Practice Test GeeksCCDS - Certified Clinical Documentation Specialist Practice Test
← All CCDS Flashcard Decks

Principal Procedure Selection and MS-DRG Flashcards

7 cards from real CCDS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Principal Procedure Selection and MS-DRG flashcards as text

  1. A patient undergoes percutaneous transluminal coronary angioplasty (PTCA) with stent placement and also receives a pacemaker insertion during the same admission. How does this affect MS-DRG assignment?

    Answer: Both procedures are coded; the grouper selects the DRG that optimally captures the resource use

    The MS-DRG grouper evaluates all coded OR procedures and assigns the DRG combination that best reflects the resource intensity of the admission.

  2. Under ICD-10-PCS, what distinguishes 'Fusion' from 'Arthrodesis' in spinal procedure coding?

    Answer: ICD-10-PCS uses 'Fusion' as the root operation; 'Arthrodesis' is the clinical term for the same concept

    In ICD-10-PCS the official root operation is Fusion; 'arthrodesis' is the clinical/surgical synonym that maps to the Fusion root operation.

  3. A patient is admitted for sepsis and undergoes incision and drainage (I&D) of an abscess on the right thigh. The sepsis is identified as originating from the abscess. What is the principal procedure?

    Answer: Incision and drainage, as it treats the source of the principal diagnosis

    The I&D treats the underlying source of the sepsis (the principal diagnosis), making it the principal procedure.

  4. Which ICD-10-PCS device character is used when a synthetic substitute mesh is placed during a ventral hernia repair?

    Answer: Synthetic substitute (J)

    Synthetic substitute (character J) is used in ICD-10-PCS when a synthetic mesh or other man-made material is placed during repair.

  5. The MS-DRG system groups cases into Major Diagnostic Categories (MDCs) primarily based on which factor?

    Answer: The principal diagnosis

    MDC assignment is driven by the principal diagnosis, which determines the body system or disease category for the case.

  6. A CDS notices that a physician documented 'lysis of adhesions' performed incidentally during an abdominal hysterectomy. Should lysis of adhesions be coded as a separate procedure?

    Answer: No, integral steps of a principal procedure are not coded separately per ICD-10-PCS guidelines

    ICD-10-PCS instructs coders not to separately code procedures that are integral to completing the principal procedure.

  7. How does the presence of a Major Complication or Comorbidity (MCC) most directly affect MS-DRG assignment compared to the presence of a CC?

    Answer: MCCs shift the case to a higher-severity DRG with a greater relative weight than a CC would

    MS-DRGs are subdivided into three severity levels—with MCC, with CC, and without CC/MCC—and the MCC subgroup carries the highest relative weight.