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Exam Review

Key Facts: CCS-P Medical Coding Exam

205

Practice Questions Here

OpenExamPrep CCS-P bank

300/400

Passing Score

AHIMA scaled scoring

4h

Exam Duration

AHIMA CCS-P format

AHIMA

Credentialing Body

American Health Information Management Association

2026

Content Refresh

Current code-year prep

Physician

Setting Focus

Outpatient/physician coding

The AHIMA CCS-P exam covers physician-based diagnosis coding, procedure coding, research, compliance, revenue cycle work, and E/M, Surgery, and Medicine scenarios. It contains 121 questions (97 scored and 24 pretest) in a four-hour Pearson VUE test-center appointment. The passing scaled score is 300; AHIMA's experience pathways are recommended, not required.

Sample CCS-P Medical Coding Practice Questions

Try these sample questions to review concepts for the CCS-P Medical Coding exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 205+ question experience with AI tutoring.

1A patient presents to a physician office with a chief complaint of right knee pain. The documentation states the patient has primary osteoarthritis of the right knee. Which ICD-10-CM code is most appropriate?
A.M17.11
B.M17.12
C.M17.9
D.M25.561
Explanation: M17.11 is the correct code for primary osteoarthritis of the right knee. M17.12 would indicate the left knee, M17.9 is unspecified, and M25.561 is pain in the right knee but does not capture the underlying condition. Exam Tip: Always code the underlying condition rather than just the symptom when the diagnosis is documented.
2When coding an established patient office visit where the physician documents a level of medical decision making (MDM) that is moderate, which E/M code is correct?
A.99214
B.99213
C.99215
D.99212
Explanation: CPT 99214 corresponds to an established patient office visit with moderate MDM. Under current E/M guidelines, level selection is based on either MDM complexity or total time on the date of encounter. Exam Tip: Remember the MDM levels — straightforward (99212/99202), low (99213/99203), moderate (99214/99204), and high (99215/99205).
3A physician performs a diagnostic colonoscopy and discovers a polyp during the procedure. The polyp is removed by snare technique. Which CPT code should be reported?
A.45385
B.45378
C.45380
D.45384
Explanation: CPT 45385 reports a colonoscopy with removal of tumor(s), polyp(s), or other lesion(s) by snare technique. The diagnostic colonoscopy (45378) is bundled into the surgical endoscopy code and should not be reported separately. Exam Tip: Surgical endoscopy always includes the diagnostic endoscopy.
4Which modifier indicates that a procedure was performed on the left side of the body?
A.Modifier LT
B.Modifier RT
C.Modifier 50
D.Modifier 59
Explanation: Modifier LT indicates a procedure performed on the left side. Modifier RT indicates the right side. Modifier 50 is for bilateral procedures, and modifier 59 is for distinct procedural services. Exam Tip: Use LT/RT for unilateral procedures and modifier 50 for bilateral procedures reported as a single line item.
5A patient is seen for follow-up of type 2 diabetes mellitus with diabetic chronic kidney disease, stage 3 (not specified as 3a or 3b). Which code(s) and sequence are correct?
A.E11.22 followed by N18.30
B.N18.30 followed by E11.22
C.E11.9 followed by N18.30
D.E13.22 followed by N18.30
Explanation: E11.22 (type 2 diabetes mellitus with diabetic chronic kidney disease) is listed first, and its Tabular note says to use an additional code to identify the CKD stage (N18.1-N18.6). Stage 3 without a 3a/3b specification is N18.30; N18.3 is a subcategory, not a reportable code. Category N18 carries a matching 'code first' note for diabetic CKD, so the etiology precedes the stage code. Exam Tip: The 'with' convention presumes the link between diabetes and CKD unless the provider states they are unrelated.
6What is the purpose of HCPCS Level II codes in physician-based coding?
A.To report supplies, drugs, DME, and services not included in CPT
B.To replace CPT codes for all outpatient services
C.To identify facility charges only
D.To report inpatient procedures exclusively
Explanation: HCPCS Level II codes supplement CPT by providing codes for items like drugs, supplies, durable medical equipment (DME), and ambulance services not covered in the CPT code set. They are essential for physician-based coding when reporting injectable medications, orthotics, or prosthetics. Exam Tip: HCPCS Level II codes begin with a letter (A-V) followed by four digits.
7A physician performs an excision of a 2.5 cm benign lesion from the trunk with a 0.5 cm margin. What is the correct measurement to determine the CPT code?
A.3.0 cm (lesion diameter plus one margin only)
B.2.5 cm (lesion diameter only)
C.3.5 cm (lesion diameter plus both margins)
D.0.5 cm (margin only)
Explanation: For excision of skin lesions, the excised diameter equals the lesion's greatest clinical diameter plus twice the narrowest margin, because the margin is taken on BOTH sides of the lesion. The correct measurement is 2.5 cm + (2 x 0.5 cm) = 2.5 + 1.0 = 3.5 cm total excised diameter. Exam Tip: The formula is lesion size + (2 x narrowest margin); adding only one margin understates the excised diameter and is a common error.
8Which coding guideline applies when a patient presents with symptoms but no definitive diagnosis has been established in the physician office?
A.Code the signs and symptoms to the highest degree of certainty
B.Code the suspected or probable diagnosis
C.Code the condition listed as 'rule out' in the plan
D.Assign a Z code for observation of a suspected condition
Explanation: ICD-10-CM Official Guidelines Section IV.H states that in the outpatient setting, conditions documented as probable, suspected, questionable, rule out, or working diagnosis are not coded as if established; instead, code the condition to the highest degree of certainty for that encounter, such as the signs, symptoms, or abnormal findings. Observation Z codes (Z03.-) are for a suspected condition that is ruled out after observation, not for an encounter with active symptoms. Exam Tip: The inpatient uncertain-diagnosis rule (Section II.H and III.C) does not apply to physician office or outpatient coding.
9A Medicare patient's screening mammogram reveals a suspicious mass, and the radiologist performs a diagnostic mammogram on the same day. How should the services be reported?
A.Report both codes, with modifier GG on the diagnostic mammogram
B.Report only the diagnostic mammogram, since the screening converted
C.Report only the screening mammogram, with the added views bundled
D.Report both codes, with modifier GG on the screening mammogram
Explanation: When a screening mammogram and a diagnostic mammogram are performed for the same beneficiary on the same day, Medicare pays both. Per the Medicare Claims Processing Manual (Pub. 100-04, Ch. 18), modifier GG (performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day) is appended to the diagnostic code, such as 77065 or 77066, not to the screening code (77067). Reporting only one study loses a payable service. Exam Tip: Commercial payers may have their own rules, so check the payer policy.
10What does modifier 25 indicate when appended to an E/M service code?
A.A significant, separately identifiable E/M by the same physician on the day of a procedure
B.A distinct procedure performed on a separate site during the same session
C.An E/M visit at which the decision for major surgery was made
D.An unrelated E/M service furnished during a postoperative global period
Explanation: Modifier 25 reports a significant, separately identifiable E/M service by the same physician or other qualified health care professional on the same day as a procedure or other service; the E/M must go beyond the usual pre- and postoperative work of the procedure. A distinct procedure on a separate site is reported with 59 or XS, the decision-for-surgery visit uses modifier 57, and an unrelated E/M in the global period uses modifier 24. Exam Tip: Documentation must show the separate problem and work that justify the E/M.

