Solution and Answer Guide: Advanced Medical Coding Practicum, 2025/2026 Edition, 9780357932575; Chapter 04: Physician Office Practicum
Solution and Answer Guide
ADVANCED MEDICAL CODING PRACTICUM, 2025/2026 EDITION, 9780357932575;
CHAPTER 04: PHYSICIAN OFFICE PRACTICUM
TABLE OF CONTENTS
Cases..............................................................................................................................1
Practicum Case 1: Homer Maynard........................................................................................................... 1
Practicum Case 2: Brett Crawford.............................................................................................................2
Practicum Case 3: Justine Dodd................................................................................................................ 2
Practicum Case 4: Carmine Tibbs..............................................................................................................2
Practicum Case 5: James Gleason..............................................................................................................3
Practicum Case 6: Betty Bronte................................................................................................................. 3
Practicum Case 7: Leonard Truman.......................................................................................................... 3
Practicum Case 8: Aneesha Reddy............................................................................................................4
Practicum Case 9: Kenji Sato.................................................................................................................... 4
Practicum Case 10: William Billson..........................................................................................................4
Practicum Case 11: Alejandro Sanchez.....................................................................................................5
Practicum Case 12: Carson Stewart........................................................................................................... 5
Practicum Case 13: Jennifer May..............................................................................................................5
Practicum Case 14: Louis Kearns.............................................................................................................. 6
Practicum Case 15: Melvin Yarrow...........................................................................................................6
Practicum Case 16: Albert Morgansten.....................................................................................................7
Practicum Case 17: Samuel Mason............................................................................................................7
Practicum Case 18: Irene Hines................................................................................................................. 8
CASES
PRACTICUM CASE 1: HOMER MAYNARD
Answer:
Primary Diagnosis Code: M19.90
Secondary Diagnosis Code: R26.2
Primary CPT Code: 99213
Rationale: The patient was diagnosed with degenerative joint disease, which codes to “osteoarthritis” in the
ICD-10-CM code book. The site of DJD was not indicated, so unspecified osteoarthritis M19.90 is assigned as the
© 2026 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 1
accessible website, in whole or in part.
,Solution and Answer Guide: Advanced Medical Coding Practicum, 2025/2026 Edition, 9780357932575; Chapter 04: Physician Office Practicum
primary diagnosis. R26.2 is also
assigned for difficulty walking.
E&M code 99213 is assigned for an established patient office visit with low level medical decision making.
PRACTICUM CASE 2: BRETT CRAWFORD
Answer:
Primary Diagnosis Code: L02.01
Secondary Diagnosis Codes: I10, F31.9, E29.1
Primary CPT Code: 99214
Rationale: Diagnosis code L02.01 is assigned for “abscess, face, left cheek.” Per the documentation, the patients culture
data suggests a high probability of MRSA; however, this is not a definitive diagnosis and suggests uncertainty so we
cannot assign a code for MRSA. ICD-10-CM codes I10 for hypertension, F31.9 for manic depressive disorder (also
known as bipolar disorder), and E29.1 for hypogonadism are also assigned because they are listed in the impression,
which indicates they are being medically managed by the provider.
Medical-decision-making (MDM) is used to select the proper E&M code level; therefore, 99214 is assigned for
moderate MDM office visit for an established patient.
PRACTICUM CASE 3: JUSTINE DODD
Answer:
Primary Diagnosis Code: J03.00
Secondary Diagnosis Codes: K21.9, F32.A, J45.909
Primary CPT Code: 99214
Rationale: The patient presented with a sore throat. Upon examination, it was determined patient has
streptococcal tonsilitis and a treatment plan was described; therefore, J03.00 is assigned the first-listed diagnosis. In
addition, K21.9 for GERD, F32.A for depression, and J45.909 for asthma are assigned as they are listed in the
Impression.
Medical-decision-making (MDM) is used to select the proper E&M code level; therefore, 99214 is assigned for
moderate MDM office visit for an established patient.
