Certified Coding Specialist (CCS®) is a professional certification credential offered by the American Health Information Management Association (AHIMA). It is designed for individuals who have expertise in medical coding in both inpatient and outpatient settings.
CCS credential holders have demonstrated proficiency in coding medical data from patient records, including diagnoses, procedures, and other medical services, according to the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) code sets. They have also shown mastery in coding compliance and quality.
Certified Coding Specialist (CCS®) Exam Glossary
Here is a glossary of key terms related to the Certified Coding Specialist (CCS®) exam:
- ICD: International Classification of Diseases, a system of diagnostic codes used to classify diseases and medical conditions.
- CPT: Current Procedural Terminology, a set of codes used to describe medical procedures and services.
- DRG: Diagnosis Related Group, a system used by Medicare to classify hospital cases into groups based on diagnoses and procedures.
- MS-DRG: Medicare Severity-Diagnosis Related Group, a system used by Medicare to classify hospital cases into groups based on diagnoses, procedures, and severity.
- APC: Ambulatory Payment Classification, a system used by Medicare to pay for outpatient services.
- NCCI: National Correct Coding Initiative, a system used to identify and prevent improper coding of medical procedures.
- Revenue codes: Codes used to identify specific categories of charges on a hospital bill, such as room charges, laboratory charges, and radiology charges.
- E&M codes: Evaluation and Management codes, a set of codes used to describe medical services related to patient evaluation and management.
- Modifiers: Codes used to provide additional information about a medical service or procedure, such as the location or type of service provided.
- Compliance: The act of adhering to coding guidelines and regulations to ensure accuracy and consistency in medical coding.
- HIPAA: Health Insurance Portability and Accountability Act, a law that sets standards for protecting the privacy and security of patient health information.
- CCI: Correct Coding Initiative, a system used to identify and prevent improper coding of medical procedures.
- Encoder: Software or tool used to assist in medical coding by suggesting appropriate codes based on the medical record and other relevant information.
- Query: A request for clarification or additional information from a physician or other healthcare provider to ensure accurate and complete medical coding.
- Sequencing: The process of arranging codes in the correct order according to coding guidelines and regulations.
Understanding these key terms can help candidates prepare for the CCS® exam and demonstrate their proficiency in medical coding.
Certified Coding Specialist (CCS®) Exam Tips and Tricks
Here are some tips and tricks to help individuals prepare for the Certified Coding Specialist (CCS®) exam:
- Review the exam content: The CCS exam covers a wide range of topics, including ICD-10-CM/PCS, CPT, and HCPCS Level II codes, as well as medical terminology, anatomy and physiology, and pharmacology. Review the exam content outline and ensure that you have a solid understanding of all the topics covered.
- Practice coding scenarios: Practice coding scenarios from real medical records or simulated medical records to improve your coding skills and increase your speed and accuracy. This will also help you identify any areas where you may need further study.
- Use study materials: Utilize study materials such as review books, online courses, and practice exams to help you prepare for the exam. These resources will help you identify areas where you need improvement and provide you with feedback on your progress.
- Manage your time: The CCS exam is a timed exam, so it is important to manage your time effectively. Allocate time for each section of the exam and make sure to pace yourself accordingly.
- Familiarize yourself with the coding guidelines: The CCS exam is based on coding guidelines and conventions set forth by various organizations, such as CMS and the American Medical Association. Familiarize yourself with these guidelines and ensure that you are applying them correctly.
- Utilize coding tools: Use coding tools such as encoders, coding manuals, and coding software to help you during the exam. These tools can save you time and improve your accuracy.
By following these tips and tricks, individuals can improve their chances of passing the CCS® exam and demonstrating their proficiency in medical coding.
How to pass the Certified Coding Specialist (CCS®) Exam?
We are now providing you with a preparatory guide to assist you with your preparation. Let’s start with the guide!
