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| Certification Vendor: | ACDIS (Association of Clinical Documentation Integrity Specialists) |
|---|---|
| Exam Name: | ACDIS Certified Clinical Documentation Specialist – Outpatient (CCDS-O) Examination |
| Exam Number: | CCDS-O |
| Real Exam Qty: | 140 questions (120 scored) |
| Passing Score: | 85 out of 120 scored questions |
| Exam Format: | Multiple-choice, Computer-based exam |
| Available Languages: | English |
| Related Certifications: | Certified Clinical Documentation Specialist (CCDS) |
| Recommended Training: | ACDIS CCDS-O Exam Candidate Handbook (download via official site) ACDIS Official Certification Resources |
| Exam Registration: | CCDS-O Certification Information ACDIS Certification Page |
| Sample Questions: | ACDIS CCDS-O Sample Questions |
| Exam Way: | Computer-based testing via Prometric test centers or remote proctoring (ProProctor). |
| Pre Condition: | Must meet education and experience requirements (e.g., RN, MD, DO, or HIM/coding credential such as RHIA, RHIT, CCS, CPC, CRC, COC) plus approximately 1–2 years of outpatient clinical documentation experience using U.S. reimbursement systems. |
| Official Syllabus URL: | https://acdis.org/certification/ccds-o |
>> CCDS-O Zertifizierungsfragen <<
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71. Frage
A 67-year-old male patient has been seen by a PCP multiple times this year. Diagnoses reported are diabetes with nephropathy with an HCC weight of 0.166; diabetes with retinopathy with an HCC weight of 0.166; atrial fibrillation with an HCC weight of 0.299, and a demographic risk factor weight of 0.332. Which of the following is this patient's final RAF score for these diagnoses?
Antwort: B
Begründung:
The patient's RAF is calculated by adding the applicable HCC weights plus the demographic factor, but only after applying the HCC model's hierarchy rules. In outpatient risk adjustment education (as emphasized in ACDIS-based training), certain condition groups are hierarchical-meaning multiple related diagnoses in the same hierarchy do not "stack." Instead, only the highest-ranked HCC in that disease group contributes to the RAF. Here, "diabetes with nephropathy" and "diabetes with retinopathy" both carry the same HCC weight (0.166) and fall within the diabetes complication hierarchy, so they do not add together; only one 0.166 value is counted. Atrial fibrillation contributes separately (0.299), and the demographic risk factor contributes (0.332). Therefore, the final RAF is 0.166 + 0.299 + 0.332 = 0.797. This illustrates why outpatient CDI focuses on documenting all clinically supported conditions for care accuracy, while understanding that some related diagnoses won't increase RAF beyond the highest applicable HCC in that hierarchy.
72. Frage
An elderly patient with a PMH of CHF, DM type 1, arthritis, and HTN is seen in the clinic for a follow-up appointment after a recent hospitalization. After an evaluation of the patient's current health status, the provider documents the following: "HFrEF: lungs clear, no edema, continue meds. DM: no changes to insulin pump. Arthritis: asymptomatic joint destruction. HTN: BP stable. Continue meds." Which of the following is the clarification opportunity in the above scenario?
Antwort: D
Begründung:
This encounter documents both hypertension and heart failure management, creating a key outpatient documentation/coding clarification opportunity: whether the heart failure is related to hypertension (hypertensive heart disease with heart failure). Outpatient CDI principles emphasize capturing the true clinical relationships that affect code assignment, risk adjustment, and longitudinal disease management. When HTN and HF coexist, coding may require combination coding and correct sequencing, plus an additional heart failure code to describe the specific HF type. Provider documentation that explicitly links (or explicitly rules out) a causal relationship supports compliant selection of the most accurate diagnosis codes and reduces ambiguity during chart review. The other options are weaker: the provider already documents HFrEF (type), and while added severity detail can help, the scenario's primary clarification "opportunity" is the HTN-HF relationship. DM type 1 inherently involves insulin, so "insulin status" is not the key outpatient clarification point here, and there is no typical direct linkage between DM and arthritis supported by the note.
73. Frage
CMS-HCCs are used to
Antwort: C
Begründung:
The CMS-HCC model is a risk adjustment methodology used primarily to set capitated payments for Medicare Advantage (MA) organizations based on the expected cost of caring for their enrolled beneficiaries. Under this approach, CMS calculates a Risk Adjustment Factor (RAF) for each member using demographic variables (such as age/sex and certain entitlement factors) plus disease burden captured from ICD-10-CM diagnoses that map to Hierarchical Condition Categories (HCCs). The resulting RAF increases or decreases the plan's payment to better match predicted healthcare needs-higher RAF for sicker, more complex patients and lower RAF for healthier patients. ACDIS outpatient CDI education emphasizes that the purpose is not physician reimbursement based on a "principal diagnosis" (an inpatient concept) and not payment distribution tied directly to quality performance (that aligns more with MIPS/VBP frameworks). It also does not adjust capitation payments specifically "to physicians," nor does it exclude advanced practice providers in the way described. The correct use is to determine MA plan capitation payments through risk-adjusted member-level projections.
74. Frage
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
Antwort: A
Begründung:
Outpatient CDI follow-up must balance responsiveness with confidentiality and professional standards. The most compliant approach is to communicate query-related information in a setting that protects protected health information and minimizes the risk of incidental disclosure. Discussing the query in a private room with the door closed supports timely clarification while maintaining privacy, avoiding conversations that could be overheard by patients, visitors, or staff who are not involved in the patient's care. Catching the provider in the hallway is faster but increases privacy risk because clinical details can be overheard, and it may also distract the provider in a high-traffic environment. Leaving a sticky note on the next patient's chart is inappropriate because it can be seen by others, may be misplaced, and can create compliance and medico-legal concerns (including mixing patients or leaving PHI unsecured). Waiting for the next scheduled meeting may be compliant but does not support a quick response, potentially delaying coding completion and data integrity. Therefore, a private discussion is both the quickest and most compliant option.
75. Frage
In review of a clinic record, a CDI specialist notes the provider has directly copied and pasted a previous inpatient problem list into the current ambulatory visit note. Which of the following is the CDI specialist's BEST course of action?
Antwort: D
Begründung:
Copy-and-paste of an inpatient problem list into an outpatient note creates significant documentation integrity risks: outdated diagnoses may be carried forward, resolved conditions may appear active, and the note may not clearly show which problems were actually evaluated or managed during the current encounter. Outpatient CDI best practice is not to assume relevance (eliminating D) and not to reflexively query every listed diagnosis (B), which can be burdensome, non-targeted, and may lead to "query fatigue." Likewise, blanket instruction to "not code" anything pasted (A) is not appropriate because some conditions may still be active and reportable if the provider documents assessment/management (e.g., monitoring, evaluation, addressing, or treatment). The most effective and sustainable action is provider education: explain why indiscriminate copy-forward threatens accuracy, compliance, medical necessity support, quality reporting, and risk adjustment validity; reinforce documenting current status and care provided for each active condition; and encourage updating the problem list and assessment to reflect what is truly addressed at the visit. Targeted queries can still be used when specific contradictions or high-impact ambiguities are identified.
76. Frage
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CCDS-O Prüfungs: https://de.fast2test.com/CCDS-O-premium-file.html
Außerdem sind jetzt einige Teile dieser Fast2test CCDS-O Prüfungsfragen kostenlos erhältlich: https://drive.google.com/open?id=1l8r2ScLcYDp9MJR9XTZ85hLHmHvgfx6o