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CCDS Practice EXAM STUDY GUIDE WITH COMPLETE
250 QUESTIONS AND RATIONALISED SOLUTIONS
LATEST UPDATE JUST RELEASED THIS YEAR
Question: A patient is admitted with pneumonia, stage 1 chronic renal failure, chronic anemia,
and COPD. While hospitalized, the patient received IV abx, inhalers, O2, IVFs at 50ml/hr., and
iron tablets. Which conditions should be coded?
A. PNA only
B. PNA and COPD only
C. PNA, COPD, anemia
D. PNA, CKD stage 1, anemia, COPD - CORRECT ANSWER✔✔D. PNA, CKD stage 1, anemia, COPD
Rationale: Documentation and clinical indicators support that the documented acute condition
is PNA, which is being treated with abx, inhalers, and O2. CKD stage 1, COPD and anemia are
chronic conditions that are documented and may influence treatment of PNA, but they would
not be the Pdx. See Official Guidelines for Coding and Reporting, Section II.
Question: Which of the following is an example of a CMS-monitored hospital-acquired
condition (HAC)?
A. IV infiltration
B. Fat embolism
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C. PNA
D. Fractured ulna - CORRECT ANSWER✔✔D. Fractured ulna
Rationale: Per CMS, fractured ulna is the only CMS-monitored HAC on the most recent list.
ICD-10 HAC List | CMS
Question: A patient is admitted from the ED with a diagnosis of weakness and anemia. After
further treatment with PRBCs, GI consult and endoscopy, the physician includes the following
diagnoses in the d/c summary: anemia, suspected bleeding gastric ulcer, and GERD. What is the
post appropriate Pdx?
A. Bleeding Gastric Ulcer
B. Anemia
C. GERD
D. Weakness - CORRECT ANSWER✔✔A. Bleeding gastric ulcer
Rationale: Although anemia is treated with PRBC, the anemia is d/t the ulcer. GERD is ancillary
to the ulcer and not the cause of symptoms. Weakness if a symptom likely d/t the blood loss.
*Official Guidelines for Coding and Reporting, Section I.A.15, and Coding clinic, Third Quarter
2017, p. 27
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Question: A patient is admitted with new-onset seizures. Head CT reveals a mass in the
occipital region. The physician documents possible brain tumor, and the patient is transferred to
another hospital for further workup. What is the most appropriate diagnosis?
A. Seizure
B. Neoplasm of occipital region
C. Head mass
D. Head tumor - CORRECT ANSWER✔✔B. Neoplasm of occipital region
Rationale: Per the Official Guidelines for Coding and Reporting Section II.H Uncertain Diagnoses,
the seizure is a symptom of the possible brain tumor. Head mass and head tumor are not as
specific as neoplasm of occipital region.
Question: A hospital's base rate, or blended rate, is:
1. Calculated annually
2. Dependent on indirect costs for graduate medical education and new technology
3. Adjusted based on number of low-income patients
4. Adjusted based on capital profits
A. 1 & 2
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B. 2 & 3
C. 1, 2, & 3
D. 1, 2, 3, and 4 - CORRECT ANSWER✔✔C. 1, 2, & 3
Rationale: According to CMS, base rates are calculated annually and include adjustments for
operating expenses and capital expenses, including graduate medical education and care for the
indigent.
Question: The final MS-DRG assigned to a patient's medical record should:
A. Reflect the amount of time the physician spent with the patient
B. Depend on the patient's length of stay
C. Be assigned by the physician
D. Reflect the patient's severity of illness (SOI) and the resources used in the patient's care -
CORRECT ANSWER✔✔D. Reflect the patient's severity of illness (SOI) and the resources used in
the patient's care.
Rationale: Per CMS, based on documentation of conditions being monitored and treated during
the inpatient admission, coding professionals translate the documentation into ICD-19-CM/PCS
codes that group to the final MS-DRG regardless of the patient's length of stay or the amount of
time a provider spend providing care. The final MS-DRG is assigned after discharge.