PRACTICUM CASE 4: CARMINE TIBBS
Answer:
Primary Diagnosis Code: F31.9
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99213
Rationale: Code F31.9 is assigned for bipolar disorder. Z79.899 may optionally be assigned for the patients
current medication regimen.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99213 is assigned
for low MDM office visit.
© 2026 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 2
accessible website, in whole or in part.
,Solution and Answer Guide: Advanced Medical Coding Practicum, 2025/2026 Edition, 9780357932575; Chapter 04: Physician Office Practicum
PRACTICUM CASE 5: JAMES GLEASON
Answer:
Primary Diagnosis Code: E11.9
Secondary Diagnosis Codes: Z79.84, E78.5
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99214
Rationale: Code E11.9 is assigned for type 2 diabetes. The instructional note for code E11.9 states to use additional
code to identify diabetes control; thus, Z79.84 is also assigned. E78.5 is assigned for hyperlipidemia. Code Z79.899
may optionally be assigned for the patient’s Lipitor prescription.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for Moderate MDM office visit (2 stable chronic illnesses with prescription drug management).
PRACTICUM CASE 6: BETTY BRONTE
Answer:
Primary Diagnosis Code: N92.1
Secondary Diagnosis Code: F32.A
Optional Diagnosis Code: Z79.899
Primary CPT Code: 99213
Rationale: N92.1 is assigned as the first-listed diagnosis for the patient’s excessive menses with an irregular
menstruation. In addition, F32.A is assigned for depression.
Z79.899 may optionally be assigned for the patient’s medication.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for Moderate MDM office visit.
PRACTICUM CASE 7: LEONARD TRUMAN
Answer:
Primary Diagnosis Code: G57.91
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99213
Rationale: G57.91 is assigned for mononeuropathy of the right lower extremity. A code for paresthesias is not
assigned because it is a sign/symptom of the mononeuropathy. Z79.899 may optionally be assigned for the patient’s
medication.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99213 is assigned
for Low MDM office visit.
PRACTICUM CASE 8: ANEESHA REDDY
Answer:
Primary Diagnosis Code: R45.4
© 2026 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 3
accessible website, in whole or in part.
, Solution and Answer Guide: Advanced Medical Coding Practicum, 2025/2026 Edition, 9780357932575; Chapter 04: Physician Office Practicum
Secondary Diagnosis Codes: K50.90, Z79.52
Primary CPT Code: 99214
Rationale: At this point there is not a known cause for the patient’s feelings of anger; therefore, symptom code
R45.4 is assigned. In addition, K50.90 is assigned for Crohn’s disease and Z79.52 for the patient’s Prednisone therapy.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for Moderate MDM office visit (undiagnosed new problem and prescription drug management).
PRACTICUM CASE 9: KENJI SATO
Answer:
Primary Diagnosis Code: R26.89
Secondary Diagnosis Codes: M47.812, G62.9
Optional Secondary Diagnosis Codes: Z79.01, Z79.899
Primary CPT Code: 99214
Rationale: Patient returns for a recheck of gait instability. Assign R26.89 for gait instability. In addition, assign
M47.712 for cervical spondylosis and G62.9 for peripheral neuropathy. You may optionally assign Z79.01 and
Z79.899 for patient’s current medication regimen.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for Moderate MDM office visit.
PRACTICUM CASE 10: WILLIAM BILLSON
Answer:
Primary Diagnosis Code: G25.0
Secondary Diagnosis Codes: I10, Z86.76
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99214
Rationale: G25.0 is assigned for essential tremor. In addition, I10 is assigned for hypertension. Z86.73 is assigned
for the patient’s history of CVA. Z79.899 may optionally be assigned for the patient’s current drug therapy.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for moderate MDM office visit. This is considered moderate because the patient’s medications were reviewed, as
well as a decision to schedule a right knee replacement next month.
PRACTICUM CASE 11: ALEJANDRO SANCHEZ
Answer:
Primary Diagnosis Code: E78.5
Secondary Diagnosis Codes: I25.10, I67.9, K21.9, F32.A
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99214
© 2026 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 4
accessible website, in whole or in part.
