• Ccds Exam Practice Questions

I am rewieing for the CCDS exam and have the study guide. I need help with a 'sample test question'. (This type example was discussed during the conference call 8/18).

A patient is admitted with hypertension and CHF. Appropriate code assignment would: A. Identify individual codes for each condition. Identify the most appropriate combination code.

Require a query for a link between the conditions. Use the combination code with individual codes listed as secondary. Answer: B I understood there was an assumed relationship HTN and CKD where the combination code would be used. Because there is not an assumed relationship between HTN and CHF. I chose to query for a link and then you could choose the combination code. If there is no explicit link wouldn't the individual codes be assigned for each condition?

Ccds Exam Practice Questions

I'm confused. Can someeone help me to understand? I think the wording is a bit convoluted, myself. From my perspective, it is not practical to query for every chart I review with the Diagnoses of hypertension and heart disease.

The number of cases that would be queried would be 'very' problematic. I do recognize this cause and effect can exist, and the record must establish the linkage between htn and heart disease. In my 'real world', I would not institute a query every time I saw hypertension and heart disease charted.not feasible.

Paul Evans, RHIA, CCS, CCS-P Paul Evans, RHIA, CCS, CCS-P Supervisor, Clinical Documentation Integrity, Quality Department California Pacific Medical Center 2351 Clay San Francisco, CA 94115 Cell: 415.637.9002 Fax: 415.600.1325 Ofc: 415.600.3739. Agreed that this could represent a very large number of queries.however there is the situation where one absolutely will want to query - acute specified heart failure & where there is either documented or clinical support for CKD. Would then potentially have the Htn heart & CKD combo as the pdx with the acute HF as an MCC. Apart from that, developing the physician pattern of documentation linkage by query (to raise attention and awareness) when reasonable & practicable will be helpful. Ccnp switch cert guide pdf.

Can't help but think of HF & combos as far as I10 prep (it is not too early). A reasonable guideline of when to query might be for those cases where there is not fairly strong evidence of ischemic dz - if there is, the underlying HF cause is murky as htn vs ischemic dz (or both). Don: Good advice - definitely need to establish a 'baseline' (if/then) type of decision point that can be quantified for 'hypertensive heart disease'. I like to have a 'strong' clinical basis before I initiate any query, o/w, the credibility of the query process can be eroded. At my facility, we see hypertension, CKD and CHF in many, many charts, and I do believe a query for ALL of these would not be wise unless very strong evidence-based parameters could be stated on the query to indicate hypertensive heart disease.

Just my opinion. I think this particular question should be withdrawn (or edited) as it is very subjective, and there should only be 'one' correct answer. I can think of several responses to this question, in my mind, all valid. In my opinion, there are other coding scenarios in the exam test book that are murky, in particular regarding sequencing of Principal Diagnosis, that really can't be answered unless more detailed clinical information in the scenario is stated, to include the focus of the diagnostic and therapeutic efforts. Paul Evans, RHIA, CCS, CCS-P Paul Evans, RHIA, CCS, CCS-P Supervisor, Clinical Documentation Integrity, Quality Department California Pacific Medical Center 2351 Clay San Francisco, CA 94115 Cell: 415.637.9002 Fax: 415.600.1325 Ofc: 415.600.3739.