CCDS-O Free Exam Questions & Answers PDF Updated on Oct-2026 [Q30-Q51]

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CCDS-O Free Exam Questions and Answers PDF Updated on Oct-2026

Latest CCDS-O Exam Dumps Recently Updated 137 Questions

ACDIS CCDS-O Exam Syllabus Topics:

Topic	Details
Topic 1	Healthcare regulations, reimbursement, and documentation requirements related to the Official Guidelines for
Topic 2	and billing: Covers Official Coding Guidelines, OPPS reimbursement (APCs), and professional billing concepts including CPT E M codes and Medicare Physician Fee Schedule documentation.
Topic 3	Diseases and Disease Processes and Application to the Clinical Chart Review: Covers clinical indicators across all ICD-10-CM chapters, applied to chart reviews, with recognition of medications, diagnostic tests, and abbreviations as documentation clarification triggers.

NEW QUESTION 30
Which of the following is covered under the Outpatient Prospective Payment System (OPPS)? (Select all that apply)

Community mental health centers

Indian health services

Physical therapy treatment

Clinical diagnostic lab services

NEW QUESTION 31
The primary purpose of the RADV program is to

ensure risk-adjusted payment integrity and accuracy.

verify medical necessity of care provided.

identify over-payments rendered to individual physicians.

support accuracy of Evaluation and Management billing.

NEW QUESTION 32
Clinic visit documentation describes patient complaints of increased shortness of breath, following recent inpatient admission for pneumonia. Diagnoses include COPD – GOLD stage 3. Increase home O2 to 3 liters. Home health follow-up to begin home nebulizers, and Solu-Medrol ordered. Which of the following is the MOST significant query opportunity?

Specificity of the organism causing the pneumonia

Acuity of the COPD

Presence of chronic respiratory failure

Oxygen dependence

NEW QUESTION 33
A patient presents to the clinic with indwelling Foley catheter, symptoms of fatigue, and low back pain with BPH. Labs reveal WBC 20, and the urine culture is positive for E. coli. Prescription antibiotics are ordered for a UTI. Which of the following is the BEST query opportunity?

Etiology of BPH

UTI related to catheter

Etiology of low back pain

Leukocytosis

NEW QUESTION 34
An 81-year-old is seen by his family physician for continued confusion and poor memory. PMH includes HTN, GERD, and Parkinson’s. The provider reviews the neurologist’s consultation notes, evaluates the patient’s current mental state, and addresses the diagnoses of HTN, GERD, and Parkinson’s. The provider’s problem list included: Dementia, GERD, HTN, and Parkinson’s. Which of the following is the first-listed diagnosis?

HTN

GERD

Dementia

Parkinson’s

NEW QUESTION 35
A patient is scheduled to see his PCP in 3 days. A CDI specialist notes that during the patient’s last visit earlier this year, the problem list shows both DM 2 associated erectile dysfunction and DM 2 without complications. The last clinic note states that DM 2 with autonomic neuropathy was addressed. The CDI specialist should do which of the following FIRST?

Remove DM 2 without complications from the problem list

Query if the DM 2 is with or without complications

Ask the patient if he still has DM 2 with autonomic neuropathy

Query the provider for the link between erectile dysfunction and DM 2

NEW QUESTION 36
Along with history and examination, which of the following is considered a key component in reporting evaluation and management services?

Nature of presenting problem

Medical decision making

Review of systems

Coordination of care

NEW QUESTION 37
The principal diagnosis is defined as:

The first diagnosis listed on the chart

The condition established after study to be chiefly responsible for occasioning the admission

Any condition treated during the hospital stay

The most severe condition present

NEW QUESTION 38
When a CDI specialist identifies a discrepancy in documentation, the next step is to:

Change the record

Query the provider for clarification

Escalate to compliance

Code the record as is

NEW QUESTION 39
Which diagnosis and treatment plan may generate a query?

Prostate carcinoma and luteinizing hormone-releasing hormone

Atrial fibrillation and amiodarone

Malnutrition and parenteral nutrition

Severe major depressive disorder and immunotherapy

NEW QUESTION 40
Given the following CMS-HCC categories, which is the correct order (highest to lowest) in the hierarchy?

HCC 35, HCC 36, HCC 37, HCC 38

HCC 38, HCC 37, HCC 36, HCC 35

HCC 35, HCC 37, HCC 36, HCC 38

HCC 38, HCC 36, HCC 37, HCC 35

NEW QUESTION 41
Which of the following BEST describes a Stage 3 pressure ulcer?

