CCS Certified Coding Specialist Exam — Questions and Answers

Question 1: In ICD-10-PCS, what is the root operation for a coronary artery bypass graft (CABG) procedure?

Bypass (Correct answer)
Transfer
Replacement
Repair

Correct answer: Bypass

CABG is classified using the ICD-10-PCS root operation 'Bypass' (value 1), which means altering the route of passage of the contents of a tubular body part.

Question 2: A patient is treated for a fractured femur resulting from a fall from a ladder at a construction site. In addition to the fracture code, what additional code type is required by ICD-10-CM?

A Z code for the occupational setting
A code for osteoporosis as the underlying cause
A social determinants of health (SDOH) code
An external cause code (V00-Y99) for the mechanism and place of injury (Correct answer)

Correct answer: An external cause code (V00-Y99) for the mechanism and place of injury

ICD-10-CM Guidelines require external cause codes (Chapter 20, V00-Y99) to capture the mechanism of injury (fall from ladder) and place of occurrence (construction site) when injuries are coded.

Question 3: Which ICD-10-PCS root operation describes 'putting in a nonbiological device that monitors, assists, performs, or prevents a physiological function but does not physically take the place of a body part'?

Insertion (Correct answer)
Supplement
Fusion
Replacement

Correct answer: Insertion

ICD-10-PCS defines root operation Insertion (H) as putting in a nonbiological appliance that monitors, assists, performs, or prevents a physiological function - such as pacemakers, monitoring devices, or ports.

Question 4: ICD-10-CM Chapter 21 (Z codes) is primarily used to report:

Factors influencing health status and contact with health services (Correct answer)
Injuries and poisonings
Mental and behavioral disorders
Neoplasms and their morphology

Correct answer: Factors influencing health status and contact with health services

Z codes (Chapter 21) capture reasons for encounters other than disease or injury, such as screenings, vaccinations, or status conditions.

Question 5: The surgical package in CPT includes all of the following EXCEPT:

Writing orders and evaluating the patient the day before or day of surgery
Post-operative pain management beyond the global period requiring a return visit (Correct answer)
Local infiltration and topical anesthesia
Immediate post-operative care in the recovery area

Correct answer: Post-operative pain management beyond the global period requiring a return visit

Services required beyond the global period due to complications or new conditions are separately billable and are not included in the surgical package.

Question 6: Under OPPS, which type of service is assigned to 'APC status indicator V'?

Packaged service - no separate APC payment
Clinic or emergency department visit - paid under the visit APC (Correct answer)
Significant procedure - paid under a procedure APC
Device-dependent procedure requiring cost report settlement

Correct answer: Clinic or emergency department visit - paid under the visit APC

Status indicator V denotes clinic and emergency department visit codes (CPT E/M codes for hospital outpatient) that are paid under visit APCs under OPPS.

Question 7: Under the Medicare Inpatient Prospective Payment System (IPPS), which factor does NOT directly influence DRG assignment?

Complication and Comorbidity (CC) or Major CC (MCC)
Principal diagnosis
Patient's age
Patient's insurance carrier (Correct answer)

Correct answer: Patient's insurance carrier

DRG assignment is based on clinical factors (principal diagnosis, CCs/MCCs, procedures, age, discharge status) - the patient's insurance carrier has no effect on DRG grouping.

Question 8: Which document published by CMS and the cooperating parties annually updates the Official Guidelines for Coding and Reporting?

ICD-10-CM Tabular List of Diseases
ICD-10-CM Official Guidelines for Coding and Reporting (Correct answer)
CPT Assistant Newsletter
Coding Clinic for ICD-10-CM/PCS

Correct answer: ICD-10-CM Official Guidelines for Coding and Reporting

The ICD-10-CM Official Guidelines for Coding and Reporting is published jointly by the four cooperating parties (AHIMA, AHA, CMS, NCHS) and is updated annually for each fiscal year.

Question 9: A combination code in ICD-10-CM is best described as:

A code requiring a 7th character extension
A code used only for inpatient settings
A single code that classifies two diagnoses, a diagnosis with an associated complication, or a diagnosis with an associated manifestation (Correct answer)
Two codes used together to fully describe a condition

Correct answer: A single code that classifies two diagnoses, a diagnosis with an associated complication, or a diagnosis with an associated manifestation

A combination code captures two related conditions in a single code, avoiding the need for multiple codes when one fully describes the situation.

Question 10: CPT add-on codes (identified by a '+' symbol) must:

Always be used alone as a standalone code
Apply exclusively to E/M services
Be reported in conjunction with the primary procedure code they supplement and cannot be reported alone (Correct answer)
Be reported only with a modifier -51

Correct answer: Be reported in conjunction with the primary procedure code they supplement and cannot be reported alone

CPT add-on codes represent additional work performed alongside a primary procedure and are never reported as standalone codes.

Question 11: CPT modifier -51 is used to indicate:

A service was provided by a resident under supervision
Multiple procedures performed by the same provider at the same session other than E/M services or add-on codes (Correct answer)
A procedure was discontinued after anesthesia was administered
The procedure was performed on a bilateral body part

Correct answer: Multiple procedures performed by the same provider at the same session other than E/M services or add-on codes

Modifier -51 is appended to secondary and subsequent procedure codes when multiple procedures are performed at the same operative session.

Question 12: Which component of the health record documents the patient's subjective complaints, the physician's objective findings, the assessment, and the plan of care?

Discharge summary
SOAP note (Correct answer)
Operative report
History and physical

Correct answer: SOAP note

A SOAP note (Subjective, Objective, Assessment, Plan) is a structured progress note format documenting the patient's complaints, clinical findings, diagnosis, and treatment plan.

Question 13: Under the 2023 CPT E/M guidelines for outpatient office visits, what are the two elements used to select the level of service?

Number of diagnoses and diagnostic tests ordered
History and physical examination
Chief complaint and review of systems
Medical decision making (MDM) or total time on the date of encounter (Correct answer)

Correct answer: Medical decision making (MDM) or total time on the date of encounter

The revised CPT 2021+ E/M guidelines for office/outpatient visits base code selection on either Medical Decision Making (MDM) or total time spent on the date of service - history and exam are no longer separately scored.

Question 14: Which health record document would a coder primarily reference to assign CPT codes for surgical procedures performed in the operating room?

Recovery room notes
Pre-operative nursing checklist
Anesthesia record
Operative report (Correct answer)

Correct answer: Operative report

The operative report, dictated by the surgeon, describes the procedure performed in detail and is the primary source for assigning surgical CPT procedure codes.

