CPC STUDY COURSE · 2026 EDITION
Screening discovers a lesion
Read an original fictional chart, identify the supported facts, and explain your coding workflow.
Chart gym · Original fictional record
Service date: 2026-09-09 · Medicare outpatient digestive professional service
Use your code books and write your reasoning before opening the walkthrough. This exercise contains no real patient information.
Screening origin
Fictional Medicare beneficiary, age 67, attends a screening colonoscopy. For this exercise, coverage eligibility and interval have been verified. The referral documents no bowel symptoms. No positive preceding non-invasive screening test is documented, so qualifying follow-on conditions must not be invented.
Completed service
The colonoscope enters through the anus and reaches the cecum with adequate preparation. A single 7 mm descending-colon lesion is found and removed by snare. No other intervention occurs. The report documents both the screening indication and the performed removal.
Diagnosis evidence
The specimen is submitted for pathology. At this review, histology is pending. The endoscopist records the lesion finding but does not diagnose cancer. The learner must use the supported screening and finding documentation under the applicable diagnosis instructions.
Claim choice
One worksheet retains the screening-only G-code despite the removal. Another investigates the performed therapeutic procedure with PT. A third substitutes KX solely because a lesion was found. Compare these pathways against CMS guidance, then consult the full current procedure entry.
Your coding worksheet
- Preserve the original screening indication.
- Identify the intervention that actually occurred.
- Distinguish PT conversion from KX follow-on conditions.
- Keep pending pathology separate from a confirmed diagnosis.
In your notebook, record the supported facts, your index route, the instructions you checked, and any missing detail that limits your answer.
Compare with the worked explanation
- This examination began as a covered screening service under the stated assumptions.
- The removal must be represented through the performed procedure pathway, with PT for the described screening conversion.
- A lesion finding alone does not establish the qualifying positive prior-test conditions for KX.
- Do not infer malignant or specific histological findings from a pending specimen. Verify the complete diagnosis and procedure instructions.
Reference sections: 60.2
Practice the linked chart questions
Review the lesson
Sources
- CMS — Transmittal 13921: Colorectal Cancer Screening / CR14581. Issued August27/2026; effective June8/2026; implementation January4/2027. Accessed 2026-09-10.