CCDS資格認證考試是非常熱門的一項考試，雖然很難通過，但是你只要找准了切入點，考試合格並不是什麼難題。KaoGuTi就是你最好的選擇。KaoGuTi命中率高達100%的資料，可以幫你解決CCDS考試上的任何難題，只要你認真學習資料上的問題，相信一切難題都可以迎刃而解，你購買了考古題以後還可以得到一年的免費更新服務，一年之內，只要你想更新你擁有的資料，那麼你就可以得到最新版。快點來體驗一下吧。
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Healthcare facility CDI program analysis | 8.33% | - Hospital-specific financial data - CDI program forecasting - Publicly reported data - PEPPER data - CDI specialist productivity metrics - High-frequency DRGs - Hospital Value-Based Purchasing measures - Patient Safety Indicators - Tracking and trending physician, department, and hospital performance - Severity of illness and risk of mortality - Physician performance measurement - Basic computer and software application skills - CC/MCC capture - Case mix index (CMI) - Provider response rates |
| Topic 2: Healthcare regulations, reimbursement, and documentation requirements related to the IPPS | 12.5% | - Complication/comorbidity (CC) - Medicare Severity Diagnosis Related Groups (MS-DRGs) - Major complication/comorbidity (MCC) - Coding and billing practices vulnerable to denial - Principal diagnosis and medical necessity - IPPS and its updates and revisions - Documentation and medical necessity of setting - Medical staff and clinical staff documentation responsibilities - Inpatient admission criteria and CMS Two-Midnight Rule - Documentation impact on IPPS reimbursement - Medicare contractors and their impact on CDI - Case mix index (CMI) |
| Topic 3: Professionalism, ethics, and compliance | 9.17% | - Compliance risks indicated by PEPPER - Potential DRG creep - DRG compliance initiatives - CDI department goals beyond reimbursement - Medical record confidentiality - Leading queries |
| Topic 4: Impact of reportable diagnoses on quality of care | 8.33% | - Healthcare-associated infections and complication codes - Coded data elements affecting Patient Safety Indicators - Hospital Inpatient Quality Reporting Program - Mortality reviews and observed/expected ratios - Patient Safety Indicators - Hospital Value-Based Purchasing - CDI impact on Hospital Value-Based Purchasing - Documentation and code assignment impact on mortality index - Quality data from record abstraction and claims data - Hospital Readmissions Reduction Program - Hospital-Acquired Condition Reduction Program - 30-day mortality measures |
| Topic 5: Anatomy and physiology, pathophysiology, pharmacology, and medical terminology | 19.17% | - Diseases and disorders of the circulatory system - Alcohol/drug use and alcohol/drug-induced organic brain disorders - Diseases and disorders of the digestive system - Diseases and disorders of the respiratory system - Endocrine, nutritional, and metabolic diseases and disorders - Infectious and parasitic diseases - Diagnostic tests as clinical indicators - Diseases and disorders of the nervous system - Pharmaceuticals and disease processes - Medications as clinical indicators - Diseases and disorders of the blood and blood-forming organs and immunological disorders - Diseases and disorders of the skin, subcutaneous tissue, and breast - Diseases and disorders of the musculoskeletal system - Injuries, poisonings, and toxic effects of drugs - Mental diseases and disorders - Diseases and disorders of the hepatobiliary system - Myeloproliferative diseases and disorders and poorly differentiated neoplasms - Diseases and disorders of the kidney and urinary tract - HIV infections - Standard medical abbreviations - Clinical indicators and query opportunities by Major Diagnostic Category |
| Topic 6: Medical record documentation | 19.17% | - ACDIS/AHIMA Guidelines for Achieving a Compliant Query Practice - Clinical indicators - When a physician query is warranted - Types of physician queries - Provider role and diagnosis code assignment - Addressing diagnoses without clinical support - Compliant and noncompliant queries - Translating clinical indicators into compliant queries - Physician query formats - Situations in which queries are not appropriate - Documentation requiring clarification - Health record elements used for diagnosis and procedure code assignment |
| Topic 7: Communication skills | 9.17% | - Reconciling CDI working DRGs with final coded DRGs - Physician education forms and tools - Roles and responsibilities of coders working with CDI departments - Effective and non-confrontational physician communication - Roles and responsibilities of CDI specialists - Verbal versus written physician communication - Educational presentations for healthcare departments and administration |
| Topic 8: Official Guidelines for Coding and Reporting | 14.17% | - Working DRG assignment for multiple diagnoses - Coding guidelines for principal diagnosis selection - Principal diagnosis assignment - Official Guidelines for Coding and Reporting updates - Present on admission indicators - Hospital-acquired conditions - Secondary diagnosis assignment - AHA Coding Clinic - Discharge dispositions and transfers |
KaoGuTi的CCDS考古題是很好的參考資料。這個考古題決定是你一直在尋找的東西。這是為了考生們特別製作的考試資料。它可以讓你在短時間內充分地準備考試，並且輕鬆地通過考試。如果你不想因為考試浪費太多的時間與精力，那麼KaoGuTi的CCDS考古題無疑是你最好的選擇。用這個資料你可以提高你的學習效率，從而節省很多時間。
問題 #19
Which of the following is a characteristic of a reportable secondary diagnosis?