Question 15: Which of the following best describes an 'uncertain diagnosis' in the context of inpatient coding?

A condition documented as 'possible,' 'probable,' or 'suspected' at the time of discharge (Correct answer)
A chronic condition that is not actively managed during the admission
A diagnosis requiring additional outpatient workup
A diagnosis that has been ruled out after testing

Correct answer: A condition documented as 'possible,' 'probable,' or 'suspected' at the time of discharge

For inpatient coding, conditions documented as 'possible,' 'probable,' 'suspected,' or similar qualifying terms at discharge are coded as if confirmed per UHDDS guidelines.

Question 16: Which organization administers and owns the CCS credential?

American Academy of Professional Coders (AAPC)
Centers for Medicare & Medicaid Services (CMS)
American Medical Association (AMA)
American Health Information Management Association (AHIMA) (Correct answer)

Correct answer: American Health Information Management Association (AHIMA)

The CCS credential is owned and administered by AHIMA (American Health Information Management Association), the professional association for health information management professionals.

Question 17: Which ICD-10-CM instruction requires the underlying condition to be coded first, followed by the manifestation?

Use additional code
Code also
Code first (Correct answer)
Excludes2

Correct answer: Code first

A 'Code first' note instructs the coder to sequence the underlying etiology before the manifestation code.

Question 18: An 'Excludes2' note in ICD-10-CM indicates:

The condition has been reclassified to a different chapter
The code is deleted from the classification
The excluded condition is not part of the indexed condition but may occur simultaneously and both may be coded (Correct answer)
The excluded condition can never be coded with the code containing the note

Correct answer: The excluded condition is not part of the indexed condition but may occur simultaneously and both may be coded

An Excludes2 note means the excluded condition is distinct from the indexed condition and, if both are present, both may be coded.

Question 19: Social engineering in the context of healthcare information security refers to:

Manipulating people into revealing confidential information or granting unauthorized access (Correct answer)
Organizing patient data into structured social networks
A method of encrypting social media data
Using software to automate coding workflows

Correct answer: Manipulating people into revealing confidential information or granting unauthorized access

Social engineering involves psychologically manipulating individuals into divulging confidential information or performing actions that compromise security.

Question 20: In ICD-10-PCS, what is the approach value for a procedure performed entirely through a natural body orifice using an endoscope (e.g., colonoscopy)?

8 - Via Natural or Artificial Opening Endoscopic (Correct answer)
F - Via Natural or Artificial Opening With Percutaneous Endoscopic Assistance
3 - Percutaneous
7 - Via Natural or Artificial Opening

Correct answer: 8 - Via Natural or Artificial Opening Endoscopic

Approach 8 (Via Natural or Artificial Opening Endoscopic) is used for endoscopic procedures performed through a natural orifice using an endoscope - such as colonoscopy, upper GI endoscopy, or cystoscopy.

Question 21: What is 'DRG creep' in the context of inpatient billing compliance?

The process of appealing incorrectly assigned low-weight DRGs
The natural migration of cases to higher DRGs as patient populations become sicker
The systematic pattern of coding to higher-weighted DRGs without clinical documentation support (Correct answer)
The gradual annual increase in DRG relative weights due to inflation

Correct answer: The systematic pattern of coding to higher-weighted DRGs without clinical documentation support

DRG creep refers to systematic upcoding - assigning codes that produce higher-paying DRGs than the clinical documentation supports - which is fraudulent and a major target of Medicare audits.

Question 22: In health information management, what does 'data integrity' specifically mean?

Data is accurate, complete, consistent, and has not been altered or destroyed in an unauthorized manner (Correct answer)
All data is encrypted using AES-256 standards
Data is available 24/7 without downtime
Data is stored securely and cannot be hacked

Correct answer: Data is accurate, complete, consistent, and has not been altered or destroyed in an unauthorized manner

Data integrity means health information is accurate, complete, consistent, unaltered, and trustworthy - encompassing both data quality and data security dimensions.

Question 23: CPT Category II codes are used for:

New or experimental technology not yet assigned a Category I code
Inpatient-only procedures requiring a hospital setting
Telemedicine services only
Supplemental tracking codes for performance measurement that are optional and do not affect reimbursement (Correct answer)

Correct answer: Supplemental tracking codes for performance measurement that are optional and do not affect reimbursement

Category II codes are alphanumeric tracking codes used for quality measurement and data collection but have no reimbursement value.

Question 24: A patient undergoes an open reduction and internal fixation (ORIF) of a displaced femoral shaft fracture. What is the ICD-10-PCS root operation?

Repair
Reposition (Correct answer)
Replacement
Fusion

Correct answer: Reposition

ORIF is classified as 'Reposition' in ICD-10-PCS - moving a body part to its normal or other suitable location - with an internal fixation device applied.

Question 25: In Scrum (an Agile framework), who is responsible for prioritizing the product backlog?

Development Team
Product Owner (Correct answer)
Project Sponsor
Scrum Master

Correct answer: Product Owner

The Product Owner owns and prioritizes the backlog to ensure the team works on the highest-value features first.

Question 26: Which data structure is best suited for implementing a breadth-first search (BFS)?

Queue (Correct answer)
Hash Table
Stack
Heap

Correct answer: Queue

BFS uses a queue to process nodes level by level in FIFO order.

Question 27: A 'closed panel' HMO requires members to:

Use only providers employed by or exclusively contracted with the HMO (Correct answer)
Select any provider and submit claims themselves
Pay all costs upfront and seek reimbursement
Obtain a secondary insurer before receiving services

Correct answer: Use only providers employed by or exclusively contracted with the HMO

A closed-panel HMO restricts members to providers who are exclusively employed by or contracted with the HMO, offering no out-of-network coverage.

Question 28: In ICD-10-PCS, what does the qualifier 'X - Diagnostic' indicate when appended to an Excision code?

The procedure was not completed as planned
The patient was under general anesthesia
The tissue removed was sent for biopsy/pathologic examination (Correct answer)
The excision was performed as an emergency procedure

Correct answer: The tissue removed was sent for biopsy/pathologic examination

Qualifier X (Diagnostic) in ICD-10-PCS indicates the excision was performed for biopsy purposes - tissue was removed for pathologic examination rather than for definitive treatment.

Question 29: Which algorithm is used to find a minimum spanning tree in a weighted undirected graph?

