AHIMA CCS EXAM 2026 ACTUAL
QUESTIONS WITH VERIFIED
COMPLETE SOLUTIONS/A+ SCORE
Claim Submission for Emergency Procedure - answers The provider should submit the
claim with an appropriate emergency code and follow up for insurance information.
Coding for Myocardial Infarction - answers Code the MI diagnosis and report
hypertension and diabetes as additional diagnoses, as both contribute to the patient's
condition.
Use of 'Z' Code in ICD-10-CM - answers A patient presenting for the treatment of a
chronic condition that is not active would not require a 'Z' code, as this is typically used
for health encounters not involving illness or injury.
Claim Submission for Outpatient Procedure - answers Report the procedure without any
modifier since the global surgery package covers all related services, unless there are
specific exceptions or additional services provided.
Coding Practice for Fracture and Laceration - answers Code the fracture of the left arm
first, followed by the laceration of the left leg. In ICD-10, the fracture would be prioritized
as the primary diagnosis when both a fracture and a laceration are present.
HIPAA violation - answers A coder discussing a patient's condition in a public place is a
HIPAA violation, as PHI should not be disclosed in an unauthorized manner.
Inpatient claims submission - answers Claims should not be submitted with outpatient
codes if the patient is admitted for less than 24 hours, as inpatient services require
inpatient codes regardless of the length of stay.
Refusal of treatment coding - answers Report a code for 'refusal of treatment' or
'refused diagnostic test' if such a code is available in the coding system.
Sequela codes - answers Sequela codes represent late effects of a previous injury or
condition and should be used when applicable.
Modifier 24 - answers Modifier 24 should be used to indicate that a procedure was
performed during the global period of a major surgery, but it is unrelated to the surgery.
Fluid accumulation coding - answers Do not report the fluid accumulation code, as the
surgeon did not specify a cause, and it cannot be coded without further clarification or a
more specific diagnosis.
,Planned surgery code - answers Report the planned surgery code, as it was scheduled
but never performed.
Procedure cancellation code - answers Report a code for the procedure and a code for
the cancellation of the surgery.
Diagnosis code for canceled procedure - answers Report the diagnosis code for the
condition that would have been treated by the procedure, along with the discharge
code.
Failed procedure code - answers Report the code for a 'failed procedure' and discharge
code.
Depression coding scenario - answers Do not report any code for depression since the
patient is not currently being treated.
HIPAA compliance for staged surgery - answers You should not submit a separate code
for each stage unless the guidelines specifically indicate it.
Traumatic brain injury coding - answers Report both the TBI and the intellectual
disability as separate diagnoses.
Family history coding - answers Report the family history codes for hypertension and
diabetes, as they are part of the patient's family medical history.
Active diagnosis coding - answers A physician documents that a patient has an active
diagnosis of Type 2 Diabetes Mellitus with Chronic Kidney Disease Stage 3.
Diabetes Code Reporting - answers Report the diabetes code first, followed by the
chronic kidney disease code, as the guidelines indicate that diabetes is typically coded
before related conditions.
Chronic Kidney Disease Code Reporting - answers Report the chronic kidney disease
code first, as it is the more severe condition.
Chronic Kidney Disease Only Reporting - answers Code only for the chronic kidney
disease, as it is the more serious diagnosis.
Diabetes Code Only Reporting - answers Report only the diabetes code, as the chronic
kidney disease is a complication.
Post-Surgery Follow-Up Coding - answers Report the routine visit code, as the patient is
stable with no complications, and the follow-up is for the routine post-surgery check.
, Procedure Code Reporting After Surgery - answers Report the code for the procedure
performed, as the visit is related to the surgery.
Post-Operative Condition Coding - answers Report the code for the patient's post-
operative condition, even if no complications are present.
Chronic Conditions Reporting - answers Report a code for any chronic conditions that
the patient has, regardless of their relevance to the surgery.
Hip Replacement Procedure Reporting - answers Report both the hip replacement and
osteomyelitis codes, with osteomyelitis listed as the secondary diagnosis, as it was
discovered during surgery and is a contributing factor to the treatment.
Osteomyelitis Code Reporting - answers Report the osteomyelitis code as a secondary
diagnosis, but not the hip replacement code.
Hip Replacement Only Reporting - answers Report the hip replacement procedure code
only, as osteomyelitis is unrelated.
Osteomyelitis Only Reporting - answers Report only the osteomyelitis code and omit the
hip replacement code.
Sore Throat and Cough Coding - answers Report the code for a sore throat and cough,
as these are the symptoms documented by the physician.
Suspected Strep Throat Coding - answers Report the code for strep throat, as it is the
suspected diagnosis.
Pharyngitis Coding - answers Report the code for pharyngitis due to the throat
symptoms, but do not report any specific diagnosis.
Confirmed Diagnosis Requirement - answers Report the code for strep throat only if the
diagnosis is confirmed by laboratory results.
Acute Respiratory Failure Documentation - answers Query the physician to clarify
whether acute respiratory failure was present during the admission.
Hypoxia Documentation Query - answers Query the physician to confirm if 'acute
respiratory failure' should be replaced with 'hypoxia.'
Discharge Summary Coding - answers Code acute respiratory failure because it is in
the discharge summary.
Hypoxia Coding - answers Code hypoxia because it is consistently documented in the
progress notes.
