CPC Practice Exam 1| QUESTIONS WITH COMPLETE SOLUTIONS
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CPC
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Liberty University
46 year-old female had a previous biopsy that indicated positive malignant margins anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision of an 8 cm lesion. Layered closure was performed after the removal. The specimen was sent for ...
cpc practice exam 1| questions with complete solutions
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CPC Practice Exam 1| QUESTIONS WITH COMPLETE
SOLUTIONS
46 year-old female had a previous biopsy that indicated positive malignant margins anteriorly on
the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for
full excision of an 8 cm lesion. Layered closure was performed after the removal. The specimen
was sent for permanent histopathologic examination. What are the CPT® code(s) for this
procedure?
A. 11626
B. 11626, 12004-51
C. 11626, 12044-51
D. 11626, 13132-51, 13133 Correct Answer: According to CPT® guidelines "Repair of an
excision of a malignant lesion requiring intermediate or complex closure should be reported
separately". The intermediate repair code is reported because it was a layered closure. Answer C
30 year-old female is having 15 sq cm debridement performed on an infected ulcer with eschar
on the right foot. Using sharp dissection, the ulcer was debrided all the way to down to the bone
of the foot. The bone had to be minimally trimmed because of a sharp point at the end of the
metatarsal. After debriding the area, there was minimal bleeding because of very poor circulation
of the foot. It seems that the toes next to the ulcer may have some involvement and cultures were
taken. The area was dressed with sterile saline and dressings and then wrapped. What CPT®
code should be reported?
A. 11043
B. 11012
C. 11044
D. 11042 Correct Answer: Debridement is not being performed on an open fracture/open
dislocation eliminating multiple choice answer B. The ulcer was debrided all the way to the bone
of the foot, making multiple choice answer C, the correct procedure. Answer C
64 year-old female who has multiple sclerosis fell from her walker and landed on a glass table.
She lacerated her forehead, cheek and chin and the total length of these lacerations was 6 cm.
Her right arm and left leg had deep cuts measuring 5 cm on each extremity. Her right hand and
right foot had a total of 3 cm lacerations. The ED physician repaired the lacerations as follows:
The forehead, cheek, and chin had debridement and cleaning of glass debris with the lacerations
being closed with one layer closure, 6-0 Prolene sutures. The arm and leg were repaired by
layered closure, 6-0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and
foot were closed with adhesive strips. Select the appropriate procedure codes for this visit.
A. 99283-25, 12014, 12034-59, 12002-59, 11042-51
B. 99283-25, 12053, 12034-59, 12002-59
C. 99283-25, 12014, 12034-59, 11042-51
D. 99283-25, 12053, 12034-59 Correct Answer: To start narrowing your choices down, the hand
and foot were closed with adhesive strips. The Section Guidelines in the CPT® manual for
Repair (Closure) states: "Wound closure utilizing adhesive strips as the sole repair material
should be coded using the appropriate E/M code." Eliminating multiple choice answers A and B.
The lacerations on the face are intermediate repairs, because debridement and glass debris was
,removed. The guidelines in the CPT® codebook for Repair (Closure) states: "Single-layer
closure of heavily contaminated wounds that have required extensive cleaning or removal of
particulate matter also constitutes intermediate repair." Eliminating multiple choice answer C.
The intermediate repair of the lacerations to the face totaled 6 cm (12053). The right arm and left
leg had cuts measuring 5 cm each which totaled 10 cm requiring intermediate repair (12034).
Answer D
52 year-old female has a mass growing on her right flank for several years. It has finally gotten
significantly larger and is beginning to bother her. She is brought to the Operating Room for
definitive excision. An incision was made directly overlying the mass. The mass was down into
the subcutaneous tissue and the surgeon encountered a well encapsulated lipoma approximately 4
centimeters. This was excised primarily bluntly with a few attachments divided with
electrocautery. What CPT® and ICD-10-CM codes are reported?
