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| Certification Vendor: | ACDIS (Association of Clinical Documentation Integrity Specialists) |
|---|---|
| Exam Name: | ACDIS Certified Clinical Documentation Specialist โ Outpatient (CCDS-O) Examination |
| Exam Number: | CCDS-O |
| Exam Format: | Multiple-choice, Computer-based exam |
| Related Certifications: | Certified Clinical Documentation Specialist (CCDS) |
| Real Exam Qty: | 140 questions (120 scored) |
| Available Languages: | English |
| Passing Score: | 85 out of 120 scored questions |
| 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 1โ2 years of outpatient clinical documentation experience using U.S. reimbursement systems. |
| Official Syllabus URL: | https://acdis.org/certification/ccds-o |
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NEW QUESTION # 115
Which of the following is a form of a cardiac condition that may be treated with a beta-blocker?
Answer: D
Explanation:
Beta-blockers are commonly used in the management of coronary artery disease (CAD) because they lower heart rate, decrease myocardial contractility, and reduce oxygen demand-key goals in treating stable angina and in secondary prevention after myocardial infarction. In outpatient chart review, ACDIS-focused clinical documentation education emphasizes linking the medication to the condition being managed (e.g., "CAD with angina-on metoprolol for symptom control" or "history of MI-on beta-blocker for secondary prevention") to support accurate diagnosis reporting and demonstrate ongoing assessment and treatment. By contrast, third-degree (complete) heart block and sinus bradycardia are conditions where beta-blockers are typically avoided or used only with extreme caution because they can worsen conduction delay and slow the heart rate further. Cardiomyopathy can sometimes be treated with certain evidence-based beta-blockers when the clinical context is systolic heart failure, but the option most broadly and reliably associated with beta-blocker treatment in standard outpatient practice and documentation is CAD.
NEW QUESTION # 116
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?
Answer: A
Explanation:
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.
NEW QUESTION # 117
Which of the following is covered under the Outpatient Prospective Payment System (OPPS)? (Select all that apply)
Answer: A
Explanation:
Under Medicare, OPPS is the payment system used primarily for hospital outpatient department (HOPD) services paid under APCs, and it also applies to a limited set of non-hospital entities for specific covered services. Community Mental Health Centers (CMHCs) are included under OPPS for certain outpatient mental health services, most notably partial hospitalization-type services that are paid using OPPS methodology, which is why CMHCs are considered "covered under OPPS" in many outpatient CDI education materials. In contrast, clinical diagnostic laboratory services are generally excluded from OPPS and paid under the Clinical Laboratory Fee Schedule (with separate billing and payment rules). Indian Health Services follow different statutory and payment structures and are not paid broadly under OPPS in the same way as HOPDs/CMHC OPPS services. Physical therapy reimbursement is typically governed by therapy-specific rules and fee schedule methodologies rather than being a standard OPPS-covered category in this context. Therefore, among the listed options, CMHCs are the correct OPPS-covered selection.
NEW QUESTION # 118
Which of the following payment models enables Medicare to forecast costs for Medicare Advantage members for the coming year?
Answer: C
Explanation:
Medicare Advantage (MA) payments are risk adjusted so CMS can predict expected healthcare costs for each enrollee in the upcoming payment year. The model used for this forecasting is the CMS-HCC (Hierarchical Condition Category) risk adjustment methodology. It converts demographic factors (such as age/sex and eligibility status) plus documented, coded diagnoses (ICD-10-CM codes that map to HCCs) into a Risk Adjustment Factor (RAF). CMS then uses the RAF to adjust capitation payments to MA plans to reflect the member's anticipated resource needs. This is why outpatient CDI places heavy emphasis on accurate, specific capture and annual "recapture" of active chronic conditions that are monitored, evaluated, assessed/addressed, or treated during the encounter-because the prior year's valid HCCs drive the next year's predicted cost and payment. By contrast, APCs relate to OPPS facility outpatient payment, RVUs/RBRVS relate to physician fee schedule valuation, and GPCIs adjust payment geographically; none of those are the MA risk forecasting model.
NEW QUESTION # 119
CMS-HCC risk adjustment methodology seeks to measure
Answer: D
Explanation:
The CMS-HCC risk adjustment methodology is designed to estimate an individual beneficiary's expected healthcare resource use and cost relative to an average Medicare beneficiary. It does this by converting demographic factors (such as age/sex and certain eligibility variables) plus documented, coded chronic conditions into a Risk Adjustment Factor (RAF). That RAF is then used to forecast the likely cost of caring for that specific patient in the payment year and to adjust benchmarks/payments so plans and providers managing sicker patients are compared more fairly to those managing healthier patients. This is why outpatient CDI emphasizes accurate, specific documentation and annual recapture of active conditions that are monitored, evaluated, assessed/addressed, or treated-because those coded conditions drive the predicted cost profile. CMS-HCC is not a mortality prediction tool (eliminating B), nor is it intended to measure "group costs" as the primary target (C), even though aggregated risk scores can be used for population analytics. It also does not measure an individual physician's cost of care provision (D); it measures patient-level expected cost burden.
NEW QUESTION # 120
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