Prim's algorithm (Correct answer)
Floyd-Warshall algorithm
Dijkstra's algorithm
Bellman-Ford algorithm

Correct answer: Prim's algorithm

Prim's algorithm (and Kruskal's) finds a minimum spanning tree by greedily selecting the lowest-weight edges.

Question 30: What is the passing score required for the CCS certification exam?

300 (Correct answer)
350
400
250

Correct answer: 300

To pass the CCS certification exam, candidates must achieve a scaled score of 300 or higher. This score reflects a sufficient level of competency in medical coding as determined by AHIMA's rigorous standards. Meeting this benchmark demonstrates a candidate's readiness to perform the duties of a certified coding specialist.

Question 31: What is the purpose of medical coding in the billing process?

To determine physician salaries.
To ensure proper billing and reimbursement. (Correct answer)
To eliminate medical documentation.
To increase insurance premiums.

Correct answer: To ensure proper billing and reimbursement.

The purpose of medical coding in the billing process is to translate healthcare services, diagnoses, and procedures into standardized alphanumeric codes. These codes are essential for submitting accurate claims to insurance companies, which then use them to determine appropriate reimbursement for providers. Proper coding ensures efficient processing and prevents claim denials.

Question 32: What is the purpose of the HCPCS Level II code set?

To code for physician services only when CPT codes are not available
To supplement CPT codes for services, supplies, and equipment not described in CPT (Correct answer)
To describe ICD-10-CM diagnoses in outpatient billing
To replace CPT codes for all Medicare billing

Correct answer: To supplement CPT codes for services, supplies, and equipment not described in CPT

HCPCS Level II codes (A0000-V9999) supplement CPT codes by describing non-physician services, supplies, equipment, drugs, and other items that CPT does not adequately represent.

Question 33: What coding resources are candidates permitted to use during the CCS exam?

Electronic versions of ICD-10-CM, ICD-10-PCS, and CPT code books built into the exam (Correct answer)
No references allowed - all from memory
Internet access to CMS coding guidelines
Personal printed code books brought by the candidate

Correct answer: Electronic versions of ICD-10-CM, ICD-10-PCS, and CPT code books built into the exam

The CCS exam is an open-book exam: AHIMA provides electronic versions of ICD-10-CM, ICD-10-PCS, and CPT code sets within the testing software - candidates do not bring personal books.

Question 34: A hospital's inpatient coding is found to have a 12% query rate for physician clarification. What does this primarily indicate?

Physicians are routinely upcoding their documentation
The coders are undercoding diagnoses
The hospital has too few coders for its patient volume
Clinical documentation is frequently insufficient to code accurately without clarification (Correct answer)

Correct answer: Clinical documentation is frequently insufficient to code accurately without clarification

A high physician query rate indicates that clinical documentation lacks the specificity or completeness needed for accurate coding, requiring coders to ask physicians for clarification.

Question 35: Under IPPS, what is a 'cost outlier' payment?

A payment reduction for cases with costs below the DRG amount
A supplemental payment for teaching hospitals only
A penalty charged when a hospital's average costs exceed the national norm
An additional payment made when a case's costs significantly exceed the DRG threshold plus a fixed loss amount (Correct answer)

Correct answer: An additional payment made when a case's costs significantly exceed the DRG threshold plus a fixed loss amount

When an inpatient case's costs are extraordinarily high - exceeding the DRG payment plus a fixed loss threshold - Medicare pays an outlier payment of 80% of the costs above the threshold.

Question 36: Under ICD-10-CM, a patient with Type 2 diabetes mellitus and diabetic chronic kidney disease stage 3 should be coded as:

E11.65 only (Type 2 DM with hyperglycemia)
N18.3 as principal diagnosis with E11.9 as secondary
E11.9 and N18.3 coded separately without a combination code
E11.22 (Type 2 DM with diabetic CKD) and N18.3 (CKD stage 3) together (Correct answer)

Correct answer: E11.22 (Type 2 DM with diabetic CKD) and N18.3 (CKD stage 3) together

ICD-10-CM provides combination code E11.22 for Type 2 DM with diabetic chronic kidney disease, and guidelines require an additional code from N18.- to identify the CKD stage.

Question 37: In ICD-10-CM, what is the 'default code' concept?

A code automatically applied when no documentation exists
A code that covers all unspecified conditions in a chapter
The first code in a code range used for billing
The code listed next to a main term in the Index when no additional detail or subterm is provided (Correct answer)

Correct answer: The code listed next to a main term in the Index when no additional detail or subterm is provided

The default code is the code listed next to a main term in the Alphabetic Index and is used when documentation does not specify additional detail.

Question 38: When reviewing an operative report for coding purposes, which element is most critical for assigning the correct procedure code?

The post-operative diagnosis and description of the procedure performed (Correct answer)
The pre-operative diagnosis
The estimated blood loss documented
The anesthesia type used

Correct answer: The post-operative diagnosis and description of the procedure performed

The post-operative diagnosis and the detailed description of the procedure performed are the most critical elements, as the actual findings may differ from the pre-operative diagnosis.

Question 39: Which SDLC phase formally closes the project after verifying deliverables are accepted?

Deployment
Testing
Maintenance
Project closure (Correct answer)

Correct answer: Project closure

Project closure involves formal sign-off, lessons learned documentation, and release of project resources after deliverables are accepted.

Question 40: On the CCS exam, medical record simulations primarily test a candidate's ability to:

Interpret laboratory values and vital signs
Accurately assign and sequence ICD-10-CM, ICD-10-PCS, and/or CPT codes from clinical documentation (Correct answer)
Complete the UB-04 form with all required fields
Identify billing errors and calculate claim totals

Correct answer: Accurately assign and sequence ICD-10-CM, ICD-10-PCS, and/or CPT codes from clinical documentation

The medical record simulations on the CCS exam require candidates to read clinical documentation and correctly assign and sequence codes - the fundamental skill of a hospital coder.

Question 41: According to ICD-10-CM coding guidelines, how should a patient's chronic condition that is being managed during an inpatient admission be coded?

Code all chronic conditions that coexist at the time of admission and affect care (Correct answer)
Do not code chronic conditions; code only the principal diagnosis
Code only if the physician specifically states it affected the patient's care
Code chronic conditions only if they required specific treatment during the stay

Correct answer: Code all chronic conditions that coexist at the time of admission and affect care

ICD-10-CM Guidelines require coding of all conditions that coexist at the time of admission and affect patient care, treatment, or require monitoring during the encounter.

