Certified Coding Specialist (CCS) Exam Prep -
Questions With Actual Solutions
Diagnostic-related groups (DRGs) and ambulatory patient classifications
(APCs) are similar in that they are both:
a. Determined by HCPCS codes
b. Focused on hospital outpatients
c. Focused on hospital inpatients
d. Prospective payment systems Correct Answer - d. Prospective
payment systems
** Both are types of prospective payment systems (Casto and Forrestal 2015,
6).
A patient is treated for esophageal varices with hemorrhage due to cirrhosis.
The diagnostic codes that would be assigned are:
I85.01 Esophageal varices with bleeding
I85.11 Secondary esophageal varices with bleeding
K74.60 Unspecified cirrhosis of liver Correct Answer - d. K74.60, I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
**The patient has cirrhosis of the liver with resulting bleeding esophageal
varices. Cirrhosis of liver is sequenced first followed by the code for the
bleeding esophageal varices (HHS 2017, Section I.A.13, 11).
Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for
each lobe of each lung.
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 Correct Answer -
Assign the code(s) for endoscopic sinusotomy with bilateral anterior
ethmoidectomy.
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate
procedure)
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial
(anterior)
−50 Bilateral procedurea.
a. 31254
b. 31254-50
c. 31254, 31254
d. 31231 Correct Answer - b. 31254-50
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial
(anterior)
−50 Bilateral procedurea.
** A code for the anterior ethmoidectomy is assigned and to denote the
bilateral procedure, a modifier of -50 is added (CPT Assistant Winter 1993,
23; Jan. 1997, 4; Sept. 1997, 10; Oct. 1997, 5; Dec. 2001, 6; May 2003, 5). The
sinusotomy is not coded separately, as it is a diagnostic procedure.
The most common language used for both data definition language and data
manipulation language is:
a. Unified modeling language
b. JAVA
c. Perl
d. Structured query language Correct Answer - d. Structured query
language
** Structured query language (SQL) is used commonly for data language and
data definitions (Sharp 2016, 184).
,An ethmoidectomy removes infected tissue and bone in the ethmoid sinuses
that blocks natural drainage. The surgeon views your ethmoid sinuses with an
endoscope, a thin flexible tube with a very small camera and light at the end of
it. Correct Answer -
Documentation from the nursing or other allied health professionals' notes
can be used to establish which of the following diagnoses:
a. Body mass index (BMI)
b. Malnutrition
c. Aspiration pneumonia
d. Fatigue Correct Answer - a. Body mass index (BMI)
** The physician must establish the diagnosis—obesity or morbid obesity—
and the additional information can be pulled from ancillary documentation to
establish the correct code assignment for body mass index (BMI) (Leon-
Chisen 2017, 168).
A 55-year-old patient has hypertensive heart disease with congestive heart
failure. What code would be assigned?
a. I15.8, Other secondary hypertension
b. I11.0, Hypertensive heart disease with heart failure and I50.9, Heart failure,
unspecified
c. I50.9, Heart failure, unspecified and I15.0, Renovascular hypertension
d. N18.6, End stage renal disease Correct Answer - b. I11.0,
Hypertensive heart disease with heart failure and I50.9, Heart failure,
unspecified
** There is a cause and effect relationship established between the
hypertension and the congestive heart failure. A separate code for the
congestive heart failure is assigned based on the "code also" note (HHS 2017,
Section I.C.9.a., 40).
A surgeon would like to undertake a research study on his patients with stage
II malignant melanoma of the back, who have undergone wide excision of the
melanoma. What work processes and associated software could be used to
provide this information?
, a. Obtain a summary of the cases from the cancer registry, import them into a
spreadsheet, and provide to the surgeon.
b. Obtain a summary of the cases from the chart completion software, import
them into a spreadsheet, and provide to the surgeon.
c. Obtain a summary of the cases from the master patient index, import them
into a spreadsheet, and provide to the surgeon.
d. Obtain a summary of the cases from the transcription tracking software,
import them into a spreadsheet, and provide to the surgeon. Correct
Answer - a. Obtain a summary of the cases from the cancer registry, import
them into a spreadsheet, and provide to the surgeon.
**The cancer registry can be used to undertake studies in addition to
reporting cases to a central registry (Sharp and Madlock-Brown 2016, 173).
A facility located near a national park has a significant number of snake bites,
and patients receive treatment with antivenom in urgent-care settings.
Sometimes a patient is admitted to the hospital after several days. Can the
urgent-care setting provide the hospital with a list of names of patients
treated with snake antivenom?
a. Only the names of patients who are admitted to the hospital can be
requested if the physician needs it for continuity of care, but an entire list of
patients cannot be provided.
b. A list of names could be provided.
c. No information can be obtained under any circumstances.
d. A list of patients may be available after consultation with the national park
ranger. Correct Answer - a. Only the names of patients who are
admitted to the hospital can be requested if the physician needs it for
continuity of care, but an entire list of patients cannot be provided.
**Only records that are required for care or authorized by the patient can be
released by the urgent-care facility to the acute-care facility (Brodnik 2012,
225; Rinehart-Thompson 2016b, 243-247).
What diagnoses and procedures should be reported for recurrent left inguinal
hernia with laparoscopic repair?
