The CCDS Exam Study Guide (2012 Edition)

The CCDS Exam Study Guide has been updated to prepare candidates for the Certified Clinical Documentation Specialist (CCDS) exam. It follows the content outline established by the advisory board that created the exam.

Each chapter reviews clinical documentation improvement program principles and contains sample questions for self-testing.

The CCDS Exam Study Guide will:

- Help candidates determine whether they are ready to take the CCDS exam
- Give qualified candidates the confidence they need for success
- Provide sample questions for self-assessment
- Deliver proven test-taking strategies

Table of Contents

Chapter 1: IPPS Payment System
MS- DRGs
Complication/comorbidities (CCs) and major CCs
Case mix index implications for CDI

Chapter 2: Coding Guidelines and Coding Clinics
International Classification of Diseases
Code identification and sequencing
ICD-9-CM Official Coding Guidelines, compliance, and CDI

Chapter 3: The Query Process
Retrospective/concurrent queries
AHIMA Physician Query Practice Brief
Leading/non-leading queries

Chapter 4: Identification of Clinical Indicators
Query opportunities in Major Diagnostic Categories (MDC)
Test result interpretation for query opportunities
Common clinical documentation improvement scenarios

Chapter 5: Program Metrics
Baseline statistics
Scope/goals of CDI program
Data mining/data tracking
Analysis of public quality data

Chapter 6: RAC Preparedness
RAC target areas
CDI on the RAC prep team
Self-audits

Appendices
Determining the MS-DRG
Glossary
Core Measures