TopexamのACDISのCCDS認証試験について最新な研究を完成いたしました。無料な部分ダウンロードしてください。きっと君に失望させないと信じています。最新ACDISのCCDS認定試験は真実の試験問題にもっとも近くて比較的に全面的でございます。
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Official Guidelines for Coding and Reporting | 14.17% | - Principal diagnosis assignment - Working DRG assignment for multiple diagnoses - Official Guidelines for Coding and Reporting updates - Present on admission indicators - Coding guidelines for principal diagnosis selection - Hospital-acquired conditions - AHA Coding Clinic - Secondary diagnosis assignment - Discharge dispositions and transfers |
| Topic 2: Professionalism, ethics, and compliance | 9.17% | - CDI department goals beyond reimbursement - Medical record confidentiality - Potential DRG creep - DRG compliance initiatives - Compliance risks indicated by PEPPER - Leading queries |
| Topic 3: Healthcare facility CDI program analysis | 8.33% | - CDI specialist productivity metrics - Tracking and trending physician, department, and hospital performance - PEPPER data - Physician performance measurement - Publicly reported data - Severity of illness and risk of mortality - Hospital-specific financial data - Case mix index (CMI) - High-frequency DRGs - Patient Safety Indicators - CDI program forecasting - Basic computer and software application skills - CC/MCC capture - Hospital Value-Based Purchasing measures - Provider response rates |
| Topic 4: Communication skills | 9.17% | - Reconciling CDI working DRGs with final coded DRGs - Educational presentations for healthcare departments and administration - Physician education forms and tools - Roles and responsibilities of CDI specialists - Effective and non-confrontational physician communication - Verbal versus written physician communication - Roles and responsibilities of coders working with CDI departments |
| Topic 5: Medical record documentation | 19.17% | - Physician query formats - Provider role and diagnosis code assignment - Translating clinical indicators into compliant queries - When a physician query is warranted - Types of physician queries - Documentation requiring clarification - Situations in which queries are not appropriate - ACDIS/AHIMA Guidelines for Achieving a Compliant Query Practice - Addressing diagnoses without clinical support - Health record elements used for diagnosis and procedure code assignment - Compliant and noncompliant queries - Clinical indicators |
| Topic 6: Impact of reportable diagnoses on quality of care | 8.33% | - 30-day mortality measures - Hospital Value-Based Purchasing - Mortality reviews and observed/expected ratios - Documentation and code assignment impact on mortality index - Quality data from record abstraction and claims data - Hospital Inpatient Quality Reporting Program - Hospital-Acquired Condition Reduction Program - Patient Safety Indicators - Coded data elements affecting Patient Safety Indicators - Hospital Readmissions Reduction Program - CDI impact on Hospital Value-Based Purchasing - Healthcare-associated infections and complication codes |
| Topic 7: Healthcare regulations, reimbursement, and documentation requirements related to the IPPS | 12.5% | - Medical staff and clinical staff documentation responsibilities - Major complication/comorbidity (MCC) - Documentation and medical necessity of setting - Principal diagnosis and medical necessity - Complication/comorbidity (CC) - IPPS and its updates and revisions - Case mix index (CMI) - Documentation impact on IPPS reimbursement - Coding and billing practices vulnerable to denial - Medicare contractors and their impact on CDI - Inpatient admission criteria and CMS Two-Midnight Rule - Medicare Severity Diagnosis Related Groups (MS-DRGs) |
| Topic 8: Anatomy and physiology, pathophysiology, pharmacology, and medical terminology | 19.17% | - Pharmaceuticals and disease processes - Standard medical abbreviations - Alcohol/drug use and alcohol/drug-induced organic brain disorders - Clinical indicators and query opportunities by Major Diagnostic Category - Injuries, poisonings, and toxic effects of drugs - Mental diseases and disorders - HIV infections - Infectious and parasitic diseases - Diseases and disorders of the respiratory system - Diseases and disorders of the circulatory system - Diagnostic tests as clinical indicators - Diseases and disorders of the nervous system - Diseases and disorders of the blood and blood-forming organs and immunological disorders - Diseases and disorders of the hepatobiliary system - Diseases and disorders of the kidney and urinary tract - Endocrine, nutritional, and metabolic diseases and disorders - Medications as clinical indicators - Myeloproliferative diseases and disorders and poorly differentiated neoplasms - Diseases and disorders of the digestive system - Diseases and disorders of the musculoskeletal system - Diseases and disorders of the skin, subcutaneous tissue, and breast |
数年以来の整理と分析によって開発されたCCDS問題集は権威的で全面的です。CCDS問題集を利用して試験に合格できます。この問題集の合格率は高いので、多くのお客様からCCDS問題集への好評をもらいました。CCDS問題集のカーバー率が高いので、勉強した問題は試験に出ることが多いです。だから、弊社の提供するCCDS問題集を暗記すれば、きっと試験に合格できます。
質問 # 65
For FY 2026 Hospital Value-Based Purchasing, each of the four scored domains generally contributes what percentage to the Total Performance Score when all four domains are scored?
正解：D
解説：
When all four Hospital VBP domains are scored, each domain contributes 25% of the hospital's Total Performance Score.
For FY 2026, the four domains are Clinical Outcomes, Person and Community Engagement, Safety, and Efficiency and Cost Reduction. CMS's Provider Data Catalog confirms that each contributes one-quarter of the Total Performance Score under the standard four-domain configuration.
The Clinical Outcomes domain includes mortality and complication measures. Person and Community Engagement incorporates HCAHPS patient-experience dimensions. The Safety domain contains healthcare- associated infection and safety-related measures, while Efficiency and Cost Reduction incorporates Medicare spending measures.