答案：D
解題說明：
Increased nursing care is specifically included in the UHDDS/ICD-10-CM definition of a clinically significant reportable secondary diagnosis. A secondary condition is reportable when it affects patient care by requiring clinical evaluation, therapeutic treatment, diagnostic procedures, an extended length of stay, or increased nursing care and/or monitoring.
This distinction prevents conditions that merely appear in the record but have no relevance to the current encounter from automatically becoming reportable secondary diagnoses. For example, a historical diagnosis that does not influence treatment, monitoring, evaluation, or length of stay generally should not be coded simply because it appears in a problem list.
Option A is imprecise. A secondary condition may extend the hospitalization, but it does not need to be the condition that originally "required hospital stay." Option B is the opposite of the guideline criterion, which refers to extended, not decreased, length of stay. Option C is also insufficient by itself: provider documentation establishes diagnoses, but documentation alone does not necessarily make every historical or clinically irrelevant condition reportable.
CDI specialists must therefore evaluate both provider documentation and the clinical significance of secondary conditions.
CCDS Reference Topics: Reporting additional diagnoses; UHDDS; secondary diagnosis criteria; resource utilization.
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問題 #20
Under the FY 2026 Hospital-Acquired Condition Reduction Program, which hospitals are subject to the program's payment reduction?
答案：A
解題說明：
Under the FY 2026 Hospital-Acquired Condition Reduction Program (HACRP), applicable subsection (d) hospitals in the worst-performing quartile based on the Total HAC Score receive a 1% payment reduction on applicable Medicare fee-for-service payments. CMS defines the worst-performing quartile as hospitals whose Total HAC Score is above the 75th percentile.
The FY 2026 program incorporates the CMS Patient Safety and Adverse Events Composite (PSI 90) plus five healthcare-associated infection measures: CLABSI, CAUTI, specified surgical-site infection, MRSA bacteremia, and C. difficile infection.
A single HAC does not automatically trigger the hospital-wide 1% HACRP reduction. Likewise, CMI is not the criterion used to determine HACRP penalties.
It is also important for CCDS candidates to distinguish the HAC Reduction Program from the separate DRA HAC/POA payment provision. CMS explicitly identifies them as distinct programs.
Accurate documentation and coding are important because quality measures rely on reliable clinical data, but CDI activity must remain focused on accurately representing the clinical record rather than manipulating quality metrics.
CCDS Reference Topics: HAC Reduction Program; PSI 90; HAI measures; quality payment; hospital performance.
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問題 #21
A patient has chronic gastroesophageal reflux disease listed in the past medical history. During the current hospitalization for bacterial pneumonia, GERD receives no clinical evaluation, treatment, diagnostic testing, increased nursing monitoring, or effect on length of stay. Which statement is MOST accurate?
答案：B
解題說明：
A condition documented in the medical record does not automatically qualify as a reportable secondary diagnosis. For inpatient coding, additional diagnoses generally must be clinically significant during the current hospitalization. Qualifying significance includes clinical evaluation, therapeutic treatment, diagnostic procedures, an extended length of stay, or increased nursing care and/or monitoring.
