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The HCS-D exam has 90 questions and runs 3 hours 30 minutes.
These 10 free HCS-D questions are organized by exam domain, so you can see how each part of the Home Care Coding Specialist - Diagnosis (HCS-D) blueprint is tested. Reveal the answer and explanation under each question.
Under current Medicare rules, which practitioners may certify a patient's eligibility for the home health benefit and establish the plan of care?
Correct answer: A - A physician, nurse practitioner, clinical nurse specialist, or physician assistant
A wound care nurse documents a Stage 3 pressure ulcer of the sacrum in the home health record. The certifying physician's documentation refers only to a "sacral wound" and never identifies it as a pressure ulcer. What may the coder assign?
Correct answer: C - No pressure ulcer code - query the physician to confirm the pressure ulcer diagnosis
A patient is admitted to home health following a hospitalization for community-acquired pneumonia. At the start of care the pneumonia has resolved. The plan of care establishes skilled nursing for weekly assessment and teaching related to newly diagnosed type 2 diabetes mellitus, plus physical therapy for generalized deconditioning. Which condition should be reported as the primary diagnosis in OASIS item M1021?
Correct answer: B - The type 2 diabetes mellitus, because it is the focus of the home health plan of care
A coder finds an Excludes1 note under the code she intends to assign. The note lists a second condition that is also documented for this patient. Under which circumstance may both codes still be reported?
Correct answer: D - When the two conditions are unrelated to each other, as the documentation supports
A patient is admitted to home health for physical therapy six weeks after open reduction and internal fixation of a closed fracture of the neck of the right femur. Documentation states the fracture is healing normally. Which code is reported as the primary diagnosis?
Correct answer: C - S72.001D - Fracture of neck of right femur, subsequent encounter for closed fracture with routine healing
A patient's record documents essential hypertension and chronic diastolic heart failure. The physician has not described the heart failure as hypertensive and has not attributed it to the hypertension. How is this coded?
Correct answer: D - I10 and I50.32 reported separately - the link to heart disease must be stated or implied
A home health agency submits a 30-day period claim reporting M62.81, Muscle weakness (generalized), as the principal diagnosis. What is the most likely outcome, and what is the coder's appropriate response?
Correct answer: B - The claim is returned to the provider; the coder should review documentation and query
A patient with type 2 diabetes mellitus is admitted to home health for skilled wound care of a chronic ulcer of the right heel with fat layer exposed. The physician documents both the diabetes and the ulcer. What is the correct code sequence?
Correct answer: A - E11.621 first, then L97.412 - as directed by the instructional notes at both codes
A home health patient has a pressure ulcer of the sacral region that is completely covered by eschar, preventing determination of the depth of tissue damage. Which code is assigned?
Correct answer: D - L89.150 - Pressure ulcer of sacral region, unstageable
A coder reviewing a start-of-care record finds a Stage 3 sacral pressure ulcer, purulent drainage, a white blood cell count of 18,000, and a new antibiotic order, but no documented infection. Which query is compliant?
Correct answer: B - "The clinical indicators below are noted in the record. Can the etiology of these findings be further specified?"
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