Steps to Prepare for the CCS and CCS-P Exams

Vol. 13 •Issue 1 • Page 6
CCS Prep!

Steps to Prepare for the CCS and CCS-P Exams

Welcome to the first 2003 CCS Prep! column. As it has in the past, this column will continue to serve as a resource for those who are preparing to take the certified coding specialist (CCS) and certified coding specialist — physician-based (CCS-P) examinations offered by the American Health Information Management Association (AHIMA). The dates for the 2003 examinations have not yet been released by AHIMA but will be published in this column as soon as they are available.

In this issue, we will provide some links and information you can use to prepare for either exam. In the next two columns, we will review the updated ICD-9-CM Official Guidelines for Coding and Reporting published by the cooperating parties. In subsequent columns, we plan to discuss reimbursement methodologies, modifiers and other confusing coding topics. To help us to better prepare you for the exams, we would like you to tell us what else you would like to see covered. Did you just take the exam only to find out that you should have prepared more in a particular area? Are there coding scenarios that you find confusing? We will utilize your feedback to determine the content of some future columns.

The AHIMA Web site ( has extensive information to review and help you prepare for the exam. If you are not yet a member of AHIMA, it is recommended that you join. If you are a member, the Communities of Practice (COP) ( offer up-to-date coding news, links to helpful resources and, most importantly, a vehicle to interact with others preparing to take the examination. You should consider joining the various coding, student and coding education COPs.

General Preparation Tips and Suggestions

1. Study the Certification Guides from AHIMA. The certification guides tell you everything you need to know about taking the examinations, including deadlines and instructions. The certification guides, which include 2003 deadlines, will be available in early spring 2003. In the meantime, read the entire guide from cover to cover. Pay particular attention to the coding competencies and the format for the questions. You can access this information through AHIMA’s Web site at You will be able to download all the information you need to take the exam, and you can apply online.

2. Sign up for a review seminar before the exams. Pre-exam seminars are a good refresher before the test. Contact your state health information management (HIM) association for a list of schools or local associations that may offer pre-exam reviews. Be sure to determine whether the session is based upon hospital-based coding (CCS) or physician-based coding (CCS-P). There are many similarities, but the focus and total content may vary somewhat between the two.

3. Use code books instead of encoders. When studying for the exam, code books must be used. Encoders are not permitted for test taking. If you have not coded from a code book for a while, it is important that you practice using the books. Updated coding information and notes must be written directly or attached permanently into your coding books because no loose material is allowed.

4. Review hard copies of Coding Clinic for ICD-9-CM and CPT Assistant. Many facilities and physician practices purchase encoding systems with online coding resources, such as Coding Clinic and CPT Assistant. In some cases, the references are not reviewed unless an issue directly related to a particular case is being coded or discussed. Some encoders may not provide the ability to read through each issue of CPT Assistant and Coding Clinic. The CCS and CCS-P examinations rely heavily upon coding scenarios based upon guidelines discussed in both the Coding Clinic and CPT Assistant. Become very familiar with at least the last several years’ issues.

5. Time yourself when coding cases. Increase your coding speed by practicing and timing yourself. A number of recent exam takers have commented on how important it is to keep track of time while taking the exam. You will need to increase your speed if you are taking more than 13 to 15 minutes per coding case question. This is based upon approximately 21 coded cases required in 300 minutes for the CCS exam. Be sure to time yourself on inpatient, outpatient surgery, emergency room, physician office and clinic cases, because a combination of cases could be represented on the test, depending upon which test you are taking.

6. Organize how you will handle problems encountered when taking the exam. Pre-determine how you will handle questions that you are not able to answer immediately. Will you move on and come back to them later? Or, will you give each question your best guess and move on? Practice these types of scenarios so you are prepared.

7. Purchase study guides and take mock examinations. Complete the exercises that will be included in upcoming columns of CCS Prep! Purchase study guides such as the Professional Review Guide for the CCS and CCS-P Examinations. This book and others recommended below contain case studies and mock examinations from which to practice.

8. Review basic coding principles. Review ICD-9-CM, CPT and HCPCS coding texts to re-enforce coding principles. Be sure to review the official coding conventions, including abbreviations and their definitions, symbols, font type (such as boldface or italicized) and instructional notes. Do not assume that you will be able to review this information in the front of the coding books during the exam. In many cases, this information appears in the multiple-choice portion of the exam, when you cannot use the coding books. Review guidelines for modifier use. Depending upon which exam you are taking, modifiers may have a significant impact on your answers. Questions regarding modifiers will most likely appear in the multiple-choice section of the exams.

