CCS – (Certified Coding Specialist) Certification

CCS (Certified Coding Specialist) Course

Domain 1 – Coding Knowledge and Skills

Domain 2 – Coding Documentation

Domain 3 – Provider Queries

Domain 4 – Regulatory Compliance

Domain 5 – Information Technologies

Detailed CCS curriculum :

Domain 1 – Coding Knowledge and Skills (39-41%)

Tasks:

1. Assign diagnosis and procedure codes based on the provider’s documentation in the health record
2. Identify principal/first-listed diagnosis and procedure based on the respective guidelines
3. Apply coding conventions/guidelines and regulatory guidance
4. Attach CPT/HCPCS modifiers to outpatient procedures
5. Determine appropriate sequencing of diagnoses and procedure codes based on the case scenario
6. Apply present on admission (POA) guidelines
7. Demonstrate knowledge of coding edits (e.g., NCCI, Medical Necessity)
8. Demonstrate knowledge of reimbursement methodologies (e.g., DRG, APC)
9. Abstract applicable data from the health record
10. Identify major co-morbid conditions (MCC) and co-morbid conditions (CC)

Domain 2 – Coding Documentation (18-22%)

Tasks:

1. Resolve conflicting documentation in the health record (e.g., admission type, laterality)
2. Ensure all required documentation for assigning a specified code is available within the body of the health record
3. Verify and validate documentation within the health record

Domain 3 – Provider Queries (9-11%)

Tasks:

1. Identify elements of an ethical compliant query
2. Determine if a provider query is compliant (e.g., non-leading, contains appropriate clinical indicators)
3. Analyze current documentation to identify query opportunities

Domain 4 – Regulatory Compliance (18-22%)

Tasks:

1. Ensure completeness and accuracy of health records
2. Understand payer-specific guidelines
3. Identify patient safety indicators (PSIs) and hospital-acquired conditions (HACs) based on the provider’s documentation
4. Ensure compliance with HIPAA guidelines
5. Ensure adherence to AHIMA Standards of Ethical Coding 6. Ensure compliance with the Uniform Hospital Discharge Data Set (UHDDS)

Domain 5 – Information Technologies (9-11%)

Tasks:

1. Distinguish various types of Electronic Health Records (EHR)
2. Demonstrate a basic understanding of encoding and grouper software
3. Exhibit an understanding of computer-assisted coding (CAC) software and its impact on coding
4. Ensure compliance with HITECH guidelines