Pre-ulcer skin changes limited to persistent focal edema

Full thickness skin loss involving damage or necrosis of subcutaneous tissue

Necrosis of soft tissues through to underlying muscle, tendon, or bone

Abrasion, blister, partial thickness skin loss involving epidermis and/or dermis

NEW QUESTION 42
A CDI specialist is following up on a query while the provider is seeing patients in the clinic. The BEST action that will support a quick and compliant response to the query is to

wait to speak with the provider during the next scheduled meeting.

catch the provider in the hallway between patients.

discuss in a private room with the door closed.

leave a sticky note on the chart of the next patient.

NEW QUESTION 43
A provider has been determined to be a high-cost provider after a total claims cost analysis. The provider’s patient panel has an overall low HCC average score. Which of the following is the MOST likely explanation regarding the low HCC average score?

The provider cares for patients of a higher acuity

The provider is failing to capture all relevant diagnoses

The provider has a less complex patient population

The provider is not reporting unspecified diagnoses

NEW QUESTION 44
How does accurate documentation impact APC assignment in outpatient services?

It has no effect

It delays reimbursement

It ensures appropriate APC assignment, impacting reimbursement

It reduces coding accuracy

NEW QUESTION 45
A 75-year-old with a PMH of chronic foot ulcer, CKD, and depression is seen by his PCP for continued fatigue and decreased urination. Labs drawn on previous day are reviewed. Patient describes extreme fatigue and no motivation. Assessment and plan include: “CKD 3 with renal failure – refer to nephrologist. Chronic nonpressure foot ulcer – home care for wound assessment. Depression – Rx for SSRI.” Which of the following are the validated diagnoses that risk adjust and qualify as CMS-HCCs?

Renal failure; CKD 3

CKD 3; chronic non-pressure ulcer

Depression; renal failure

Chronic non-pressure ulcer; depression

NEW QUESTION 46
Which of the following Medicare patients demonstrates the highest level of risk based on the above chart?

65-year-old female, living at home, history includes diabetes type 2, obesity, and depression

64-year-old female, living at home, disabled due to chronic pain, history includes diabetes type 2, peripheral neuropathy, obesity, and depression

72-year-old female, living in skilled nursing facility, history includes diabetes type 2, peripheral neuropathy, morbid obesity, and depression

94-year-old female, living in skilled nursing facility, history includes diabetes type 2, peripheral neuropathy, morbid obesity, and depression

NEW QUESTION 47
Which coding guideline is primarily used to assign ICD-10-CM codes in outpatient settings?

Inpatient Coding Guidelines

Outpatient Coding Guidelines

Uniform Hospital Discharge Data Set

CPT Coding Guidelines

NEW QUESTION 48
A female patient who underwent total hip replacement 2 weeks ago is in for a follow-up visit with her PCP. The visit note states: “Patient complains of fatigue and lethargy. Hgb on discharge was 10.4gm/dL – now is 8.6 gm/dL. Will start FeSO4 325mg po daily with food. Repeat H/H in 2 weeks. She has return visit with Ortho then.” Which of the following is the BEST course of action for the CDI specialist?

Instruct the provider to add iron deficiency anemia to the problem list.

Review the lab work referenced by the provider in the progress note for congruence.

Query the provider for a diagnosis related to fatigue, decreased Hgb, and FeSO4.

Add acute blood loss anemia to the diagnoses reported on the claim.

NEW QUESTION 49
A patient is seen in the office for a persistent cough. Provider documentation states: “History of chronic obstructive pulmonary disease, asthma, and hypertension. Hypertension treated with Enalapril. Cough an adverse effect of the ACE inhibitor; discontinue Enalapril. COPD stable. Instructed to continue meds for COPD/asthma.” Which of the following diagnoses should be reported for this encounter?

COPD, unspecified; asthma, unspecified, uncomplicated; hypertension

Cough; adverse effect of an ACE inhibitor; COPD, unspecified; hypertension

COPD, unspecified; hypertension

Cough; adverse effect of an ACE inhibitor; COPD, unspecified; asthma, unspecified, uncomplicated; hypertension

NEW QUESTION 50
What is the goal of an MSSP program?

Optimize risk score

Share in savings

Improve transitions of care

Increase fee schedule payment

NEW QUESTION 51
PCP notes describe declining renal function with creatinine trending upward over the last 12 months. Nephrology consult ordered. Which of the following diagnostic tests could support a query to identify status of the patient’s baseline renal function?

Creatinine

BUN (Blood urea nitrogen)

eGFR (glomerular filtration rate)

ACR (albumin to creatinine ratio)