OST-249: CPC -Exam Prep - Chapter 2
Questions Well Answered 2026
Update.
When wound debridement is performed by curette to fibrin and slough, what code series would
be utilized? - Answer 97597-97602
(Codes from the Medicine Section, Active Wound Care Management would be assigned. The
surgery debridement codes are for surgical excision with surgical instrumentation only and
therefore not appropriate in this instance.)
A complete abdominal ultrasound is ordered, and all structures are identified, the appendix is
documented as "surgically absent." What service(s) should be assigned? - Answer Complete
abdominal ultrasound
(Documentation reflects all structures were either identified or documented as surgically
absent; therefore, it would be appropriate to assign the complete abdominal ultrasound code in
this circumstance.)
When surgical or evaluation and management services are mandated by the third-party carrier,
what modifier should be appended to those services? - Answer modifier -32
(Modifier -32 is appended when a third-party carrier requires a service be performed.)
When colonoscopy with biopsy (CPT code 45380) is performed as well as colonoscopy with
polypectomy removed by snare to a different site/polyp (CPT code 45385) during the same
surgical session at another site, what code(s) are reported? - Answer 45385, 45380-59
(Both codes are reported. A modifier -59 is appended to the subsequent procedure 45380 to
indicate the biopsy was taken from a location other than the site of the polypectomy.)
Patient presented for knee pain associated with an injury that occurred at work approximately 6
weeks ago. Expanded problem-focused history and exam and low MDM were documented and
coded/billed to Medicare. Determine why these services were denied by Medicare? - Answer
Visit coded to Medicare, visit should be billed to Workers' Compensation as injury at work.
(The injury occurred at the workplace and, therefore, should have been billed to Workers'
Compensation, not Medicare.)
Patient presents to clinic, status postarthroscopy of left knee 7 days ago for follow-up. Problem-
focused history and exam and straightforward MDM were performed. What code(s)/modifier(s)
would be appropriate for this encounter? - Answer 99024
(All surgical procedures include a global period that covers the normal, uncomplicated
postoperative care; therefore, CPT code 99024, postoperative visit would be assigned for which
there is no value/charge.)
, When multiple surgical procedures are performed during the same surgical session, what
determines the appropriate order for reporting those services? - Answer Most significant
procedure is listed first.
(The most significant procedure should be listed first, followed by the next most significant
procedure.)
Patient presents with nausea, vomiting, and was determined to be suffering from dehydration.
IV Normal Saline was administered from 9:00 AM to 9:45 AM for dehydration. Phenergan was
administered IVP at 11:25 AM, following another IVP of Phenergan at 12:15 PM. Patient's
symptoms appeared improved and the patient was released. What services would be
appropriate to code/bill? - Answer 96360, 96375, 96376
(Codes 96360 should be assigned for the infusion of normal saline. Since this service was
performed first, and appeared to be the main treatment for the patient's condition, then, in
physician coding, it would be assigned first, followed by the IVP of Phenergan with 96375 (as
only one initial code may be utilized per encounter) and 96376 for the subsequent IVP of the
same substance.)
Patient is seen in observation for 2 days and the services are coded/billed as follows: 01/01/XX
Code 99218, Place of Service Inpatient Hospital, 01/02/XX Code 99217, Place of Service
Inpatient Hospital. What is incorrect in the coding for these services? - Answer POS should be
outpatient 22 for observation care.
(The place of service for this claim should be reflected as 22 outpatient service rather than 21
inpatient as submitted.)
When bilateral procedures are performed during the same surgical session, how should those
services be reported? - Answer One line with modifier -50 appended
(Bilateral procedures for purposes of the CPC exam should be assigned on one line with the
modifier -50.)
When excision of two sentinel lymph nodes is performed, what services are coded? - Answer
Excision of lymph nodes
(The axillary lymphadenectomy codes should only be utilized when the majority of the axillary
nodes are removed. Since only two are removed, this would be coded with the excision of
lymph node codes.)
When the physician makes the medical decision to discontinue a procedure in the hospital
operating room due to a decline of the patient's medical condition, how should the service be
coded? - Answer Append modifier -53.
(Modifier -53 is appended when a procedure is discontinued due to the patient's condition.
Modifiers -73/74 are for outpatient facility and ASC only.)
