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2026 Statistics

Key Facts: CCS Exam

107

Total Questions

AHIMA CCS page

97

Scored Items

AHIMA CCS page

4 hrs

Exam Time

AHIMA CCS page

300

Passing Score

AHIMA CCS page

$299/$399

Member/Non-Member Fee

AHIMA CCS page

84%

2025 First-Time Pass Rate

AHIMA CCS page

The current AHIMA CCS exam has 107 total items, including 97 scored items and 10 pretest items, and candidates have 4 hours to complete it. The passing score is 300, the current exam fee is $299 for AHIMA members or $399 for non-members, exams delivered on or after May 1, 2026 require 2026 code books, and CCS is delivered in person at Pearson VUE Authorized Test Centers rather than through OnVUE.

Sample CCS Practice Questions

Try these sample questions to test your CCS exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 199+ question experience with AI tutoring.

1According to ICD-10-CM Official Guidelines for Coding and Reporting, which code is sequenced first when a patient is admitted for management of anemia due to malignancy?
A.The anemia code (D64.9)
B.The malignancy code (C78.7)
C.Both codes are sequenced with equal priority
D.The procedure code only
Explanation: Per ICD-10-CM Official Guidelines Section I.C.2.c.1, when a patient is admitted for treatment of anemia resulting from a malignancy, the malignancy is sequenced as the principal diagnosis, followed by the appropriate anemia code. The underlying malignancy is the condition being treated, even though the anemia may be the symptom that prompted admission.
2A patient is diagnosed with Type 2 diabetes mellitus with diabetic nephropathy. What is the correct ICD-10-CM coding sequence?
A.E11.9, N18.9
B.E11.21, N18.9
C.E11.22 only
D.E11.9 only
Explanation: Type 2 diabetes with diabetic nephropathy is coded as E11.21 (Type 2 diabetes mellitus with diabetic nephropathy) as a combination code. However, if the stage of chronic kidney disease is known, it should also be coded (N18.x series). The combination code E11.21 includes both the diabetes and the nephropathy manifestation.
3In ICD-10-CM, what does the seventh character "A" indicate in injury codes?
A.Subsequent encounter
B.Sequela
C.Initial encounter
D.Not applicable
Explanation: In ICD-10-CM injury codes (categories S00-T88), the seventh character "A" indicates an initial encounter. This is used when the patient is receiving active treatment for the condition. "D" indicates a subsequent encounter, and "S" indicates a sequela (late effect).
4A patient is admitted with pneumonia due to MRSA (methicillin-resistant Staphylococcus aureus). The correct ICD-10-CM coding includes:
A.J15.212 only
B.J18.9, B95.62
C.J15.212, Z16.24
D.J15.212, B95.62
Explanation: Pneumonia due to MRSA is coded as J15.212 (Pneumonia due to Methicillin resistant Staphylococcus aureus) as the principal diagnosis. Additionally, B95.62 (Methicillin resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere) is assigned as a secondary code to identify the specific causative organism.
5According to ICD-10-CM guidelines, when should a code from category Z38 (Liveborn infants according to place of birth and type of delivery) be assigned?
A.Only for the newborn's birth record
B.For all encounters during the first year of life
C.For any encounter involving a newborn
D.Only when the birth was by cesarean section
Explanation: Per ICD-10-CM Official Guidelines Section I.C.16.a.1, a code from category Z38 should be assigned only once, to the newborn at the time of birth. If the newborn is transferred to another institution, the Z38 code should not be repeated at the receiving facility.
6A patient undergoes a laparoscopic cholecystectomy. What is the correct ICD-10-PCS root operation for this procedure?
A.Resection
B.Excision
C.Removal
D.Destruction
Explanation: A cholecystectomy (removal of the gallbladder) is coded with the root operation "Resection" in ICD-10-PCS. Resection is defined as cutting out or off, without replacement, all of a body part. The complete code would be 0FT44ZZ (Resection of Gallbladder, Percutaneous Endoscopic Approach).
7In ICD-10-PCS, what is the correct approach value for a procedure performed through a natural or artificial opening with percutaneous endoscopic assistance?
A.Via Natural or Artificial Opening
B.Via Natural or Artificial Opening Endoscopic
C.Via Natural or Artificial Opening with Percutaneous Endoscopic Assistance
D.Percutaneous Endoscopic
Explanation: ICD-10-PCS defines approach value 4 as "Via Natural or Artificial Opening with Percutaneous Endoscopic Assistance." This approach is used when the procedure is primarily performed through a natural or artificial opening, but requires percutaneous endoscopic assistance to complete the procedure.
8A patient undergoes a coronary artery bypass graft (CABG) using the left internal mammary artery (LIMA) to the left anterior descending artery (LAD). What is the correct ICD-10-PCS coding?
A.02100Z9
B.021109W
C.02100AW
D.02100Z8
Explanation: A LIMA-to-LAD CABG is coded 02100Z9 (Bypass Coronary Artery, One Artery, from Left Internal Mammary, Open Approach). Because the left internal mammary artery is left in situ as a pedicled graft (it is not detached and re-implanted), no graft material is taken, so the device value is Z (No Device); the qualifier 9 identifies the source vessel, the Left Internal Mammary. A device value would be coded only when separate graft material (e.g., autologous vein) is used.
9An established patient is seen in the office. Using 2021+ CPT guidelines, code selection is based on medical decision making (MDM) of low complexity. Which CPT code range applies and which level is appropriate?
A.99212-99215; 99213 for low MDM
B.99201-99205; 99203 for low MDM
C.99241-99245; 99243 for low MDM
D.99381-99397; 99393 for low MDM
Explanation: Effective January 1, 2021, office/outpatient E/M codes are selected by MDM or total time only; history and examination are no longer level-determining components. Established patient codes are 99211-99215, and 99213 corresponds to low-complexity MDM (or 20-29 minutes total time). 99201 was deleted in 2021, the 99241-99245 consultation series was deleted by CPT in 2023, and 99381-99397 are preventive medicine visits.
10Which CPT modifier indicates that a surgical procedure was performed on the left side of the body?
A.Modifier 50
B.Modifier LT
C.Modifier RT
D.Modifier 51
Explanation: Modifier LT is used to indicate that a procedure was performed on the left side of the body. Modifier RT indicates the right side. Modifier 50 indicates a bilateral procedure, and Modifier 51 indicates multiple procedures performed during the same session.

