2026 Reliable CCDS-O Exam Syllabus Help You Pass CCDS-O Easily
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As the tech industry continues to evolve and adapt to new technologies, professionals who hold the Certified Clinical Documentation Specialist-Outpatient (CCDS-O) certification are better equipped to navigate these changes and stay ahead of the curve, increasing their value to employers and clients. In today's fast-paced and ever-changing ACDIS sector, having the ACDIS CCDS-O Certification has become a necessary requirement for individuals looking to advance their careers and stay competitive in the job market.
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ACDIS Certified Clinical Documentation Specialist-Outpatient Sample Questions (Q14-Q19):
NEW QUESTION # 14
Which of the following illustrates an example of a compliant, prospective query?
- A. "Dr.: Your patient has a past medical history of CHF noted in her problem list. A review of her medication list shows Lasix 20 mg QD. Please review this diagnosis for pertinence and relevance during her upcoming visit and specify the type and acuity of the CHF if the diagnosis is still being addressed."
- B. "Dr.: Your patient was here for her Annual Wellness Visit. A review of her medication list shows a new order for Lasix 20mg QD. A review of your progress note from that visit notes 2+ pitting edema bilaterally and that the patient complains of shortness of breath at night requiring her to sleep on 2 pillows. Please add CHF to the problem list if this is the diagnosis you are treating with the Lasix."
- C. "Dr.: Your patient has chronic diastolic heart failure documented in her problem list. Can you please add this diagnosis to your progress note from her office visit?"
- D. "Dr.: Your patient was ordered an echocardiogram at her last visit. Can you please document that the CHF was addressed as the basis for the study?"
Answer: A
Explanation:
A compliant prospective query is initiated before the next encounter so the provider can clarify documentation during the upcoming visit, using clinically relevant indicators without directing a specific diagnosis. Option A does this appropriately: it references an existing CHF history and a supportive medication (Lasix), then asks the provider to confirm whether CHF is pertinent at the next visit and, if so, to specify type and acuity. This supports accurate outpatient reporting because heart failure coding requires specificity (systolic/diastolic/combined; acute/chronic/acute on chronic) and should reflect what is actually evaluated/managed at the encounter. Option B is retrospective and attempts to justify a prior test. Option C is leading because it asks the provider to "add" a diagnosis to a past note rather than clarify current clinical status. Option D is also retrospective and uses "please add CHF," which is leading and can be perceived as prompting. Therefore, A best demonstrates a compliant prospective query.
NEW QUESTION # 15
A patient presents to the PCP's office with LLE edema and pain for 3 days. The problem list indicates morbid obesity and a history of DVT. Vital signs are T 37.9, P 76, R 12, BP 142/88, BMI 46. Documentation states: "Patient presents with LLE edema, increased pain, and hx of DVT. Sedentary lifestyle and contraindications to anticoagulation therapy. LLE warm to touch, 3+ edema from ankle to knee. Pedal pulses 2+ on L and 3+ on R." Doppler exam indicates DVT. The PCP should be queried for which of the following diagnoses?
- A. Morbid obesity and status of the DVT
- B. Hypertensive urgency and status of the DVT
- C. Hypercoagulability and morbid obesity
- D. Hypercoagulability and hypertensive urgency
Answer: A
Explanation:
The documented indicators strongly support two clarification needs that affect accurate outpatient reporting. First, morbid obesity is supported by an objective BMI of 46, and outpatient CDI practice emphasizes ensuring obesity class is clearly documented as a diagnosis (not only implied by BMI) and that it is clinically relevant to care planning and risk (e.g., contributes to thrombotic risk, impacts treatment options). Second, the Doppler "indicates DVT," but the record also notes a history of DVT, creating ambiguity about status-is this an acute new/recurrent DVT, a chronic/residual thrombosis, or a prior condition now re-identified? Clarifying acuity/status is essential because it changes code selection and clinical severity representation and supports medical necessity for management decisions, especially given "contraindications to anticoagulation." Hypertensive urgency is not supported (BP 142/88 without crisis features), and "hypercoagulability" is not established by the provided indicators. Therefore, querying for morbid obesity and DVT status is most appropriate.
