Skip to content
CPCSTUDY COURSEMy progress

CPC STUDY COURSE · 2026 EDITION

Three knee views and an independent interpretation

Read an original fictional chart, identify the supported facts, and explain your coding workflow.

Chart gym · Original fictional record

Service date: 2026-09-08 · Professional outpatient claim; Original Medicare unless stated otherwise

Use your code books and write your reasoning before opening the walkthrough. This exercise contains no real patient information.

Order and symptoms

Fictional patient Omar Lane, age 39, is referred for a three-view right-knee radiographic study because of persistent atraumatic knee pain. The ordering clinician documents right-knee pain and a possible internal derangement, without a confirmed injury diagnosis. No fall or other traumatic mechanism is reported. The order specifies the right side and the requested study.

Technical acquisition

An independent imaging center supplies the equipment and technologist. The technologist obtains anteroposterior, lateral and patellar views of the right knee. The first lateral image is repeated because of positioning quality. The final examination still consists of three distinct requested views; the repeat does not add a new projection. No contrast is administered.

Interpretation

A separately contracted radiologist interprets the completed examination and signs a report. The report describes preserved alignment and joint spaces, no acute fracture or dislocation and no definitive radiographic explanation for the pain. It does not diagnose a meniscal tear or other internal derangement. The radiologist sends the report to the ordering clinician.

Reporting roles

The imaging center furnished the technical work. The radiologist furnished only the interpretation and report, with no ownership or supply of the equipment for this examination. The worksheet concerns the radiologist’s professional claim. Assume that the selected radiographic entry has a PC/TC indicator permitting separate component reporting; verify the current complete entry in the licensed book.

Coding desk

The draft radiologist claim uses the global service, counts four views because four images were acquired, and replaces the symptom with the ordering note’s possible internal derangement. Review each choice. Identify the actually documented diagnosis, the distinct views and the professional-component relationship. Do not infer a diagnosis from what the examination was intended to investigate.

Your coding worksheet

  1. Identify the reason for this encounter and the supported diagnoses.
  2. List the services actually completed and the applicable code sets.
  3. Use your books to select final codes, units and any supported modifiers.
  4. Sequence the diagnoses and explain the relevant instruction.
  5. Review included work and any separate coverage question. Explain why the strongest alternative does not fit.

In your notebook, record the supported facts, your index route, the instructions you checked, and any missing detail that limits your answer.

Write your answer

Use only this fictional record. Your entries stay on this page and disappear when you leave or reload. Do not enter real patient information.

Compare with the worked explanation
  1. No definitive condition replaces the symptom in this completed packet. The Index route Pain, joint, knee and the right-sided Tabular branch support M25.561. Outpatient uncertainty does not permit coding the possible internal derangement as confirmed.
  2. The three distinct views are anteroposterior, lateral and patellar. A positioning repeat of the same lateral view does not add a different projection. Select the licensed entry corresponding to the actual complete examination.
  3. The radiologist furnished interpretation and a report only. Under the stated separately reportable component assumption, modifier 26 identifies the professional component; the radiologist does not report the global or technical-only service.
  4. The technical center’s work is a separate reporting-role question. Do not add its equipment and technologist resources to the radiologist’s claim merely because both contributed to one study.
  5. The study is unilateral right knee without contrast. Keep those facts consistent with the chosen entry and any applicable payer anatomical-modifier instructions. No bilateral or contrast-enhanced service is documented.
  6. A negative study does not make the examination unperformed. It also does not establish the suspected diagnosis. Preserve the completed study and the supported reason for it, then apply the relevant payer coverage rules separately.

Reference sections: M25.561; ICD IV.H/diagnosticservices; claims13 20.1–20.2 and23 PC/TC indicators

Practice the linked chart questions

Review the lesson

Sources

  1. CDC NCHS — ICD-10-CM April1,2026 Index and Tabular XML. April1–September30,2026. Accessed 2026-09-12.
  2. CDC/NCHS and CMS — ICD-10-CM April 1 2026 Guidelines. FY2026 April. Accessed 2026-09-10.
  3. CMS — Medicare Claims Processing Manual, Chapter 13: Radiology and Other Diagnostic Procedures. 2026 service window; cited current manual sections. Accessed 2026-09-10.
  4. CMS — Medicare Claims Processing Manual, Chapter 23: Fee Schedule Administration and Coding Requirements. 2026 service window; cited current manual sections. Accessed 2026-09-10.

Return to the chart gym →