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| Certification Vendor: | ACDIS |
|---|---|
| Exam Name: | Certified Clinical Documentation Specialist-Outpatient (CCDS-O) Exam |
| Exam Number: | CCDS-O |
| Related Certifications: | Certified Clinical Documentation Specialist (CCDS) |
| Available Languages: | English |
| Exam Duration: | 150 minutes |
| Exam Format: | Remotely proctored or test center delivery, Computer-based, Multiple-choice questions |
| Passing Score: | 85 out of 120 scored questions |
| Certificate Validity Period: | 2 years |
| Exam Price: | $280 (ACDIS members), $380 (non-members), +$100 international fee |
| Real Exam Qty: | 140 (120 scored, 20 unscored) |
| Recommended Training: | CCDS-O Exam Candidate Handbook CCDS-O Official Study Guide |
| Exam Registration: | Prometric Scheduling ACDIS Certification Application |
| Sample Questions: | ACDIS CCDS-O Sample Questions |
| Exam Way: | Computer-based testing at Prometric centers or remote proctoring via ProProctor |
| Pre Condition: | RN, MD, DO, or HIM/coding certification (RHIA, RHIT, CCS, CPC, CRC, COC) + 2 years outpatient CDI experience; OR 1 year outpatient + 1 year inpatient CDI experience; minimum 2,000 hours per year |
| Official Syllabus URL: | https://acdis.org/certification/ccds-o |
ITDumpsKR의 경험이 풍부한 전문가들이ACDIS CCDS-O인증시험관련자료들을 계획적으로 페펙트하게 만들었습니다.ACDIS CCDS-O인증시험응시에는 딱 좋은 자료들입니다. ITDumpsKR는 최고의 덤프만 제공합니다. 응시 전ACDIS CCDS-O인증시험덤프로 최고의 시험대비준비를 하시기 바랍니다.
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질문 # 121
Which of the following descriptors is classified as an uncertain diagnosis?
정답：A
설명：
In outpatient CDI and coding guidance, an "uncertain diagnosis" is identified by wording that indicates the provider has not confirmed the condition (e.g., possible, probable, suspected, rule out, question of, concern for). These terms reflect diagnostic consideration rather than an established diagnosis. Option A uses the phrase "concern for," which is a classic uncertainty qualifier and signals the provider is considering streptococcal pneumonia but has not definitively diagnosed it. In contrast, options B and D describe active treatment "for streptococcal pneumonia," which implies the provider is managing the condition as a working diagnosis; however, in outpatient coding, treatment alone does not automatically make a diagnosis confirmed if the documentation still reflects uncertainty-CDI would look for explicit provider confirmation. Option C ("evidence of") generally suggests supportive findings and is commonly interpreted as stronger than "concern for," though CDI would still assess whether the provider has clearly stated a confirmed diagnosis in the assessment/plan. Therefore, the clearest uncertain descriptor is "concern for."
질문 # 122
Which of the following physician performance metrics BEST illustrates provider engagement with outpatient CDI specialist?
정답：C
설명：
Provider engagement in an outpatient CDI program is best reflected by measures that show the provider is actively interacting with CDI processes and improving documentation behaviors in real time. Query response rates directly indicate whether the provider is reading and responding to CDI clarifications promptly and consistently, which is a fundamental engagement behavior and a key operational driver of documentation accuracy. Problem list updates further demonstrate sustained engagement because they reflect the provider's willingness to maintain an accurate, current list of active conditions (adding validated diagnoses, removing resolved problems, and updating specificity such as stage, severity, or laterality). Together, these two metrics show both immediate participation (responding to queries) and longer-term adoption of documentation best practices (maintaining the problem list). In contrast, RAF scores and RAF capture rates are influenced by patient complexity, payer mix, and coding capture processes, and may improve even without meaningful provider participation. MIPS scores reflect broader quality program performance and are not specific to CDI-provider interaction. Therefore, query responsiveness plus problem list maintenance most directly measures engagement with outpatient CDI.
질문 # 123
CMS-HCCs are used to
정답：B
설명：
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.
질문 # 124
Upon retrospective review of a patient visit 2 weeks prior, a CDI specialist notes physician documentation stating the following: "Sick Sinus Syndrome in 2016 s/p pacemaker placement. Latest EKG shows normal paced rhythm." There are no codes noted for Sick Sinus Syndrome or the pacemaker. Which of the following is the BEST course of action for the CDI specialist?
정답：B
설명：
In outpatient CDI, diagnoses reported for an encounter must be supported as current and clinically relevant to that visit (evaluated, monitored, assessed, treated, or otherwise affecting care). The note documents a history of sick sinus syndrome with pacemaker placement in 2016 and indicates the current rhythm is paced. The most clearly reportable, present condition is the presence of a cardiac pacemaker, which is a status that can affect clinical decision-making (e.g., interpretation of rhythm findings, medication choices, procedures, and future cardiac evaluation) and is appropriate to code when documented. However, the documentation does not show that sick sinus syndrome itself was actively assessed or managed during this visit; it is referenced as a past condition leading to the device. Because outpatient coding does not assume an active diagnosis solely from historical mention, the best action is to capture the pacemaker status code only. Retrospective amendment requests or rebilling steps are not the first-line CDI action when the documentation does not support active management of the underlying arrhythmia.
질문 # 125
An African American male enrolled in Medicaid has not been taking his blood pressure medication. Which of the following factors impacts this beneficiary's risk score?
정답：C
설명：
Medicaid risk adjustment models generally calculate risk using two major categories of inputs: demographics and diagnosis data. Demographic factors commonly include gender and indicators tied to Medicaid status/eligibility (for example, eligibility category, dual status, disability-related eligibility, or other program qualifiers depending on the state/model). These demographic elements adjust expected cost and are foundational to the risk score even before considering diagnoses. By contrast, race is not a standard input for calculating Medicaid risk scores in typical risk adjustment methodologies, so options that include race are not supported. Likewise, "patient noncompliance" is primarily a clinical and quality-of-care issue and may affect treatment outcomes, but it is not itself a standard risk-score driver unless it is documented as a reportable, supported diagnosis that the specific model recognizes (and most models don't directly risk-adjust for nonadherence codes). Therefore, among the options given, Medicaid status and gender are the most clearly valid factors that impact the beneficiary's risk score.
질문 # 126
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