Questions With Actual Solutions
Diagnostic-related groups (DRGs) and ambulatory patient classifications
(APCs) are similar in that they are both:
a. Determined by HCPCS codes
b. Focused on hospital outpatients
c. Focused on hospital inpatients
d. Prospective payment systems Correct Answer - d. Prospective
payment systems
** Both are types of prospective payment systems (Casto and Forrestal 2015,
6).
A patient is treated for esophageal varices with hemorrhage due to cirrhosis.
The diagnostic codes that would be assigned are:
I85.01 Esophageal varices with bleeding
I85.11 Secondary esophageal varices with bleeding
K74.60 Unspecified cirrhosis of liver Correct Answer - d. K74.60, I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
**The patient has cirrhosis of the liver with resulting bleeding esophageal
varices. Cirrhosis of liver is sequenced first followed by the code for the
bleeding esophageal varices (HHS 2017, Section I.A.13, 11).
Assign the code(s) for bronchoscopy with bilateral transbronchial biopsy for
each lobe of each lung.
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 Correct Answer -
Assign the code(s) for endoscopic sinusotomy with bilateral anterior
ethmoidectomy.
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate
procedure)
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial
(anterior)
−50 Bilateral procedurea.
a. 31254
b. 31254-50
c. 31254, 31254
d. 31231 Correct Answer - b. 31254-50
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial
(anterior)
−50 Bilateral procedurea.
** A code for the anterior ethmoidectomy is assigned and to denote the
bilateral procedure, a modifier of -50 is added (CPT Assistant Winter 1993,
23; Jan. 1997, 4; Sept. 1997, 10; Oct. 1997, 5; Dec. 2001, 6; May 2003, 5). The
sinusotomy is not coded separately, as it is a diagnostic procedure.
The most common language used for both data definition language and data
manipulation language is:
a. Unified modeling language
b. JAVA
c. Perl
d. Structured query language Correct Answer - d. Structured query
language
** Structured query language (SQL) is used commonly for data language and
data definitions (Sharp 2016, 184).
,An ethmoidectomy removes infected tissue and bone in the ethmoid sinuses
that blocks natural drainage. The surgeon views your ethmoid sinuses with an
endoscope, a thin flexible tube with a very small camera and light at the end of
it. Correct Answer -
Documentation from the nursing or other allied health professionals' notes
can be used to establish which of the following diagnoses:
a. Body mass index (BMI)
b. Malnutrition
c. Aspiration pneumonia
d. Fatigue Correct Answer - a. Body mass index (BMI)
** The physician must establish the diagnosis—obesity or morbid obesity—
and the additional information can be pulled from ancillary documentation to
establish the correct code assignment for body mass index (BMI) (Leon-
Chisen 2017, 168).
A 55-year-old patient has hypertensive heart disease with congestive heart
failure. What code would be assigned?
a. I15.8, Other secondary hypertension
b. I11.0, Hypertensive heart disease with heart failure and I50.9, Heart failure,
unspecified
c. I50.9, Heart failure, unspecified and I15.0, Renovascular hypertension
d. N18.6, End stage renal disease Correct Answer - b. I11.0,
Hypertensive heart disease with heart failure and I50.9, Heart failure,
unspecified
** There is a cause and effect relationship established between the
hypertension and the congestive heart failure. A separate code for the
congestive heart failure is assigned based on the "code also" note (HHS 2017,
Section I.C.9.a., 40).
A surgeon would like to undertake a research study on his patients with stage
II malignant melanoma of the back, who have undergone wide excision of the
melanoma. What work processes and associated software could be used to
provide this information?
, a. Obtain a summary of the cases from the cancer registry, import them into a
spreadsheet, and provide to the surgeon.
b. Obtain a summary of the cases from the chart completion software, import
them into a spreadsheet, and provide to the surgeon.
c. Obtain a summary of the cases from the master patient index, import them
into a spreadsheet, and provide to the surgeon.
d. Obtain a summary of the cases from the transcription tracking software,
import them into a spreadsheet, and provide to the surgeon. Correct
Answer - a. Obtain a summary of the cases from the cancer registry, import
them into a spreadsheet, and provide to the surgeon.
**The cancer registry can be used to undertake studies in addition to
reporting cases to a central registry (Sharp and Madlock-Brown 2016, 173).
A facility located near a national park has a significant number of snake bites,
and patients receive treatment with antivenom in urgent-care settings.
Sometimes a patient is admitted to the hospital after several days. Can the
urgent-care setting provide the hospital with a list of names of patients
treated with snake antivenom?
a. Only the names of patients who are admitted to the hospital can be
requested if the physician needs it for continuity of care, but an entire list of
patients cannot be provided.
b. A list of names could be provided.
c. No information can be obtained under any circumstances.
d. A list of patients may be available after consultation with the national park
ranger. Correct Answer - a. Only the names of patients who are
admitted to the hospital can be requested if the physician needs it for
continuity of care, but an entire list of patients cannot be provided.
**Only records that are required for care or authorized by the patient can be
released by the urgent-care facility to the acute-care facility (Brodnik 2012,
225; Rinehart-Thompson 2016b, 243-247).
What diagnoses and procedures should be reported for recurrent left inguinal
hernia with laparoscopic repair?
