ICD-10-CM — Portfolio Projects
Build coded work that shows fluency with ICD-10-CM's structure, conventions, and sequencing rules across realistic documentation — not code memorization.
Project 1: Chapter Deep-Dive Coding Set
Level: Beginner | Time: 2 days
Pick one ICD-10-CM chapter (e.g., Diseases of the Circulatory System, Endocrine Diseases) and code 15-20 encounter scenarios drawn specifically from that chapter, applying its chapter-specific guidelines.
Steps
Skills Demonstrated
Note
Chapter content and guidelines are revised on an annual cycle — verify chapter-specific rules against a current-year ICD-10-CM Official Guidelines document, since specific code assignments in an older source may no longer be current.
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Project 2: POA Indicator and HCC Risk-Adjustment Practice
Level: Intermediate | Time: 3-4 days
Work through 10+ inpatient scenarios assigning present-on-admission (POA) indicators, and separately identify which diagnoses in a set of outpatient/chronic-condition scenarios would be relevant to HCC (Hierarchical Condition Category) risk adjustment.
Steps
Skills Demonstrated
Note
Verify current HCC model version and category mappings against current CMS guidance — HCC models are updated periodically (e.g., version changes affecting which codes map to which categories), and this project should be framed as demonstrating the concept, not a memorized, unchanging mapping.
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Project 3: Full ICD-10-CM Audit Portfolio
Level: Advanced | Time: 1 week
A comprehensive coding audit spanning multiple chapters, inpatient and outpatient settings, POA assignment, and self-audit — the centerpiece project for an ICD-10-CM-focused portfolio.
Steps
Skills Demonstrated
Portfolio Artifact Name
icd-10-cm-audit-portfolio
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Tips for Great Projects
Work from documentation, not a code list. Deriving the code from a clinical scenario — the way you will on the job — is the actual skill being demonstrated.
Cite the specific convention or guideline behind each code choice. "Combination code because..." or "Excludes1 applies because..." is a far stronger portfolio artifact than a bare code.
Track your own accuracy over time. A visible, documented self-audit trend is a stronger signal than any single project's polish.
Treat anything guideline- or model-specific as needing a current-source check. ICD-10-CM content, POA rules, and HCC mappings are all revised on recurring cycles.