CCS Exam prep Questions and Answers Latest Update
2023 (Verified Answers) (95 Questions)
This patient was admitted for chemotherapy due to a primary hepatocellular
carcinoma of the transplanted liver. What codes are assigned?
a. Z51.11, C22.0
b. Z51.11, C22.0, C80.2
c. Z51.11, T86.49, C80.2, C22.0
d. T86.49, C80.2, C22.0 - Correct answer: C
Code T86.49 should be assigned for complication of liver transplant along
with code C80.2 for malignancy associated with organ transplant. A
malignant neoplasm of a transplanted organ should be coded as a transplant
complication (CMS 2018a, Section I.C.2.r., 34).
A 7-year-old patient was admitted to the emergency department for
treatment of shortness of breath. The patient is given epinephrine and
nebulizer treatments. The shortness of breath and wheezing are unabated
following treatment. What diagnosis should be suspected?
a. Acute bronchitis
b. Acute bronchitis with chronic obstructive pulmonary disease
c. Asthma with status asthmaticus
d. Chronic obstructive asthma - Correct answer: C
"Status asthmaticus is an acute asthmatic attack in which the degree of
bronchial obstruction is not relieved by the usual treatment, such as by
epinephrine or aminophylline" (Schraffenberger and Palkie 2018, 346-347).
. A patient is admitted with a high temperature, lethargy, hypotension,
tachycardia, oliguria, and elevated WBC. The patient also has more than
Page 1 of 75
,CCS Exam prep Questions and Answers Latest Update
2023 (Verified Answers) (95 Questions)
100,000 organisms of Escherichia coli per cc of urine. The attending
physician documents "urosepsis." What is the next step for the coder?
a. Code sepsis as the principal with a secondary diagnosis of urinary tract
infection due to E. coli.
b. Code urinary tract infection with sepsis as a secondary diagnosis.
c. Query the physician to determine if the patient is being treated for sepsis,
highlighting the clinical signs and symptoms.
d. Ask the physician whether the patient had septic shock so that this may
be used as the principal diagnosis. - Correct answer: C
The term urosepsis is a nonspecific term. It has no default code in the
Alphabetic Index. Should providers use this term, they must be queried for
clarification (CMS 2018a, Section I.C.1.d., 22).
During a coronary artery bypass surgery, the patient underwent saphenous
bypass grafts; from the aorta to the left anterior descending branch of the
left main coronary artery, and the left posterior descending of the left main
coronary artery. The patient also underwent a repositioning of the
mammary artery to the right coronary artery. Choose the best description
for this procedure.
a. Three aortocoronary grafts
b. Two aortocoronary grafts and one mammary-coronary graft
c. Two aortocoronary grafts and two saphenous bypass grafts
d. Three aortocoronary grafts and one mammary-coronary graft - Correct
answer: B
It is rare for only one coronary artery to be bypassed, and it is also fairly
common to perform both an internal mammary-coronary artery bypass and
Page 2 of 75
,CCS Exam prep Questions and Answers Latest Update
2023 (Verified Answers) (95 Questions)
an aortocoronary bypass at the same operative episode (Schraffenberger
and Palkie 2018, 324-326).
According to CPT, an endoscopy that is undertaken to the level of the
midtransverse colon would be coded as a:
a. Proctosigmoidoscopy
b. Sigmoidoscopy
c. Colonoscopy
d. Proctoscopy - orrect Answer: C
A colonoscopy is an examination of the entire colon, from the rectum to the
cecum that may include the terminal ileum. In general, a colonoscopy
examines the colon to a level of 60 cm or higher (Smith 2018, 135-136).
Infusion of Herceptin, a monoclonal antibody used for treatment of breast
cancer in patients carrying a certain mutation of the HER2 gene, is classified
as:
a. Chemotherapy
b. Radiotherapy
c. Molecular Targets
d. Immunotherapy - Correct answer: C
Targeted cancer therapies are drugs or other substances that block the
growth and spread of cancer by interfering with specific molecules involved
in tumor growth and progression. Herceptin is a type of targeted cancer
therapy also referred to as a monoclonal antibody (National Cancer Institute
2018).
Page 3 of 75
, CCS Exam prep Questions and Answers Latest Update
2023 (Verified Answers) (95 Questions)
A patient has findings suggestive of chronic obstructive pulmonary disease
(COPD) on chest x-ray. The attending physician mentions the x-ray finding in
one progress note but no medication, treatment, or further evaluation is
provided. The coder should:
a. Query the attending physician regarding the x-ray finding
b. Code the condition because the documentation reflects it
c. Question the radiologist regarding whether to code this condition
d. Use a code from abnormal findings to reflect the condition - Correct
answer: A
Query the attending physician regarding the clinical significance of the
findings and request that appropriate documentation be provided. This is an
example of a circumstance where the chronic condition must be verified. All
secondary conditions must meet the UHDDS definitions; it is not clear if
COPD does (CMS 2018a, Section III, 105-106).
If a patient undergoes an inpatient procedure and the final summary
diagnosis is different from the diagnosis on the pathology report, the coder
should:
a. Code only from the discharge diagnoses
b. Code the diagnosis reflected on the pathology report
c. Code the most severe symptom
d. Query the attending physician as to the final diagnosis - Correct answer: D
Coding strictly from the pathology report is not appropriate as the coder is
assigning a diagnosis without the attending physician's corroboration. It is
therefore appropriate to query the physician (CMS 2018a, Section III, 105-
106).