About the CCS Exam

The AHIMA Certified Coding Specialist (CCS) credential validates facility coding proficiency across medical-record abstraction, ICD-10-CM diagnosis coding, ICD-10-PCS procedure coding, CPT/HCPCS outpatient and emergency department coding, documentation quality, compliant provider queries, regulatory compliance, and coding information technologies.

Questions

107 scored questions

Time Limit

4 hours

Passing Score

300 scaled score

Exam Fee

$299 AHIMA member / $399 non-member (AHIMA / Pearson VUE Authorized Test Centers)

CCS Exam Content Outline

39-41%

Coding Knowledge and Skills

Diagnosis and procedure coding, principal/first-listed selection, sequencing, guidelines, modifiers, POA, NCCI/medical necessity edits, DRG/APC methodology, abstraction, and MCC/CC identification.

18-22%

Coding Documentation

Resolving conflicting documentation, confirming documentation supports a specified code, and verifying/validating health-record documentation.

9-11%

Provider Queries

Ethical compliant query elements, non-leading clinical indicators, and documentation analysis for query opportunities.

18-22%

Regulatory Compliance

Completeness and accuracy, payer-specific guidelines, PSIs, HACs, HIPAA, AHIMA Standards of Ethical Coding, and UHDDS compliance.

9-11%

Information Technologies

EHR types, encoder and grouper software, computer-assisted coding, HITECH, and coding-data quality workflows.

How to Pass the CCS Exam

What You Need to Know

  • Passing score: 300 scaled score
  • Exam length: 107 questions
  • Time limit: 4 hours
  • Exam fee: $299 AHIMA member / $399 non-member

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

CCS Study Tips from Top Performers

1Use 2026 code books for current CCS testing after May 1, 2026 and practice with the same books you will bring to Pearson VUE.
2Build separate workflows for ICD-10-CM diagnosis coding, ICD-10-PCS inpatient procedure coding, CPT/HCPCS outpatient coding, and medical-scenario abstraction.
3Study principal/first-listed diagnosis, procedure sequencing, POA, MCC/CC, and DRG/APC methodology as connected decisions rather than isolated terms.
4Use compliant query practice to separate missing documentation, conflicting documentation, uncertain diagnosis, and leading-query traps.
5Review HIPAA, AHIMA ethical coding standards, UHDDS, PSIs, HACs, NCCI, medical necessity, payer rules, and audit defensibility.
6Practice encoder, grouper, CAC, EHR, and HITECH questions as workflow and data-quality questions, not software trivia.
7Run mixed inpatient, outpatient, and emergency department case sets because AHIMA splits medical scenarios evenly across those settings.
8Time full simulations to four hours and use flag/review workflow because pretest questions are mixed into the exam.

Frequently Asked Questions

How many questions are on the CCS exam?

AHIMA lists the CCS exam as 107 total questions: 97 scored items and 10 pretest items. The CCS crosswalk breaks this into 79 scored multiple-choice items, 7 pretest multiple-choice items, 18 scored case-scenario items, and 3 pretest case-scenario items.

How long is the CCS exam?

AHIMA gives candidates four hours to complete the CCS exam. Candidates can move back and forth between items after selecting an answer, flag items, and review items before submitting if time remains.

What score do I need to pass CCS?

The AHIMA CCS passing score is 300. The score is not the same thing as a simple raw percentage because AHIMA uses certification-exam scoring methods.

Can I take the CCS exam online with OnVUE?

No. Pearson VUE states RHIA, RHIT, CCA, CCS, and CCS-P are available in person at Pearson VUE Authorized Test Centers. OnVUE online delivery is listed for CHDA, CHPS, and CDIP only.

What code books do I need for CCS in 2026?

AHIMA states CCS exams delivered on or after May 1, 2026 require 2026 code books. Candidates who do not bring the correct required code books to the test center are not allowed to test and forfeit exam fees.

What are the current CCS domains?

The effective CCS outline has five domains: Coding Knowledge and Skills 39-41%, Coding Documentation 18-22%, Provider Queries 9-11%, Regulatory Compliance 18-22%, and Information Technologies 9-11%. Medical scenarios are split evenly across inpatient, outpatient, and emergency department scenarios.

What is the CCS retake policy?

AHIMA states unsuccessful CCS candidates must submit a new application and fee. Candidates must wait at least 30 days before the new application is approved, and AHIMA says it cannot waive retest periods due to test security policy.