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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Quality, Risk Adjustment & Health Initiatives | 15% | - Risk adjustment models and documentation impact - Quality reporting, public reporting, and compliance programs - Severity of Illness (SOI) / Risk of Mortality (ROM) |
| Topic 2: Clinical Knowledge & Disease Processes Application | 20% | - Disease processes across body systems applied to chart review - Clinical indicators, lab results, medications, diagnostic findings - Medical terminology, anatomy, physiology, pathophysiology |
| Topic 3: Coding Guidelines & Official Reporting Standards | 15% | - ICD-10-CM/PCS Official Guidelines for Coding and Reporting - AHIMA/ACDIS Guidelines for Compliant Query Practice - Coding integrity and compliant documentation practices |
| Topic 4: Clinical Documentation Review & Query Practices | 20% | - Query development, communication, and ethical standards - Concurrent and retrospective chart review methodologies - Documentation gap identification and resolution |
| Topic 5: Healthcare Regulations, Reimbursement & Documentation Requirements – IPPS | 15% | - Documentation responsibilities of medical and clinical staff - Medicare Severity Diagnostic Related Groups (MS-DRGs) - Inpatient Prospective Payment System (IPPS) fundamentals |
| Topic 6: CDI Program Management & Professional Practice | 15% | - Provider education and training strategies - Ethics, HIPAA, and professional conduct - Program metrics, benchmarks, and performance measurement |
今まで、たくさんのお客様はACDIS CCDS試験参考資料に満足しています。そのほかに、弊社は引き続くみんなに合理的な価格で高品質なCCDS参考資料を提供します。もちろん、いいサービスを提供し、CCDS参考資料について、何か質問がありましたら、遠慮なく弊社と連絡します。
質問 # 129
A hospital had 1,000 inpatient discharges during a reporting period. The sum of the MS-DRG relative weights for those discharges was 1,750. What is the hospital's case mix index (CMI)?
正解：C
解説：
Case mix index is calculated by dividing the total MS-DRG relative weights by the number of discharges:
1,750 ÷ 1,000 = 1.75
Therefore, the hospital's CMI is 1.75.
CMI is an aggregate measure representing the average relative resource intensity of the hospital's inpatient population under the MS-DRG system. A higher CMI generally indicates that the hospital treated cases assigned to DRGs with higher average relative weights.
However, CMI should never be interpreted as a pure measure of clinical quality. It can be affected by patient population, service-line composition, surgical volume, transplant activity, documentation completeness, coding accuracy, changes in grouper methodology, and other factors.
CMS specifically publishes hospital CMI data and uses MS-DRG relative weights in the IPPS payment methodology. CMS also maintains FY 2026 case-mix and relative-weight files as part of the final-rule data package.
For CDI program analysis, unexplained CMI changes should trigger investigation rather than an automatic assumption of poor documentation. Service-line and diagnosis-level analysis usually provides a more meaningful interpretation.
CCDS Reference Topics: Case mix index; relative weights; CDI analytics; MS-DRGs; program performance.
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質問 # 130
A CDI specialist reviews a prior hospitalization and finds that the patient previously had chronic systolic heart failure. During the current admission, the provider documents only "history of CHF," although the patient remains on long-term heart-failure therapy. What is the BEST approach?
正解：C
解説：
Prior-encounter information may provide valuable clinical context, but it should not automatically be imported as a current reportable diagnosis without considering whether the condition remains active and relevant to the present encounter.
Here, a prior diagnosis of chronic systolic heart failure, ongoing heart-failure therapy, and ambiguous current wording such as "history of CHF" create a reasonable opportunity to clarify the patient's current heart-failure status if that information is clinically relevant.
The CDI specialist should not independently carry forward the previous diagnosis or escalate it to acute heart failure. Conversely, rigidly ignoring reliable prior clinical information can prevent identification of legitimate documentation gaps.
The 2026 ACDIS/AHIMA query guidance specifically includes the role of prior encounters as part of its updated query-practice framework, while emphasizing compliant provider clarification and accurate representation of the current patient's clinical status.
A query should make clear which current clinical indicators support the need for clarification and should not imply that a previous diagnosis must automatically remain valid.
CCDS Reference Topics: Prior encounters; chronic conditions; heart failure; query practice; current- encounter documentation.