Question 42: CPT modifier -59 is used to indicate:

The patient refused part of the service
The procedure was reduced due to extenuating circumstances
A procedure was performed by a different surgeon
A distinct procedural service not normally reported together but appropriate under the circumstances (Correct answer)

Correct answer: A distinct procedural service not normally reported together but appropriate under the circumstances

Modifier -59 identifies a procedure or service as distinct or independent from other services performed on the same day when other modifiers do not adequately describe the situation.

Question 43: In health IT, a 'go-live cutover' strategy where the old and new systems run simultaneously is called:

Direct cutover
Parallel conversion (Correct answer)
Pilot conversion
Phased rollout

Correct answer: Parallel conversion

Parallel conversion runs both systems concurrently to validate the new system's accuracy before decommissioning the old one.

Question 44: What is the purpose of CPT modifier -25?

Indicates a significant, separately identifiable E/M service was performed by the same physician on the same day as a procedure (Correct answer)
Indicates a reduced service was performed
Indicates the procedure was performed by a different provider
Indicates a bilateral procedure

Correct answer: Indicates a significant, separately identifiable E/M service was performed by the same physician on the same day as a procedure

Modifier -25 is appended to an E/M code to indicate that a separate, significant E/M service was provided on the same day as a procedure or service.

Question 45: What does the term 'chargemaster' refer to in hospital billing?

A comprehensive list of services, supplies, and procedures with their assigned charges and billing codes (Correct answer)
A software system for scheduling inpatient admissions
A list of all credentialed medical staff
The master file of approved ICD-10-CM codes

Correct answer: A comprehensive list of services, supplies, and procedures with their assigned charges and billing codes

The chargemaster (charge description master/CDM) is the hospital's comprehensive price list that assigns charge codes, revenue codes, HCPCS/CPT codes, and dollar amounts to every billable item.

Question 46: A coder notices that a physician documented 'acute respiratory failure' in the progress notes but did not include it in the discharge summary. What is the appropriate action?

Ignore the progress note finding and code only what is in the discharge summary
Code the acute respiratory failure from the progress notes without further action
Query the physician to confirm whether acute respiratory failure should be included as a final diagnosis (Correct answer)
Code the acute respiratory failure as a secondary diagnosis automatically

Correct answer: Query the physician to confirm whether acute respiratory failure should be included as a final diagnosis

When a significant diagnosis appears in progress notes but is absent from the discharge summary, the coder should query the physician to confirm whether it should be included as a final diagnosis.

Question 47: What is the purpose of a work breakdown structure (WBS)?

To assign blame for delays
To list all project team members
To decompose the project into smaller, manageable work packages (Correct answer)
To track financial expenditures only

Correct answer: To decompose the project into smaller, manageable work packages

A WBS hierarchically breaks down the total scope of work into smaller, defined deliverables that can be planned and managed.

Question 48: What is a potential consequence of poor health data management?

Improved healthcare reimbursement.
Billing errors and compliance issues. (Correct answer)
Faster insurance processing.
Enhanced staff productivity.

Correct answer: Billing errors and compliance issues.

Poor health data management can lead to significant consequences, primarily billing errors and compliance issues. Inaccurate or incomplete records result in incorrect coding, which can cause claim denials, delayed payments, and financial losses for healthcare providers. It also increases the risk of regulatory penalties and audits due to non-compliance with standards like HIPAA.

Question 49: A pathology report confirming malignancy is received after the patient has been discharged. The attending physician documented 'suspected carcinoma' in the discharge summary. How should the diagnosis be coded?

Query the physician before coding either diagnosis
Code the confirmed malignancy based on the pathology report (Correct answer)
Code the uncertain term 'suspected carcinoma'
Code only the signs and symptoms

Correct answer: Code the confirmed malignancy based on the pathology report

Per ICD-10-CM guidelines, when a pathology report confirms a diagnosis after discharge, the confirmed diagnosis should be coded rather than the uncertain term.

Question 50: Which regulation protects patient health information (PHI)?

Medicare Modernization Act (MMA)
Patient Safety Act (PSA)
Affordable Care Act (ACA)
HIPAA (Correct answer)

Correct answer: HIPAA

The Health Insurance Portability and Accountability Act (HIPAA) is the key regulation that protects patient health information (PHI). Enacted in 1996, HIPAA established national standards for the privacy and security of electronic health records, ensuring that patient data is handled confidentially and securely by healthcare providers and related entities.

Question 51: Which government program provides healthcare coverage for individuals aged 65 and older?

Affordable Care Act (ACA)
TRICARE
Medicaid
Medicare (Correct answer)

Correct answer: Medicare

Medicare is the federal government program that provides healthcare coverage primarily for individuals aged 65 and older. It also covers certain younger people with disabilities and those with End-Stage Renal Disease. Medicare helps cover hospital stays, doctor visits, and prescription drugs, playing a crucial role in the U.S. healthcare system.

Question 52: What does the Explanation of Benefits (EOB) provide to patients?

A detailed medical diagnosis.
An itemized hospital bill.
A referral for specialist care.
A summary of insurance payment and patient responsibility. (Correct answer)

Correct answer: A summary of insurance payment and patient responsibility.

The Explanation of Benefits (EOB) is a document sent by an insurance company to a patient after a medical service has been processed. It details what the insurance plan paid for the service, the amount adjusted or discounted, and the remaining balance that is the patient's responsibility. The EOB is not a bill, but rather an informative summary of how the claim was handled.

Question 53: The three key components used to select an E/M (Evaluation and Management) level of service are:

Chief complaint, past history, and review of systems
Diagnosis, treatment plan, and follow-up interval
Time, diagnosis, and procedure performed
History, examination, and medical decision making (Correct answer)

Correct answer: History, examination, and medical decision making

E/M code selection is based on the level of history obtained, the extent of physical examination performed, and the complexity of medical decision making.

Question 54: According to CPT coding guidelines, what is the definition of a 'new patient' for E/M office visits?

A patient who has not received professional services from the physician or another physician of the same specialty in the same group practice within the past 3 years (Correct answer)
A patient who has changed insurance plans within the past year
A patient who has never seen any physician in their life
A patient presenting for the first time to the current facility

Correct answer: A patient who has not received professional services from the physician or another physician of the same specialty in the same group practice within the past 3 years

CPT defines a new patient as one who has not received professional services from the physician, or another physician of the same exact specialty and subspecialty in the same group practice, within the past 3 years.

Question 55: In MS-DRG logic, what is an 'unacceptable principal diagnosis'?

