Corrections

Certified Coding Specialist (CCS) Exam Preparation, Third Edition; AHIMA Product # AC400410

Coding Exercise question 4 (pages xxxiv, 236) Book lists the correct answer as 345.00, 350.1; however, under code
st
345.90 it states recurrent seizures NOS. Further Coding Clinic 1 Quarter 2008 states recurrent or repetitive
seizures should be coded to category 345.90. Note the wording in the exercise says “repetitive” not recurrent. In
the Alphabetic Index under seizure, “repetitive”, is 780.39. However, based on Coding Clinic, assign code 345.90.

Coding Exercise question 25 (pages xxxv, 237) Book states correct answer is 427.31, 427.89, 33213, 33233; however,
427.31 is Atrial fibrillation whereas 427.81 is Sinus bradycardia. Correct answer is 427.81, 427.89, 33213, 33233.

Practice question 42 (page 240): Answer is c. 172.6, 11601

Practice question 43 (page 19): The second code option listed for each answer is incorrect because the first two
digits are transposed. There correct code answer options should be listed as follows:
Colonoscopy with cauterization of diverticular bleeding. What diagnosis and procedures should be reported?
a. 578.9, 45382
b. 562.12, 455382
c. 563.13, 45382
d. 562.10, 45382

Practice question 45 (pages 20, 240): The answer should be d and also include code E849.9.
A patient was admitted after a fall down a series of steps. Patient was unconscious for approximately 45 minutes
and was admitted to the emergency department within 3 hours of the fall. A CT scan was performed within an
hour of admission to ED. A skull vault fracture with cerebral contusion was found on CT scan. What condition(s)
should be reported on the UB- 04?
a. 800.12, E880.9, 3111F
b 780.09, 87.03
c. 803.02, 87.03, E880.9, E849.9
d. 800.12, E880.9, 87.03, E849.9

Exam 1, question 19 (page 55). Option b should read: 349.31, Accidental Puncture or laceration of Dura during a
th
procedure and 349.0, Spinal fluid loss headache. Reference remains Coding Clinic 4 Quarter 2008, 25(4):109-100.

Exam 1, question 22 (page 248): Answer is b.

Exam 1, patient 13 (page 268): Per the ICD-9-CM procedure codes (page xxxii), codes 87.01–99.99 “should not be
coded on the exam.” Therefore, code 99.10 (TPA) should not be used on the CCS exam.

Exam 2, question 1 (page 142): should read: A 23-year-old female is admitted for a miscarriage two weeks prior to
this admission. She is afebrile at this time and is treated with an aspiration dilation and curettage. Products of
conception are found. Which of the following should be the principal diagnosis?
a. 634, spontaneous abortion
b. 639, complications following abortion and ectopic and molar pregnancies
c. 785.50, shock NOS
d. 998.0, postoperative shock
a is correct and should include the following reference: (Brown 2010, 294)
 Certified Coding Specialist (CCS) Exam Preparation Corrections (continued)

Exam 2, question 10 (page 270) Principal diagnosis is a. Abdominal pain (Brown 2010, 97)

Exam 2, question 17 (page 270): Answer is d 173.7, Malignant neoplasm of skin, skin of lower limb, including hip. The
ICD-9-CM Neoplasm table reference directs you to code to “skin of knee”, where 195.5* directs you to code to
“malignant neoplasm of skin”. Follow that path to the ICD-9-CM book and code to neoplasm, skin, knee, and the
answer is 173.7. In accordance with note 2 of the ICD-9-CM Neoplasm Table, code to skin of knee (Brown 2010, ch.25).