NEW QUESTION # 16
A CDI specialist reviews the record of a patient with a history of CHF and DM Type 2 who was seen in the clinic earlier that day for possible bronchitis, fever, congestion, dyspnea, and cough. A chest x-ray indicated LLL infiltrate, and a nebulizer treatment was administered while in the office. Levofloxacin and albuterol were prescribed. Which of the following is MOST appropriate to query?
- A. Presence of pneumonia
- B. Specificity of heart failure
- C. Diabetic complications
- D. Acuity of bronchitis
Answer: A
Explanation:
The documented clinical picture and treatment plan better align with pneumonia than uncomplicated bronchitis, creating a clear documentation/coding consistency opportunity. A LLL infiltrate on chest x-ray is a classic clinical indicator for pneumonia, and prescribing levofloxacin supports treatment of a likely bacterial lower respiratory infection rather than routine viral bronchitis. The patient also has fever, dyspnea, cough, and required an in-office nebulizer treatment, all of which can accompany pneumonia and increase clinical significance. In outpatient CDI practice, the most appropriate query is the one that clarifies the provider's definitive diagnosis when objective findings and management suggest a more specific condition than what is stated (e.g., "possible bronchitis"). Querying for diabetic complications or heart failure specificity is not as directly supported by the encounter's indicators and treatment actions provided, and "acuity of bronchitis" is secondary if the true condition is pneumonia. Clarifying whether pneumonia is present ensures accurate reporting, medical necessity support, and appropriate risk/quality capture.
NEW QUESTION # 17
An ACO with 50,000 beneficiaries just completed its first year of a 3-year contract where the final scores were quality 90%; expected costs were $50 million, and actual costs were $52 million. The shared savings rate determined by CMS was 50%. Which of the following is MOST accurate and applies for the ACO?
- A. The ACO will be eligible for shared savings after the second year.
- B. The ACO will have shared savings or penalty determined at the end of the agreement period.
- C. The ACO will expect to receive dollars in shared savings.
- D. The ACO will expect to pay back dollars in shared savings.
Answer: D
Explanation:
In MSSP-style ACO financial reconciliation, performance is evaluated against a benchmark (expected costs). Here, the ACO's actual spending ($52M) exceeds the expected benchmark ($50M) by $2M, meaning the ACO generated shared losses rather than savings. In risk-bearing ACO arrangements, when costs exceed the benchmark and the ACO is in a track that includes downside risk, the organization may owe CMS a portion of those losses. The shared savings/loss rate (50% in this scenario) represents the percentage of the difference from the benchmark that the ACO shares with CMS, assuming applicable thresholds are met. Thus, instead of receiving a shared savings payment, the ACO would be accountable to pay back a share of the excess spending (conceptually 50% of the $2M overage, if all model requirements are satisfied). Option D is not correct because reconciliation is typically performed on a performance-year basis rather than only at the end of the full agreement period, and option C is not how MSSP eligibility works.
NEW QUESTION # 18
A patient with stage 3 CKD presents to the clinic for evaluation. Upon review of labs, an elevated iPTH and a normal phosphorus level are noted. Which of the following diagnoses may be appropriately queried based upon these lab values?
- A. Primary hyperparathyroidism
- B. Secondary hyperparathyroidism of renal origin
- C. Hyperparathyroidism secondary to hypophosphatemia
- D. CKD stage 3 with hypoparathyroidism
Answer: B
Explanation:
In stage 3 chronic kidney disease, impaired vitamin D activation and early disturbances in calcium-phosphate regulation commonly drive a compensatory rise in parathyroid hormone (PTH), known as secondary hyperparathyroidism of renal origin. Outpatient CDI chart review looks for clinical indicators that suggest a condition being evaluated or requiring management, and an elevated iPTH in a CKD patient is a classic indicator that supports querying the provider for CKD-related mineral and bone disorder, specifically renal secondary hyperparathyroidism, if it is clinically being assessed/treated (e.g., monitoring trends, prescribing vitamin D analogs, calcimimetics, dietary counseling, nephrology follow-up). Primary hyperparathyroidism is less supported here because it typically requires a different biochemical pattern and clinical context (often hypercalcemia) rather than being driven by CKD physiology. Hypoparathyroidism is the opposite process (low PTH), making option C inconsistent with the lab finding. Option D is not supported because phosphorus is normal, not low, and hypophosphatemia is not documented as a driver. Therefore, querying for renal secondary hyperparathyroidism is most appropriate.
NEW QUESTION # 19
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