QUESTIONS WITH VERIFIED
COMPLETE SOLUTIONS/A+ SCORE
Claim Submission for Emergency Procedure - answers The provider should submit the
claim with an appropriate emergency code and follow up for insurance information.
Coding for Myocardial Infarction - answers Code the MI diagnosis and report
hypertension and diabetes as additional diagnoses, as both contribute to the patient's
condition.
Use of 'Z' Code in ICD-10-CM - answers A patient presenting for the treatment of a
chronic condition that is not active would not require a 'Z' code, as this is typically used
for health encounters not involving illness or injury.
Claim Submission for Outpatient Procedure - answers Report the procedure without any
modifier since the global surgery package covers all related services, unless there are
specific exceptions or additional services provided.
Coding Practice for Fracture and Laceration - answers Code the fracture of the left arm
first, followed by the laceration of the left leg. In ICD-10, the fracture would be prioritized
as the primary diagnosis when both a fracture and a laceration are present.
HIPAA violation - answers A coder discussing a patient's condition in a public place is a
HIPAA violation, as PHI should not be disclosed in an unauthorized manner.
Inpatient claims submission - answers Claims should not be submitted with outpatient
codes if the patient is admitted for less than 24 hours, as inpatient services require
inpatient codes regardless of the length of stay.
Refusal of treatment coding - answers Report a code for 'refusal of treatment' or
'refused diagnostic test' if such a code is available in the coding system.
Sequela codes - answers Sequela codes represent late effects of a previous injury or
condition and should be used when applicable.
Modifier 24 - answers Modifier 24 should be used to indicate that a procedure was
performed during the global period of a major surgery, but it is unrelated to the surgery.
Fluid accumulation coding - answers Do not report the fluid accumulation code, as the
surgeon did not specify a cause, and it cannot be coded without further clarification or a
more specific diagnosis.
,Planned surgery code - answers Report the planned surgery code, as it was scheduled
but never performed.
Procedure cancellation code - answers Report a code for the procedure and a code for
the cancellation of the surgery.
Diagnosis code for canceled procedure - answers Report the diagnosis code for the
condition that would have been treated by the procedure, along with the discharge
code.
Failed procedure code - answers Report the code for a 'failed procedure' and discharge
code.
Depression coding scenario - answers Do not report any code for depression since the
patient is not currently being treated.
HIPAA compliance for staged surgery - answers You should not submit a separate code
for each stage unless the guidelines specifically indicate it.
Traumatic brain injury coding - answers Report both the TBI and the intellectual
disability as separate diagnoses.
Family history coding - answers Report the family history codes for hypertension and
diabetes, as they are part of the patient's family medical history.
Active diagnosis coding - answers A physician documents that a patient has an active
diagnosis of Type 2 Diabetes Mellitus with Chronic Kidney Disease Stage 3.
Diabetes Code Reporting - answers Report the diabetes code first, followed by the
chronic kidney disease code, as the guidelines indicate that diabetes is typically coded
before related conditions.
Chronic Kidney Disease Code Reporting - answers Report the chronic kidney disease
code first, as it is the more severe condition.
Chronic Kidney Disease Only Reporting - answers Code only for the chronic kidney
disease, as it is the more serious diagnosis.
Diabetes Code Only Reporting - answers Report only the diabetes code, as the chronic
kidney disease is a complication.
Post-Surgery Follow-Up Coding - answers Report the routine visit code, as the patient is
stable with no complications, and the follow-up is for the routine post-surgery check.
, Procedure Code Reporting After Surgery - answers Report the code for the procedure
performed, as the visit is related to the surgery.
Post-Operative Condition Coding - answers Report the code for the patient's post-
operative condition, even if no complications are present.
Chronic Conditions Reporting - answers Report a code for any chronic conditions that
the patient has, regardless of their relevance to the surgery.
Hip Replacement Procedure Reporting - answers Report both the hip replacement and
osteomyelitis codes, with osteomyelitis listed as the secondary diagnosis, as it was
discovered during surgery and is a contributing factor to the treatment.
Osteomyelitis Code Reporting - answers Report the osteomyelitis code as a secondary
diagnosis, but not the hip replacement code.
Hip Replacement Only Reporting - answers Report the hip replacement procedure code
only, as osteomyelitis is unrelated.
Osteomyelitis Only Reporting - answers Report only the osteomyelitis code and omit the
hip replacement code.
Sore Throat and Cough Coding - answers Report the code for a sore throat and cough,
as these are the symptoms documented by the physician.
Suspected Strep Throat Coding - answers Report the code for strep throat, as it is the
suspected diagnosis.
Pharyngitis Coding - answers Report the code for pharyngitis due to the throat
symptoms, but do not report any specific diagnosis.
Confirmed Diagnosis Requirement - answers Report the code for strep throat only if the
diagnosis is confirmed by laboratory results.
Acute Respiratory Failure Documentation - answers Query the physician to clarify
whether acute respiratory failure was present during the admission.
Hypoxia Documentation Query - answers Query the physician to confirm if 'acute
respiratory failure' should be replaced with 'hypoxia.'
Discharge Summary Coding - answers Code acute respiratory failure because it is in
the discharge summary.
Hypoxia Coding - answers Code hypoxia because it is consistently documented in the
progress notes.
