CPT Coding: Case Studies
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These are a few CPT medical coding case study questions along with their correct answers for practice. Medical coding requires accurate code selection based on the provided scenario. Remember to consult the latest CPT codebook for the most up-to-date information. Let's begin:
Case Study 1: Evaluation and Management (E/M) Coding
Scenario: A 35-year-old female patient with complaints of chest pain and shortness of breath visits the primary care physician's office. The physician performs a comprehensive history and examination, and the medical decision-making is of high complexity.
Question 1: Assign the appropriate E/M code for this encounter.
Answer 1: CPT code 99205 (Office or other outpatient visit for the evaluation and management of a new patient, which requires a comprehensive history, comprehensive examination, and high-level medical decision-making) would be appropriate for this encounter.
Case Study 2: Surgical Coding
Scenario: A patient undergoes a laparoscopic cholecystectomy with cholangiography due to gallstones and biliary colic.
Question 2: Assign the appropriate CPT code for the laparoscopic cholecystectomy with cholangiography.
Answer 2: CPT code 47562 (Laparoscopy, surgical; cholecystectomy) should be assigned for the laparoscopic cholecystectomy. Additionally, CPT code 47563 (Cholangiography, intraoperative, when performed, and includes the use of a cholangiogram, real-time fluoroscopic guidance, and all associated radiological supervision and interpretation; intraoperative) should be assigned for the cholangiography.
Case Study 3: Pathology/Laboratory Coding
Scenario: A patient undergoes a comprehensive metabolic panel (CMP) and complete blood count (CBC) tests at a clinical laboratory.
Question 3: Assign the appropriate CPT codes for the CMP and CBC tests.
Answer 3: CPT code 80053 (Comprehensive metabolic panel) should be assigned for the CMP. CPT code 85025 (Complete (CBC), automated (Hgb, Hct, RBC, WBC, and platelet count)) should be assigned for the CBC.
Case Study 4: Radiology Coding
Scenario: A patient comes to the radiology department for an X-ray of the right ankle after twisting it during a sports activity.
Question 4: Assign the appropriate CPT code for the X-ray of the right ankle.
Answer 4: CPT code 73610 (Radiologic examination, ankle; 2 views) should be assigned for the X-ray of the right ankle.
Case Study 5: Emergency Department (ED) Coding
Scenario: A 25-year-old male patient arrives at the emergency department with a deep laceration on his left forearm. The physician performs wound exploration, extensive cleaning, and suturing.
Question 5: Assign the appropriate E/M code for this emergency department encounter.
Answer 5: CPT code 99284 (Emergency department visit for the evaluation and management of a patient, which requires a detailed history, detailed examination, and medical decision-making of moderate complexity) would be appropriate for this emergency department encounter.
Please note that medical coding is a vast field, and these case studies cover only a few scenarios. It is essential to continue studying and practicing with a wide range of real-world scenarios to gain expertise in CPT medical coding. Always verify the codes with the latest CPT codebook and any relevant official guidelines.
