COSC study plan
COSC · Give each week a clear focus.
8 weeks · About 6 hours per week
Orthopaedic anatomy, terminology, and operative report fundamentals & Musculoskeletal CPT coding: fractures, dislocations, and trauma repair
Define orthopaedic anatomical terms - planes, joint motion, bone landmarks, and directional terminology - and use them precisely in written coding rationale.
Deconstruct operative reports into their component parts by identifying approach, anatomic site, technique, and implanted hardware from narrative language.
Differentiate fracture descriptors (open versus closed, displaced, comminuted, segmental, pathologic, intra-articular) and state the coding implication of each.
Apply CPT fracture coding rules to select codes for closed and open treatment with and without manipulation across several anatomic sites.
Your checkpoint
Annotated coding log of 15 de-identified operative report excerpts with selected codes, written rationale, and a self-scored terminology quiz at 90% or better.
Musculoskeletal CPT coding: fractures, dislocations, and trauma repair
Assign CPT codes for closed reduction, open reduction with internal fixation, percutaneous pinning, and external fixation across major anatomic regions.
Select codes for dislocation treatment and for muscle, tendon, and wound repair services that commonly accompany trauma care.
Sequence multi-procedure trauma cases correctly and confirm that approach, closure, and routine hardware work are bundled rather than separately reported.
Justify every assigned code in writing by citing the guideline or code descriptor language that supports it.
Your checkpoint
Timed 25-case trauma coding worksheet covering fractures, dislocations, and repairs, scored at 85% or better against source guidelines, with written rationale for every missed item.
Arthroscopy and minimally invasive joint procedures & Musculoskeletal CPT coding: fractures, dislocations, and trauma repair
Distinguish arthroscopic from open procedures and identify the point at which an arthroscopic case converts to an open one for coding purposes.
Select joint-specific arthroscopy code families for the knee, shoulder, hip, wrist and elbow, and ankle.
Apply bundling logic to arthroscopy combinations involving chondroplasty, meniscectomy, meniscal repair, synovectomy, and loose body removal.
Build a decision path for choosing among meniscectomy, meniscal repair, and chondroplasty codes when several are documented.
Re-drill three trauma case types missed on the week 2 worksheet to confirm the correction holds.
Your checkpoint
One-page arthroscopy decision tree plus 20 practice cases with full code sets and bundling notes, scored at 85% or better.
Spine, arthroplasty, and major joint replacement coding & Orthopaedic anatomy, terminology, and operative report fundamentals
Classify spinal procedures by category, approach, and level count: decompression, discectomy, corpectomy, arthrodesis, and instrumentation.
Assign codes for primary and revision total hip, knee, and shoulder arthroplasty, including removal and component-specific add-on codes.
Determine which services are included in a major joint replacement versus which are separately reportable, such as synovectomy or hardware removal.
Re-review weeks 1 through 3 material and close documented accuracy gaps before advancing.
Your checkpoint
Twenty-case spine and arthroplasty code set plus a cumulative domains 1 to 3 quiz scored at 80% or better.
ICD-10-CM diagnosis coding for musculoskeletal conditions and injuries
Construct injury diagnosis codes using site, laterality, encounter type, and the correct seventh-character pattern.
Assign external cause, place of occurrence, and activity codes for musculoskeletal injuries and document the linkage.
Select sequela and complication codes for late effects and post-procedural musculoskeletal conditions.
Recognize the osteoarthritis, spondylopathy, and soft tissue disorder code families and their key inclusion terms.
Cross-check diagnosis codes against the procedure code to confirm medical necessity in orthopaedic scenarios.
Your checkpoint
Diagnosis code set for 30 clinical vignettes, each with correct seventh characters and external cause codes, scored at 85% or better.
Modifiers, surgical package, and E/M services in orthopaedic practice & ICD-10-CM diagnosis coding for musculoskeletal conditions and injuries
Apply modifiers 24, 25, 50, 51, 57, 58, 59, 78, 79, and the X{EPSU} subset correctly to operative and E/M scenarios.
Determine global period status for common orthopaedic procedures and list what the surgical package includes.
Decide when a separately identifiable E/M service is billable with a same-day procedure and document the supporting elements.
Verify each modifier decision against the applicable NCCI edit pair before finalizing the claim.
Your checkpoint
Modifier decision table mapping each modifier to its indication and a worked example, plus 20 scenario exercises scored at 85% or better.
Compliance: NCCI edits, medical necessity, documentation, and payer rules & Modifiers, surgical package, and E/M services in orthopaedic practice
Screen orthopaedic code pairs against NCCI column-one and column-two edits and identify which pairs permit a modifier override.
Evaluate operative and office documentation for medical necessity and sufficiency relative to the service level reported.
Identify common payer-specific orthopaedic rules and denial reasons, and state the corrective coding action for each.
Audit a small sample of charts end to end from operative note to final code set.
Your checkpoint
Ten-chart audit workbook containing NCCI edit screening results, documentation findings, denial risk notes, and corrected code sets.
Musculoskeletal CPT coding: fractures, dislocations, and trauma repair & Arthroscopy and minimally invasive joint procedures & Spine, arthroplasty, and major joint replacement coding & ICD-10-CM diagnosis coding for musculoskeletal conditions and injuries & Modifiers, surgical package, and E/M services in orthopaedic practice & Compliance: NCCI edits, medical necessity, documentation, and payer rules
Complete a timed 100-question mock examination under test conditions with no reference material open.
Categorize every missed item by domain and by root cause, such as terminology gap, bundling error, or modifier misuse.
Re-drill the two lowest-scoring domains with targeted practice sets until accuracy holds above 85%.
Consolidate a personal quick-reference sheet of high-risk topics and recurring error patterns.
Your checkpoint
Full mock examination scored at 85% or better, accompanied by a written remediation plan covering any remaining domain below 80%.
Milestones
Week 2: Score 85% or better on the timed 25-case trauma worksheet, with no repeated bundling error between the first and second attempt.
Week 4: Score 80% or better on the cumulative domains 1 to 3 quiz and demonstrate correct level counting on at least four of five spine fusion cases.
Week 6: Score 85% or better on the modifier scenario set and correctly state the global period for ten consecutive procedures without reference.
Week 8: Score 85% or better overall on the 100-question mock exam with every domain at or above 75% and no domain below 70%.