Exam 2, question 25 (page 150): The patient was monitored under general anesthesia for excision of diseased
cornea. A controlled depth-setting blade was used to cut partially into the recipient’s cornea in a manner to allow
the lamellar graft to fit. Which CPT code should be used?
65710 Keratoplasty (corneal transplant); anterior lamellar
65730 Keratoplasty; penetrating (except in aphakia or pseudophakia)
65750 Keratoplasty; penetrating (in aphakia)
65755 Keratoplasty; penetrating (in pseudophakia)
a. 65710
b. 65730
c. 65750
d. 65755

Exam 2, question 26 (page 150): Assign the CPT code for 50-year-old female patient admitted to outpatient surgery
department for laparoscopic surgical repair of a recurrent, incarcerated incisional hernia with mesh insertion.
49561 Repair initial incisional or ventral hernia, reducible, incarcerated or strangulated
49566 Repair recurrent incisional or ventral hernia, reducible, incarcerated or strangulated
49657 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); reducible,
incarcerated or strangulated
49565 Repair recurrent incisional or ventral hernia, reducible
a. 49561
b. 49566
c. 49657
d. 49565
Exam 2, question 27 (page 151): Patient with renal tumors received percutaneous cryotherapy ablation of 3 tumors on the
right kidney in the same day surgery department of Memorial Hospital. Assign CPT code(s) for this procedure.
50592 Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency
50593 Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy
50590 Lithotripsy, extracorporeal shock wave
50250 Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound, if performed
a. 50592
b. 50593
c. 50590
d. 50250

Exam 2, question 28 (page 151): A physician performed PTCA and inserted a drug-eluting stent into the left circumflex
artery and inserted a non-drug-eluting stent into the left anterior descending artery of a 56-year-old female. Assign
CPT code(s) for this outpatient procedure.
92980 Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any
method; single vessel
92981 Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any
method; each additional vessel
G0291 Transcatheter placement of a drug eluting intracoronary stent(s), percutaneous, with or without other therapeutic
intervention, any method; each additional vessel
–LC Left circumflex coronary artery
–LD Left anterior descending coronary artery
 a. 92981–LC; 92980–LD
b. 92980–LC, 92981–LD
c. G0291–LC; 92980–LD
d. G0291–LC; 92981–LD

Exam 2, question 29 (page 151): Patient admitted for repair of diaphragmatic hernia via abdominal approach.
Assign ICD-9-CM procedure code(s) for this laparoscopic surgery.

53.71 Laparoscopic repair of diaphragmatic hernia, abdominal approach

53.72 Other and open repair of diaphragmatic hernia, abdominal approach
53.83 Laparoscopic repair of diaphragmatic hernia, with thoracic approach
53.84 Other and open repair of diaphragmatic hernia, with thoracic approach
a. 53.71
b. 53.72
c. 53.83
d. 53.84

Exam 2, question 30 (page 151): Patient presents in the ER with thrombosis of a loop PTFE hemodialysis fistula
without mechanical complications. The physician performed a thrombectomy of the left forearm graft. Assign a
facility code for this outpatient procedure.

39.49 Other revision of vascular procedure

36831 Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft
(separate procedure)
996.73 Other complications of internal (biological) (synthetic) prosthetic device, implant, and graft, due to renal
dialysis device, implant, and graft
36832 Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft
(separate procedure)
a. 39.49
b. 36831
c. 996.73
d. 36832

Exam 2, question 31 (page 151): Physician performed a myringotomy under general anesthesia for insertion of
ventilating tubes bilaterally on a 4-year-old male due to chronic otitis media as an outpatient procedure. What is
the CPT code assignment (and modifier, if applicable) to this procedure code(s)?

69421 Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia
–50 Bilateral procedure
a. 69421
b. 69421–50
c. 69436
d. 69436–50

Exam 2, question 55 (page 158): Option c should read: “Ask the physician to come back when the supervisor gets back”.

Exam 2, patient 6 (page 278): PDX should be 338.3

Exam 2, patient 10 (page 284): DX8 should be Stage V Chronic Kidney Disease, 585.5

Exam 2, patient 11 (page 286): DX10 should be V12.54

Clarification: Practice Exam 2, patient 5 (page 277) does not incorporate the CPT codes 93555 and 93556. Per the
Coding Procedures for Coding Part II of the CCS Exam (page xxxi), codes from the Medicine section of the CPT book
should not be coded unless the cover sheet specifies they should be assigned.