If a hospital receives valid scores in only three domains, CMS proportionately reweights the scored domains rather than simply assigning zero to the missing domain.
For CCDS practice, understanding these domains helps explain why accurate documentation influences more than MS-DRG reimbursement. Clinical documentation can affect severity adjustment, complications analysis, mortality calculations, and the reliability of administrative data used in performance measurement.
CCDS Reference Topics: Hospital VBP; Total Performance Score; quality domains; risk adjustment; hospital performance.
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質問 # 66
A patient is admitted with fever and weakness. On hospital day 3, final blood cultures identify an infection that the physician documents was present at the time of admission. Which statement about present-on- admission status is MOST accurate?
正解：C
解説：
A condition can be assigned present-on-admission status even when the definitive diagnosis is not made until later in the hospitalization. POA refers to whether the condition was present at the time the order for inpatient admission occurred, not the calendar date on which diagnostic confirmation became available.
This distinction is particularly relevant for infections, malignancies, fractures, acute vascular events, and other conditions whose definitive identification may require cultures, pathology, imaging, or additional diagnostic testing.
Therefore, a blood culture finalized on hospital day 3 does not automatically make the infection hospital acquired. The clinical record and provider documentation must establish whether the disease process was present at admission.
POA assignment applies to applicable principal and secondary diagnoses, not only the principal diagnosis.
CDI specialists should recognize unclear timing as a potential clarification opportunity because POA status can affect CMS Hospital-Acquired Condition payment logic and quality reporting.
The CCDS content outline expressly includes the basics of POA assignment and its impact on payment, as well as identification of CMS HACs.
CCDS Reference Topics: Present on admission; diagnosis timing; HACs; inpatient coding; quality reporting.
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質問 # 67
An MS-DRG family is divided into three severity levels: with MCC, with CC, and without CC/MCC.
Assuming all other grouper conditions are identical, which secondary diagnosis category generally results in the highest severity-level assignment?
正解：D
解説：
An MCC-major complication or comorbidity-represents the highest secondary-diagnosis severity category within the standard three-tier MS-DRG hierarchy. CMS describes MCCs as diagnoses with the highest level of severity affecting hospital resource use, CCs as conditions with a moderate level, and non-CC diagnoses as the lowest severity level.
When an MS-DRG family is divided into "with MCC," "with CC," and "without CC/MCC," the presence of a qualifying MCC generally moves the case into the highest severity subdivision, assuming no exclusion or other grouper rule prevents that effect.
This does not mean every MCC always increases payment. Some secondary diagnoses are excluded as MCCs or CCs in particular circumstances because of principal-diagnosis exclusions or DRG-specific logic. CMS's FY 2026 Definitions Manual specifically contains exclusion lists and severity logic for such situations.
CDI specialists should understand MCC/CC logic to interpret working DRGs, but query activity must be driven by clinical accuracy rather than the financial value of a severity level.
CCDS Reference Topics: MS-DRGs; MCC; CC; severity subdivisions; resource utilization; reimbursement compliance.
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質問 # 68
A physician is completing rounds when a CDI specialist identifies conflicting documentation that can be clarified immediately. Which approach is MOST appropriate?
正解：C
解説：
Direct verbal communication can be an effective and appropriate CDI technique, particularly when the responsible physician is available and the issue can be clarified efficiently. The interaction must remain professional, clinically focused, and compliant with the organization's process for documenting or retaining verbal queries.
ACDIS specifically identifies collaboration with providers, verbal discussion, written queries, and resolution of missing, unclear, or conflicting documentation as core inpatient CDI responsibilities. The CCDS blueprint also tests situations in which personal or verbal communication may be preferable to written communication.
Option C is inappropriate because the CDI specialist should not direct the physician toward a diagnosis based on MS-DRG impact. The discussion should present the clinical issue neutrally and allow the physician to exercise independent clinical judgment.
There is also no rule requiring all queries to be electronic. Query format and retention should follow compliant organizational policies and current ACDIS/AHIMA standards. Waiting until final billing can unnecessarily delay resolution and undermine the advantages of concurrent CDI review.
Effective CDI communication balances clinical precision, efficiency, collegiality, and auditability.
CCDS Reference Topics: Verbal queries; physician communication; concurrent CDI; nonleading clarification; query documentation.
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質問 # 69
Documentation indicates an excisional debridement was performed without further specification. The CDI specialist should query to clarify which of the following?
正解：C
解説：
The most critical missing element is the depth or level of tissue actually debrided. Documentation of an excisional debridement should identify whether tissue removed included skin, subcutaneous tissue, fascia, muscle, bone, or another anatomical layer. The level removed is fundamental to accurate procedural classification and coding.
CMS wound-care documentation standards similarly emphasize that the medical record should describe the type and depth of tissue removed. Merely knowing that an excisional debridement occurred does not establish the anatomical level of the procedure.
The instrument may provide useful procedural context-for example, scalpel, scissors, curette, or other technique-but the instrument alone does not identify the deepest tissue excised. Wound size can be important for clinical care and certain coding systems, but it does not replace documentation of the tissue level removed. The identity of the person performing the procedure is also part of procedural documentation but does not answer the principal coding-specific deficiency in this scenario.
A CDI query should therefore seek the deepest tissue level actually excised rather than infer it from the wound's overall depth.
CCDS Reference Topics: Medical record documentation; ICD-10-PCS/procedure documentation; debridement specificity.
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質問 # 70
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