| Course | HS292 Billing and Coding Practicum |
|---|---|
| Unit | Unit 3 |
| Paper type | Diagnosis coding set |
| Length | About 880 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | Associate of Applied Science in Health Science |
| Updated | October 2026 |
Free sample paper for HS292 Unit 3
When the Purpose of the Visit Comes First: A Unit 3 Diagnosis Coding Set Ordering Six Outpatient Encounters
[Student Name]
Purdue University Global
HS292: Billing and Coding Practicum
Unit 3 Diagnosis Coding Set
[Instructor Name]
[Date]
The six encounters are composite; the code set and official guidelines cited are real, and codes should be confirmed against the code set year your section uses.
The Outpatient Principle
In outpatient settings, the first-listed diagnosis names whatever chiefly brought the patient in that day, and a diagnosis the provider calls probable, suspected or likely stays off the claim, with its signs and symptoms reported in its place (National Center for Health Statistics, 2025). Several encounter types have their own sequencing rules. Every answer below gives the first-listed code, the additional codes in order, the rule that decided the order, the phrase in the stem that triggered it and the order a hurried coder might choose instead.
Encounters Where the Purpose Leads
Encounter 1. Stem: A 68-year-old woman is seen for medical clearance before a scheduled right total knee replacement for primary osteoarthritis. Blood pressure is 148/92; the provider notes her known hypertension, continues her medication and clears her for surgery.
Answer: Encounter for other preprocedural examination [Z01.818]; unilateral primary osteoarthritis, right knee [M17.11]; essential hypertension [I10]. Rule: for preoperative evaluations only, a code from the preprocedural examination category comes first, with the condition that made surgery necessary and anything found during the evaluation listed after it. Trigger phrase: "clearance before a scheduled." Hurried order: osteoarthritis first, because it is the reason for everything. Code titles throughout follow the tabular list (Centers for Medicare & Medicaid Services, 2025).
Encounter 2. Stem: A 54-year-old woman with malignant neoplasm of the left breast, upper outer quadrant, arrives at the infusion center for her third cycle of chemotherapy. The cycle is given without complication.
Answer: Encounter for antineoplastic chemotherapy [Z51.11]; malignant neoplasm of upper outer quadrant of left female breast [C50.412]. Rule: when an encounter is solely for administration of chemotherapy, the chemotherapy encounter code is listed first and the malignancy follows. Trigger phrase: "arrives at the infusion center for her third cycle." Hurried order: the breast cancer first.
In the first two encounters the patient's disease is the reason the visit exists, yet the guidelines put the service ahead of it, because the code set is describing why this encounter happened.
Encounter 3. Stem: A 61-year-old man who completed treatment for colon cancer two years ago, with no current evidence of disease, comes for his scheduled surveillance visit. Examination and labs show no recurrence.
Answer: the Z code for a follow-up visit once cancer treatment is finished [Z08]; personal history of other malignant neoplasm of large intestine [Z85.038]. Rule: when treatment is complete and no malignancy is present, the follow-up examination code leads and a personal history code shows what is being watched. Trigger phrase: "completed treatment" with "no current evidence of disease." Hurried order: an active colon cancer code, which would describe a disease the patient no longer has.
Encounters Where the Condition or Symptom Leads
Encounter 4. Stem: A 34-year-old man reports eight hours of crampy pain across the whole abdomen with nausea and three episodes of vomiting. Examination is benign apart from mild diffuse tenderness. Impression: probable viral gastroenteritis. Oral fluids and an antiemetic are given.
Answer: Nausea with vomiting, unspecified [R11.2]; generalized abdominal pain [R10.84]. Rule: an uncertain diagnosis is not coded in the outpatient setting, so the documented symptoms are reported. Trigger phrase: "probable." Hurried order: gastroenteritis, as if confirmed.
Encounter 5. Stem: A 47-year-old woman is sent by her primary care office for a chest X-ray because of two weeks of cough. The radiologist's final report reads "right lower lobe pneumonia."
Answer: Pneumonia, unspecified organism [J18.9]. Rule: for patients receiving diagnostic services only, a coder may report the diagnosis interpreted by a physician in the final report, and the symptom that prompted the test is not added when the interpreted finding explains it. Trigger phrase: "final report reads." Hurried order: cough only, because the ordering office wrote cough.
Encounter 6. Stem: At a three-month diabetes follow-up, a 66-year-old retired machinist's filtration rate measures 52, and the assessment reads "T2DM with CKD 3a; continue metformin, recheck in three months."
Answer: the combination code for type 2 diabetes with diabetic kidney disease [E11.22]; the stage 3a kidney disease code [N18.31]; the status code for ongoing oral diabetes medication [Z79.84]. Rule: a filtration rate of 52 falls in the stage 3a band of 45 to 59 (Stevens et al., 2024), and the code set presumes a link between diabetes and chronic kidney disease when both are present unless the provider states another cause, and the combination code is followed by a code for the stage. Trigger phrase: "T2DM with CKD 3a." Hurried order: the kidney disease code alone, or diabetes without complications.