CCDS Practice EXAM STUDY GUIDE WITH COMPLETE
250 QUESTIONS AND RATIONALISED SOLUTIONS
LATEST UPDATE JUST RELEASED THIS YEAR
Question: A patient is admitted with pneumonia, stage 1 chronic renal failure, chronic anemia,
and COPD. While hospitalized, the patient received IV abx, inhalers, O2, IVFs at 50ml/hr., and
iron tablets. Which conditions should be coded?
A. PNA only
B. PNA and COPD only
C. PNA, COPD, anemia
D. PNA, CKD stage 1, anemia, COPD - CORRECT ANSWER✔✔D. PNA, CKD stage 1, anemia, COPD
Rationale: Documentation and clinical indicators support that the documented acute condition
is PNA, which is being treated with abx, inhalers, and O2. CKD stage 1, COPD and anemia are
chronic conditions that are documented and may influence treatment of PNA, but they would
not be the Pdx. See Official Guidelines for Coding and Reporting, Section II.
Question: Which of the following is an example of a CMS-monitored hospital-acquired
condition (HAC)?
A. IV infiltration
B. Fat embolism
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C. PNA
D. Fractured ulna - CORRECT ANSWER✔✔D. Fractured ulna
Rationale: Per CMS, fractured ulna is the only CMS-monitored HAC on the most recent list.
ICD-10 HAC List | CMS
Question: A patient is admitted from the ED with a diagnosis of weakness and anemia. After
further treatment with PRBCs, GI consult and endoscopy, the physician includes the following
diagnoses in the d/c summary: anemia, suspected bleeding gastric ulcer, and GERD. What is the
post appropriate Pdx?
A. Bleeding Gastric Ulcer
B. Anemia
C. GERD
D. Weakness - CORRECT ANSWER✔✔A. Bleeding gastric ulcer
Rationale: Although anemia is treated with PRBC, the anemia is d/t the ulcer. GERD is ancillary
to the ulcer and not the cause of symptoms. Weakness if a symptom likely d/t the blood loss.
*Official Guidelines for Coding and Reporting, Section I.A.15, and Coding clinic, Third Quarter
2017, p. 27
, Page 3 of 59
Question: A patient is admitted with new-onset seizures. Head CT reveals a mass in the
occipital region. The physician documents possible brain tumor, and the patient is transferred to
another hospital for further workup. What is the most appropriate diagnosis?
A. Seizure
B. Neoplasm of occipital region
C. Head mass
D. Head tumor - CORRECT ANSWER✔✔B. Neoplasm of occipital region
Rationale: Per the Official Guidelines for Coding and Reporting Section II.H Uncertain Diagnoses,
the seizure is a symptom of the possible brain tumor. Head mass and head tumor are not as
specific as neoplasm of occipital region.
Question: A hospital's base rate, or blended rate, is:
1. Calculated annually
2. Dependent on indirect costs for graduate medical education and new technology
3. Adjusted based on number of low-income patients
4. Adjusted based on capital profits
A. 1 & 2
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B. 2 & 3
C. 1, 2, & 3
D. 1, 2, 3, and 4 - CORRECT ANSWER✔✔C. 1, 2, & 3
Rationale: According to CMS, base rates are calculated annually and include adjustments for
operating expenses and capital expenses, including graduate medical education and care for the
indigent.
Question: The final MS-DRG assigned to a patient's medical record should:
A. Reflect the amount of time the physician spent with the patient
B. Depend on the patient's length of stay
C. Be assigned by the physician
D. Reflect the patient's severity of illness (SOI) and the resources used in the patient's care -
CORRECT ANSWER✔✔D. Reflect the patient's severity of illness (SOI) and the resources used in
the patient's care.
Rationale: Per CMS, based on documentation of conditions being monitored and treated during
the inpatient admission, coding professionals translate the documentation into ICD-19-CM/PCS
codes that group to the final MS-DRG regardless of the patient's length of stay or the amount of
time a provider spend providing care. The final MS-DRG is assigned after discharge.
