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ACDIS CCDS-O Exam Syllabus Topics:

TopicDetails
Topic 1
  • Risk Adjustment Models and Impact of Documentation and Coding: Covers CMS-HCC model fundamentals, RAF scoring, Medicare Advantage payments, hierarchies, disease interactions, and compliant HCC reporting requirements.
Topic 2
  • Coding and Reporting, the Outpatient Prospective Payment System (OPPS), and provider coding
Topic 3
  • and billing: Covers Official Coding Guidelines, OPPS reimbursement (APCs), and professional billing concepts including CPT E
  • M codes and Medicare Physician Fee Schedule documentation.
Topic 4
  • Quality, Regulatory, and Health Initiatives: Covers population health, MSSP, ACO models, MACRA
  • MIPS, compliant query development, RADV audits, OIG compliance, problem list maintenance, and HIPAA requirements in outpatient CDI.
Topic 5
  • Diseases and Disease Processes and Application to the Clinical Chart Review: Covers clinical indicators across all ICD-10-CM chapters, applied to chart reviews, with recognition of medications, diagnostic tests, and abbreviations as documentation clarification triggers.
Topic 6
  • Healthcare regulations, reimbursement, and documentation requirements related to the Official Guidelines for

Reference: https://acdis.org/sites/acdis/files/Handbook_CCDS_CCDS-O.pdf

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