Certified Coding Specialist (CCS) Exam
Quiz_________________?
.In order to accurately code a cardiac catheterization, what needs to be determined based
on a review of the documentation?
a. The approach and the side of the heart (chambers) into which the catheter was inserted
b. The approach, the side of the heart (chambers) into which the catheter was inserted, as
well as any additional procedures performed
c. The duration of the procedure
d. If there is documentation of the procedure in the medical record that stents are
considered -
Answer✅
b. The approach, the side of the heart (chambers) into which the catheter was inserted, as
well as any additional procedures performed
Quiz_________________?
(OPPS)
outpatient prospective payment system -
Answer✅
outpatient prospective payment system (OPPS).
Quiz_________________?
1. Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for each lobe of
each lung.
1
, 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial lung biopsy(s), single lobe
31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)
31632 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial lung biopsy(s), each additional lobe
−50 Bilateral procedure
a. 31628
b. 31628-50
c. 31628, 31632
d. 31629 -
Answer✅
c. 31628, 31632
31628: Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial lung biopsy(s), single lobe
31632: Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial lung biopsy(s), each additional lobe
In contrast to question 28, the code description for the transbronchial biopsy includes the
specification that the biopsy is in a single lobe. An additional CPT code is needed (as
opposed to a modifier) to denote the bilateral aspect of the biopsy. CPT code 31632 is an
"add-on" code, which means it is coded in addition to the primary procedure code (CPT
Assistant 2005; May 2008, 15; Feb. 2010, 6; April 2010, 5; AMA CPT Professional Edition
2017, 181).
Quiz_________________?
A 12-year-old boy was seen in an ambulatory surgical center for pain in his right arm. The x-
ray showed fracture of ulna. Patient underwent closed reduction of fracture right proximal
ulna. What diagnostic and procedure codes should be assigned?
2
, S52.101A Unspecified fracture of upper end of right radius, initial encounter for closed
fracture
S52.101B Unspecified fracture of upper end of right radius, initial encounter for open
fracture
S52.001A Unspecified fracture of upper end of right ulna, initial encounter for closed
fracture
S52.001B Unspecified fracture of upper end of right ulna, initial encounter for open fracture
0PSH0ZZ Reposition right radius, open approach
0PSK0ZZ Reposition right ulna, open approach
24670 Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid
process(es) ); without manipulation
24675 Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process
-
Answer✅
d. S52.001A, 24675
S52.001A: Unspecified fracture of upper end of right ulna, initial encounter for closed
fracture.
24675: Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid
process(es) ); with manipulation
**The patient has a fracture of the right proximal ulna and closed reduction is necessary. In
the ICD-10-CM codebook, under Fracture, ulna, proximal, the coder is referred to
Fracture, ulna, upper end. The term "manipulation" is used to indicate reduction in CPT
(AMA CPT Professional Edition 2017, 104). [Note: Since this is an ambulatory surgery
center case, CPT codes are assigned, rather than ICD-10-PCS codes.]
Quiz_________________?
A 35-year-old woman has hypertension with acute renal failure and stage 3 chronic kidney
disease. What code would be assigned?
a. N17.9, Acute kidney failure, unspecified
3
, b. I13.2, Hypertensive heart and chronic kidney disease with heart failure and with stage 5
chronic kidney disease, or end stage renal disease
c. I50.9, Heart failure, unspecified
d. N17.9, Acute kidney failure, unspecified and I12.9, Hypertensive chronic kidney disease
with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
and N18.3, Chronic kidney disease, stage 3 (moderate) -
Answer✅
d. N17.9, Acute kidney failure, unspecified and I12.9, Hypertensive chronic kidney disease
with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
and N18.3, Chronic kidney disease, stage 3 (moderate)
**Code the hypertension with stage 3 chronic kidney disease. In this case, both
hypertension and chronic kidney disease are documented and a combination code is used.
Also the code for the stage 3 chronic kidney disease must be assigned due to the "code
also" note. The acute renal failure is identified with a separate code (HHS 2017, Section
I.C.9.a., 40; HHS 2017, Section I.C.14.a., 53).
Quiz_________________?
A 45-year-old female with chronic ulcerative enterocolitis and steroid induced osteoporosis
due to long-term steroid therapy. What codes should be assigned?
K50.00 Crohn's disease of small intestine without complications
K51.00 Ulcerative pancolitis without complications
M81.0 Age-related osteoporosis without current pathological fracture
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
Z79.899 Other long term (current) drug therapy
a. K51.00, M81.8, T38.0X5A, Z79.52
b. K50.00, M81.0, T38.0X5A, Z79.52
c. K51.00, M81.0, T38.0X5A, Z79.899
4
Quiz_________________?
