NCICS case studies
NCICS · Put your knowledge to work in context.
The Insurance and Coding Specialist certification, designated NCICS, is one of the credentials offered by the National Center for Competency Testing (NCCT), an independent credentialing organization that has tested healthcare professionals and instructors throughout the United States since 1989. NCCT states that its Insurance and Coding Specialist certification is accredited by NCCA. The NCICS case studies are 5 cases and about 3,682 words.
1Same-Day Office Visit and Knee Injection: E/M Level and Modifier 25
Family practice, established patient, 64 years old, seen March 4. The note documents three problems: right knee osteoarthritis with pain that now wakes her at night; hypertension uncontrolled at 158/94, with a switch from lisinopril to lisinopril/HCTZ; and type 2 diabetes with an A1c of 8.6%, on metformin, with empagliflozin added.
754 words, about 4 min2Global Surgical Period: Choosing Between Modifiers 24, 58, 78, and 79
A general surgeon performs a laparoscopic cholecystectomy (47562) on January 6 for symptomatic cholelithiasis. The payer recognizes the standard 90-day global period.
712 words, about 4 min3Screening Colonoscopy Converted to Diagnostic With Polypectomy
A 58-year-old Medicare Part B patient presents for a screening colonoscopy. She is average risk, asymptomatic, and her last screening 10 years ago was normal.
744 words, about 4 min4Medicare Secondary Payer and a Conditional Medicare Payment
A 69-year-old patient is seen February 12 for cataract surgery. At intake she presents her Medicare card and a card from a group health plan; staff do not ask about employment.
707 words, about 4 min5Lumbar MRI Denied for Medical Necessity Without an ABN
A 71-year-old Medicare patient undergoes a lumbar spine MRI without contrast (72148) ordered by her primary care provider for low back pain present for 3 weeks. The note records no red flags, no radicular symptoms, no prior physical therapy, and no real trial of anti-inflammatory medication.
765 words, about 4 min