Pattern Across the Set
Three encounters lead with a Z code because the visit was for a service: clearance, chemotherapy, surveillance. One leads with symptoms because the diagnosis was uncertain. Only two lead with a disease, and in one of those the disease is confirmed by a radiologist rather than the ordering clinician. The common thread is that the first-listed code answers the question of why this particular encounter occurred.
References
Centers for Medicare & Medicaid Services. (2025). ICD-10-CM tabular list of diseases and injuries FY 2026. U.S. Department of Health and Human Services.
National Center for Health Statistics. (2025). ICD-10-CM official guidelines for coding and reporting FY 2026. Centers for Disease Control and Prevention.
Stevens, P. E., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., Herrington, W. G., Hill, G., Inker, L. A., Kazancıoğlu, R., Lamb, E., Lin, P., Madero, M., McIntyre, N., Morrow, K., Roberts, G., Sabanayagam, D., Schaeffner, E., Shlipak, M., . . . Levin, A. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International, 105(4S), S117-S314. https://doi.org/10.1016/j.kint.2023.10.018
Reading the HS 292 Unit 3 instructions
Unit 3 typically gives a set of outpatient encounters and asks you to assign and sequence diagnosis codes, explaining each decision. Expect five to eight short cases. Instructors look for correct first-listed codes under the outpatient rules, including the encounter types where a Z code leads, and for uncertain diagnoses handled as symptoms. Many sections reward naming the specific guideline that decides each sequence and the phrase in the stem that triggered it. Showing the order a careless coder might choose instead demonstrates understanding of why the rule matters. Codes should be checked against the tabular list for the code set year your section names. A closing note on the pattern across cases often earns credit, and grouping the encounters by the rule that decides them helps a grader see it.
How the HS 292 Unit 3 example is put together
A short preface states the outpatient principle and the rule on uncertain diagnoses. The first group of three encounters leads with Z codes: clearance, chemotherapy and surveillance, each with the condition behind the visit listed after. The highlighted sentence explains why the service comes before the disease. The second group covers probable gastroenteritis coded as symptoms, the chest X-ray coded from the radiologist's finding and the diabetes follow-up with its combination code, stage code and medication status code, citing kidney guidance for the stage. Each answer block gives codes, rule, trigger phrase and the hurried order. A final paragraph names the common thread: the first code answers why this encounter occurred.
HS292 Unit 3 rubric: what earns full points
Diagnosis coding sets are graded on correct code selection, correct sequencing, accurate application of guidelines, clarity of explanation and consistency of format. Sequencing tends to decide the grade in this unit, since the set is designed around encounters where the obvious order is wrong. Code selection rewards specificity, such as laterality and stage. Guideline application earns credit when the specific rule is named for each case. Explanations should identify the trigger in the stem. A consistent answer format lets the grader compare cases. Citations of the guidelines and tabular list complete the expectations. Sets with correct codes but no explanation usually score below sets that explain each choice, even with a minor code error.
HS292 Unit 3 help: mistakes that cost points
The most common error is leading with the disease at a clearance, chemotherapy or surveillance visit. Another is coding a probable diagnosis as confirmed in an outpatient setting. Some students code the cough as well as the pneumonia in the X-ray case, or code only the cough because the order said so. Others overlook that the code set assumes diabetes caused the kidney disease unless told otherwise, and code the two separately. Coding an active cancer at a surveillance visit after completed treatment is another frequent slip. If your section's encounters differ, perhaps an aftercare visit or a screening with findings, send them, and we can help you sequence each with the rule and the trigger phrase that decides it.
Get an HS292 Unit 3 example written to your instructions
Which edition of the code set does your course use? Name it alongside the Unit 3 encounters, the instructions and the rubric. Every visit is returned with its first-listed code, additional codes in reported order and the outpatient paragraph that fixes the sequence, within 24-48h. A first custom sample is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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HS292 Unit 3 questions, answered
Why does the knee condition not come first at the clearance visit?
Because the visit exists to evaluate fitness for surgery, not to treat the knee. The outpatient guidelines place the pre-procedural examination code first for encounters of that kind, add the reason for the surgery after it, and then report any findings from the evaluation. Answer keys in coding practica often include one such visit because the instinct to lead with the disease is strong.
What if the infusion patient is treated for a complication at the same visit?
Then the purpose of the visit decides. If the visit was for chemotherapy and a complication such as dehydration was treated along the way, the chemotherapy encounter still typically leads, with the complication after it. If the visit existed mainly to manage the complication, the answer shifts. Your instructions may set a specific scenario; the sample describes the plain infusion case only.
How many additional codes should each encounter carry?
Every documented condition the visit addressed or that affected the care, and nothing more. The clearance visit carries more than the infusion visit because findings from the evaluation are reportable. The earache in the fifth encounter earns a second code because the provider examined the ear and recorded a plan. Each additional code in the sample carries the stem phrase that justifies it.
Where can I find a free HS292 Unit 3 sample paper?
You can read the complete Unit 3 diagnosis coding set here, sequencing six outpatient encounters under the guidelines.
Which code comes first at a preoperative clearance visit?
The preprocedural examination code, followed by the condition that made surgery necessary and any findings from the evaluation.