Any diagnosis code that is not in the ICD-10-CM code set
A code that produces a DRG with a relative weight below 0.5
Any chronic condition sequenced first on the claim
A code that cannot be used as a principal diagnosis per MCE edits, such as a manifestation code or a code flagged as not principal (Correct answer)

Correct answer: A code that cannot be used as a principal diagnosis per MCE edits, such as a manifestation code or a code flagged as not principal

Unacceptable principal diagnosis codes are flagged by the Medicare Code Editor - these include manifestation codes, external cause codes, signs/symptoms that cannot be principal, and codes specifically flagged as unacceptable as principal.

Question 56: A patient has a pacemaker generator implanted in the subcutaneous tissue of the chest wall along with insertion of pacing leads into the right ventricle. How many ICD-10-PCS codes are needed?

Three codes - generator, right ventricular lead, and subcutaneous pocket
Two codes - one for the generator insertion and one for the lead insertion (Correct answer)
One code with a combination device value
One code captures the entire procedure

Correct answer: Two codes - one for the generator insertion and one for the lead insertion

ICD-10-PCS guidelines require separate codes for pacemaker generator insertion (into subcutaneous tissue) and lead insertion (into the cardiac chamber), as they involve different body parts.

Question 57: Which of the following is the most appropriate use of a physician query?

To request additional procedures be documented to improve the DRG
To clarify ambiguous or incomplete documentation that impacts code assignment (Correct answer)
To ask the physician to add a more specific diagnosis that will increase reimbursement
To suggest diagnoses that were not documented in the record

Correct answer: To clarify ambiguous or incomplete documentation that impacts code assignment

Physician queries are appropriate only to clarify ambiguous or incomplete documentation; they must never be leading or designed to influence reimbursement.

Question 58: Which of the following Z code categories is used to indicate a patient's history of a resolved condition that no longer exists but may affect future care?

Z80-Z84 (Family history)
Z00-Z13 (Encounters for examinations)
Z85-Z87 (Personal history) (Correct answer)
Z77-Z99 (Persons with potential health hazards)

Correct answer: Z85-Z87 (Personal history)

Z85-Z87 personal history codes document past conditions that have been resolved but may influence current or future medical management.

Question 59: Under the Official Guidelines, what is the correct approach to coding a patient's HIV disease with an HIV-related condition?

Code Z21 (Asymptomatic HIV) with the related condition
Query the physician before coding any HIV-related diagnosis
Sequence B20 (HIV disease) first, followed by codes for all HIV-related conditions (Correct answer)
Code only the HIV-related condition; HIV is implied

Correct answer: Sequence B20 (HIV disease) first, followed by codes for all HIV-related conditions

ICD-10-CM Guidelines Section I.C.1.a state that B20 (HIV disease) is sequenced as principal/first-listed when the patient has confirmed HIV disease with associated conditions, followed by codes for all documented manifestations.

Question 60: What is the purpose of unit testing?

To test the entire application at once
To verify that individual components of code work correctly in isolation (Correct answer)
To check network connectivity
To measure code performance only

Correct answer: To verify that individual components of code work correctly in isolation

Unit tests verify individual components in isolation, catching bugs early and making code more maintainable.

Question 61: A claim is denied due to a 'coordination of benefits' issue. What does this mean?

The patient has more than one insurance plan and payer order is disputed (Correct answer)
The patient has exceeded their annual deductible
The provider is not in the payer's network
The diagnosis code does not support medical necessity

Correct answer: The patient has more than one insurance plan and payer order is disputed

Coordination of benefits (COB) determines which payer is primary and which is secondary when a patient has multiple insurance plans.

Question 62: If a candidate earns the CCS credential and subsequently violates AHIMA's Code of Ethics, what is a potential consequence?

Mandatory 1-year suspension without revocation
Revocation of the CCS credential by AHIMA (Correct answer)
Automatic criminal prosecution by CMS
Loss of Medicare billing privileges for their employer

Correct answer: Revocation of the CCS credential by AHIMA

AHIMA can revoke a CCS credential for ethical violations including falsifying credentials, upcoding, or other professional misconduct under its Code of Ethics enforcement process.

Question 63: Which of the following represents a physical safeguard under the HIPAA Security Rule?

Locked server rooms with key card access (Correct answer)
Password complexity requirements
Automatic logoff from workstations after inactivity
Encryption of data at rest

Correct answer: Locked server rooms with key card access

Physical safeguards control physical access to facilities and equipment where ePHI is stored or accessed, such as locked rooms with controlled entry.

Question 64: Which document created during SDLC analysis describes the boundaries of a health IT project?

System architecture diagram
Scope statement (Correct answer)
Data flow diagram
Test plan

Correct answer: Scope statement

A scope statement defines what is included in and excluded from the project to prevent scope creep.

Question 65: Which ICD-10-CM guideline governs sequencing when a patient is admitted due to a complication of surgery performed at another facility?

Sequence the complication as the principal diagnosis (Correct answer)
Sequence the most resource-intensive condition as principal
Query the physician to determine the principal diagnosis
Sequence the original condition treated surgically as principal diagnosis

Correct answer: Sequence the complication as the principal diagnosis

Per ICD-10-CM Guidelines, when a patient is admitted for a postoperative complication, the complication is sequenced as the principal diagnosis.

Question 66: What does the term 'present on admission' (POA) indicator primarily help distinguish?

Whether a procedure was performed on an inpatient or outpatient basis
Whether a diagnosis was the principal or secondary condition
Whether a condition existed at the time of inpatient admission versus developed during the stay (Correct answer)
Whether a diagnosis meets medical necessity requirements

Correct answer: Whether a condition existed at the time of inpatient admission versus developed during the stay

The POA indicator identifies whether a condition was present at the time of inpatient admission, which helps distinguish hospital-acquired conditions from pre-existing ones.

Question 67: Under IPPS, what is the 'geometric mean length of stay' (GMLOS) for a DRG used to calculate?

The required LOS for quality reporting purposes
The minimum LOS required before a DRG payment is made
The maximum days a Medicare beneficiary can stay before the hospital receives no additional payment
A statistical measure used in transfer payment calculations and outlier determinations (Correct answer)

Correct answer: A statistical measure used in transfer payment calculations and outlier determinations

The geometric mean LOS (GMLOS) for each MS-DRG is used in transfer payment calculations (to determine if the transferring hospital gets a full or reduced DRG) and in outlier payment thresholds.