.In order to accurately code a cardiac catheterization, what needs to be determined based
on a review of the documentation?
a. The approach and the side of the heart (chambers) into which the catheter was inserted
b. The approach, the side of the heart (chambers) into which the catheter was inserted, as
well as any additional procedures performed
c. The duration of the procedure
d. If there is documentation of the procedure in the medical record that stents are
considered -
Answer✅
b. The approach, the side of the heart (chambers) into which the catheter was inserted, as
well as any additional procedures performed
Quiz_________________?
(OPPS)
outpatient prospective payment system -
Answer✅
outpatient prospective payment system (OPPS).
Quiz_________________?
1. Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for each lobe of
each lung.
1
, 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial lung biopsy(s), single lobe
31629 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)
31632 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial lung biopsy(s), each additional lobe
−50 Bilateral procedure
a. 31628
b. 31628-50
c. 31628, 31632
d. 31629 -
Answer✅
c. 31628, 31632
31628: Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial lung biopsy(s), single lobe
31632: Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed;
with transbronchial lung biopsy(s), each additional lobe
In contrast to question 28, the code description for the transbronchial biopsy includes the
specification that the biopsy is in a single lobe. An additional CPT code is needed (as
opposed to a modifier) to denote the bilateral aspect of the biopsy. CPT code 31632 is an
"add-on" code, which means it is coded in addition to the primary procedure code (CPT
Assistant 2005; May 2008, 15; Feb. 2010, 6; April 2010, 5; AMA CPT Professional Edition
2017, 181).
Quiz_________________?
A 12-year-old boy was seen in an ambulatory surgical center for pain in his right arm. The x-
ray showed fracture of ulna. Patient underwent closed reduction of fracture right proximal
ulna. What diagnostic and procedure codes should be assigned?
2
, S52.101A Unspecified fracture of upper end of right radius, initial encounter for closed
fracture
S52.101B Unspecified fracture of upper end of right radius, initial encounter for open
fracture
S52.001A Unspecified fracture of upper end of right ulna, initial encounter for closed
fracture
S52.001B Unspecified fracture of upper end of right ulna, initial encounter for open fracture
0PSH0ZZ Reposition right radius, open approach
0PSK0ZZ Reposition right ulna, open approach
24670 Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid
process(es) ); without manipulation
24675 Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process
-
Answer✅
d. S52.001A, 24675
S52.001A: Unspecified fracture of upper end of right ulna, initial encounter for closed
fracture.
24675: Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid
process(es) ); with manipulation
**The patient has a fracture of the right proximal ulna and closed reduction is necessary. In
the ICD-10-CM codebook, under Fracture, ulna, proximal, the coder is referred to
Fracture, ulna, upper end. The term "manipulation" is used to indicate reduction in CPT
(AMA CPT Professional Edition 2017, 104). [Note: Since this is an ambulatory surgery
center case, CPT codes are assigned, rather than ICD-10-PCS codes.]
Quiz_________________?
A 35-year-old woman has hypertension with acute renal failure and stage 3 chronic kidney
disease. What code would be assigned?
a. N17.9, Acute kidney failure, unspecified
3
, b. I13.2, Hypertensive heart and chronic kidney disease with heart failure and with stage 5
chronic kidney disease, or end stage renal disease
c. I50.9, Heart failure, unspecified
d. N17.9, Acute kidney failure, unspecified and I12.9, Hypertensive chronic kidney disease
with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
and N18.3, Chronic kidney disease, stage 3 (moderate) -
Answer✅
d. N17.9, Acute kidney failure, unspecified and I12.9, Hypertensive chronic kidney disease
with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
and N18.3, Chronic kidney disease, stage 3 (moderate)
**Code the hypertension with stage 3 chronic kidney disease. In this case, both
hypertension and chronic kidney disease are documented and a combination code is used.
Also the code for the stage 3 chronic kidney disease must be assigned due to the "code
also" note. The acute renal failure is identified with a separate code (HHS 2017, Section
I.C.9.a., 40; HHS 2017, Section I.C.14.a., 53).
Quiz_________________?
A 45-year-old female with chronic ulcerative enterocolitis and steroid induced osteoporosis
due to long-term steroid therapy. What codes should be assigned?
K50.00 Crohn's disease of small intestine without complications
K51.00 Ulcerative pancolitis without complications
M81.0 Age-related osteoporosis without current pathological fracture
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
Z79.899 Other long term (current) drug therapy
a. K51.00, M81.8, T38.0X5A, Z79.52
b. K50.00, M81.0, T38.0X5A, Z79.52
c. K51.00, M81.0, T38.0X5A, Z79.899
4