Here, GERD is merely part of the patient's historical medical background and does not affect current management. Therefore, it generally should not be reported as an additional diagnosis solely because it appears in the past medical history.
Whether a diagnosis is classified as a CC or MCC is a separate issue. A condition must first satisfy applicable reporting requirements before its MS-DRG severity classification matters. CDI specialists should never encourage coding of clinically irrelevant historical conditions merely because they could affect reimbursement.
This principle protects the clinical integrity of coded data and prevents inappropriate inflation of disease burden. CDI review should focus on conditions that meaningfully describe the patient's current hospitalization, treatment requirements, clinical risk, and resource consumption.
CCDS Reference Topics: Reporting additional diagnoses; secondary-diagnosis criteria; medical-record review; resource utilization; coding compliance.
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問題 #22
A patient underwent open small bowel resection with anastomosis for colon cancer. The physician notes,
"Post-op ileus, awaiting return of bowel function." Which of the following actions should a CDI specialist take FIRST?
答案：B
解題說明：
The phrase "post-op ileus" establishes that the ileus occurred after surgery, but it does not necessarily establish that the ileus represents a reportable surgical complication rather than an expected transient consequence of abdominal surgery. The relationship and clinical significance therefore require clarification.
ICD-10-CM guidance on complications of care states that not every condition occurring during or following surgery is automatically classified as a complication. Code assignment depends on provider documentation establishing the relationship between the condition and the care or procedure, and the documentation must support clinical significance. When that relationship is unclear, the provider should be queried.
Assigning a complication code immediately would therefore be premature. Likewise, simply coding postoperative ileus without resolving whether it represents expected postoperative physiology or a clinically significant complication could misrepresent the episode.
Escalation to a physician advisor or CDI manager is unnecessary as the first action because this is a standard documentation-clarification issue that can be addressed directly through a compliant provider query.
CCDS Reference Topics: Official Guidelines-complications of care; medical record documentation; compliant provider clarification.
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問題 #23
Under the IPPS Post-Acute Care Transfer policy, which documentation element is particularly important because it can affect whether transfer-payment methodology applies?
答案：B
解題說明：
Accurate discharge disposition is critical to application of the Post-Acute Care Transfer policy because the patient's destination after the acute inpatient stay can determine whether transfer-payment methodology applies.
Qualifying discharges to certain post-acute settings can be subject to transfer-payment rules when other criteria are met. These settings can include skilled nursing facilities and other specified post-acute arrangements, depending on applicable CMS requirements and the MS-DRG involved.
Therefore, an incorrectly documented discharge destination can affect reimbursement even when the diagnoses, procedures, and MS-DRG are otherwise accurate.
The PACT concept demonstrates why CDI and coding accuracy extend beyond diagnosis capture. The inpatient claim also relies on accurate demographic, procedural, discharge-status, and utilization information.
Dietary preference, physician experience, and the number of daily progress notes do not determine whether PACT methodology applies.
CDI specialists should recognize when conflicting documentation exists regarding whether a patient went home, to skilled nursing, rehabilitation, another acute facility, hospice, or another destination and collaborate with the appropriate departments to ensure the final record accurately reflects the actual disposition.
CCDS Reference Topics: PACT; discharge disposition; IPPS transfer rules; reimbursement; data integrity.
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問題 #24
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為了讓生活過得更好些，參加 CCDS 認證考試獲取 ACDIS 認證是每位選擇IT行業的工作人員必經之路。只有獲取了公司要求的這張證書既可獲得加薪和升遷的機會。而 ACDIS 在考古題考試方面的雄厚實力源於業界企業的大力支持。數千家公司均依託 ACDIS 標準來提供一個可靠的員工業績評估。此外，數十家擁有自己考古題專案的公司也非常信賴 ACDIS 的 CCDS 考古題，以確保員工具備扎實的技能功底。此舉可以為公司節省大量的時間和開銷。
CCDS PDF: https://www.kaoguti.com/CCDS_exam-pdf.html