AMA Clinical Examples in Radiology - 2007 Issue 2 (Spring)
Radiology Test Case
Radiology Test Case This radiology test case is provided for coding professionals to test their knowledge. Please take some time to review and code the case. Once you are confident with your answer, turn to page 11 for the correct answer and discussion. Patient The patient is a 48-year-old male with acute right flank pain radiating into the right groin. Procedure CT urography Unenhanced CT scans were obtained on multislice CT scanner from the diaphragm to the public symphysis. CT scans were obtained in the axial plane of section. CT scans demonstrate mild distension of the right renal pelvis...
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Article Overview
This article presents a radiology test case intended for coding practice and self-check review. It centers on urinary tract imaging findings from a CT urography study and includes a brief impression section for comparison after the reader codes the case. The content is aimed at coding professionals and is useful for those working with radiology documentation, diagnostic imaging studies, and case-based learning.
Why This Topic Matters
It helps coders and auditors practice interpreting radiology documentation in a test-case format, especially for imaging studies involving the urinary tract and abdomen. The case structure makes it relevant to professionals reviewing how exam documentation is presented and evaluated.
Article Sections
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Patient
Provides the patient context and presenting symptoms relevant to the imaging study.
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Procedure
Describes the imaging exam performed and summarizes the reported observations from the study.
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Impression
Summarizes the radiologist’s overall findings from the case.
What You Will Learn
- How a radiology test case is structured for coding review
- How CT urography documentation is presented in a case-based format
- What information is typically included in the patient, procedure, and impression sections of a radiology report
- How radiology case studies support coding practice and self-assessment
Who Should Read This
- Radiology coders
- Medical coding professionals
- Coding auditors
- Clinical documentation reviewers
- Students learning radiology coding
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