Solution and Answer Guide
ADVANCED MEDICAL CODING PRACTICUM, 2025/2026 EDITION, 9780357932575;
CHAPTER 04: PHYSICIAN OFFICE PRACTICUM
TABLE OF CONTENTS
Cases..............................................................................................................................1
Practicum Case 1: Homer Maynard........................................................................................................... 1
Practicum Case 2: Brett Crawford.............................................................................................................2
Practicum Case 3: Justine Dodd................................................................................................................ 2
Practicum Case 4: Carmine Tibbs..............................................................................................................2
Practicum Case 5: James Gleason..............................................................................................................3
Practicum Case 6: Betty Bronte................................................................................................................. 3
Practicum Case 7: Leonard Truman.......................................................................................................... 3
Practicum Case 8: Aneesha Reddy............................................................................................................4
Practicum Case 9: Kenji Sato.................................................................................................................... 4
Practicum Case 10: William Billson..........................................................................................................4
Practicum Case 11: Alejandro Sanchez.....................................................................................................5
Practicum Case 12: Carson Stewart........................................................................................................... 5
Practicum Case 13: Jennifer May..............................................................................................................5
Practicum Case 14: Louis Kearns.............................................................................................................. 6
Practicum Case 15: Melvin Yarrow...........................................................................................................6
Practicum Case 16: Albert Morgansten.....................................................................................................7
Practicum Case 17: Samuel Mason............................................................................................................7
Practicum Case 18: Irene Hines................................................................................................................. 8
CASES
PRACTICUM CASE 1: HOMER MAYNARD
Answer:
Primary Diagnosis Code: M19.90
Secondary Diagnosis Code: R26.2
Primary CPT Code: 99213
Rationale: The patient was diagnosed with degenerative joint disease, which codes to “osteoarthritis” in the
ICD-10-CM code book. The site of DJD was not indicated, so unspecified osteoarthritis M19.90 is assigned as the
© 2026 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 1
accessible website, in whole or in part.
,Solution and Answer Guide: Advanced Medical Coding Practicum, 2025/2026 Edition, 9780357932575; Chapter 04: Physician Office Practicum
primary diagnosis. R26.2 is also
assigned for difficulty walking.
E&M code 99213 is assigned for an established patient office visit with low level medical decision making.
PRACTICUM CASE 2: BRETT CRAWFORD
Answer:
Primary Diagnosis Code: L02.01
Secondary Diagnosis Codes: I10, F31.9, E29.1
Primary CPT Code: 99214
Rationale: Diagnosis code L02.01 is assigned for “abscess, face, left cheek.” Per the documentation, the patients culture
data suggests a high probability of MRSA; however, this is not a definitive diagnosis and suggests uncertainty so we
cannot assign a code for MRSA. ICD-10-CM codes I10 for hypertension, F31.9 for manic depressive disorder (also
known as bipolar disorder), and E29.1 for hypogonadism are also assigned because they are listed in the impression,
which indicates they are being medically managed by the provider.
Medical-decision-making (MDM) is used to select the proper E&M code level; therefore, 99214 is assigned for
moderate MDM office visit for an established patient.
PRACTICUM CASE 3: JUSTINE DODD
Answer:
Primary Diagnosis Code: J03.00
Secondary Diagnosis Codes: K21.9, F32.A, J45.909
Primary CPT Code: 99214
Rationale: The patient presented with a sore throat. Upon examination, it was determined patient has
streptococcal tonsilitis and a treatment plan was described; therefore, J03.00 is assigned the first-listed diagnosis. In
addition, K21.9 for GERD, F32.A for depression, and J45.909 for asthma are assigned as they are listed in the
Impression.
Medical-decision-making (MDM) is used to select the proper E&M code level; therefore, 99214 is assigned for
moderate MDM office visit for an established patient.
PRACTICUM CASE 4: CARMINE TIBBS
Answer:
Primary Diagnosis Code: F31.9
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99213
Rationale: Code F31.9 is assigned for bipolar disorder. Z79.899 may optionally be assigned for the patients
current medication regimen.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99213 is assigned
for low MDM office visit.
