2026/2027
CPC Certified Professional Coder
Final Certification Exam
Preparation Guide 2026/2027
Question 1
A patient with chronic gallstones and hypertension is scheduled for same-day
cholecystectomy. Before surgery, her cardiologist performs a cardiovascular
examination specifically to determine whether she is medically suitable for the
procedure. Which ICD-10-CM code sequence should the cardiologist report?
A. Z01.810, K80.20, I10
B. I10, Z01.818, K80.20
C. K80.20, I10, Z01.810
D. K80.21, Z01.89, I10
Correct Answer: A. Z01.810, K80.20, I10
Rationale: Z01.810 is reported first because the primary purpose of the encounter is a
preprocedural cardiovascular examination. The gallstone diagnosis, K80.20, explains
why surgery is planned, and I10 identifies the coexisting hypertension evaluated by
the cardiologist. Options B and C place the diagnoses in an inappropriate sequence,
while option D incorrectly describes gallstones with acute cholecystitis and uses a
nonspecific examination code.
Question 2
During an upper gastrointestinal examination, a physician advances an endoscope
through the esophagus, stomach, and duodenum. An acquired esophageal stricture is
identified and dilated using a 20-mm balloon passed through the endoscope. Which
CPT® and ICD-10-CM codes should be reported?
A. 43235, K22.2
B. 43235, C15.9
C. 43248, Q39.3
D. 43249, K22.2
Correct Answer: D. 43249, K22.2
Rationale: CPT® 43249 describes transendoscopic balloon dilation of the esophagus
measuring less than 30 mm in diameter. K22.2 identifies an acquired esophageal
obstruction or stricture. Code 43235 represents diagnostic endoscopy only and is
included in the therapeutic procedure. Code 43248 describes dilation over a guidewire,
,2026/2027
while Q39.3 represents a congenital esophageal stenosis rather than an acquired
stricture.
Question 3
A 50-year-old patient with a family history of colorectal cancer undergoes a screening
colonoscopy. Two transverse-colon polyps are removed using hot biopsy forceps, and
three ascending-colon polyps are removed using a snare. Pathology later confirms
benign neoplasms. Which coding combination is most appropriate?
A. 45384 × 2, 45385 × 3, K63.5
B. 45384, 45385-59, K63.5, Z12.11, Z80.0
C. 45384 × 2, 45385 × 3, Z80.0, K63.5, Z12.11
D. 45384, 45385-59, Z12.11, D12.3, D12.2, Z80.0
Correct Answer: D. 45384, 45385-59, Z12.11, D12.3, D12.2, Z80.0
Rationale: Each colonoscopy technique is reported once, regardless of the number of
lesions removed by that technique. Modifier 59 distinguishes the snare removal from
the hot biopsy removal. Z12.11 identifies the screening purpose, D12.3 and D12.2
identify benign neoplasms at the documented sites, and Z80.0 records the family
history. The other options incorrectly multiply procedure codes or use an unspecified
polyp diagnosis.
Question 4
A physician begins an upper gastrointestinal endoscopy to evaluate possible peptic
ulcer disease. After identifying a bleeding gastric ulcer and a perforated jejunal ulcer,
the patient develops severe hypotension, and the physician terminates the procedure
for safety. Which codes are appropriate?
A. 43235-52, K25.4, K28.5
B. 43235-53, K25.4, K28.5
C. 43200-52, K25.5, K28.5
D. 43235-53, K25.4, K28.1
Correct Answer: B. 43235-53, K25.4, K28.5
Rationale: Modifier 53 is used when a physician discontinues a procedure because
circumstances threaten the patient’s well-being. CPT® 43235 represents the upper
gastrointestinal endoscopy that was begun. K25.4 identifies a gastric ulcer with
hemorrhage, while K28.5 identifies a gastrojejunal ulcer with perforation. Modifier 52
indicates reduced services rather than an urgently discontinued procedure, and K28.1
does not describe perforation.
,2026/2027
Question 5
A physician attempts to dilate a patient’s esophagus using a bougie, but the attempt is
unsuccessful. The physician then performs successful transendoscopic balloon
dilation using a 25-mm balloon. Which CPT® coding is appropriate?
A. 43220
B. 43450-53, 43220
C. 43450, 43220
D. 43220, 43450-52
Correct Answer: A. 43220
Rationale: CPT® 43220 represents transendoscopic balloon dilation of the esophagus
using a balloon measuring 30 mm or larger under the applicable coding framework in
the source material. The unsuccessful bougie attempt is not separately reported
because it did not result in a completed distinct service. Options B through D
improperly report the failed bougie dilation in addition to the completed therapeutic
procedure.
Question 6
A 65-year-old Medicare beneficiary with a family history of colorectal cancer
undergoes a screening colonoscopy. The physician successfully advances the
colonoscope to the cecum, and no therapeutic intervention is performed. Which codes
should be reported?
