New Details About The 2020 CSS® Exam Are Released

CCS® is a medical coding certification. According to AHIMA the CCS® credential demonstrates that the coder has attained mastery level inpatient and outpatient coding. Solid training and preparation for the CCS certification exam are essential for successful outcomes when taking this rigorous exam.

Each year the CCS® certification exam changes the content; this is called the Beta Period. This year (May 1, 2020) is particularly significant because a new exam format will be released. According to, the new exam will have only four testing Domains as opposed to the Seven testing Domains currently being tested. The following represents the newly expanded testing domains:

Domain #1: Coding Knowledge and Skills – This domain represents 51.9% of the exam. The CCS® tester will have the following Domain one tasks:

  • Apply diagnosis and procedure codes based on provider’s documentation
  • Determine the Principal/primary diagnosis and procedure
  • Apply coding conventions/guidelines and regulatory guidance
  • Apply CPT/HCPCS modifiers to outpatient proceduresSequence diagnoses and procedures
  • Apply present on admission (POA) guidelines
  • Address coding edits
  • Assign reimbursement classifications
  • Abstract pertinent data from the health record
  • Recognize Major complication and co-morbidity (MCC) and complication and co-morbidity (CC)

Domain #2: Coding Documentation – This domain represents 10.1% of the exam. The CCS® tester will have the following Domain two tasks:

  • Review health record to assign diagnosis and procedure codes for an encounter
  • Review and address health record discrepancies

Domain #3: Provider Queries – This domain represents 8.9% of the exam. The CCS® tester will have the following Domain three tasks:

  • Determine if a provider query is compliant
  • Analyze current documentation to identify query opportunities

Domain #4: Regulatory Compliance This domain represents 29.1% of the exam. The CCS® tester will have the following Domain four tasks:

  • Ensure the integrity of health records
  • Apply payer-specific guidelines
  • Recognize patient safety indicators (PSIs) and Hospital-acquired conditions (HACs) based on documentation
  • Ensure compliance with HIPAA guidelines
  • Ensure adherence to AHIMA’s Standards of Ethical Coding
  • Apply the Uniform Hospital Discharge Data Set (UHDDS)

The exam layout is below:

There are 105 exam questions. 97 multiple-choice questions – Measures all four of the Domains (only 79 multiple choice questions will be scored), and 8 medical scenarios – Measures Domains one and two (only 6 scenarios will be scored)

My take: In comparison to previous Exam Domains, the 2020 exam will be very similar. The most notable change is a stronger emphasis on queries. Students testing will undoubtedly need a keen understanding of proper provider querying — additionally, more emphasis will be placed on AHIMA Standards of Ethical coding and HIPAA guidelines. Additionally all who test must have a very strong knowledge of ICD-10-CM specific coding guidelines, PCS coding as well as CPT coding guidelines as these areas represent almost 60% of the exam. To learn more about the exam and preparation, download the Commission on Certification for Health Informatics and Information Management (CCHIIM) Candidate’s Guide