Questions Well Answered 2026
Update.
When wound debridement is performed by curette to fibrin and slough, what code series would
be utilized? - Answer 97597-97602
(Codes from the Medicine Section, Active Wound Care Management would be assigned. The
surgery debridement codes are for surgical excision with surgical instrumentation only and
therefore not appropriate in this instance.)
A complete abdominal ultrasound is ordered, and all structures are identified, the appendix is
documented as "surgically absent." What service(s) should be assigned? - Answer Complete
abdominal ultrasound
(Documentation reflects all structures were either identified or documented as surgically
absent; therefore, it would be appropriate to assign the complete abdominal ultrasound code in
this circumstance.)
When surgical or evaluation and management services are mandated by the third-party carrier,
what modifier should be appended to those services? - Answer modifier -32
(Modifier -32 is appended when a third-party carrier requires a service be performed.)
When colonoscopy with biopsy (CPT code 45380) is performed as well as colonoscopy with
polypectomy removed by snare to a different site/polyp (CPT code 45385) during the same
surgical session at another site, what code(s) are reported? - Answer 45385, 45380-59
(Both codes are reported. A modifier -59 is appended to the subsequent procedure 45380 to
indicate the biopsy was taken from a location other than the site of the polypectomy.)
Patient presented for knee pain associated with an injury that occurred at work approximately 6
weeks ago. Expanded problem-focused history and exam and low MDM were documented and
coded/billed to Medicare. Determine why these services were denied by Medicare? - Answer
Visit coded to Medicare, visit should be billed to Workers' Compensation as injury at work.
(The injury occurred at the workplace and, therefore, should have been billed to Workers'
Compensation, not Medicare.)
Patient presents to clinic, status postarthroscopy of left knee 7 days ago for follow-up. Problem-
focused history and exam and straightforward MDM were performed. What code(s)/modifier(s)
would be appropriate for this encounter? - Answer 99024
(All surgical procedures include a global period that covers the normal, uncomplicated
postoperative care; therefore, CPT code 99024, postoperative visit would be assigned for which
there is no value/charge.)
, When multiple surgical procedures are performed during the same surgical session, what
determines the appropriate order for reporting those services? - Answer Most significant
procedure is listed first.
(The most significant procedure should be listed first, followed by the next most significant
procedure.)
Patient presents with nausea, vomiting, and was determined to be suffering from dehydration.
IV Normal Saline was administered from 9:00 AM to 9:45 AM for dehydration. Phenergan was
administered IVP at 11:25 AM, following another IVP of Phenergan at 12:15 PM. Patient's
symptoms appeared improved and the patient was released. What services would be
appropriate to code/bill? - Answer 96360, 96375, 96376
(Codes 96360 should be assigned for the infusion of normal saline. Since this service was
performed first, and appeared to be the main treatment for the patient's condition, then, in
physician coding, it would be assigned first, followed by the IVP of Phenergan with 96375 (as
only one initial code may be utilized per encounter) and 96376 for the subsequent IVP of the
same substance.)
Patient is seen in observation for 2 days and the services are coded/billed as follows: 01/01/XX
Code 99218, Place of Service Inpatient Hospital, 01/02/XX Code 99217, Place of Service
Inpatient Hospital. What is incorrect in the coding for these services? - Answer POS should be
outpatient 22 for observation care.
(The place of service for this claim should be reflected as 22 outpatient service rather than 21
inpatient as submitted.)
When bilateral procedures are performed during the same surgical session, how should those
services be reported? - Answer One line with modifier -50 appended
(Bilateral procedures for purposes of the CPC exam should be assigned on one line with the
modifier -50.)
When excision of two sentinel lymph nodes is performed, what services are coded? - Answer
Excision of lymph nodes
(The axillary lymphadenectomy codes should only be utilized when the majority of the axillary
nodes are removed. Since only two are removed, this would be coded with the excision of
lymph node codes.)
When the physician makes the medical decision to discontinue a procedure in the hospital
operating room due to a decline of the patient's medical condition, how should the service be
coded? - Answer Append modifier -53.
(Modifier -53 is appended when a procedure is discontinued due to the patient's condition.
Modifiers -73/74 are for outpatient facility and ASC only.)