A. 45330, Z13.818, Z80.0
B. 45378, Z12.11, Z85.038
C. G0104, Z13.818, Z85.038
D. G0105, Z12.11, Z80.0
Correct Answer: D. G0105, Z12.11, Z80.0
Rationale: G0105 is used for a Medicare screening colonoscopy in a patient
considered high risk because of a family history of colorectal cancer. Z12.11
identifies screening for malignant neoplasm of the colon, and Z80.0 documents the
family history. G0104 represents screening sigmoidoscopy, while 45378 is generally
used for diagnostic colonoscopy rather than the Medicare high-risk screening benefit
described.
Question 7
A patient has a 2-cm benign lesion involving the lip. The surgeon removes the lesion
together with a full-thickness wedge of lip tissue and performs a single-layer closure.
Which CPT® code should be reported?
, 2026/2027
A. 40510
B. 11442, 12011-51
C. 40510, 12011-51
D. 11442, 40510
Correct Answer: A. 40510
Rationale: CPT® 40510 describes a full-thickness wedge excision of the lip. The
closure is integral to the excision and is not separately reportable. Code 11442 applies
to excision of a benign cutaneous lesion of the face rather than a full-thickness lip
wedge. Code 12011 describes a simple repair, but reporting it separately would
constitute unbundling because repair is included in 40510.
Question 8
A patient is diagnosed with irritable bowel syndrome, but the physician does not
document whether diarrhea or constipation is present. Which ICD-10-CM code is
most appropriate?
A. K58.9
B. K59.2
C. K58.0
D. K59.8
Correct Answer: A. K58.9
Rationale: K58.9 represents irritable bowel syndrome without diarrhea and is used
when no more specific manifestation is documented. K58.0 requires documented
diarrhea. K59.2 identifies neurogenic bowel, while K59.8 describes other specified
functional intestinal disorders. Coding must be based on the provider’s documentation
and should not assume symptoms or manifestations that are not clearly stated.
Question 9
A surgeon performs a partial distal gastrectomy with Roux-en-Y reconstruction and
also completes a vagotomy during the same operative session. Which CPT® code
combination should be reported?
A. 43633, 43635
B. 43634, 43635
C. 43621, 43635
D. 43633, 43640-51
Correct Answer: A. 43633, 43635
Rationale: CPT® 43633 describes a partial distal gastrectomy with Roux-en-Y
reconstruction. CPT® 43635 is reported for the additional vagotomy when it is
CPC Certified Professional Coder
Final Certification Exam
Preparation Guide 2026/2027
Question 1
A patient with chronic gallstones and hypertension is scheduled for same-day
cholecystectomy. Before surgery, her cardiologist performs a cardiovascular
examination specifically to determine whether she is medically suitable for the
procedure. Which ICD-10-CM code sequence should the cardiologist report?
A. Z01.810, K80.20, I10
B. I10, Z01.818, K80.20
C. K80.20, I10, Z01.810
D. K80.21, Z01.89, I10
Correct Answer: A. Z01.810, K80.20, I10
Rationale: Z01.810 is reported first because the primary purpose of the encounter is a
preprocedural cardiovascular examination. The gallstone diagnosis, K80.20, explains
why surgery is planned, and I10 identifies the coexisting hypertension evaluated by
the cardiologist. Options B and C place the diagnoses in an inappropriate sequence,
while option D incorrectly describes gallstones with acute cholecystitis and uses a
nonspecific examination code.
Question 2
During an upper gastrointestinal examination, a physician advances an endoscope
through the esophagus, stomach, and duodenum. An acquired esophageal stricture is
identified and dilated using a 20-mm balloon passed through the endoscope. Which
CPT® and ICD-10-CM codes should be reported?
A. 43235, K22.2
B. 43235, C15.9
C. 43248, Q39.3
D. 43249, K22.2
Correct Answer: D. 43249, K22.2
Rationale: CPT® 43249 describes transendoscopic balloon dilation of the esophagus
measuring less than 30 mm in diameter. K22.2 identifies an acquired esophageal
obstruction or stricture. Code 43235 represents diagnostic endoscopy only and is
included in the therapeutic procedure. Code 43248 describes dilation over a guidewire,
,2026/2027
while Q39.3 represents a congenital esophageal stenosis rather than an acquired
stricture.
Question 3
A 50-year-old patient with a family history of colorectal cancer undergoes a screening
colonoscopy. Two transverse-colon polyps are removed using hot biopsy forceps, and
three ascending-colon polyps are removed using a snare. Pathology later confirms
benign neoplasms. Which coding combination is most appropriate?
