These CCS practice questions target reimbursement — including Pdx, Official Guidelines, Stage Renal Disease, Acute Myocardial Infarction. The complete CCS deck holds 1009 flashcards, 70 of them dedicated to this topic. Study the free samples below, then unlock the whole collection for a one-time $7.
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A patient is admitted for both acute cholecystitis and acute exacerbation of COPD. Both are treated equally. How is the principal diagnosis (Pdx) selected according to 2026 Official Guidelines?
Show answer →When two or more diagnoses equally meet the definition for Pdx (Section II.C), any one may be sequenced first. However, for MS-DRG optimization, the coder should select the diagnosis that results in the highest-weighted MS-DRG, provided it is supported by medical documentation. AHIMA often tests this by presenting two valid Pdx options where one has a higher-tier CC/MCC impact. Strategy: Check the MS-DRG weight for both scenarios before final selection.
The record lists End-Stage Renal Disease (N18.6) as a secondary diagnosis for a patient admitted for pneumonia. What is the MCC status of this condition?
Show answer →End-Stage Renal Disease (ESRD) is a designated MCC. It reflects a high level of chronic resource intensity, including the need for dialysis coordination during an inpatient stay. Note: Chronic Kidney Disease (CKD) Stage 4 and 5 are also MCCs as of recent IPPS updates. Exam Tip: Differentiate between AKI (Acute Kidney Injury) and CKD. AKI (N17.9) is also an MCC. If a patient has both, only one is needed to trip the DRG to the MCC level, but both should be coded for clinical accuracy.
A patient has a principal diagnosis of Acute Myocardial Infarction. A secondary diagnosis of Atrial Fibrillation (I48.91) is coded. Does Atrial Fibrillation qualify as a CC for an AMI patient?
Show answer →Yes, Atrial Fibrillation (I48.91) is a CC and is NOT on the exclusion list for AMI. While both are cardiac, A-Fib is not considered inherent to an AMI and requires separate management (e.g., rate control, anticoagulation). Exam Tip: Common arrhythmias (A-fib, Flutter) are reliable CCs for most MS-DRGs unless the PDX is the arrhythmia itself. If the PDX was Atrial Fibrillation, then a secondary code of Atrial Flutter would likely be excluded.
Once the cost of an IPPS case exceeds the outlier threshold, what is the standard percentage of the excess costs that CMS pays the hospital (the marginal cost factor)?
Show answer →CMS typically pays 80% of the difference between the hospital's estimated cost and the outlier threshold (MS-DRG payment + Fixed Loss Threshold). Exception: For specific Burn DRGs (MS-DRGs 927-935), the marginal cost factor is 90% due to the extreme resource intensity of these cases. Exam Strategy: Don't confuse the 80% marginal cost factor with the 5.1% total pool target. AHIMA may use 50% or 100% as distractors.
Contrast the reimbursement behavior of Status Indicator 'S' versus Status Indicator 'T' when multiple procedures of each type are reported on the same date of service.
Show answer →SI 'S' (Significant Procedure, Not Discounted) is always paid at 100% of the APC rate, regardless of other procedures. SI 'T' (Significant Procedure, Multiple Reduction Applies) is subject to a 50% reduction for all but the highest-weighted 'T' procedure. CCS Exam Tip: If a claim has one 'S' and two 'T' procedures, you get 100% for 'S', 100% for the top 'T', and 50% for the second 'T'. This is a very high-yield distinction for the CCS.
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Try 30 free CCS cards firstThe full CCS deck contains 1009 flashcards, and 70 of them focus on reimbursement. This page shows 5 free samples.
Our CCS deck dedicates 70 of 1009 cards (7%) to reimbursement — always cross-check the official AHIMA exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CCS preview page has 30 more free cards. Full access to all 1009 cards is a one-time $7.
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