Certified Coding Specialist (CCS)
Exam Preparation RATED A
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).
,Certified Coding Specialist (CCS)
Exam Preparation RATED A
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.
,Certified Coding Specialist (CCS)
Exam Preparation RATED A
** 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
, Certified Coding Specialist (CCS)
Exam Preparation RATED A
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?
Exam Preparation RATED A
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).
,Certified Coding Specialist (CCS)
Exam Preparation RATED A
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.
,Certified Coding Specialist (CCS)
Exam Preparation RATED A
** 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
, Certified Coding Specialist (CCS)
Exam Preparation RATED A
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?