Page 4 of 75
2023 (Verified Answers) (95 Questions)
This patient was admitted for chemotherapy due to a primary hepatocellular
carcinoma of the transplanted liver. What codes are assigned?
a. Z51.11, C22.0
b. Z51.11, C22.0, C80.2
c. Z51.11, T86.49, C80.2, C22.0
d. T86.49, C80.2, C22.0 - Correct answer: C
Code T86.49 should be assigned for complication of liver transplant along
with code C80.2 for malignancy associated with organ transplant. A
malignant neoplasm of a transplanted organ should be coded as a transplant
complication (CMS 2018a, Section I.C.2.r., 34).
A 7-year-old patient was admitted to the emergency department for
treatment of shortness of breath. The patient is given epinephrine and
nebulizer treatments. The shortness of breath and wheezing are unabated
following treatment. What diagnosis should be suspected?
a. Acute bronchitis
b. Acute bronchitis with chronic obstructive pulmonary disease
c. Asthma with status asthmaticus
d. Chronic obstructive asthma - Correct answer: C
"Status asthmaticus is an acute asthmatic attack in which the degree of
bronchial obstruction is not relieved by the usual treatment, such as by
epinephrine or aminophylline" (Schraffenberger and Palkie 2018, 346-347).
. A patient is admitted with a high temperature, lethargy, hypotension,
tachycardia, oliguria, and elevated WBC. The patient also has more than
Page 1 of 75
,CCS Exam prep Questions and Answers Latest Update
2023 (Verified Answers) (95 Questions)
100,000 organisms of Escherichia coli per cc of urine. The attending
physician documents "urosepsis." What is the next step for the coder?
a. Code sepsis as the principal with a secondary diagnosis of urinary tract
infection due to E. coli.
b. Code urinary tract infection with sepsis as a secondary diagnosis.
c. Query the physician to determine if the patient is being treated for sepsis,
highlighting the clinical signs and symptoms.
d. Ask the physician whether the patient had septic shock so that this may
be used as the principal diagnosis. - Correct answer: C
The term urosepsis is a nonspecific term. It has no default code in the
Alphabetic Index. Should providers use this term, they must be queried for
clarification (CMS 2018a, Section I.C.1.d., 22).
During a coronary artery bypass surgery, the patient underwent saphenous
bypass grafts; from the aorta to the left anterior descending branch of the
left main coronary artery, and the left posterior descending of the left main
coronary artery. The patient also underwent a repositioning of the
mammary artery to the right coronary artery. Choose the best description
for this procedure.
a. Three aortocoronary grafts
b. Two aortocoronary grafts and one mammary-coronary graft
c. Two aortocoronary grafts and two saphenous bypass grafts
d. Three aortocoronary grafts and one mammary-coronary graft - Correct
answer: B
It is rare for only one coronary artery to be bypassed, and it is also fairly
common to perform both an internal mammary-coronary artery bypass and
Page 2 of 75
,CCS Exam prep Questions and Answers Latest Update
2023 (Verified Answers) (95 Questions)
an aortocoronary bypass at the same operative episode (Schraffenberger
and Palkie 2018, 324-326).
According to CPT, an endoscopy that is undertaken to the level of the
midtransverse colon would be coded as a:
a. Proctosigmoidoscopy
b. Sigmoidoscopy
c. Colonoscopy
d. Proctoscopy - orrect Answer: C
A colonoscopy is an examination of the entire colon, from the rectum to the
cecum that may include the terminal ileum. In general, a colonoscopy
examines the colon to a level of 60 cm or higher (Smith 2018, 135-136).
Infusion of Herceptin, a monoclonal antibody used for treatment of breast
cancer in patients carrying a certain mutation of the HER2 gene, is classified
as:
a. Chemotherapy
b. Radiotherapy
c. Molecular Targets
d. Immunotherapy - Correct answer: C
Targeted cancer therapies are drugs or other substances that block the
growth and spread of cancer by interfering with specific molecules involved
in tumor growth and progression. Herceptin is a type of targeted cancer
therapy also referred to as a monoclonal antibody (National Cancer Institute
2018).
Page 3 of 75
, CCS Exam prep Questions and Answers Latest Update
2023 (Verified Answers) (95 Questions)
A patient has findings suggestive of chronic obstructive pulmonary disease
(COPD) on chest x-ray. The attending physician mentions the x-ray finding in
one progress note but no medication, treatment, or further evaluation is
provided. The coder should:
a. Query the attending physician regarding the x-ray finding
b. Code the condition because the documentation reflects it
c. Question the radiologist regarding whether to code this condition
d. Use a code from abnormal findings to reflect the condition - Correct
answer: A
Query the attending physician regarding the clinical significance of the
findings and request that appropriate documentation be provided. This is an
example of a circumstance where the chronic condition must be verified. All
secondary conditions must meet the UHDDS definitions; it is not clear if
COPD does (CMS 2018a, Section III, 105-106).
If a patient undergoes an inpatient procedure and the final summary
diagnosis is different from the diagnosis on the pathology report, the coder
should:
a. Code only from the discharge diagnoses
b. Code the diagnosis reflected on the pathology report
c. Code the most severe symptom
d. Query the attending physician as to the final diagnosis - Correct answer: D
Coding strictly from the pathology report is not appropriate as the coder is
assigning a diagnosis without the attending physician's corroboration. It is
therefore appropriate to query the physician (CMS 2018a, Section III, 105-
106).
Page 4 of 75