Question 68: What is the purpose of a clinical documentation improvement (CDI) program in a hospital?

To train coders on new CPT codes each year
To reduce the number of physician queries by limiting coder access to records
To improve the accuracy and completeness of clinical documentation to support coding, reimbursement, and quality reporting (Correct answer)
To convert paper records to electronic format

Correct answer: To improve the accuracy and completeness of clinical documentation to support coding, reimbursement, and quality reporting

CDI programs proactively review and improve clinical documentation to ensure it accurately reflects patient severity, supports correct code assignment, and accurately represents quality outcomes.

Question 69: According to ICD-10-CM guidelines for sepsis, which of the following sequences is correct when a patient is admitted with sepsis due to MRSA pneumonia?

Sepsis cannot be coded with pneumonia on the same claim
B95.62 (MRSA) sequenced first, then A41.02
A41.02 (Sepsis due to MRSA) sequenced first, then J15.212 (Pneumonia due to MRSA) (Correct answer)
J18.9 (Pneumonia, unspecified) sequenced first, then A41.02 (Sepsis due to MRSA)

Correct answer: A41.02 (Sepsis due to MRSA) sequenced first, then J15.212 (Pneumonia due to MRSA)

When sepsis is present on admission with a localized infection, the sepsis is sequenced as principal diagnosis, followed by the specific infection (MRSA pneumonia).

Question 70: Which data quality characteristic ensures that health information is available when needed by authorized users?

Completeness
Accuracy
Timeliness
Accessibility (Correct answer)

Correct answer: Accessibility

Accessibility refers to data being available and retrievable by authorized users when needed - a core characteristic of high-quality health information.

Question 71: Under HIPAA, which type of health information is subject to privacy protections?

Individually identifiable health information (Protected Health Information) (Correct answer)
Aggregate de-identified statistical health data
Anonymous survey data about health behaviors
Publicly available health information from news reports

Correct answer: Individually identifiable health information (Protected Health Information)

HIPAA's Privacy Rule protects individually identifiable health information (PHI), which is information that could be used to identify a specific individual and relates to their health, treatment, or payment.

Question 72: What is the primary advantage of a trie (prefix tree) over a hash table for string lookups?

Tries use less memory for all datasets
Tries support prefix searches and ordered iteration efficiently (Correct answer)
Tries have O(1) lookup regardless of string length
Tries require no collision handling

Correct answer: Tries support prefix searches and ordered iteration efficiently

Tries allow efficient prefix queries and alphabetical iteration, which hash tables cannot natively support.

Question 73: Under the ICD-10-CM Official Guidelines, the term 'code also' means:

Only one code may be assigned for this condition
An additional code should be reported if applicable and present (Correct answer)
The code following should always be sequenced first
An additional code is required to fully describe the condition

Correct answer: An additional code should be reported if applicable and present

'Code also' is an instructional note indicating that an additional code may be assigned if the condition is present and applicable - it is not always mandatory.

Question 74: The CCS exam uses which type of questions exclusively?

True/false and fill-in-the-blank
Multiple-choice and medical record coding simulations (Correct answer)
Multiple-choice only
Essay and case study analysis

Correct answer: Multiple-choice and medical record coding simulations

The CCS exam includes multiple-choice questions AND medical record simulation sections where candidates must assign codes from actual (simulated) medical records.

Question 75: Under OPPS, what is a 'Comprehensive APC' (C-APC)?

An APC reserved for complex surgical procedures requiring inpatient-level care
A payment model where a primary service drives a single comprehensive payment that includes all related services on the claim (Correct answer)
A bundled payment covering 90-day global surgical care in outpatient settings
An APC for high-cost drugs that are packaged into comprehensive payments

Correct answer: A payment model where a primary service drives a single comprehensive payment that includes all related services on the claim

Comprehensive APCs (C-APCs) are OPPS payment groups where the primary procedure drives a single comprehensive payment encompassing all related items and services on the claim, replacing individual APC payments.

Question 76: What distinguishes an MS-DRG from an AP-DRG or APR-DRG?

MS-DRGs are the Medicare-specific DRG system; All Patient DRGs (AP-DRG) and All Patient Refined DRGs (APR-DRG) extend coverage to pediatric and non-Medicare populations with more severity levels (Correct answer)
MS-DRGs assign CCs/MCCs; AP-DRGs use a different comorbidity methodology
MS-DRGs include outpatient cases; AP-DRGs and APR-DRGs are inpatient only
MS-DRGs are used only for Medicare; AP-DRGs and APR-DRGs are used for Medicaid and commercial payers

Correct answer: MS-DRGs are the Medicare-specific DRG system; All Patient DRGs (AP-DRG) and All Patient Refined DRGs (APR-DRG) extend coverage to pediatric and non-Medicare populations with more severity levels

MS-DRGs were designed for Medicare; AP-DRGs and APR-DRGs were developed to better capture non-Medicare, pediatric, obstetric, and complex patients, with APR-DRGs adding severity of illness (SOI) and risk of mortality (ROM) subclasses.

Question 77: In ICD-10-CM, 'laterality' refers to:

Specifying which side of the body (right, left, bilateral) is affected (Correct answer)
A code extension used for pediatric conditions
The encounter type for bilateral procedures
The severity level of a diagnosis

Correct answer: Specifying which side of the body (right, left, bilateral) is affected

Laterality codes in ICD-10-CM identify the specific side of the body involved when a condition is site-specific.

Question 78: How does accurate data entry benefit healthcare organizations?

It improves patient care and efficiency. (Correct answer)
It increases administrative costs.
It removes the need for compliance audits.
It slows down the billing process.

Correct answer: It improves patient care and efficiency.

Accurate data entry significantly benefits healthcare organizations by improving patient care and operational efficiency. Precise information leads to correct diagnoses, appropriate treatments, and seamless communication among care providers, reducing medical errors. It also streamlines administrative processes, leading to more efficient billing and resource allocation.

Question 79: Which SDLC artifact maps system inputs, processes, outputs, and data stores?

Network topology map
PERT chart
Gantt chart
Data flow diagram (DFD) (Correct answer)

Correct answer: Data flow diagram (DFD)

A data flow diagram visually represents how data moves through a system, showing processes, storage, and external entities.

Question 80: What is the time complexity of searching for an element in a balanced BST?

O(n log n)
O(n)
O(log n) (Correct answer)
O(1)

Correct answer: O(log n)

A balanced BST halves the search space at each step, yielding O(log n) search time.

