CCS Exam Study Questions 2023/ 2024 |
Questions and Answers (Verified Answers)
Q: Assign code(s) for mammographic guidance for bilateral breast needle localization for lesion
placement with fine needle aspiration:
Answer:
19081-50, Biopsy, breast, with placement of localization device(s) (clip, metallic pellet) when
performed, and imaging of biopsy specimen, percutaneous; first lesion incl stereotactic guidance,
bilateral procedure
10022-50, Fine needle aspiration, with imaging guidance, bilateral procedure
Q: Doc in record reveals pt is adm w/acute exacerbation of COPD (MS-DRG 192). Higherpaying DRG may be appropriate if doc is present in record at the time the decision was made to
admit pt that confirms dx associated with:
Answer:
Blood gases of pO2 of 58, pCO2 of 55, pH of 7.32 upon adm and treated w/intubation and
mechanical vent for 23 hours since this would bump to MS-DRG 208
Q: Female pt dx w/CHF, but what would incr MS-DRG weight if POA?
Answer:
Stage III pressure ulcer would optimize DRG. CHF alone, with atrial fib, with blood loss anemia,
and with coronary artery disease all remain the same weight.
Q: If PD is initial episode of anterior wall myocardial infarction, which procedure will result in
highest DRG?
Answer:
Transbronchial lung biopsy would optimize DRG. Myocardial infarction alone, with insertion of
central venous catheter are a lower weight, and myocardial infarction with mechanical ventilator
is also a lower weight.
Q: Pt adm with hemorrhage due to placenta previa w/twin pgs. Pt had 2 prior C-section
deliveries. Emergency C-Section was performed due to hemorrhage. Assign PD:
Answer:
Placenta previa with hemorrhage
Q: Pt adm w/spotting, fever, and found to have been tx for miscarriage which was resolved 2
wks prior to this adm. She is tx w/aspiration D&C and POC are found, along w/her being septic.
What is the PD?
Answer:
Sepsis following incomplete spontaneous abortion
Q: Pt adm w/acute inferior myocardial infarction and discharged alive. What cond would incr
DRG weight?
Answer:
Respiratory failure since myocardial infarction alone, with atrial fib, with hypertension, and with
hx of myocardial infarction all carry the same weight
Q: 70yo pt adm w/pneu and H&P doc pt has hx of diabetes, hypertension, and migraine
headache about 10yrs ago w/o recurrence. Pt was adm IV antibiotics, metformin, and Altace
during the hosp stay. What cond would be reported at time of discharge?
Answer:
Pneumonia, diabetes, and hypertension
Q: Diabetic pt adm for tx of pressure ulcer and also has hx of diabetic neuropathy. Pt is blind
and add’l nursing card and extended time with pt was req. What cond should be coded at time of
discharge?
Answer:
Pressure ulcer, diabetic neuropathy, diabetic retinopathy, and blindness
Q: During adm for CHF a chest x-ray was done to eval for presence of CHF and an
asymptomatic hernia was found for which no tx/eval was done. What is the primary reason that
the hernia should not be coded?
Answer:
Hernia is incidental finding and does not meet UHDDS guidelines for “other cond”.
Q: When inpt had had mult test to eval an abnormal finding but no definitive dx has been doc
the coder should:
Answer:
Query phys re: whether dx should be assigned or not
Q: Pt present to facility w/hx of prostate cancer and mental confusion on adm. Pt completed
radiation therapy for prostatic carcinoma 3yrs ago and is status post a radical resection of the
prostate. CT scan of brain reveals metastatic carcinoma of brain, so correct coding/seq of this pt’s
record is:
Answer:
Metastatic carcinoma of the brain, hx of carcinoma of prostate
Q: What are pymt status indicators that are assigned to an APC and indicate APC pymt?
Answer:
G,H,K,P,R,S,T,U,X,V
Q: What status indicator denotes no specific pymt for that APC since procedure pymt is
included in another APC?
Answer:
N
Q: T/F: There may not be mult APCs w/same or different pymt status indicators per claim.
Answer:
False
Q: Mult surgical procedures performed during the same operative session are discounted with
what indicator?
Answer:
T
Q: The highest-weight T procedure is reimbursed to what percentage?
Answer:
100%
Q: All other procedures w/pymt status indicator T are reimbursed at what percentage?
Answer:
50%