About the CCS-P Medical Coding Exam

The CCS-P credential from AHIMA is a nationally recognized coding certification focused on physician-based services. The exam tests proficiency in ICD-10-CM diagnosis coding, CPT procedural coding, HCPCS Level II, E/M level selection, modifier usage, and coding compliance in outpatient physician settings.

Exam sponsor: AHIMA (Pearson VUE). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

121 questions

Time Limit

4 hours total appointment time

Passing Score

Scaled 300 (100-400)

Exam / Certification Fees

$299 members / $399 non-members

Exam sponsor website

Reported exam pass rate: 50%. AHIMA-published 2025 first-time pass rate: 357 first-time testers This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

24-26%

Diagnosis Coding

Code assignment, sequencing rules, conventions, and official guidelines for physician encounters

28-32%

Procedure Coding

Surgery, radiology, pathology/lab, medicine, and E/M code selection with modifier logic

6-10%

Research

Coding rules, authoritative sources, and natural language processing

18-22%

Compliance

Ethical queries, documentation, auditing, HIPAA, incident-to billing, and ABNs

14-18%

Revenue Cycle

Claims, payer responses, RBRVS, diagnosis linkage, HCCs, risk adjustment, and denials

Preparing for the CCS-P Medical Coding Exam

What You Need to Know

  • Passing score: Scaled 300 (100-400)
  • Exam length: 121 questions
  • Time limit: 4 hours total appointment time
  • Exam / certification fees: $299 members / $399 non-members Official sources

Using Our Practice Resources

  • Work through all 205 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

CCS-P Medical Coding: Suggested Study Strategy

1Master ICD-10-CM Official Guidelines — especially outpatient sections relevant to physician coding
2Practice CPT code selection from operative notes and documentation across all body systems
3Know E/M level selection using MDM and time-based criteria under current guidelines
4Study modifier logic thoroughly: 25, 26, 59, 50, LT/RT, 76, 77, 78, 79 and NCCI modifier indicators
5Complete timed coding scenarios to build speed and accuracy under exam conditions

Frequently Asked Questions

What is the CCS-P exam format?

The CCS-P exam has 121 questions: 97 scored and 24 unscored pretest items. The four-hour appointment is delivered at a Pearson VUE test center, and the passing scaled score is 300.

What is the difference between CCS-P and CPC?

CCS-P is administered by AHIMA and tests physician-based coding using coding scenarios and multiple-choice questions. CPC is administered by AAPC and is an open-codebook exam with 100 multiple-choice questions. Both certify physician/outpatient coding competency, but they are from different credentialing organizations with different exam formats.

How should I study for CCS-P in 2026?

Focus on ICD-10-CM official guidelines, CPT procedural coding across all body systems, E/M level selection, HCPCS Level II, and modifier logic. Practice with coding scenarios that require applying guidelines to documentation. AHIMA recommends at least 2 years of coding experience before attempting the exam.

What topics are most heavily tested on CCS-P?

The current five-domain outline is Diagnosis Coding 24-26%, Procedure Coding 28-32%, Research 6-10%, Compliance 18-22%, and Revenue Cycle 14-18%. Medical scenarios cover E/M, Surgery, and Medicine equally.

Is CCS-P an open-book or closed-book exam?

Candidates must bring the exact current physical codebooks on AHIMA's codebook list. For exams on or after May 1, 2026, the required books are the listed 2026 editions.

How do I maintain my CCS-P certification?

CCS-P has a two-year recertification cycle. A holder maintaining one AHIMA credential must earn 20 CEUs and meet AHIMA's recertification requirements before the cycle ends.