CPC Medical Coding case studies
CPC Medical Coding · Put your knowledge to work in context.
The Certified Professional Coder (CPC®) is AAPC's credential for outpatient and physician-based medical coding. It validates comprehensive knowledge of ICD-10-CM diagnosis coding, CPT® and HCPCS Level II procedure and supply coding, and the guidelines, conventions, and sequencing rules that connect them. As the entry benchmark for the field, it fits people launching a coding career, experienced but uncertified professionals validating their skills, and healthcare staff moving from administrative or clinical support roles into coding. The exam tests three areas: core coding knowledge; outpatient and physician services, including evaluation and management visits, procedures in physician practices, outpatient clinics, and same-day surgical centers; and compliance and payer requirements covering Medicare, Medicaid, and commercial rules, modifier use, and fraud, abuse, and compliance standards. The CPC Medical Coding case studies are 5 cases and about 2,960 words.
1Sepsis, Organ Dysfunction, and the Query That Changes the Claim
A 74-year-old man is admitted through the emergency department with fever, productive cough, and new confusion. Chest x-ray shows a right lower lobe infiltrate, and blood cultures grow Klebsiella pneumoniae.
510 words, about 3 min2Screening Colonoscopy That Becomes Therapeutic - Two Payers, Two Answers
A 58-year-old woman whose mother had colon cancer at age 52 presents for a screening colonoscopy; she has no symptoms, no anemia, and no prior polyps. The gastroenterologist reaches the cecum.
516 words, about 3 min3Two Stable Chronic Conditions and a Prescription Refill: What Level Is It Really?
An established 62-year-old patient with hypertension and type 2 diabetes returns to her family physician. Both conditions are documented as stable and at goal on current therapy.
495 words, about 2 min4The Nurse Practitioner, the Absent Cardiologist, and the Machine-Made ECG
A 70-year-old Medicare patient returns to a cardiology practice with a three-week history of palpitations. The nurse practitioner takes the history, examines the patient, orders a 12-lead ECG, and increases the metoprolol dose.
676 words, about 3 min5Ninety-Day Global: Sorting Unrelated Care From a Return to the Procedure Room
A 47-year-old woman undergoes a laparoscopic cholecystectomy on March 3; the payers treat the procedure as having a 90-day global period. On March 18 she is seen in the office for a right ankle sprain sustained playing basketball.
763 words, about 4 min