Question 81: A coder is reviewing a record where the physician documented 'dehydration due to nausea and vomiting secondary to chemotherapy.' Which condition should be sequenced as the principal diagnosis for an inpatient admission?

Nausea and vomiting
The underlying malignancy being treated with chemotherapy
Adverse effect of chemotherapy
Dehydration (Correct answer)

Correct answer: Dehydration

Dehydration is the condition established after study to be chiefly responsible for occasioning the admission; the nausea/vomiting and chemotherapy context are coded as additional diagnoses.

Question 82: Which of the following is an example of a 'technical safeguard' under the HIPAA Security Rule?

Implementing multi-factor authentication for EHR access (Correct answer)
Training staff on phishing awareness
Installing deadbolt locks on server room doors
Shredding paper records containing PHI

Correct answer: Implementing multi-factor authentication for EHR access

Technical safeguards are technology-based controls like MFA, encryption, and automatic logoff that protect ePHI from unauthorized access.

Question 83: In hospital outpatient coding, the 'significant, separately identifiable E/M service' performed the same day as a procedure is reported with which modifier?

-91
-57
-59
-25 (Correct answer)

Correct answer: -25

Modifier -25 is appended to the E/M code to indicate that a significant, separately identifiable E/M service was performed by the same physician on the same day as a procedure or other service.

Question 84: In hospital outpatient coding, what is the OPPS 'packaging' concept?

Combining all physician and facility charges onto a single claim form
Grouping outpatient claims by diagnosis for quality reporting
Bundling all services from multiple visits into one monthly claim
Certain ancillary services (labs, minor drugs, supplies) are packaged into the APC payment for the primary service and not separately payable (Correct answer)

Correct answer: Certain ancillary services (labs, minor drugs, supplies) are packaged into the APC payment for the primary service and not separately payable

Under OPPS packaging, certain ancillary items and services - such as minor laboratory tests, low-cost drugs, and supplies - are bundled into the APC payment for the primary procedure and are not separately reimbursed.

Question 85: How long is the CCS certification valid before requiring renewal?

It does not expire
Five years
Two years (Correct answer)
One year

Correct answer: Two years

The CCS certification is valid for a period of two years. To maintain the certification, professionals must complete continuing education units (CEUs) and adhere to AHIMA's recertification requirements within this two-year cycle. This ensures that certified coders stay current with evolving coding guidelines and industry changes.

Question 86: A patient undergoes debridement of a wound where only the skin and subcutaneous tissue are removed. Which ICD-10-PCS root operation applies?

Destruction
Extraction
Excision (Correct answer)
Repair

Correct answer: Excision

Debridement that cuts out or removes a portion of tissue (skin/subcutaneous) is classified as Excision (value B) - cutting out or off a portion of a body part.

Question 87: In the context of EHR development, what is a 'use case'?

A legal document authorizing system access
A type of database query
A description of how a user interacts with a system to achieve a goal (Correct answer)
A test scenario used during QA

Correct answer: A description of how a user interacts with a system to achieve a goal

A use case describes a specific interaction between a user and the system to accomplish a particular objective.

Question 88: When a surgical procedure is performed bilaterally during the same operative session and the CPT code does not specify bilateral, the coder should:

Report the code twice with modifier -51 on the second
Report the unilateral code twice without any modifier
Query the AMA for a bilateral code
Report the code once with modifier -50 appended (Correct answer)

Correct answer: Report the code once with modifier -50 appended

Modifier -50 is appended to indicate a bilateral procedure performed during the same operative session when the CPT code does not specify bilateral.

Question 89: Which of the following best describes the work setting for which the CCS credential is primarily designed?

Hospital and other inpatient/outpatient facility settings (Correct answer)
Public health departments and epidemiology offices
Insurance company claims review departments
Physician office and ambulatory surgery centers only

Correct answer: Hospital and other inpatient/outpatient facility settings

The CCS is AHIMA's facility-based coding credential, designed for coders working in hospitals and other institutional settings using UB-04 claim forms.

Question 90: Which technique resolves hash table collisions by storing multiple entries in a linked list at each bucket?

Separate chaining (Correct answer)
Quadratic probing
Open addressing
Linear probing

Correct answer: Separate chaining

Separate chaining stores colliding elements in a linked list at the same bucket, allowing multiple values per index.

Question 91: When a transaction in a hospital billing database is interrupted mid-process, which database property ensures the data is returned to its previous state?

Consistency
Durability
Isolation
Atomicity (Correct answer)

Correct answer: Atomicity

Atomicity guarantees that a transaction is treated as a single unit — either all operations complete or none are applied.

Question 92: Which coding system is primarily used for outpatient procedures?

HCPCS Level II
CPT (Correct answer)
ICD-10-CM
DRG

Correct answer: CPT

CPT (Current Procedural Terminology) is the coding system primarily used for reporting outpatient medical, surgical, and diagnostic procedures and services. These codes are essential for healthcare providers to accurately describe the services rendered to patients for billing and reimbursement purposes, particularly in physician offices and outpatient clinics.

Question 93: What is the significance of the 'two-midnight rule' introduced by CMS for IPPS payment?

Hospitals must submit claims within two midnight periods of discharge
Patients must be hospitalized at least two midnights before any diagnostic testing can be billed
An inpatient admission is generally appropriate for Medicare payment when a physician expects the patient to require hospital care spanning at least two midnights (Correct answer)
Medicare only covers the first two midnights of any inpatient stay

Correct answer: An inpatient admission is generally appropriate for Medicare payment when a physician expects the patient to require hospital care spanning at least two midnights

The Two-Midnight Rule states that inpatient admission is generally appropriate for Medicare Part A payment when the physician reasonably expects the patient to require care crossing at least two midnights; shorter stays typically should be observation status.

Question 94: What does an 'Excludes1' note in ICD-10-CM mean?

The two conditions cannot occur together and cannot be coded simultaneously (Correct answer)
The condition is included in the default code
The excluded code may be used together with this code
The excluded code should always be sequenced first

Correct answer: The two conditions cannot occur together and cannot be coded simultaneously

An Excludes1 note means the two conditions are mutually exclusive and cannot be reported together on the same claim.

Question 95: Under ICD-10-PCS guidelines, when a procedure is converted from laparoscopic to open, how is it coded?

