Certified Coding Specialist (CCS) Practice Exam
Certified Coding Specialist (CCS)
About Certified Coding Specialist (CCS)
A Certified Coding Specialist (CCS) is a health information technician who practices in medical coding, also known as a medical coder. Also, they assess patients' medical information and insert it into electronic health records and databases based on a system coding system. They may additionally facilitate conversations between clinical care providers and medical billing offices.
Who should take the exam?
Eligibility requirements to apply for the CCS exam includes credentials held, education, and experience. Candidates must assemble one of the five eligibility claims from the list below:
- Hold the RHIA®, RHIT®, or CCS-P® credentials;
- Complete courses in all the following topics: anatomy & physiology, pharmacology, pathophysiology, medical terminology, intermediate/advanced ICD diagnostic/procedural and CPT coding, reimbursement methodology OR
- Attain a minimum of two years of related coding experience straight applying codes;
- Hold the CCA® credential plus one year of coding experience directly applying codes;
- Hold a coding credential from another certifying organization plus one year of coding experience directly applying codes.
Course Structure
As the course has been updated the updated Certified Coding Specialist Exam covers the following topics -
Module 1 – Describe the Coding Knowledge and Skills (39-41%)
- Skills to assign diagnosis and procedure codes on the basis of provider’s documentation in the health record
- Ability to identify principal/first-listed diagnosis and procedure on the basis of respective guidelines
- Skills to apply coding conventions/guidelines and regulatory guidance
- Learn to attach CPT/HCPCS modifiers to outpatient procedures
- Identify suitable sequencing of diagnoses and procedure codes based on the case scenario
- Implement present on admission (POA) guidelines
- Illustrate knowledge of coding edits (including, NCCI, Medical Necessity)
- Showcase knowledge of reimbursement methodologies (including DRG, APC)
- Learn about abstract applicable data from the health record
- Determine major co-morbid conditions (MCC) and co-morbid conditions (CC)
Module 2 – Understanding the Coding Documentation (18-22%)
- Ability to identify and resolve conflicting documentation in the health record (e.g., admission type, laterality)
- Making sure all documentation required for assigning a specified code is available within the body of the health record
- Skills to verify and validate documentation within the health record
Module 3 – Understanding Provider Queries (9-11%)
- Determine the elements of an ethical compliant query
- Identify and evaluate if a provider query is compliant (like non-leading, contains appropriate clinical indicators)
- Evaluate current documentation to identify query opportunities
Module 4 – Understanding Regulatory Compliance (18-22%)
- Making sure the health records are complete and accurate
- Learn payer-specific guidelines
- Determine patient safety indicators (PSIs) and hospital-acquired conditions (HACs) based on the provider’s documentation
- Make sure to comply with HIPAA guidelines
- Ensure compliance with the ethical coding standards established by AHIMA
- Ensure compliance with the Uniform Hospital Discharge Data Set (UHDDS)
Module 5 – Understanding Information Technologies (9-11%)
- Learn about the various types of Electronic Health Records (EHR) and their application
- Illustrate a basic understanding of encoding and grouper software
- Showcase and understanding of computer-assisted coding (CAC) software and its impact on coding
- Ensure compliance with HITECH guidelines
Exam Format
- Exam Name: Certified Coding Specialist (CCS)
- Number of Questions: 97 questions
- Exam Format: Multiple-choice
- Passing score: 80%
- Time Given: 4 Hours
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