This column serves as a resource for those who are preparing to take the certified coding specialist (CCS) and CCS-P (physician-based) examinations offered by the American Health Information Management Association (AHIMA). This column provides general preparation tips and suggestions, as well as recommended study material.
The AHIMA Web site (www.ahima.org/certification/default.aspx) has extensive information to help you prepare for the exam as well as application forms. Specifically, for both the CCS and the CCS-P examination, this site provides information on eligibility, exam information, exam preparation and FAQ's. If you are not yet a member of AHIMA, it is recommended that you join. If you are a member, the Communities of Practice (COP) offer up-to-date coding news, links to helpful resources and, most importantly, a vehicle to interact with others preparing to take the examination.
General Preparation Tips and Suggestions
1. Study the Certification Guide from AHIMA. The certification guide tells you everything you need to know about taking the examinations, including deadlines and instructions, content outline, allowable code books and recommended resources. Read the entire guide from cover to cover. You can access this information through AHIMA's Web site at http://ahima.org/downloads/pdfs/certification/Candidate_Guide.pdf.
2. Sign up for a review seminar before the exam. Pre-exam seminars are a good refresher before the test. Contact your state health information management (HIM) association for a list of schools or local associations that may offer pre-exam reviews. Be sure to determine whether the session is based upon CCS or CCS-P. There are many similarities, but the focus and total content may vary somewhat between the two.
3. Use code books instead of encoders. When studying for the exam, code books must be used. Encoders are not permitted for test taking. If you have not coded from a code book for a while, it is important that you practice using the books. Updated coding information and notes must be written directly or attached permanently into your code books because no loose material is allowed while taking the exam. A list of allowable code books is included on the AHIMA certification site listed above.
4. Review hard copies of Coding Clinic for ICD-9-CM and CPT Assistant. Many facilities and physician practices purchase encoding systems with online coding resources, such as Coding Clinic and CPT Assistant. In some cases, the references are not reviewed unless an issue directly related to a particular case is being coded or discussed. Some encoders may not provide the ability to read through each issue of CPT Assistant and Coding Clinic. The CCS and CCS-P examinations rely heavily upon coding scenarios based upon guidelines discussed in both the Coding Clinic and CPT Assistant. Become very familiar with at least the last several years' issues.
5. Time yourself when coding cases. Previous test takers have commented on how important it is to keep track of time while taking the exam. The exam is 4 hours long and is split into two parts. You cannot return to Part I after beginning Part II of the exam.
- Part I: Both exams consist of 60 multiple-choice items. However 60 minutes is allocated for CCS and 90 minutes for CCS-P.
- Part II: The CCS exam requires you to code 13 medical records (seven outpatient and six inpatient) that must be completed in 180 minutes. The CCS-P exam includes 16 cases that must be completed in 150 minutes.
You will need to increase your speed if you are taking more than 14 minutes per CCS coding case or 9-10 minutes per CCS-P coding case. Be sure to time yourself on inpatient, outpatient surgery, emergency room, physician office and clinic cases, because a combination of cases could be represented on the test, depending upon which test you are taking.
6. Organize how you will handle problems encountered when taking the exam. Pre-determine how you will handle questions that you are not able to answer immediately. Will you move on and come back to them later? Or, will you give each question your best guess and move on? Practice these types of scenarios so you are prepared.
7. Purchase study guides and take mock examinations. Complete the exercises included in the CCS Prep! columns. Purchase study guides such as the Professional Review Guide for the CCS Examinations or Professional Review Guide for the CCS-P Examinations. These publications are available from various sources. This book and others recommended below contain case studies and mock examinations from which to practice.
8. Review basic coding principles. Review ICD-9-CM, CPT and HCPCS coding texts to reinforce coding principles. Be sure to review the official coding conventions, including abbreviations and their definitions, symbols, font type (such as boldface or italicized) and instructional notes. Do not assume you will be able to review this information in the front of the coding books during the exam. In many cases, this information appears in the multiple-choice portion of the exam, when you cannot use the coding books. Review guidelines for modifier use. Depending upon which exam you are taking, modifiers may have a significant impact on your answers. Questions regarding modifiers will most likely appear in the multiple-choice section of the exams.
Recommended Study Materials
The following study materials are recommended in preparation for the exam:
ICD-9-CM Official Guidelines for Coding and Reporting. These guidelines were updated effective Oct. 1, 2010, and include both inpatient and outpatient ICD-9-CM coding guidelines. The guidelines are developed by the four cooperating parties: the American Hospital Association (AHA), AHIMA, the Centers for Medicare and Medicaid Services (CMS) and National Center for Health Statistics (NCHS). The guidelines can be viewed at http://www.cdc.gov/nchs/data/icd9/icdguide10.pdf.
Coding Clinic for ICD-9-CM. Published by the AHA, Coding Clinic may be purchased online at https://www.associationstores.org/OA_HTML/ibeCCtpSctDspRte.jsp?section=10446. Many of the questions will test your Coding Clinic knowledge.
CPT Assistant. Published by the American Medical Association (AMA), this resource provides guidance on the assignment of CPT codes. CPT Assistant may be purchased online at https://catalog.ama-assn.org/Catalog/product/product_detail.jsp?productId=prod170136.
ICD-9-CM Coding Handbook with Answers. (Previously Fay Brown's Coding Handbook) This publication helps coders understand the principles behind the classification system and includes extensive case summary and chapter exercises. Published by the AHA, it is available online at https://www.associationstores.org/OA_HTML/ibeCCtpItmDspRte.jsp?section=11208&item=5040.
ICD-9-CM Diagnostic Coding and Reimbursement for Physician Services (w/answer key) by Anita C. Hazelwood, MLS, RHIA, and Carol A. Venable, MPH, RHIA. Available at https://www.ahimastore.org/ProductDetailBooks.aspx?ProductID=14535.
CPT/HCPCS Coding and Reimbursement for Physician Services. Authored by Lynn Kuehn, MS, RHIA, CCS-P. It may be ordered online at https://www.ahimastore.org/ProductDetailBooks.aspx?ProductID=14261.
Documentation Guidelines for Evaluation and Management Services. The 1995 and 1997 documentation guidelines may be downloaded from the CMS Web site at http://www.cms.gov/MLNEdWebGuide/25_EMDOC.asp.
Coder's Desk References by Ingenix. These publications are essential tools for ICD-9-CM, CPT and HCPCS coding. They will help you better understand the medical codes and their definitions. Order online at. http://www.shopingenix.com/Category/100038/100188.
Clinical Coding Workout by AHIMA. This publication includes excerpts from real medical records and questions pertaining to these excerpts. It may be ordered online at https://www.ahimastore.org/ProductDetailBooks.aspx?ProductID=14779.
In addition to the above and to your updated ICD-9-CM, CPT and HCPCS Level II code books, you will also benefit from having access to the following resources:
- Medical Abbreviations Book
- Medical Dictionary
- Medication Handbook
These tips and resource suggestions will help you get started in your preparation to take the CCS or CCS-P exam. In upcoming issues of CCS Prep! we will continue to address specific topics. Should you have a topic you would like included, send an e-mail to ADVANCE at firstname.lastname@example.org.
This month's column has been prepared by Cheryl D'Amato, RHIT, CCS, director of HIM, hospital solutions, and Melinda Stegman, MBA, CCS, clinical technical editor, Ingenix.
Coding Clinic is published quarterly by the American Hospital Association.
CPT is a registered trademark of the American Medical Association.