© 2026 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 2
accessible website, in whole or in part.
,Solution and Answer Guide: Advanced Medical Coding Practicum, 2025/2026 Edition, 9780357932575; Chapter 04: Physician Office Practicum
PRACTICUM CASE 5: JAMES GLEASON
Answer:
Primary Diagnosis Code: E11.9
Secondary Diagnosis Codes: Z79.84, E78.5
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99214
Rationale: Code E11.9 is assigned for type 2 diabetes. The instructional note for code E11.9 states to use additional
code to identify diabetes control; thus, Z79.84 is also assigned. E78.5 is assigned for hyperlipidemia. Code Z79.899
may optionally be assigned for the patient’s Lipitor prescription.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for Moderate MDM office visit (2 stable chronic illnesses with prescription drug management).
PRACTICUM CASE 6: BETTY BRONTE
Answer:
Primary Diagnosis Code: N92.1
Secondary Diagnosis Code: F32.A
Optional Diagnosis Code: Z79.899
Primary CPT Code: 99213
Rationale: N92.1 is assigned as the first-listed diagnosis for the patient’s excessive menses with an irregular
menstruation. In addition, F32.A is assigned for depression.
Z79.899 may optionally be assigned for the patient’s medication.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for Moderate MDM office visit.
PRACTICUM CASE 7: LEONARD TRUMAN
Answer:
Primary Diagnosis Code: G57.91
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99213
Rationale: G57.91 is assigned for mononeuropathy of the right lower extremity. A code for paresthesias is not
assigned because it is a sign/symptom of the mononeuropathy. Z79.899 may optionally be assigned for the patient’s
medication.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99213 is assigned
for Low MDM office visit.
PRACTICUM CASE 8: ANEESHA REDDY
Answer:
Primary Diagnosis Code: R45.4
© 2026 Cengage Learning, Inc. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly 3
accessible website, in whole or in part.
, Solution and Answer Guide: Advanced Medical Coding Practicum, 2025/2026 Edition, 9780357932575; Chapter 04: Physician Office Practicum
Secondary Diagnosis Codes: K50.90, Z79.52
Primary CPT Code: 99214
Rationale: At this point there is not a known cause for the patient’s feelings of anger; therefore, symptom code
R45.4 is assigned. In addition, K50.90 is assigned for Crohn’s disease and Z79.52 for the patient’s Prednisone therapy.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for Moderate MDM office visit (undiagnosed new problem and prescription drug management).
PRACTICUM CASE 9: KENJI SATO
Answer:
Primary Diagnosis Code: R26.89
Secondary Diagnosis Codes: M47.812, G62.9
Optional Secondary Diagnosis Codes: Z79.01, Z79.899
Primary CPT Code: 99214
Rationale: Patient returns for a recheck of gait instability. Assign R26.89 for gait instability. In addition, assign
M47.712 for cervical spondylosis and G62.9 for peripheral neuropathy. You may optionally assign Z79.01 and
Z79.899 for patient’s current medication regimen.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for Moderate MDM office visit.
PRACTICUM CASE 10: WILLIAM BILLSON
Answer:
Primary Diagnosis Code: G25.0
Secondary Diagnosis Codes: I10, Z86.76
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99214
Rationale: G25.0 is assigned for essential tremor. In addition, I10 is assigned for hypertension. Z86.73 is assigned
for the patient’s history of CVA. Z79.899 may optionally be assigned for the patient’s current drug therapy.
Medical-decision-making (MDM) should be used to select the proper E&M code level; therefore, 99214 is assigned
for moderate MDM office visit. This is considered moderate because the patient’s medications were reviewed, as
well as a decision to schedule a right knee replacement next month.
PRACTICUM CASE 11: ALEJANDRO SANCHEZ
Answer:
Primary Diagnosis Code: E78.5
Secondary Diagnosis Codes: I25.10, I67.9, K21.9, F32.A
Optional Secondary Diagnosis Code: Z79.899
Primary CPT Code: 99214
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accessible website, in whole or in part.
