CCS - Certified Coding Specialist Examination Questions Answers PDF Prepare for your CCS (Certified Coding Specialist) Exam with our comprehensive and reliable preparation materials. Our curated collection includes practice exams, detailed questions and answers, as well as PDF resources to enhance your coding skills and knowledge. Whether you're a seasoned professional or a newcomer to the field, our materials are designed to help you excel in the CCS Exam. For Download: https://www.certswarrior.com/exam/ccs/ Question: 1 Which of the following was adopted by the federal government as the standard for inpatient healthcare data? A. POA B. OPPS C. UHDDS D. RBRVS Answer: C Explanation: The Uniform Hospital Discharge Data Set (UHDDS) was adopted by the federal government as the standard for collecting healthcare data. By providing a list of data elements that are required when submitting a claim, the quality and efficiency of healthcare services being rendered can more easily be evaluated and the costs for which those services should be paid can be standardized. Present on admission (POA) is a type of guideline used to differentiate illnesses and/or injuries that a patient presented with upon their admission from those that developed later during their inpatient stay. The resource-based relative value scale (RBRVS) is a payment system calculated by factoring the cost of the physician's work, practice expense, professional liability insurance, and geographical location. The outpatient prospective payment system (OPPS) is a payment system designed to promote the predictability of payment, promote consistency, and encourage the quality of care given to Medicare patients receiving outpatient services in a hospital setting. Question: 2 How is data for the UHDDS collected? A. By submitting statistical data through CMS.gov B. By reviewing inpatient claim submissions C. Through annual audits D. By submitting statistical data to the Department of Health and Human Services Answer: B Explanation: All of the data required by UHDDS that should be documented in an individual's medical record is reviewed and reported by the coding staff and matched with the appropriate ICD-IO-CM and CPT codes. Each CPT code should have a cost associated with it, thus creating a total charge for the services provided. All of this information is then entered on an insurance claim form and is submitted to the healthcare payer for evaluation and review. This information is next collected by UHDDS to evaluate the quality and efficiency of healthcare services being rendered and to standardize the cost for which those services should be charged and paid. Question: 3 A patient with a history of type 1 diabetes is admitted to the hospital and later develops hyperglycemia. What ICD-IO-CM code(s) should the physician report if the POA indicator is A. ElO.69, R73.9 B. ElO.9, R73.9 C. ElO.65 D. R73.9 Answer: C Explanation: When an illness or disease is POA, but a manifestation or complication of the disease presents itself during an inpatient stay, the combination ICD-IO-CM code should always be reported. POA guidelines stipulate that if both conditions in the combination code are POA, the POA indicator should be Y. On the other hand, if the patient only presents with the one disease, in this case the type 1 diabetes mellitus, and later develops an associated complication, the POA indicator should be N. Question: 4 Which of the following is NOT a violation of HIPAA? A. An encrypted laptop is stolen from a physician's vehicle. B. A hospital with a multilayered cybersecurity defense experiences a data breach by a cybercriminal. C. An office fails to perform a risk assessment of electronic health information. D. An employee drops off patient records on a physician's porch. Answer: B Explanation: HIPAA is in place to reduce the associated risk of a potential violation or breach. Although a breach has occurred in this scenario, HIPAA was not violated because the hospital took appropriate preventative measures. High-risk behaviors, such as leaving a laptop in an unattended vehicle or leaving medical records outside, allow opportunities for an unauthorized individual to access protected health information. Finally, a medical practice is required by HIPAA to perform a risk analysis of electronic health information and rectify any issues immediately. Question: 5 Which service would NOT be covered under Medicare Part A? A. Inpatient hospital care B. Home health service C. Observation hospital care D. Hospice care Answer: C Explanation: Observation hospital care is provided to patients who are not sick enough to be admitted. Therefore, this type of care is considered outpatient and is covered under Medicare Part B. Question: 6 A low-risk obstetrical patient is told to come in for weekly ultrasounds in her first trimester. This is an example of what? A. Waste B. Abuse C. Fraud D. Misuse Answer: A Explanation: Because the patient is not at risk and most fetal organs are not developed and/or cannot be visualized in the first trimester, weekly ultrasounds are considered wasteful and an unnecessary cost to health insurance plans. Fraud is knowingly and willfully obtaining, or attempting to obtain, money by means of false pretenses from any healthcare benefit program. Abuse is similar to fraud, with the exception that the intent is not, or cannot, be proved to be willful or knowing. Question: 7 A patient is seen by her primary care physician for a severe allergic reaction to strawberries. The physician administers 0.5 mg of epinephrine subcutaneously. What code(s) should the physician report? A. 10171 (5 units) B. 99212-25, J0171 (5 units) C. 99213, J0171 D. 96372, J0171 (5 units) Answer: D Explanation: HCPCS Level II code JOI 71 can be found by either reviewing section J in the manual, "Drugs administered other than oral method" or by locating epinephrine in Appendix 1 in the manual, "Table of Drugs." Because 0.5 mg of epinephrine was administered, and each unit of code JOI 71 represents only 0.1 mg of the drug, five units should be reported. The subcutaneous injection is reported with CPT code 96372, which includes an inherent E/M component unless the physician goes beyond such services. Question: 8 Which four organizations, known collectively as the Cooperating Parties, are responsible for the official ICD- IO-CM guidelines? A. The American Health Information Management Association (AHIMA), the American Academy of Professional Coders (AAPC), the Centers for Medicare & Medicaid Services (CMS), and the American Medical Association (AMA) B. AHIMA, AAPC, CMS, and the Medical Library Association C. AMA, The American Hospital Association (AHA), CMS, and the National Center for Health Statistics D. AHA, AHIMA, CMS, and the National Center for Health Statistics Answer: D Explanation: The four organizations responsible for the official sources of coding guidelines and conventions found in the ICD-IO-CM manual are AHA, AHIMA, CMS, and the National Center for Health Statistics. Although the official guidelines can be located in the introduction of the manual, each organization publishes its own individual resources to help its members understand relevant coding advice. Question: 9 A 27-year-old new patient presents for an annual preventative visit. The visit is normal; however, the physician spends an additional 20 minutes counseling the patient on their type 2 diabetes controlled with diet and metformin. How should the physician report his services? A. 99385-25, 99202 B. 99385, 99213-25 C. 99385-25, 99213 D. 99385, 99202-25 Answer: D Explanation: Modifier 25 is a CPT modifier that is appended on a "significant, separately identifiable evaluation and management service by the same physician" on the same day of another procedure or service. In this scenario, because the patient presented for an annual, the significant and separately identifiable service is the evaluation and management of the type 2 diabetes. When selecting the CPT codes, keep in mind that they should each reflect that the patient is new to the practice. Question: 10 All of the following are repercussions of a HIPAA violation, EXCEPT: A. Fines of up to $50,000 per violation B. Civil penalties C. Prison sentences up to 15 years D. Employee dismissal Answer: C Explanation: A covered entity who violates HIPAA may be subject to employee dismissal, fines ranging from $100 to $50,000 per violation, civil penalties, prison sentences of up to 10 years, or a combination of these. Ace your CCS Exam confidently by leveraging our top-notch practice exams. These exams simulate the real testing environment, providing you with a valuable opportunity to assess your readiness. The included detailed answers and explanations ensure that you not only understand the correct solutions but also grasp the underlying coding principles. Our commitment to your success is reflected in the quality of our CCS Exam preparation materials. For Download: https://www.certswarrior.com/exam/ccs/