CCS EXAM 2
WITH COMPLETE QUESTIONS AND
CORRECT ANSWERS (2026–2027)
LATEST
A female patient with hematochezia presents to the hospital outpatient surgery
department for a colonoscopy but the procedure was not performed due to
elevated blood pressure. What is the firstlisted diagnosis for this encounter?
a. Elevated blood pressure
b. Hematochezia
c. Procedure not performed due to contraindication
d. Procedure not performed for other reason - ANSWER-Correct ANSWER: B
When a patient presents for outpatient surgery, code the reason for the surgery as
the firstlisted diagnosis (reason for the encounter) even if the surgery is not
performed due to a contraindication (CMS 2020a, Section IV.A.1., 113).
A 55-year-old patient with AIDS admitted after being struck by car while walking
in a parking lot. She has a comminuted, right femoral shaft fracture and a
contusion of both hands and right elbow abrasion. The principal diagnosis should
be the:
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,a. AIDS
b. Fractured femur
c. Abrasion elbow
d. Contusion hand - ANSWER-Correct ANSWER: B
If a patient with HIV disease is admitted for an unrelated condition (such as a
traumatic injury), the code for the unrelated condition (for example, the nature
of injury code) should be the principal diagnosis. The most severe injury should
be sequenced first. Other diagnoses would be B20 followed by additional
diagnosis codes for all reported HIV-related conditions (CMS 2020a, Section
I.C.1.a.2.b., 21).
A patient takes Coumadin as prescribed and correctly administered. However,
the patient develops hematuria secondary to the Coumadin use. The correct
coding assignment for this case would be:
a. Poisoning due to Coumadin
b. Unspecified adverse reaction to Coumadin
c. Hematuria, poisoning due to Coumadin
d. Hematuria, adverse reaction to Coumadin - ANSWER-Correct ANSWER: D
An adverse reaction can occur when a drug was correctly prescribed and
administered. In the case of an adverse reaction, the manifestation is coded
first (Hematuria) followed by a T code for the medication (Coumadin) (CMS
2 020a, Section I.C.19.e.5(a), 81).
A patient with human immunodeficiency virus (HIV) with methicillin
susceptible pneumonia due to Staphylococcus aureus was discharged from the
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,acute-care setting. The physician documented that the pneumonia was HIV
related. How should this be coded?B20Human immunodeficiency virus [HIV]
disease
J15.20Pneumonia due to staphylococcus, unspecified
J15.211Pneumonia due to methicillin susceptible Staphylococcus aureus
J15.212Pneumonia due to methicillin resistant Staphylococcus aureus
J17Pneumonia in diseases classified elsewhere
a. B20, J17
b. J15.20, B20
c. B20, J15.211
d. J15.212, B20 - ANSWER-Correct ANSWER: C
This is a confirmed HIV case; therefore, the HIV is sequenced as principal
diagnosis, followed by the additional diagnosis code for the MSSA pneumonia
(CMS 2020a, Section I.C.1.a., 21).
Assign code(s) for the following diagnosis: Congestive heart failure due to
hypertension.
I10Essential (primary) hypertension
I11.0Hypertensive heart disease with heart failure
I50.9Heart failure, unspecified
I50.23Acute on chronic systolic (congestive) heart failure
a. I10, I50.9
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, b. I11.0
c. I50.23, I10
d. I11.0, I50.9 - ANSWER-Correct ANSWER: D
Heart failure is assigned a combination code when a causal relationship is stated
(due to hypertension) or implied (hypertensive). Use an additional code to
identify the type of heart failure in those patients with heart failure (CMS 2
020a, Section I.C.9.a.1, 46-47).
A patient is seen for evaluation of a right orbital roof fracture. How should this
be coded?
S02.121AFracture of orbital roof, right side, initial encounter for closed fracture
S02.31XAFracture of orbital floor, right side, initial encounter for closed fracture
S02.92XAUnspecified fracture of facial bones, initial encounter for closed
fracture
S02.91XAUnspecified fracture of skull, initial encounter for closed fracture
a. S02.121A
b. S02.31XA
c. S02.92XA
d. S02.91XA - ANSWER-Correct ANSWER: A
Alphabetic Index for fracture, traumatic; orbit, orbital; roof guides the coder to
S02.12. Evaluation of a fracture is an example of active treatment which is
reported with 7th character "A" (Schraffenberger and Palkie 2020, 580-584).
Patient presents in the ER with thrombosis of a loop PTFE hemodialysis fistula
without mechanical complications. The physician performed a percutaneous
thrombectomy of the left brachial vein. Assign a facility code for this outpatient
procedure.
