Coding Case Studies

Name: Fernando Sanchez

Date: 9/18/18

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: a system used by physicians and other healthcare providers to classify and code all diagnoses,
symptoms and procedures in conjunction with hospital care in the United States.
2. CPT: a medical code set that is used to report medical, surgical, and diagnostic procedures and services to
entities such as physicians, health insurance companies and accreditation organizations.
3. ICD-10-PCS: a U.S. cataloging system for procedural codes that track various health interventions taken by
medical professionals.
4. HCPCS: a procedure coding system used to collect data, determine payment and support electronic health.

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?

ICD-10-PCS

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?

ICD-CM

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?

CPT

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

HCPCS
Coding Case Studies