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質問 # 131
A patient with sepsis has acute confusion, impaired attention, fluctuating mental status, and no focal neurologic findings. CT of the head is negative. The provider documents only "AMS secondary to infection." Which clarification would be MOST clinically appropriate?
正解：B
解説：
The documented acute mental-status change associated with systemic infection creates a reasonable clarification opportunity for acute metabolic encephalopathy, assuming the complete clinical record supports that diagnosis.
Encephalopathy represents diffuse cerebral dysfunction arising from systemic, metabolic, toxic, hypoxic, infectious, or other causes. Acute confusion, impaired attention, fluctuating cognition, and absence of a focal lesion can support an encephalopathic process.
However, the CDI specialist cannot convert "altered mental status" into encephalopathy independently. The provider must determine whether the patient's presentation represents metabolic encephalopathy, delirium, medication effect, dementia, another neurologic condition, or simply a nonspecific symptom.
Chronic dementia does not fit the acute fluctuating pattern unless underlying dementia is separately documented. Cerebral infarction would generally require compatible focal neurologic findings and clinical or imaging evidence. Transient global amnesia typically presents with prominent acute memory disturbance rather than generalized encephalopathy.
A compliant query should include the mental-status findings, infectious process, relevant laboratory data, neurologic evaluation, treatment, and clinical course.
CCDS Reference Topics: Encephalopathy; altered mental status; infection; neurologic clinical indicators; diagnostic clarification.
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質問 # 132
CMS identifies the complete logic used to assign inpatient cases to MS-DRGs in which FY 2026 resource?
正解：C
解説：
The ICD-10 MS-DRG Definitions Manual contains the detailed grouper logic CMS uses for MS-DRG assignment. CMS states that the FY 2026 Definitions Manual files provide the complete documentation of ICD-10 MS-DRG grouper logic.
The manual organizes MS-DRGs by Major Diagnostic Category and includes the principal diagnoses, procedures, MCC/CC structure, exclusions, and other logic needed to understand how cases group.
As of September 2026, CMS identifies FY 2026 Version 43.1 as effective for discharges from April 1 through September 30, 2026. Version 44 begins October 1, 2026 for FY 2027.
The Physician Fee Schedule governs professional services and does not define inpatient MS-DRGs. HCAHPS concerns patient-experience measurement, while the National Correct Coding Initiative focuses primarily on coding edits designed to prevent inappropriate code combinations in other reimbursement contexts.
CDI specialists do not need to memorize every grouper pathway, but they should understand how principal diagnosis, secondary conditions, procedures, and CC/MCC classifications interact to determine the working and final MS-DRG.
CCDS Reference Topics: MS-DRG Definitions Manual; grouper logic; IPPS; current fiscal-year resources.
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質問 # 133
A patient experienced a type 1 STEMI 10 days ago. The patient is readmitted and develops a new type 1 NSTEMI during the four-week acute myocardial infarction period. Which ICD-10-CM concept applies?
正解：B
解説：
ICD-10-CM provides category I22 for a subsequent acute myocardial infarction occurring within four weeks-28 days-of an initial acute MI, when the qualifying MI types and circumstances meet the classification requirements.
The FY 2026 Official Guidelines specify that when a patient with a type 1 or unspecified acute MI experiences a new type 1 or unspecified MI within four weeks of the initial MI, a code from category I22 is used together with the appropriate I21 code. Sequencing depends on the circumstances of the encounter.
This rule requires care because type 2 MI and certain other myocardial infarction classifications do not follow the same I22 subsequent-MI logic. CDI specialists therefore need accurate documentation of MI type, anatomic location when applicable, timing, and whether the current event represents a genuinely new infarction rather than ongoing care for the original MI.
The prior STEMI does not become an "old MI" merely because the patient left the hospital; the ICD-10-CM acute MI period extends for four weeks from onset.
CCDS Reference Topics: Acute MI; subsequent MI; I21/I22; four-week rule; cardiovascular coding.
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質問 # 134
......
CCDS認定試験は現在で本当に人気がある試験ですね。まだこの試験の認定資格を取っていないあなたも試験を受ける予定があるのでしょうか。確かに、これは困難な試験です。しかし、難しいといっても、高い点数を取って楽に試験に合格できないというわけではないです。では、まだ試験に合格するショートカットがわからないあなたは、受験のテクニックを知りたいですか。今教えてあげますよ。それはFast2testのCCDS問題集を利用することです。
CCDS受験準備: https://jp.fast2test.com/CCDS-premium-file.html