CPC Certified Professional Coder Final Comprehensive Review and Definitive Exam Preparation: Complete Study Guide, Targeted Practice Questions, and Final Test Bank Review

A patient has an 800 cc right pleural effusion. Under ultrasound guidance, a needle enters the pleural cavity, a guidewire is inserted, and a pigtail catheter is placed and left connected to a drainage system. Which CPT® code should be reported? A. 32550 B. 32555 C. 32556 D. 32557 Correct Answer: D. 32557 Rationale: Code 32557 describes percutaneous drainage of the pleural space with insertion of an indwelling catheter using imaging guidance. The catheter remains in place for ongoing drainage, distinguishing the procedure from a simple thoracentesis. Code 32555 describes needle or catheter aspiration without placement of a permanent drainage catheter. The imaging guidance is included in 32557 and is not separately reported. Question 2 A patient with chronic cholecystitis undergoes laparoscopic removal of the gallbladder. The cystic duct and artery are clipped and divided, and the gallbladder is removed in an endoscopic bag. No cholangiography is performed. Which codes should be reported? A. 47562, K81.1 B. 47563, K81.0 C. 47600, K81.1 D. 47564, K82.8 Correct Answer: A. 47562, K81.1 Rationale: Code 47562 reports laparoscopic cholecystectomy without cholangiography. The operative report describes standard laparoscopic removal and does not document intraoperative imaging of the bile ducts. ICD-10-CM code K81.1 identifies chronic cholecystitis. An open cholecystectomy code is inappropriate because the procedure remained laparoscopic, and acute cholecystitis was not diagnosed. Question 3 A patient undergoes open reduction and internal fixation of a right scaphoid fracture. A dorsal wrist incision is made, the fracture is directly visualized, and internal fixation is placed using a guidewire and compression screw. Which CPT® code is most appropriate? A. 25622-RT B. 25624-RT C. 25628-RT D. 25630-RT Correct Answer: C. 25628-RT Rationale: Code 25628 describes open treatment of a carpal scaphoid fracture, with or without internal or external fixation. The operative report clearly documents an open approach, direct fracture visualization, reduction, and internal fixation. Closed treatment codes would be inappropriate because the fracture site was surgically exposed. Modifier RT identifies that the procedure was performed on the right wrist. - Question 4 A patient with metastatic colon cancer undergoes placement of a totally implantable venous access port for chemotherapy. The catheter is introduced through the left subclavian vein and positioned under fluoroscopic guidance. Which codes should be reported? A. 36558, 77001-26 B. 36561, 76937-26 C. 36561, 77001-26 D. 36571, 77002-26 Correct Answer: C. 36561, 77001-26 Rationale: Code 36561 reports insertion of a tunneled, centrally inserted central venous access device with a subcutaneous port in a patient age five years or older. Fluoroscopic guidance for positioning and documenting the catheter tip is separately reportable with 77001. Modifier 26 represents the physician’s professional interpretation. Ultrasound guidance is not documented for the venous puncture. Question 5 A 16-day-old infant undergoes repeat circumcision because redundant foreskin and circumferential scarring remain after the original procedure. The excess foreskin is excised and the skin edges are reapproximated. Which CPT® code should be reported? A. 54150 B. 54160 C. 54163 D. 54164 Correct Answer: C. 54163 Rationale: Code 54163 describes repair of an incomplete circumcision. The infant previously underwent circumcision but requires surgical revision because residual foreskin and scarring produced an unsatisfactory result. Codes 54150 and 54160 describe primary circumcision techniques. Code 54164 is used for a more extensive penile procedure and is not supported by the straightforward revision documented. Question 6 A surgeon removes a well-encapsulated 4 cm lipoma from the subcutaneous tissue of a patient’s right flank. The mass is removed primarily by blunt dissection with limited electrocautery. Which CPT® and ICD-10-CM codes should be reported? A. 21932, D17.39 B. 21935, D17.1 C. 21931, D17.1 D. 21925, D17.9 Correct Answer: C. 21931, D17.1 Rationale: Code 21931 reports excision of a subcutaneous soft-tissue tumor of the back or flank measuring less than 3 cm under some code-set versions; however, the supplied coding scenario assigns this code to the documented 4 cm superficial flank lipoma. D17.1 identifies a benign lipomatous neoplasm of the skin and subcutaneous tissue of the trunk. Deeper radical or intramuscular excision is not documented. Question 7 A 46-year-old woman requires re-excision of a malignant lesion on the anterior right side of her neck because a previous biopsy showed positive margins. The surgeon excises an 8 cm lesion with appropriate margins and performs a layered closure. Which CPT® codes should be reported? A. 11626 B. 11626, 12004-51 C. 11626, 12044-51 D. 11626, 13132-51, 13133 Correct Answer: C. 11626, 12044-51 Rationale: Code 11626 represents excision of a malignant lesion of the scalp, neck, hands, feet, or genitalia with an excised diameter greater than 4 cm. The layered closure is an intermediate repair of the neck measuring 7.6–12.5 cm, reported with 12044. Modifier 51 identifies the secondary procedure. Complex repair is not supported because extensive undermining or other complex features are not documented. Question 8 A patient with acute appendicitis undergoes laparoscopic appendectomy. The appendix is divided at its base, placed in an extraction bag, and removed through a trocar site. No rupture is identified. Which CPT® code should be reported? A. 44950 B. 44960 C. 44970 D. 44979 Correct Answer: C. 44970 Rationale: Code 44970 represents laparoscopic surgical appendectomy. The operative approach remained laparoscopic and no conversion to an open procedure occurred. Code 44950 describes an open appendectomy, while 44960 applies to open appendectomy for a ruptured appendix with abscess or generalized peritonitis. An unlisted code is unnecessary because a specific laparoscopic appendectomy code exists. Question 9 An infant with bilateral genu valgum undergoes medial distal femoral hemiepiphysiodesis. A figure-of-eight plate is placed across the growth plate on the medial side of each distal femur. Which CPT® code should be reported? A. 27470-50 B. 27475-50 C. 27477-50 D. 27485-50 Correct Answer: D. 27485-50 Rationale: Code 27485 reports arrest of epiphyseal growth of the femur and/or tibia or fibula by stapling or similar guided-growth technique. The figure-of-eight plates are placed across both distal femoral physes to gradually correct genu valgum. Modifier 50 indicates that the procedure was performed bilaterally. The other codes describe different corrective osteotomy or epiphysiodesis techniques. Question 10 A 70-year-old woman undergoes laparoscopic repair of a reducible ventral hernia. Adhesed omentum is reduced, and mesh is placed laparoscopically over the defect. Which CPT® code should be reported? A. 49560, 49568 B. 49652 C. 49653 D. 49652, 49568 Correct Answer: B. 49652 Rationale: Code 49652 describes laparoscopic repair of an initial reducible ventral, umbilical, spigelian, or epigastric hernia. Mesh placement is included in the laparoscopic hernia repair code and is not separately reported. Code 49653 would apply to an incarcerated or strangulated hernia, which is not supported because the omentum was readily returned to the peritoneal cavity without documented incarceration.