Coding Case Studies

Name: Kabresha Price

Date: 9/26/2018

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: This is a code is used to code all medical service.

2. CPT: This is used to report the diagnostic procedures to bill the insurance companies.
3. ICD-10-PCS: A procedure coding system that will be used to collect data, determine payment, and support the
electronic health records.
4. HCPCS: This primarily identify the supplies and other medical need that a person had at the doctor’s visit.

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?

For this patient the coding system used is the ICD-CM code.

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 code will be the code for this one.

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?

ICD-10-PCS code, because it tracks what the patient has.

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 code, because it primarily identifies what the patient has.