A. 45384 × 2, 45385 × 3, K63.5
B. 45384, 45385-59, K63.5, Z12.11, Z80.0
C. 45384 × 2, 45385 × 3, Z80.0, K63.5, Z12.11
D. 45384, 45385-59, Z12.11, D12.3, D12.2, Z80.0
Correct Answer: D. 45384, 45385-59, Z12.11, D12.3, D12.2, Z80.0
Rationale: Each colonoscopy technique is reported once, regardless of the number of
lesions removed by that technique. Modifier 59 distinguishes the snare removal from
the hot biopsy removal. Z12.11 identifies the screening purpose, D12.3 and D12.2
identify benign neoplasms at the documented sites, and Z80.0 records the family
history. The other options incorrectly multiply procedure codes or use an unspecified
polyp diagnosis.
Question 4
A physician begins an upper gastrointestinal endoscopy to evaluate possible peptic
ulcer disease. After identifying a bleeding gastric ulcer and a perforated jejunal ulcer,
the patient develops severe hypotension, and the physician terminates the procedure
for safety. Which codes are appropriate?
A. 43235-52, K25.4, K28.5
B. 43235-53, K25.4, K28.5
C. 43200-52, K25.5, K28.5
D. 43235-53, K25.4, K28.1
Correct Answer: B. 43235-53, K25.4, K28.5
Rationale: Modifier 53 is used when a physician discontinues a procedure because
circumstances threaten the patient’s well-being. CPT® 43235 represents the upper
gastrointestinal endoscopy that was begun. K25.4 identifies a gastric ulcer with
hemorrhage, while K28.5 identifies a gastrojejunal ulcer with perforation. Modifier 52
indicates reduced services rather than an urgently discontinued procedure, and K28.1
does not describe perforation.
,2026/2027
Question 5
A physician attempts to dilate a patient’s esophagus using a bougie, but the attempt is
unsuccessful. The physician then performs successful transendoscopic balloon
dilation using a 25-mm balloon. Which CPT® coding is appropriate?
A. 43220
B. 43450-53, 43220
C. 43450, 43220
D. 43220, 43450-52
Correct Answer: A. 43220
Rationale: CPT® 43220 represents transendoscopic balloon dilation of the esophagus
using a balloon measuring 30 mm or larger under the applicable coding framework in
the source material. The unsuccessful bougie attempt is not separately reported
because it did not result in a completed distinct service. Options B through D
improperly report the failed bougie dilation in addition to the completed therapeutic
procedure.
Question 6
A 65-year-old Medicare beneficiary with a family history of colorectal cancer
undergoes a screening colonoscopy. The physician successfully advances the
colonoscope to the cecum, and no therapeutic intervention is performed. Which codes
should be reported?
A. 45330, Z13.818, Z80.0
B. 45378, Z12.11, Z85.038
C. G0104, Z13.818, Z85.038
D. G0105, Z12.11, Z80.0
Correct Answer: D. G0105, Z12.11, Z80.0
Rationale: G0105 is used for a Medicare screening colonoscopy in a patient
considered high risk because of a family history of colorectal cancer. Z12.11
identifies screening for malignant neoplasm of the colon, and Z80.0 documents the
family history. G0104 represents screening sigmoidoscopy, while 45378 is generally
used for diagnostic colonoscopy rather than the Medicare high-risk screening benefit
described.
Question 7
A patient has a 2-cm benign lesion involving the lip. The surgeon removes the lesion
together with a full-thickness wedge of lip tissue and performs a single-layer closure.
Which CPT® code should be reported?
, 2026/2027
A. 40510
B. 11442, 12011-51
C. 40510, 12011-51
D. 11442, 40510
Correct Answer: A. 40510
Rationale: CPT® 40510 describes a full-thickness wedge excision of the lip. The
closure is integral to the excision and is not separately reportable. Code 11442 applies
to excision of a benign cutaneous lesion of the face rather than a full-thickness lip
wedge. Code 12011 describes a simple repair, but reporting it separately would
constitute unbundling because repair is included in 40510.
Question 8
A patient is diagnosed with irritable bowel syndrome, but the physician does not
document whether diarrhea or constipation is present. Which ICD-10-CM code is
most appropriate?
A. K58.9
B. K59.2
C. K58.0
D. K59.8
Correct Answer: A. K58.9
Rationale: K58.9 represents irritable bowel syndrome without diarrhea and is used
when no more specific manifestation is documented. K58.0 requires documented
diarrhea. K59.2 identifies neurogenic bowel, while K59.8 describes other specified
functional intestinal disorders. Coding must be based on the provider’s documentation
and should not assume symptoms or manifestations that are not clearly stated.
Question 9
A surgeon performs a partial distal gastrectomy with Roux-en-Y reconstruction and
also completes a vagotomy during the same operative session. Which CPT® code
combination should be reported?
A. 43633, 43635
B. 43634, 43635
C. 43621, 43635
D. 43633, 43640-51
Correct Answer: A. 43633, 43635
Rationale: CPT® 43633 describes a partial distal gastrectomy with Roux-en-Y
reconstruction. CPT® 43635 is reported for the additional vagotomy when it is
