CERTIFIED CODING SPECIALIST (CCS) EXAM WITH
AHIMA / AHIMA CCS EXAM QUESTION BANK WITH
COMPLETE REAL QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALES (A NEW UPDATED
VERSION ) |GUARANTEED PASS A+ (MOST TESTED
QUESTIONS FROM THE PAST EXAMS) +B
To assign modifier ______correctly, two physicians of different ________ must have
worked together as co-surgeons and each surgeon dictated his/her own operative
report. - ANSWER: -62
specialties
When more than two physicians work together to complete a complicated
procedure and each physician has a specific portion of the surgery to complete, they
are called.... - ANSWER: co-surgeons
This modifier indicates an increased service and is overused and results in an
increase in payment of 20% to 30%. As such, the assignment of this modifier comes
under particularly close scrutiny by third-party payers. What is this modifier? -
ANSWER: -22
When adding multiple CPT modifiers to a code, you would list the modifiers from:
When adding multiple HCPCS modifiers, list in:
If CPT modifiers and HCPCS modifiers are both used, list: - ANSWER: CPT- highest to
lowest
HCPS-ascending alphabetical order
both- CPT (highest to lowest) then HCPS (ascend. alpha.)
What part of the CPT manual lists a full description for all modifiers? - ANSWER:
appendix A
When a CPT codes does not fully explain an unusual procedure,what should be
added to the code? - ANSWER: modifier
Third-Party payers require this modifier for a mandated service. - ANSWER: -32
(like a rape test required by police, or phyiscal exam needed for workers comp;
third-party payer will pay 100% for mandated services)
Modifier -47, anesthesia by the surgeon, is never added to what CPT code? -
ANSWER: Anesthesia Code
How many units of service may be billed when reporting the -50 modifier (bilateral)
to Medicare? - ANSWER: one unit
,(For medicare, just submit 27447-50 for procedure done left and right; whereas
other payers want two lines 27447 and 27447-50.)
When reporting -51 modifier to indicate multiple procedure performed, which
procedure should be reported first on the claim? - ANSWER: Primary Procedure
Medicare considers what service to be part of the surgery and bundled payment not
allowing the -56 modifier? - ANSWER: preoperative
E&M services provided the day before or the day of a major surgery are included in
what package? - ANSWER: Global Day
Modifier -63 indicates procedure provided to a neonate or infant up to what weight?
- ANSWER: 4 kg or 8.8 lbs
A surgical team consists of how many physicians? - ANSWER: More than two
What is defined as a place of service specifically equipped and staffed for the sole
purpose of performing procedures? - ANSWER: Operating Room
How many modifier area are available on a CMS-1500 insurance claim form for one-
line item charge? - ANSWER: four
Describing a physician's services in radiology or pathology. - ANSWER: Professional
component
Describing the services provided by the facility. - ANSWER: Technical Component
Bundling together of time effort and services for a specific procedure into one code
instead of reporting each component separately - ANSWER: Surgical Package
Code assignments in the E/M section varies according to three factors: - ANSWER: 1.
place of service
2. type of service
3. patient status
Type of service (for E/M) examples - ANSWER: consultation, admission, newborn
care, office visit
Six sections of the CPT manual - ANSWER: Evaluation and Management
Anesthesia
Surgery
Radiology
Pathology and Laboratory
Medicine
Patient status (for E/M) - ANSWER: new, established, outpatient, inpatient
, A new patient is one who has not received a face-to-face professional service from
that physician or another physician in the same practice of the same specialty for
_____ years. - ANSWER: 3 years
Another name for the HCPCS Level II is: - ANSWER: national codes
The face-to-face encounter between a physician and a patient for primary
management of the patient's health status is a/an _____. - ANSWER: office visit
The key component of E/M service is _____. - ANSWER: medical decision-making
The four levels of medical decision-making complexity are: - ANSWER:
1.straightforward
2.low
3.moderate
4.high
The complexity of medical decision-making is based on: - ANSWER: 1. number of
diagnoses
2. amount or complexity of data to review
3. risk of complication or death if the condition is left untreated
UHDDS - ANSWER: Uniform Hospital Discharge Data Set
The definition of a ____ ______ is one that is performed for definitive tx rather than
for diagnostic or exploratory purposes or when it is necessary to take care of a
complication - ANSWER: Principal procedure
What identifies where the patient is at conclusion of healthcare or the end time of
billing cycle - ANSWER: Discharge disposition
UB-04 is maintained by the - ANSWER: National uniform billing committee
What was created for hospital inpatient prospective payment to better to reflect the
patients severity of illness and expected risk of mortality - ANSWER: MS- DRG,
Medical severity Diagnostic related group
Conditions that develop during an outpatient encounter including ER, Observation or
outpatient surgery are considered ______ - ANSWER: Present on admission
Where are POA guidelines found in ICD-10-cm - ANSWER: Appendix 1
IPPS - ANSWER: inpatient prospective payment system
Under the _____ each case is categorized into a DRG - ANSWER: Inpatient
prospective payment system
AHIMA / AHIMA CCS EXAM QUESTION BANK WITH
COMPLETE REAL QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALES (A NEW UPDATED
VERSION ) |GUARANTEED PASS A+ (MOST TESTED
QUESTIONS FROM THE PAST EXAMS) +B
To assign modifier ______correctly, two physicians of different ________ must have
worked together as co-surgeons and each surgeon dictated his/her own operative
report. - ANSWER: -62
specialties
When more than two physicians work together to complete a complicated
procedure and each physician has a specific portion of the surgery to complete, they
are called.... - ANSWER: co-surgeons
This modifier indicates an increased service and is overused and results in an
increase in payment of 20% to 30%. As such, the assignment of this modifier comes
under particularly close scrutiny by third-party payers. What is this modifier? -
ANSWER: -22
When adding multiple CPT modifiers to a code, you would list the modifiers from:
When adding multiple HCPCS modifiers, list in:
If CPT modifiers and HCPCS modifiers are both used, list: - ANSWER: CPT- highest to
lowest
HCPS-ascending alphabetical order
both- CPT (highest to lowest) then HCPS (ascend. alpha.)
