CERTIFIED CODING SPECIALIST (CCS)
EXAM QUESTIONS AND ANSWERS | 2026
UPDATE | 100% CORRECT.
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 - ANS 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 - ANS d. K74.60, I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
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,**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 - ANS
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 - ANS 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.
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,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 - ANS 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. - ANS
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 - ANS 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
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, c. I50.9, Heart failure, unspecified and I15.0, Renovascular hypertension
d. N18.6, End stage renal disease - ANS 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. - ANS 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.
@COPYRIGHT ALL RIGHTS RESERVED PAGE 4 OF 45
EXAM QUESTIONS AND ANSWERS | 2026
UPDATE | 100% CORRECT.
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 - ANS 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 - ANS d. K74.60, I85.11
K74.60: Unspecified cirrhosis of liver
I85.11:Secondary esophageal varices with bleeding
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 45
,**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 - ANS
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 - ANS 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.
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 45
,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 - ANS 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. - ANS
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 - ANS 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
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 45
, c. I50.9, Heart failure, unspecified and I15.0, Renovascular hypertension
d. N18.6, End stage renal disease - ANS 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. - ANS 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.
@COPYRIGHT ALL RIGHTS RESERVED PAGE 4 OF 45
