CPC Practice Exam A questions with
correct answers
A 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 a full excision
of an 8 cm lesion. Layered closure was performed after the removal. The specimen was sent for
permanent histopathologic examination.
What is the CPT code(s) for this procedure? - correct answer ✔✔11626, 12044-51
Rationale :
11620 - 11626 refers to the excision of a malignant lesion located on the scalp, neck, hands, feet, &
genitalia. As the excision (margins included) was a total of 8.5 cm, 11626 is most appropriate.
As the repair was layered, it thus qualifies as an intermediate repair and in accordance with CPT
Guidelines must be reported separately. 12041-12047 refers to the intermediate repair of wounds of the
neck, scalp, hands feet, and/or genitals ; the 8.5 cm repair makes 12044 most appropriate, and the
modifier "-51" is applied to indicate multiple procedures.
A 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? - correct answer ✔✔11044
Rationale :
,11042 - 11047 refers to debridement, reported by depth & surface area of tissue removed. As the
patient's foot was debrided to the bone with a surface area of 15 sq cm, 11044 is the most appropriate
choice.
A 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. - correct answer ✔✔99283-25, 12053, 12034-59
Rationale :
The section guidelines in the CPT Codebook for Repair (Closure) states: "Wound closure utilizing
adhesive strips as the sole repair material should be coded using the appropriate E/M code." 99283 is
most appropriate due to moderate complexity of medical decision, and modifier "-25" is added to
indicate separately identifiable e/m service related to the reason of the visit.
The lacerations on the face are intermediate repairs, because of noted debridement and removal of glass
debris. 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."
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), with modifier
"-59" added to indicate distinct procedural service.
A 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? - correct answer ✔✔21931, D17.1
As the 4 cm lipoma was found in the subcutaneous tissue, 21931 is most appropriate.
The mass is identified as a lipoma ; search the alphabetic index for "Lipoma/subcutaneous/trunk" for the
code.
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 had 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 - correct answer ✔✔25628-RT
As treatment of the fracture was open, 25628 is apt as it also includes internal fixation without
manipulation ; modifier "-RT" is added to indicate the side of the body that received treatment.
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 an 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? - correct answer ✔✔27485-50
Rationale :
correct answers
A 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 a full excision
of an 8 cm lesion. Layered closure was performed after the removal. The specimen was sent for
permanent histopathologic examination.
What is the CPT code(s) for this procedure? - correct answer ✔✔11626, 12044-51
Rationale :
11620 - 11626 refers to the excision of a malignant lesion located on the scalp, neck, hands, feet, &
genitalia. As the excision (margins included) was a total of 8.5 cm, 11626 is most appropriate.
As the repair was layered, it thus qualifies as an intermediate repair and in accordance with CPT
Guidelines must be reported separately. 12041-12047 refers to the intermediate repair of wounds of the
neck, scalp, hands feet, and/or genitals ; the 8.5 cm repair makes 12044 most appropriate, and the
modifier "-51" is applied to indicate multiple procedures.
A 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? - correct answer ✔✔11044
Rationale :
,11042 - 11047 refers to debridement, reported by depth & surface area of tissue removed. As the
patient's foot was debrided to the bone with a surface area of 15 sq cm, 11044 is the most appropriate
choice.
A 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. - correct answer ✔✔99283-25, 12053, 12034-59
Rationale :
The section guidelines in the CPT Codebook for Repair (Closure) states: "Wound closure utilizing
adhesive strips as the sole repair material should be coded using the appropriate E/M code." 99283 is
most appropriate due to moderate complexity of medical decision, and modifier "-25" is added to
indicate separately identifiable e/m service related to the reason of the visit.
The lacerations on the face are intermediate repairs, because of noted debridement and removal of glass
debris. 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."
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), with modifier
"-59" added to indicate distinct procedural service.
A 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? - correct answer ✔✔21931, D17.1
As the 4 cm lipoma was found in the subcutaneous tissue, 21931 is most appropriate.
The mass is identified as a lipoma ; search the alphabetic index for "Lipoma/subcutaneous/trunk" for the
code.
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 had 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 - correct answer ✔✔25628-RT
As treatment of the fracture was open, 25628 is apt as it also includes internal fixation without
manipulation ; modifier "-RT" is added to indicate the side of the body that received treatment.
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 an 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? - correct answer ✔✔27485-50
Rationale :