What part of the CPT manual lists a full description for all modifiers? - ANSWER:
appendix A
When a CPT codes does not fully explain an unusual procedure,what should be
added to the code? - ANSWER: modifier
Third-Party payers require this modifier for a mandated service. - ANSWER: -32
(like a rape test required by police, or phyiscal exam needed for workers comp;
third-party payer will pay 100% for mandated services)
Modifier -47, anesthesia by the surgeon, is never added to what CPT code? -
ANSWER: Anesthesia Code
How many units of service may be billed when reporting the -50 modifier (bilateral)
to Medicare? - ANSWER: one unit
,(For medicare, just submit 27447-50 for procedure done left and right; whereas
other payers want two lines 27447 and 27447-50.)
When reporting -51 modifier to indicate multiple procedure performed, which
procedure should be reported first on the claim? - ANSWER: Primary Procedure
Medicare considers what service to be part of the surgery and bundled payment not
allowing the -56 modifier? - ANSWER: preoperative
E&M services provided the day before or the day of a major surgery are included in
what package? - ANSWER: Global Day
Modifier -63 indicates procedure provided to a neonate or infant up to what weight?
- ANSWER: 4 kg or 8.8 lbs
A surgical team consists of how many physicians? - ANSWER: More than two
What is defined as a place of service specifically equipped and staffed for the sole
purpose of performing procedures? - ANSWER: Operating Room
How many modifier area are available on a CMS-1500 insurance claim form for one-
line item charge? - ANSWER: four
Describing a physician's services in radiology or pathology. - ANSWER: Professional
component
Describing the services provided by the facility. - ANSWER: Technical Component
Bundling together of time effort and services for a specific procedure into one code
instead of reporting each component separately - ANSWER: Surgical Package
Code assignments in the E/M section varies according to three factors: - ANSWER: 1.
place of service
2. type of service
3. patient status
Type of service (for E/M) examples - ANSWER: consultation, admission, newborn
care, office visit
Six sections of the CPT manual - ANSWER: Evaluation and Management
Anesthesia
Surgery
Radiology
Pathology and Laboratory
Medicine
Patient status (for E/M) - ANSWER: new, established, outpatient, inpatient
, A new patient is one who has not received a face-to-face professional service from
that physician or another physician in the same practice of the same specialty for
_____ years. - ANSWER: 3 years
Another name for the HCPCS Level II is: - ANSWER: national codes
The face-to-face encounter between a physician and a patient for primary
management of the patient's health status is a/an _____. - ANSWER: office visit
The key component of E/M service is _____. - ANSWER: medical decision-making
The four levels of medical decision-making complexity are: - ANSWER:
1.straightforward
2.low
3.moderate
4.high
The complexity of medical decision-making is based on: - ANSWER: 1. number of
diagnoses
2. amount or complexity of data to review
3. risk of complication or death if the condition is left untreated
UHDDS - ANSWER: Uniform Hospital Discharge Data Set
The definition of a ____ ______ is one that is performed for definitive tx rather than
for diagnostic or exploratory purposes or when it is necessary to take care of a
complication - ANSWER: Principal procedure
What identifies where the patient is at conclusion of healthcare or the end time of
billing cycle - ANSWER: Discharge disposition
UB-04 is maintained by the - ANSWER: National uniform billing committee
What was created for hospital inpatient prospective payment to better to reflect the
patients severity of illness and expected risk of mortality - ANSWER: MS- DRG,
Medical severity Diagnostic related group
Conditions that develop during an outpatient encounter including ER, Observation or
outpatient surgery are considered ______ - ANSWER: Present on admission
Where are POA guidelines found in ICD-10-cm - ANSWER: Appendix 1
IPPS - ANSWER: inpatient prospective payment system
Under the _____ each case is categorized into a DRG - ANSWER: Inpatient
prospective payment system