A. 21932, D17.39
B. 21935, D17.1
C. 21931, D17.1
D. 21925, D17.9 Correct Answer: The mass growing turned out to be a lipoma found in the
subcutaneous tissue of the flank. In the ICD-10-CM Alphabetic Index, look for
Lipoma/subcutaneous/trunk. You are referred to code D17.1, eliminating multiple choice
answers A and D. Because the 4 cm tumor was found in the subcutaneous tissue code 21931 is
the correct CPT® code to report. Answer C
PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: Open
reduction and internal fixation of right scaphoid fracture. DESCRIPTION OF PROCEDURE:
The patient was brought to the operating room; anesthesia having been administered. The right
upper extremity was prepped and draped in a sterile manner. The limb was elevated,
exsanguinated, and a pneumatic arm tourniquet was elevated. An incision was made over the
dorsal radial aspect of the right wrist. Skin flaps were elevated. Cutaneous nerve branches were
identified and very gently retracted. The interval between the second and third dorsal
compartment tendons was identified and entered. The respective tendons were retracted. A dorsal
capsulotomy incision was made, and the fracture was visualized. There did not appear to be any
type of significant defect at the fracture site. A 0.045 Kirschner wire was then used as a
guidewire, extending from the proximal pole of the scaphoid distal ward. The guidewire was
positioned appropriately and then measured. A 25-mm Acutrak® drill bit was drilled to 25 mm.
A 22.5-mm screw was selected and inserted and rigid internal fixation was accomplished in this
fashion. This was visualized under the OEC imaging device in multiple projections. The wound
was irrigated and closed in layers. Sterile dressings were then applied. The patient tolerated the
procedure well and left the operating room in stable condition. What CPT® code is reported for
this procedure?
A. 25628-RT
B. 25624-RT
C. 25645-RT
D. 25651-RT Correct Answer: Patient had an open reduction, meaning an incision was made to
get to the fracture, eliminating multiple choice answer B. The fracture site was the scaphoid of
the wrist (carpal), eliminating multiple choices C and D. Answer A
, An infant with genu valgum is brought to the operating room to have a bilateral medial distal
femur hemiepiphysiodesis done. On each knee, the C-arm was used to localize the growth plate.
With the growth plate localized, an incision was made medially on both sides. This was taken
down to the fascia, which was opened. The periosteum was not opened. The Orthofix® figure-
of-eight plate was placed and checked with X-ray. We then irrigated and closed the medial fascia
with 0 Vicryl suture. The skin was closed with 2-0 Vicryl and 3-0 Monocryl®. What procedure
code is reported?
A. 27470-50
B. 27475-50
C. 27477-50
D. 27485-50 Correct Answer: Your keywords in the scenario to narrow your choices down to
code 27485 are: "distal femur,""genu valgum," and "hemiepiphysiodesis." Answer D
The patient is a 67 year-old gentleman with metastatic colon cancer recently operated on for a
brain metastasis, now for placement of an Infuse-A-Port for continued chemotherapy. The left
subclavian vein was located with a needle and a guide wire placed. This was confirmed to be in
the proper position fluoroscopically. A transverse incision was made just inferior to this and a
subcutaneous pocket created just inferior to this. After tunneling, the introducer was placed over
the guide wire and the power port line was placed with the introducer and the introducer was
peeled away. The tip was placed in the appropriate position under fluoroscopic guidance and the
catheter trimmed to the appropriate length and secured to the power port device. The locking
mechanism was fully engaged. The port was placed in the subcutaneous pocket and everything
sat very nicely fluoroscopically. It was secured to the underlying soft tissue with 2-0 silk stitch.
What CPT® code(s) is (are) reported for this procedure?
A. 36556, 77001-26
B. 36558
C. 36561, 77001-26
D. 36571 Correct Answer: Patient is having an Infuse-A-Port put in his chest to receive
chemotherapy. The subclavian vein (central venous) is being tunneled for the access device,
eliminating multiple choices A and D. The patient had a subcutaneous pocket created to insert
the power port, eliminating multiple choice answer B. Code 77001 reports fluoroscopic guidance
for a central venous access device. Modifier 26 denotes the professional service. Answer C
A CT scan identified moderate-sized right pleural effusion in a 50 year-old male. This was
estimated to be 800 cc in size and had an appearance of fluid on the CT Scan. A needle is used to
puncture through the chest tissues and enter the pleural cavity to insert a guidewire under
ultrasound guidance. A pigtail catheter is then inserted at the length of the guidewire and secured
by stitches. The catheter will remain in the chest and is connected to drainage system to drain the
accumulated fluid. The CPT® code is:
A. 32557
B. 32555
C. 32556
D. 32550 Correct Answer: The drainage of fluid from the pleural cavity was performed via
needle (percutaneous) with insertion of an indwelling catheter to drain the fluid, eliminating
multiple choice answers B and D. The procedure was performed under ultrasound guidance,
eliminating multiple choice answer C. Answer A
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