Health Information Careers Blog
Last-Minute Prep Advice for the CCS Exam
Date: November 10, 2010 - by Kristi Stanton
Okay, so first thing is first – the disclaimer. It’s been nearly 10 years since I took the CCS exam and the format has changed a bit. But having talked to some pros who recently took the exam, they all agree with the advice I have been giving over the years. So now I will impart those tips to you.
Pretty much everything you need to know about passing the CCS exam is in your code books. That may seem overly simple, especially considering that so many people (myself included) will tell you how difficult the exam is. The most important thing is to return to basics – basic coding guidelines, basic coding conventions, and coding parenthetical notations. The exam will test your ability to effectively and accurately navigate through the ICD-9-CM and CPT codebooks and code hospital-based inpatient and outpatient cases. Wondering where to start? Here is what I suggest:
- Double check which code book versions you will need for your test and make sure you have those versions available. Annual code updates may seem subtle, but they can make a big difference when it comes to test taking.
- Once you have the right ICD-9-CM version, download a copy of the coding guidelines for the same year. ICD-9-CM code books for the new fiscal year are often printed prior to the October update of the Official Guidelines for Coding and Reporting, so your code book may not have the most recent copy of coding guidelines. You can download each version of coding guidelines from NCHS’s website at: http://www.cdc.gov/nchs/icd/icd9cm.htm.
- Review section notes before each section in CPT and make notes or highlight text you think may be important.
- Go through the CPT book’s surgical section (1xxxx-6xxxx) and highlight any note under a code that is not a “deleted code” note. Because CPT makes a note of deleted codes, it can be very easy to overlook important instructional notes beneath codes.
- Flag Appendix A in CPT – the portion of the CPT book that lists applicable modifiers. But don’t start reading at the beginning of the appendix; flip the page and highlight the section on hospital-approved modifiers. Remember, the CCS is testing for hospital—not physician office—coding and the hospital modifiers list is a little different than the physician modifiers list.
In addition to code book review, be sure to review the Official Guidelines for Coding and Reporting that you downloaded from NCHS’s website. There are oodles of information in there that will help you with the exam. I especially recommend reviewing the following topics:
- Definition of principal diagnosis (I know you know it, but review it anyway!)
- Definition of additional diagnoses – there are five criteria for additional diagnoses. Do you know them? And newborns have one additional criterion. Learn that one too.
- Outpatient vs. inpatient coding guidelines
There are also some questions about code-based reimbursement, so be sure to bone up on information regarding DRGs and APCs. For introductory/review presentations on DRGs and APCs, check out http://www.thewilshiregroup.net/presentations/.
If you use an encoder at work, I highly recommend that you ditch the encoder for basic code assignment for a month or two before the exam. In recent years, I’ve heard many coders are not passing the CCS exam because they aren’t able to finish in the allotted time. This has been attributed to encoder dependence. And while encoders are great for reminding us we missed fifth digits, pointing out coding and billing edits, and modeling and grouping payment options, they can get us out of practice when it comes to book coding. I realize this might not be possible at work, since you have productivity standards to uphold, so you might have to spend time on evenings and weekends practicing book coding.