CPC Practice Exam A
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? - 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? - 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. - 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? - 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
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? - 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? - 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. - 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? - 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
