CCS PRACTICE EXAM 1 & 2 LATEST EXAM 2023-2024 ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES| (ALREADY GRADED A+) |BRAND NEW!!

CCS PRACTICE EXAM 1 & 2 LATEST EXAM 2023-2024

ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED

ANSWERS WITH RATIONALES| (ALREADY GRADED A+)

|BRAND NEW!!

CCS PRACTICE EXAM 1

A patient was admitted to the emergency department for abdominal pain with

diarrhea and was diagnosed with infectious gastroenteritis. In addition to

gastroenteritis, the final diagnostic statement included angina and chronic

obstructive pulmonary disease. List the diagnoses that would be coded and their

correct sequence.

a. Abdominal pain, infectious gastroenteritis, chronic obstructive pulmonary

disease, angina

b. Infectious gastroenteritis, chronic obstructive pulmonary disease, angina

c. Gastroenteritis, abdominal pain, angina

d. Diarrhea, chronic obstructive pulmonary disease, angina - ANSWER- Correct

Answer: B

Rationale: The abdominal pain and diarrhea are not coded as they are symptoms

integral to the diagnosis of infectious gastroenteritis. Review Coding Guideline

IV.D for additional information on coding of symptoms, signs, and ill-defined

conditions (CMS 2020a, Section IV.D., 113).

A patient was admitted to the endoscopy unit for a screening colonoscopy. During

the colonoscopy, polyps of the colon were found and a polypectomy was

performed. What diagnostic codes should be used and how should they be

sequenced?

Z12.11Encounter for screening for malignant neoplasm of colon

D12.6Benign neoplasm of colon, unspecified

Z86.010Personal history of colonic polyps

a. Z12.11, Z86.010

b. D12.6, Z12.11, Z86.010

c. Z12.11, D12.6

d. D12.6, Z12.11 - ANSWER- Correct Answer: C

Rationale: The circumstances of the encounter are for a screening colonoscopy.

Because of this screening, colonoscopy is listed first, followed by a code for the

polyps (CMS 2020a, Section I.C.21.c.5, 97-98).

The patient is admitted for chest pain and is found to have an acute inferior

myocardial infarction with coronary artery disease and atrial fibrillation. After the

atrial fibrillation was controlled and the patient was stabilized, the patient

underwent a CABG ×2 from aorta to the right anterior descending and right obtuse,

using the left greater saphenous vein which was harvested via an open approach.

Cardiopulmonary bypass was utilized. The appropriate sequencing and ICD codes

for the hospitalization would be:

I25.10Atherosclerotic heart disease of native coronary artery without angina

pectorisI21.19ST elevation (STEMI) myocardial infarction involving other

coronary artery of inferior wallI22.1Subsequent ST elevation (STEMI) myocardial

infarction of inferior wallI21.3ST elevation (STEMI) myocardial infarction, of

unspecified siteI22.9Subsequent ST elevation (STEMI) myocardial infarction of

unspecified siteI48.91Unspecified atrial fibrillationR07.9Chest pain,

unspecified02100AWBypass coronary artery, one artery from aorta with

autologous arterial tissue, open approach021109WBypass coronary artery, two

arteries from aorta with autologous venous tissue, open

approach06BQ0ZZExcision of left saphenous vein, open

approach5A1221ZPerformance of cardiac output, continuous

a. R07.9, I21.3, I48.91, I22.9, 02100AW, 5A1221Z

b. I21.19, I48.91, I22.9, 02100AW

c. I21.19, I25.10, I48.91, 021109W, 06BQ0ZZ, 5A1221Z

d. I22.1, I48.91, I21.19, 021109W - ANSWER- Correct Answer: C

Rationale: The patient's hospitalization includes a definitive diagnosis of

myocardial infarction of the inferior wall as well as the other diagnoses of coronary

artery disease and atrial fibrillation. The chest pain is not coded as it is a symptom

of the MI. The patient underwent CABG ×2 with cardiopulmonary bypass and

harvesting of the left saphenous vein to be used as graft material. All three

procedures are reportable and should be coded (Leon-Chisen 2020, 393-396, 430-

434).