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WITH COMPLETE QUESTIONS AND
CORRECT ANSWERS (2026–2027)
LATEST
A female patient with hematochezia presents to the hospital outpatient surgery
department for a colonoscopy but the procedure was not performed due to
elevated blood pressure. What is the firstlisted diagnosis for this encounter?
a. Elevated blood pressure
b. Hematochezia
c. Procedure not performed due to contraindication
d. Procedure not performed for other reason - ANSWER-Correct ANSWER: B
When a patient presents for outpatient surgery, code the reason for the surgery as
the firstlisted diagnosis (reason for the encounter) even if the surgery is not
performed due to a contraindication (CMS 2020a, Section IV.A.1., 113).
A 55-year-old patient with AIDS admitted after being struck by car while walking
in a parking lot. She has a comminuted, right femoral shaft fracture and a
contusion of both hands and right elbow abrasion. The principal diagnosis should
be the:
Page | 1
,a. AIDS
b. Fractured femur
c. Abrasion elbow
d. Contusion hand - ANSWER-Correct ANSWER: B
If a patient with HIV disease is admitted for an unrelated condition (such as a
traumatic injury), the code for the unrelated condition (for example, the nature
of injury code) should be the principal diagnosis. The most severe injury should
be sequenced first. Other diagnoses would be B20 followed by additional
diagnosis codes for all reported HIV-related conditions (CMS 2020a, Section
I.C.1.a.2.b., 21).
A patient takes Coumadin as prescribed and correctly administered. However,
the patient develops hematuria secondary to the Coumadin use. The correct
coding assignment for this case would be:
a. Poisoning due to Coumadin
b. Unspecified adverse reaction to Coumadin
c. Hematuria, poisoning due to Coumadin
d. Hematuria, adverse reaction to Coumadin - ANSWER-Correct ANSWER: D
An adverse reaction can occur when a drug was correctly prescribed and
administered. In the case of an adverse reaction, the manifestation is coded
first (Hematuria) followed by a T code for the medication (Coumadin) (CMS
2 020a, Section I.C.19.e.5(a), 81).
A patient with human immunodeficiency virus (HIV) with methicillin
susceptible pneumonia due to Staphylococcus aureus was discharged from the
Page | 2
,acute-care setting. The physician documented that the pneumonia was HIV
related. How should this be coded?B20Human immunodeficiency virus [HIV]
disease
J15.20Pneumonia due to staphylococcus, unspecified
J15.211Pneumonia due to methicillin susceptible Staphylococcus aureus
J15.212Pneumonia due to methicillin resistant Staphylococcus aureus
J17Pneumonia in diseases classified elsewhere
a. B20, J17
b. J15.20, B20
c. B20, J15.211
d. J15.212, B20 - ANSWER-Correct ANSWER: C
This is a confirmed HIV case; therefore, the HIV is sequenced as principal
diagnosis, followed by the additional diagnosis code for the MSSA pneumonia
(CMS 2020a, Section I.C.1.a., 21).
Assign code(s) for the following diagnosis: Congestive heart failure due to
hypertension.
I10Essential (primary) hypertension
I11.0Hypertensive heart disease with heart failure
I50.9Heart failure, unspecified
I50.23Acute on chronic systolic (congestive) heart failure
a. I10, I50.9
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, b. I11.0
c. I50.23, I10
d. I11.0, I50.9 - ANSWER-Correct ANSWER: D
Heart failure is assigned a combination code when a causal relationship is stated
(due to hypertension) or implied (hypertensive). Use an additional code to
identify the type of heart failure in those patients with heart failure (CMS 2
020a, Section I.C.9.a.1, 46-47).
A patient is seen for evaluation of a right orbital roof fracture. How should this
be coded?
S02.121AFracture of orbital roof, right side, initial encounter for closed fracture
S02.31XAFracture of orbital floor, right side, initial encounter for closed fracture
S02.92XAUnspecified fracture of facial bones, initial encounter for closed
fracture
S02.91XAUnspecified fracture of skull, initial encounter for closed fracture
a. S02.121A
b. S02.31XA
c. S02.92XA
d. S02.91XA - ANSWER-Correct ANSWER: A
Alphabetic Index for fracture, traumatic; orbit, orbital; roof guides the coder to
S02.12. Evaluation of a fracture is an example of active treatment which is
reported with 7th character "A" (Schraffenberger and Palkie 2020, 580-584).
Patient presents in the ER with thrombosis of a loop PTFE hemodialysis fistula
without mechanical complications. The physician performed a percutaneous
thrombectomy of the left brachial vein. Assign a facility code for this outpatient
procedure.
Page | 4
