CCS (Customs & Trade Compliance Certifications) case studies
CCS · Put your knowledge to work in context.
The Certified Coding Specialist (CCS) is a professional credential for experienced medical coders who work with inpatient and outpatient records, often in hospital settings. It is designed for coders who already understand ICD-10-CM/PCS, CPT, and HCPCS Level II and want to demonstrate advanced proficiency in code assignment, documentation review, and compliance. The CCS case studies are 5 cases and about 2,660 words.
1Sepsis, Pressure Ulcer, and MRSA Colonization: Principal Diagnosis and Query Decision
R, a 76-year-old male, is admitted from a skilled nursing facility with fever of 39.1°C, hypotension (82/50 mmHg), confusion, and lactic acidosis (4.2 mmol/L). Blood and urine cultures grow Klebsiella pneumoniae.
683 words, about 3 min2Converted Laparoscopic Cholecystectomy: ICD-10-PCS Approach and Data Mapping
A 58-year-old male with chronic cholecystitis and cholelithiasis undergoes an elective laparoscopic cholecystectomy. During the procedure, dense adhesions prevent safe dissection, and the surgeon converts to an open cholecystectomy.
461 words, about 2 min3Parental Request and Subpoena for a Minor’s Mental Health and STI Records
A 16-year-old patient is treated at a hospital clinic for depression and receives psychotherapy notes. During the visit, the patient also receives testing and treatment for chlamydia under a state law that allows minors to consent to STI care.
535 words, about 3 min4Heart Failure vs. Pneumonia: MS-DRG Denial and Appeal
An 81-year-old female is admitted with three days of worsening dyspnea, orthopnea, and 3+ pitting edema. BNP is 2,100 pg/mL, and chest x-ray shows bilateral infiltrates and pulmonary vascular congestion.
487 words, about 2 min5Modifier 25 Audit in an Outpatient Clinic
A compliance audit of 30 outpatient charts finds 12 encounters billed with a level-4 established patient E/M code (99214) and modifier 25 on the same day as a minor procedure, destruction of a benign skin lesion (17110). In eight of the 12 charts, the E/M documentation addresses only the lesion: the history, exam, and medical decision-making are about the same skin problem.
494 words, about 2 min