Code both the laparoscopic attempt and the open procedure (Correct answer)
Code only the open procedure with approach value 0
Query the surgeon before coding the converted procedure
Code only the laparoscopic attempt with a failed procedure qualifier

Correct answer: Code both the laparoscopic attempt and the open procedure

Per ICD-10-PCS coding guidelines, when a laparoscopic procedure is converted to open, the completed open procedure is coded. The laparoscopic portion may also be coded if a distinct service was accomplished before conversion.

Question 96: HCPCS Level I codes are:

Numeric codes identical to CPT codes, maintained by the AMA (Correct answer)
Alphanumeric codes for supplies and equipment created by CMS
Codes used exclusively for Medicare claims
Codes for temporary procedures pending FDA approval

Correct answer: Numeric codes identical to CPT codes, maintained by the AMA

HCPCS Level I consists of the CPT code set (numeric codes) maintained by the AMA and adopted for use in the HCPCS system.

Question 97: A principal diagnosis of 'chest pain, unspecified' (R07.9) for an inpatient admission may be flagged by the MCE. Why?

Chest pain cannot be coded in inpatient settings
External cause codes must accompany all chest pain codes
Non-specific symptom codes like chest pain may be flagged as questionable principal diagnoses if a definitive diagnosis was established after study (Correct answer)
Chest pain codes are always manifestation codes

Correct answer: Non-specific symptom codes like chest pain may be flagged as questionable principal diagnoses if a definitive diagnosis was established after study

For inpatient claims, coders should code the confirmed diagnosis established after study. If a definitive diagnosis was identified, sequencing the symptom code as principal when a confirmed diagnosis is documented is incorrect and may be flagged.

Question 98: Under ICD-10-CM Official Coding Guidelines, when two or more diagnoses meet the definition of principal diagnosis, how should the coder proceed?

The admitting diagnosis must be listed as principal
Always code the condition with the highest DRG weight first
Query the physician to select one principal diagnosis
Either condition may be sequenced first (Correct answer)

Correct answer: Either condition may be sequenced first

When two or more conditions equally meet the definition of principal diagnosis, the Official Guidelines state that either may be sequenced first as principal diagnosis.

Question 99: According to the Uniform Hospital Discharge Data Set (UHDDS), the principal diagnosis is defined as the condition established after study to be chiefly responsible for what?

Occasioning the admission to the hospital (Correct answer)
Determining the patient's prognosis
Establishing the plan of care
The patient's chronic conditions

Correct answer: Occasioning the admission to the hospital

The UHDDS defines the principal diagnosis as the condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital.

Question 100: The 'separate procedure' designation in CPT means:

The procedure must be performed by a different surgeon
The procedure is always reported separately regardless of other services
The procedure requires its own operative report
The procedure is commonly carried out as part of a larger service and should not be reported separately when performed as an integral component (Correct answer)

Correct answer: The procedure is commonly carried out as part of a larger service and should not be reported separately when performed as an integral component

A 'separate procedure' designation means the code should only be reported independently when it is not incidental to another more complex procedure performed at the same session.

Question 101: In ICD-10-PCS, the Medical and Surgical section is identified by which first character?

0 (Correct answer)
M
1
S

Correct answer: 0

The Medical and Surgical section, which is the largest section of ICD-10-PCS, uses the value '0' as the first character of all codes.

Question 102: In ICD-10-CM, what is the purpose of a 7th character 'S' (sequela)?

Indicates a subsequent encounter for the condition
Indicates the condition is a placeholder
Indicates an initial encounter for the condition
Indicates complications or conditions that arise as a direct result of a previous injury or illness (Correct answer)

Correct answer: Indicates complications or conditions that arise as a direct result of a previous injury or illness

The 7th character 'S' identifies sequela, which are late effects or residual conditions resulting from a previous injury or illness.

Question 103: A surgeon performs a laparoscopic appendectomy. Which ICD-10-PCS approach value is used?

4 - Percutaneous Endoscopic (Correct answer)
0 - Open
3 - Percutaneous
7 - Via Natural or Artificial Opening

Correct answer: 4 - Percutaneous Endoscopic

Laparoscopic procedures use approach value 4 - Percutaneous Endoscopic, which means entry through small puncture wounds using endoscopic visualization.

Question 104: Which of the following represents the correct hierarchy of source documents when conflicting information exists for determining the principal procedure on an inpatient claim?

Nursing notes, then operative report, then discharge summary
Physician orders, then discharge summary, then operative report
Operative report, then procedure notes, then discharge summary (Correct answer)
Discharge summary, then nursing notes, then operative report

Correct answer: Operative report, then procedure notes, then discharge summary

The operative report is the most authoritative source for surgical procedures, followed by procedure notes, then the discharge summary when discrepancies exist.

Question 105: Which organization administers the CCS certification exam?

American Health Information Management Association (AHIMA) (Correct answer)
National Healthcareer Association (NHA)
American Academy of Professional Coders (AAPC)
Health Information Trust Alliance (HITRUST)

Correct answer: American Health Information Management Association (AHIMA)

The American Health Information Management Association (AHIMA) is the professional organization responsible for administering the Certified Coding Specialist (CCS) certification exam. AHIMA sets the standards for health information management and coding professionals, ensuring the credibility and recognition of the CCS credential within the healthcare industry. They are the authoritative body for this certification.

Question 106: What is the consequence of upcoding in medical coding?

Legal and financial penalties. (Correct answer)
Faster claims processing.
Increased provider reimbursement without issue.
Improved patient satisfaction.

Correct answer: Legal and financial penalties.

Upcoding involves intentionally billing for a more expensive service or procedure than what was actually performed or documented. This fraudulent practice can lead to significant legal and financial penalties for healthcare providers, including fines, audits, and exclusion from federal healthcare programs. It undermines the integrity of the billing system and can result in overpayment by insurers.

Question 107: A healthcare worker notices a colleague looking up records of a celebrity patient without a clinical reason. The worker should:

Report the activity to the Privacy Officer or compliance department (Correct answer)
Ignore the behavior if the colleague seems trustworthy
Access the same records to verify what was viewed
Warn the celebrity patient personally

Correct answer: Report the activity to the Privacy Officer or compliance department

Accessing records without a legitimate clinical purpose is a HIPAA violation, and employees are obligated to report such suspicious activity through proper channels.

CCS Certified Coding Specialist Exam

The AHIMA Certified Coding Specialist (CCS) exam validates proficiency in classifying medical data from patient records using ICD-10-CM, ICD-10-PCS, and CPT/HCPCS coding systems across inpatient and outpatient settings.

107

Questions

240 min

Time Limit

70%

To Pass

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