific payment for that
APC because the procedure payment is included in another APC
Patient undergoes colonoscopy with endometrial biopsy, so how is this coded? ✅✅ANSW-Two
codes would be used since the endometrial biopsy is an add-on code with specific directions in CPT
to use this code in conjunction with the colonoscopy code.
Who publishes CPT? ✅✅ANSW-AMA, American Medical Association
When was CPT initially developed and for what reason? ✅✅ANSW-Developed in 1966 it was
designed to meet the reporting and communication needs of Physicians
When was CPT adopted for application to the Medicare reimbursement system? ✅✅ANSW-1983
and since that time CPT has been widely used as the standard for outpatient and Ambulatory Care
procedural coding and reimbursement
When is the new edition of the CPT published? ✅✅ANSW-Annually
How often are Category II codes implemented and released? ✅✅ANSW-As needed throughout
the year; these updates can be obtained by accessing the AMA website and entering the term
"category II codes" into the site's search engine
How often are category III codes updated? ✅✅ANSW-Semi-annually on January 1st and July 1st
via the AMA's CPT website
What are the two levels of codes in hcpcs? ✅✅ANSW-Level 1 which is based on the current
edition of CPT and level 2 which is made up of the national codes that represent the medical supplies
/ services not included in CPT
,How often are hcpcs Level II codes updated? ✅✅ANSW-Annually for use by January 1
Database utilize data models and data dictionaries which are both defined how? ✅✅ANSW-Data
models provides the conceptual and graphical framework that define the entity and its attributes,
and data dictionaries provides details on each data element.
What are parts of the coding compliance plan? ✅✅ANSW-*Regular internal audits
*Audits performed by objective external reviewers
*Sharing and discussing results with coding staff
What is not a part of the coding compliance plan? ✅✅ANSW-Coding audits performed by payers
45 yo female with chronic ulcerative enterocolitis and steroid induced osteoporosis due to long-term
steroid use is coded how? ✅✅ANSW-K51.00 - Ulcerative pancolitis without complications
M81.8 - other osteoporosis without current pathological fracture
T38.0X5A - Adverse effects of glucocorticoids and synthetic analogues, initial encounter
Z79.52 - Long term (current) use of systemic steroids
What are the parts of an information system? ✅✅ANSW-*Data
*People
*Processes
*Hardware
*Software
*Communications technology
What are names of drugs used for the management of Parkinson's disease? ✅✅ANSW-*Sinemet
*Sinemet CR
*Parcopa
*Carbidopa-levodopa
75 yo woman with history of severe Parkinson's disease due to dehydration and severe diarrhea.
Earlier this year, she was found to have esophageal reflux by upper GI series and CHF. She
, accidentally took 2 does of Sinemet each day. She is admitted for rehydration and for evaluation and
treatment of diarrhea. Her CHF, hypertension, and stage V CKD are stable. What is coded? (page 229
in CCS Exam Prep book) ✅✅ANSW-T42.8X1A - Poisoning by antiparkinsonism drugs and other
central muscle-tone depressants, accidental (unintentional), initial encounter
E86.0 - Dehydration
R19.7 - Diarrhea, unspecified
G20 - Parkinson's disease
K21.9 - Gastro-esphageal reflux disease without esophagitis
I12.0 - Hypertensive CKD with state 5 CKD or ESRD
I50.9 - Heart failure, unspecified
N18.5 - CKD, stage 5
62 yo man with progressive painful blurring of vision due to aphakic bullous keratopathy with
moderate stage glaucoma in left eye. He has undergone previous Molteno implant with poor vision
and pain due to ruptured bulla. Pt is admitted for transplant, vitrectomy and lens implantation at
this time. He has angina, COPD, and underwent prostatectomy 6 years ago for prostatic carcinoma.
What is coded? (page 141 CCS Exam prep book) ✅✅ANSW-H18.12 - Bullous keratopathy, left eye
H27.02 - Aphakia, left
H40.10X2 - Unspecified open-angle glaucoma, moderate stage
H20.13 - Chronic iridocyclitis, bilateral
I20.9 - Angina
J44.9 - COPD, unspecified
65750-LT - Keraoplasty, corneal transplant); penetrating (in aphakia)
66985-LT - Insertion of intraocular lens prosthesis (secondary implant), not associated with
concurrent cataract removal
67010-LT - Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal
removal with mechanical vitrectomy
Name the pacemaker devices that each have a unique ICD-10-PCS code: ✅✅ANSW-Single
chamber rate responsive, (insert code here)
Dual chamber, (insert code here)
When coding a documented ventilator associated pneumonia, VAP, what codes should be assigned?
✅✅ANSW-The specific code for ventilator associated pneumonia is coded first, and the organism
code, if known, is coded as secondary