Recommended Study Materials

The following study materials are recommended in preparation for the exam:

ICD-9-CM Official Guidelines for Coding and Reporting. These guidelines were updated effective Oct. 1, 2002, and include both inpatient and outpatient ICD-9-CM coding guidelines. The guidelines are developed by the four cooperating parties: the American Hospital Association (AHA), AHIMA, the Centers for Medicare and Medicaid Services (CMS) and National Center for Health Statistics (NCHS). The new guidelines can be obtained by contacting NCHS at

Coding Clinic for ICD-9-CM. Published by the AHA, Coding Clinic may be purchased online at Many of the questions will test your Coding Clinic knowledge.

CPT Assistant. Published by the American Medical Associa-tion (AMA), this resource provides guidance on the assignment of CPT codes. To obtain further information on CPT Assistant, call (800) 621-8335. The AMA’s CPT Assistant may be purchased online at

ICD-9-CM Coding Handbook with Answers by Faye Brown. This newly revised annual edition incorporates official changes for fiscal year 2003. Published by the AHA, it may be purchased by calling (800) 242-2626 and is also available online at

Coding in Context: Case Studies for Advanced Practice. This resource provides scenarios for coding practice in a wide range of specialties and settings–covering both ICD-9-CM and CPT. This book is written and published by AHIMA and is available online at

•.ICD-9-CM Diagnostic Coding and Reimbursement for Physician Services 2003 Edition (w/answer key) by Anita C. Hazelwood, MLS, RHIA, and Carol A. Venable, MPH, RHIA. Available at

CPT/HCPCS Coding and Reimbursement for Physician Services. Authored by Lynn Kuehn, MS, RHIA, CCS-P, and LaVonne Wieland, RHIT. It may be ordered online at

Documentation Guidelines for Evaluation and Management Services, 1995 and 1997. May be downloaded from the CMS Web site at

•.Professional Review Guide from PRG Publishing, 2002 edition. This resource is available for online ordering at

•.Coder’s Desk Reference 2003 by Ingenix. This publication is an essential tool for CPT coding, providing a description of more than 7,000 CPT procedures, services and tests. Order online

In addition to your updated ICD-9-CM, CPT and HCPCS Level II code books, you will also benefit from having access to the following resources:

Jan. 16 OPPS APC Update
Jan. 23 HIPAA: Privacy for Patient Accounting Staff
Jan. 30 Modifiers for Hospital Outpatient Coding
Feb. 13 CPT Coding for Interventional Radiology
Feb. 20 OPPS Category Code and Pass-Through Devices
Feb. 27 HIPAA: Patient Registrars and the Privacy Rule
March 6 ICD-9-CM Diagnosis Coding Guidelines for Physician Reporting
March 20 Medical Visit Reporting for Hospital Outpatients
April 3 Diagnosis Coding for Urinary Sepsis, Septicemia, Bacteria
April 10 CPT Procedure Coding Guidelines for Physician Reporting
April 17 OPPS Observation Guidelines
April 24 Coding Clinic Update
May 8 Diagnosis Coding for Respiratory Failure
May 15 Medical Necessity Guidelines for Ancillary Tests
May 29 Diagnosis Coding for Digestive Disease/Gastrointestinal Bleeding
June 26 ICD-10-CM Overview
July 17 Coding for Knee Disorders
Aug. 14 Diagnosis Coding for Renal Failure
Sept. 25 ICD-9-CM Coding Changes for 2004
Oct. 2 Home Health Coding
Oct. 9 CPT Coding for Dialysis/Vascular Access
Oct. 30 Cerebrovascular Accident (CVA) and Transient Ischemic Attach (TIA) Coding
Nov. 13 Physician Evaluation and Management Service Reporting
Nov. 20 Reporting Cardiovascular Procedures with CPT
Dec. 4 CPT 2004 Update
Dec. 11 Reporting Post-Operative Complication
Dec. 18 ICD-10-PCS

•Medical Abbreviations Book–Stedman’s.

•Medical Dictionary–Stedman’s or Dorland’s

•Medication Handbook, such as the PDR or Mosby’s

These tips and resource suggestions will help you get started in your preparation to take the CCS or CCS-P exam. In upcoming issues of CCS Prep!, we will be addressing specific topics. Should you have a topic you would like included, send an e-mail to ADVANCE at [email protected].

This month’s column has been prepared by Cheryl D’Amato, RHIT, CCS, director of HIM, and Melinda Stegman, MBA, CCS, manager of clinical HIM services, HSS Inc. (, which specializes in the development and use of software and e-commerce solutions for managing coding, reimbursement, compliance and denial management in the health care marketplace.

Coding Clinic is published quarterly by the American Hospital Association.

CPT is a registered trademark of the American Medical Association.

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