COSC case studies
COSC · Put your knowledge to work in context.
The Certified Orthopaedic Surgery Coder (COSC) credential is intended for coders who assign CPT and ICD-10-CM codes for musculoskeletal care, including fracture and dislocation treatment, arthroscopy, spine and joint replacement, and the modifiers and compliance rules that surround surgical coding. It is aimed at experienced orthopaedic coders, ambulatory surgery and hospital outpatient coders, billing specialists, auditors, and clinicians who need to understand coding logic rather than only terminology. The COSC case studies are 5 cases and about 2,536 words.
1Distal Radius and Ulnar Styloid Fixation: One Injury, Two Bones
A 64-year-old right-handed woman falls on an outstretched hand and presents to the emergency department with a closed Colles-type distal radius fracture and a displaced ulnar styloid tip fracture. The on-call orthopaedic surgeon evaluates her, reviews imaging, and makes the decision to take her to the operating room that evening.
551 words, about 3 min2Knee Arthroscopy: Meniscectomy, Chondroplasty, and Lateral Release
A 45-year-old recreational soccer player has medial knee pain and clicking. MRI shows a medial meniscus tear and a grade 3 chondral defect of the medial femoral condyle.
487 words, about 2 min3Two-Level Lumbar Fusion With Single-Level Decompression
A 58-year-old man has neurogenic claudication and radicular symptoms. Imaging shows L4-L5 degenerative spondylolisthesis with central stenosis and L5-S1 degenerative disc disease.
494 words, about 2 min4Trimalleolar Ankle Fracture With Syndesmotic Disruption
A 32-year-old man is injured in a motorcycle crash and has a closed right trimalleolar ankle fracture-dislocation with widening of the tibiofibular syndesmosis. In the OR, the surgeon performs open reduction and internal fixation of the lateral malleolus with a plate and screws, the medial malleolus with screws, and the posterior malleolus through a posterolateral approach.
508 words, about 3 min5Shoulder Arthroscopy: Rotator Cuff Repair and Acromioplasty
A 55-year-old woman has a full-thickness supraspinatus tear, acromioclavicular joint arthritis, and subacromial impingement. At arthroscopy, the surgeon performs rotator cuff repair, subacromial decompression with acromioplasty, and distal clavicle excision.
496 words, about 2 min