PCA CPP case studies
PCA CPP · Put your knowledge to work in context.
The PCA Certified Professional Coder (CPP) credential is designed for medical coders who assign ICD-10-CM, CPT, and HCPCS Level II codes in physician and outpatient settings. It signals that a coder can translate clinical documentation into compliant claims across evaluation and management, surgery, radiology, pathology/laboratory, and medicine sections, while applying reimbursement and regulatory rules. Candidates typically include coding students, apprentices, and working coders seeking formal recognition. The exam is multiple choice and tests practical coding judgment rather than isolated memorization, so preparation should combine guideline study with hands-on code lookup. The PCA CPP case studies are 5 cases and about 2,950 words.
1Annual Wellness Visit Plus New Cardiac Complaint
R is a 62-year-old established Medicare patient who presents for her second Annual Wellness Visit (AWV). During the visit she reports three weeks of exertional chest tightness that resolves with rest.
641 words, about 3 min2Type 2 Diabetes with CKD, Retinopathy, and Hyperglycemia
K is a 68-year-old man with type 2 diabetes mellitus who takes insulin. His problem list includes diabetic chronic kidney disease, stage 4, and diabetic retinopathy with macular edema.
557 words, about 3 min3Cheek Carcinoma Excision with Rotation Flap and a Separate Neck Lesion
L excises a 3.2 cm basal cell carcinoma from the left cheek with 0.5 cm margins. The resulting defect measures 4.0 cm by 3.0 cm and is closed with a rotation flap.
561 words, about 3 min4Nivolumab Waste, Billing Units, and the JW Modifier
P, BSA 1.8 m2, is treated with nivolumab 240 mg IV. The pharmacy supplies 100 mg/10 mL vials; the nurse uses three vials (300 mg) and discards 60 mg.
570 words, about 3 min5Coordination of Benefits After a Primary Plan Denial
S has employer coverage through his job (primary) and dependent coverage through his spouse's plan (secondary). On March 3 he underwent an outpatient procedure.
621 words, about 3 min