CBCS case studies
CBCS · Put your knowledge to work in context.
The Certified Billing and Coding Specialist (CBCS) is one of the eight certifications offered by the National Healthcareer Association (NHA). NHA describes its certifications as NCCA-accredited and recognized by employers nationwide, and it lists the CBCS alongside credentials such as the CCMA, CPhT, CPT and CMAA. The CBCS case studies are 5 cases and about 3,772 words.
1Authorization Approved at the Wrong Site of Service
Okafor orders an MRI of the lumbar spine without and with contrast (CPT 70553) for a 62-year-old with progressive radiculopathy and a history of prostate cancer. The payer portal shows a prior authorization approved for 1 unit of 70553 at place of service 22 (outpatient hospital), effective 03/01 through 03/31.
697 words, about 3 min2Probable Pneumonia, a Confirmed X-ray, and a 99215
An established 55-year-old with stable hypertension and type 2 diabetes presents with three days of productive cough, fever to 101.4°F, and pleuritic chest pain. The note reads: 'Acute bronchitis.
721 words, about 4 min3Modifier 25 Denial, Deductible, and the Appeal Decision
An orthopedic practice submits 99214-25 for an established patient visit, 20610 for a right-knee large-joint injection, and J1040 (methylprednisolone acetate 80 mg). Charges are 215, 145, and 18.
738 words, about 4 min4Days in A/R, a 121+ Bucket, and an Agency Contract
The February aging report for a 12-physician group shows total A/R of 1,620,000: 0–30 days 700,000; 31–60 380,000; 61–90 260,000; 91–120 170,000; 121+ 110,000. Net revenue for the last 90 days was 2,700,000; gross charges were 4,950,000.
796 words, about 4 min5Subpoena, a Mother, a Vendor, and No Risk Analysis
A patient's attorney serves a subpoena duces tecum on a 25-employee practice for the complete record of a 34-year-old patient injured in a car accident. The subpoena is signed by the attorney, is not accompanied by a court order, and contains no assurance that the patient was notified; it demands production in 10 days.
820 words, about 4 min