Certified Coding Specialist (CCS) Practice Exam 2025 – Comprehensive All-in-One Guide to Achieve Exam Success!

The correct choice focuses on the condition of dysphagia leading to aspiration pneumonia. When a patient has dysphagia, which is difficulty swallowing, there is a significant risk of food, liquid, or secretions being inhaled into the lungs rather than being swallowed properly. This inhalation can introduce oral or gastric contents into the respiratory system, resulting in aspiration pneumonia.

Aspiration pneumonia specifically refers to lung infection caused by inhalation of foreign materials, typically from the mouth or stomach. Identifying dysphagia as a contributing factor in this context is crucial for accurate coding, as it clarifies that the pneumonia is not simply due to typical infectious processes, but rather is due to an aspirated substance stemming from a swallowing dysfunction.

In contrast, the other conditions listed would not change the coding to aspiration pneumonia. For example, normal flora and a positive gram stain pertain more to the presence and identification of bacteria in the lungs rather than the mechanism of how the pneumonia occurred. Nonproductive sputum does not provide enough information to indicate aspiration pneumonia since it doesn't relate to the patient’s swallowing ability or the risk of aspirating substances into the lungs.