A patient is admitted with hemoptysis. A bronchoscopy with transbronchial biopsy

of the lower lobe was undertaken that revealed squamous cell carcinoma of the

right lung. Which conditions should be identified as present on admission?

C34.30Malignant neoplasm of lower lobe, unspecified bronchus or lung

C34.31Malignant neoplasm of lower lobe, right bronchus or lung

P26.9Unspecified pulmonary hemorrhage originating in the perinatal period

R04.2Hemoptysis

a. C34.31, R04.2

b. R04.2

c. C34.31

d. C34.30, P26.9, R04.2 - ANSWER- Correct Answer: C

Rationale: The diagnosis after study (lung cancer) was present on admission. The

symptom (hemoptysis) of the carcinoma should not be assigned and therefore, will

not have a POA indicator. Code P26.9 would not be assigned because it is not

diagnosed and only applies to the perinatal period (CMS 2020a, Appendix I, 117-

121).

A condition is considered present on admission when it is:

a. The principal diagnosis

b. In accordance with medical staff bylaws

c. A condition that occurs prior to an inpatient admission

d. Present within three days after admission - ANSWER- Correct Answer: C

Rationale: It is important to understand the time frame for assigning a status code

specifying that a condition is present on admission. A condition is present on

admission when it occurs prior to inpatient admission (CMS 2020a, Appendix I,

117-121).

A newborn is diagnosed with meconium aspiration at birth. What is the appropriate

POA indicator for the meconium aspiration?

a. Y

b. N

c. U

d. W - ANSWER- Correct Answer: A

Rationale: Conditions present at birth are considered POA for newborns (CMS

2020a, Appendix I, 117-121).

A woman is admitted to the hospital for an exacerbation of COPD and mentions a

lump she has noticed in her right breast. While she in the hospital, a biopsy is done

of the breast lump and a diagnosis of ductal carcinoma is made. What is the POA

assignment for the carcinoma?

a. Y

b. N

c. U

d. W - ANSWER- Correct Answer: A

Rationale: Even though the diagnosis of cancer was made after admission, the

patient clearly had the condition when admitted. Therefore, a POA indicator of Y

should be assigned (CMS 2020a, Appendix I, 117-121).

The use of the outpatient code editor (OCE) is designed to:

a. Correct documentation of home health visits

b. Facilitate reporting of adverse drug events

c. Reduce the use of computer assisted coding

d. Identify incomplete or incorrect claims - ANSWER- Correct Answer: D

Rationale: The code editor software reviews many data elements and compares

them to what data specifications are required in order to weed out incomplete or

incorrect claims (Smith 2020, 314-315).

Medicare's identification of medically necessary services is outlined in:

a. Program transmittals

b. Claims processing manual

c. Local coverage determinations

d. National Correct Coding Initiative - ANSWER- Correct Answer: C

Rationale: Local coverage determinations (LCDs) are the mechanism by which

Medicare identifies medical necessity for services, procedures, and supplies (Casto

2018, 255).

Medically unlikely edits are used to identify:

a. Pairs of procedure codes that should not be billed together

b. Maximum units of service for a HCPCS code

c. Diagnoses that don't meet medical necessity

d. Procedure and gender discrepancies - ANSWER- Correct Answer: B

Rationale: Medically unlikely edits are in place to identify the maximum number

of units of service for a given HCPCS code for one beneficiary on one date of

service (Casto 2018, 256).

National Correct Coding Initiative (NCCI) Edits are released how often?

a. Monthly

b. Quarterly

c. Semi-annually

d. Annually - ANSWER- Correct Answer: B

Rationale: NCCI edits are released on a quarterly basis by Medicare (Casto 2018,

256).