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Coding Systems in Healthcare Case Studies

The document discusses different medical coding systems and provides case studies to demonstrate when each would be used. ICD-CM codes are used to describe diagnoses and nature of illnesses/injuries. CPT codes describe medical, surgical, and diagnostic services/procedures. ICD-10-PCS codes are used for inpatient hospital procedures. HCPCS codes describe supplies, durable medical equipment, etc. Case studies demonstrate that CPT codes are used for outpatient provider visits and tests, ICD-CM codes for documenting test results, and ICD-10-PCS codes for inpatient surgical procedures like a tonsillectomy.

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12 views2 pages

Coding Systems in Healthcare Case Studies

The document discusses different medical coding systems and provides case studies to demonstrate when each would be used. ICD-CM codes are used to describe diagnoses and nature of illnesses/injuries. CPT codes describe medical, surgical, and diagnostic services/procedures. ICD-10-PCS codes are used for inpatient hospital procedures. HCPCS codes describe supplies, durable medical equipment, etc. Case studies demonstrate that CPT codes are used for outpatient provider visits and tests, ICD-CM codes for documenting test results, and ICD-10-PCS codes for inpatient surgical procedures like a tonsillectomy.

Uploaded by

api-393982288
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Coding Case Studies

Name: Chantera Lee

Date: 02/08/2018

Define the Coding Systems


Write a short explanation in your own words of what is the difference between ICD-CM codes, CPT codes, and ICD-10-
PCS, and HCPCS.

1. ICD-CM: International Classification of Disease Clinical Modification


2. CPT: Current Procedural Terminology
3. ICD-10-PCS: International Classification of Diseases Tenth Revision Procedure Coding System
4. HCPCS: Healthcare Common Procedure Coding System

Case Study 1
A patient presents at an outpatient urgent care facility with an acute illness and is seen by a provider. A detailed history
with physical examination is performed. What coding system is used in this scenario?

CPT

Case Study 2
Upon review of the symptoms, the provider orders a rapid strep test and a rapid flu test. What coding system is used
in this scenario?
CPT

Case Study 3
The results of the rapid strep test were negative, but the rapid flu test was positive for the influenza virus, type A. What
coding system is used in this scenario?
ICDCM

Case Study 4
A patient presents to the hospital for a tonsillectomy. What coding system would the hospital use to bill for this service?

ICD-PCS
Coding Case Studies

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