Step 1 – Know about the Exam Syllabus
This is the exam content outline –
Domain 1 – Coding Knowledge and Skills (51.9%)
- Apply diagnosis and procedure codes based on the provider’s documentation in the health record
- Determine principal/primary diagnosis and procedure
- Apply coding conventions/guidelines and regulatory guidance
- Also, Apply CPT®/HCPCS modifiers to outpatient procedures
- Sequence diagnoses and procedures
- Furthermore, Apply present on admission (POA) guidelines
- Also, Address coding editsAssign reimbursement classifications
- Abstract pertinent data from health recordRecognize major complication/comorbidity (MCC) and complication and co-morbidity (CC)
Domain 2 – Coding Documentation (10.1%)
- Review health records to assign diagnosis and procedure codes for an encounter
- Also, Review and address health record discrepancies
Domain 3 – Provider Queries (8.9%)
- Determine if a provider query is compliant
- Also, Analyze current documentation to identify query opportunities
Domain 4 – Regulatory Compliance (29.1%)
- Ensure the integrity of health records
- Apply payer-specific guidelines
- Also, Recognize patient safety indicators (PSIs) and hospital-acquired conditions (HACs) based on documentation
- Ensure compliance with HIPAA guidelines
- Moreover, Ensure adherence to AHIMA’s Standards of Ethical CodingApply the Uniform Hospital Discharge Data Set (UHDDS)
Step 2 – Know about the exam Format
The Certified Coding Specialist (CCS®) exam lasts four hours and consists of multiple-choice questions. There are 47 questions in total. The passing score for the examination is 80% or higher. This examination will also cost you around USD 399. The exam, on the other hand, is divided into two sections: a multiple-choice section and a medical scenario section (inpatient, outpatient, and emergency department). In addition, the exam is on a computer.
Step 3 – Know about the Exam Policies
Some of the important points that you need to remember are –
Registration policy – To register for the exam, complete the following steps:
- Go to the Certified Coding Specialist (CCS®) website.
- Click on the button that says “Apply for the Exam.”
- Furthermore, Adhere to the prompt. Make your payment and finish the registration process.
- AHMA will send you a confirmation email once your registration is complete.
Recertification Policy – Individuals must earn a certain number of Continuing Education Units (CEUs) during a two-year certification cycle to recertify. For newly credentialed individuals (those who have earned their first credential), the initial recertification cycle is two years, beginning on the day the exam was passed. If you were an early tester for an exam or have multiple credentials, your recertification cycle will be under impact. Please check with your CEU Center to determine your recertification cycle.
Step 4: Carry your S.W.O.T Analysis
Understanding internal strengths and weaknesses, as well as external threats and opportunities, is a critical component of strategic planning. These are commonly known as the four S.W.O.T. analysis factors. Remember to start by focusing on your weaker areas. Furthermore, pay close attention to exam topics that carry a higher weightage. Following your plan will assist you in remaining consistent and avoiding distractions. The key to success is to get started as soon as possible, so get started as soon as possible and stay motivated.
Step 5 – Refer to Learning Resources
Some resources that you can refer to are –
Code Books – It is critical to study from the correct codebook. All candidates must bring the correct codebooks to the testing center on test day. Candidates who do not have the correct codebooks will be denied testing and will have their exam fees refunded. The International Classification of Diseases, Tenth Revision, Clinical Modification can be executed using the ICD-10-CM Code Book, 2020 as your primary reference.
Study Groups and Online tutorials – It is critical to interact with people who share a common goal in life. Joining study groups is a good way to fully immerse yourself in the certification exam for which you applied. These groups will keep you up to date on the most recent changes or updates to the exam. In addition, both beginners and professionals are present in these groups. Online Tutorials broaden your knowledge and provide a thorough understanding of exam concepts. They also go over exam specifics and policies. As a result, learning with Online Tutorials will help you prepare better.
Practice tests – It is critical to practice what you have learned so that you can analyze your practice. By practicing, you will be able to improve your answering skills, which will save you a lot of time. Furthermore, the best time to begin doing practice tests is after you have completed one full topic, as this will serve as a revision component for you. Begin practising right away!
A solid conceptual foundation is essential for sharp skills. This exam will put you to the test in a variety of ways, but if you approach it correctly, you can ace it in one sitting! The first step toward passing any exam is to practice using the available resources. The American Health Information Management Association (AHIMA) offers workshops and webinars where you can learn more about the Certified Coding Specialist (CCS®) examination.