CPC Practice Exam C
7-year-old riding his bike struck a tree stump throwing him off his bike. He received multiple lacerations.
He had a 3 cm dermis laceration on his scalp with two 0.5 cm lacerations on his face. His right arm had a
5 cm laceration and right leg has a 5cm laceration. The physician stapled the laceration for the scalp.
Physician used steri-strips (adhesive strips) to close the wounds on the face. The legs and arms were
cleaned by heavily irrigating them with normal saline and removal of embedded debris performed on
both wounds, followed with a single-layer closure. Select the repair codes to report.
A. 12032, 12032-59, 12011-59, 12002-59
B. 12002, 12002-59, 12011-59, 12002-59
C. 12005, 11042-59
D. 12034, 12002-59 - Answer-D. 12034, 12002-59
The two face lacerations were closed with steri-strips (adhesive strips). When adhesive strips are the
only repair material used to close an open wound a repair code is not reported. According to CPT®
subsection guidelines for Repair (Closure), when wound closure uses adhesive strips as the only repair
material it should be coded using the appropriate E/M service. Code 12011 is inappropriate to report for
this scenario, eliminating multiple choices A and B. The repairs for the wounds on the arm and leg are
intermediate closures. According to CPT® subsection guidelines for Repair (Closure), single-layer closure
of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter
also constitutes intermediate repair. This eliminates multiple choice C. To report multiple wounds that
are repaired in the same classification and from the anatomic sites that are grouped together into the
same code descriptor, add together the length of the wounds. The subsection guidelines also indicates
when more than one classification of wounds is repaired, append modifier 59 to the least complicated
repair(s).
,A 55-year-old male presents in the office with an ingrown toenail on the right and left foot. The
procedure was discussed in detail and the patient elected to have it performed. The right foot was
prepped and draped in sterile fashion. The right great toe was anesthetized with 50/50 solution of 2
percent lidocaine and .05 percent Marcaine. A mini-tourniquet was placed around the toe for
hemostasis in which part of the nail plate and maxtrixectomy were performed. Phenol was then applied,
the toe was then flushed. Tourniquet was released and dressing applied. At this time the patient elected
to only have one performed and will return in two weeks for the left foot. Code the procedure.
A. 11765-T5
B. 11750-T5
C. 11752-T5
D. 11740-T5 - Answer-B. 11750-T5
This patient is coming in to have an in-grown toe nail removed, eliminating multiple choice answer D
(Evacuation of Subungual Hematoma), which is evacuating blood from under the nail. You are now left
with choices A, B, and C that involves the removal of an ingrown toenail. Code 11752 is not correct. The
scenario does not mention an amputation. The clue to help you narrow down between the codes 11765
and 11750 is that there is a partial removal of the nail and nail matrix (matrixectomy).
Procedure Diagnosis: Basal cell carcinoma, left chin. Procedure:Wide local excision of 3.0 cm with 0.3 cm
margin basal cell carcinoma of the left chin with a 4 cm closure. Procedure: The patient's left chin was
examined. The site of intended excision was marked out. The site was then prepped. The patient was
then prepped and draped in the usual fashion. A 15 blade scalpel was then used to make an incision in
the previously marked site. It was carried down to the subcuticular fat. The lesion was then sharply
dissected off underlying tissue bed using a 15-blade scalpel. It was tagged for pathologic orientation. The
hyfrecator was used for hemostasis. The wound was then closed by advancing the tissue surrounding
the lesion and closing in layers with 3-0 Vicryl for the deep layer, followed by 5-0 Prolene for the skin.
The skin closure was in a running subcuticular fashion. Steri-Strips were then applied. What are the pro -
Answer-A. 11644, 12052-51, 173.31
You need to first find out if this lesion is benign or malignant. For this scenario the patient has a basal
cell carcinoma. This falls under malignant lesion, which eliminates multiple choice codes C and D as they
deal with benign lesions. Now you need to find out where the lesion is located and the size of the
removal. The malignant lesion is on the chin (face) and the size is 3.0 cm + .3 cm + .3 cm = 3.6 cm,
leading you to code 11644. CPT® subsection guidelines for Excision-Malignant Lesions state: For excision
of malignant lesion(s) requiring intermediate or complex closures should be reported separately. For this
, scenario the wound was closed in two layers qualifying the closure to be coded with an intermediate
repair of the chin (4 cm), 12052. The diagnosis, basal cell carcinoma of the chin, is indexed in the ICD-9-
CM codebook in the Neoplasm Table, under Skin/face NEC/basal cell carcinoma.
The physician removes a tumor from the patient's neck using the Mohs micrographic surgery technique.
During the first stage, the physician takes four tissue blocks and reviews them under a microscope. The
exam of the tissue blocks reveals a second stage is necessary to remove areas where the tumor is still
present. The physician removes two additional tissue blocks. What are the appropriate CPT® codes for
reporting the procedure?
A. 17311, 17312, 17315
B. 17313, 17315
C. 17313, 17314, 17315
D. 17311, 17312 - Answer-D. 17311, 17312
For narrowing down to the correct procedure code for the Mohs micrographic surgery, you should find
out where on the body the tumor was removed. For this scenario, it is the neck; eliminating multiple
choice codes B and C, which involve the trunk, arms or legs. The tissue block removals were performed
in two stages, coding 17311 and 17312. Code 17315 is not coded for this scenario, because the physician
would have to remove more than five tissue blocks in any stage. There were only four tissue blocks
removed in the first stage and two tissue blocks removed in the second stage, both falling short of six or
more tissue blocks removed in either stage.
This 45-year-old male presents to the operating room with a painful mass of the right upper arm.
General anesthesia was induced. Soft tissue dissection was carried down thru the proximal aspect of the
teres minor muscle. Upon further dissection a large mass was noted just distal of the IGHL(inferior
glenohumeral ligament), which appeared to be benign in nature. With blunt dissection and
electrocautery, the 4.5 cm mass was removed en bloc and sent to pathology. The wound was irrigated,
and repair of the teres minor with subcutaneous tissue was then closed with triple-0 Vicryl. Skin was
closed with double-0 Prolene in a subcuticular fashion. What is the correct CPT® code for this service?
A. 23076
B. 23066
C. 23075
D. 23077 - Answer-A. 23076
7-year-old riding his bike struck a tree stump throwing him off his bike. He received multiple lacerations.
He had a 3 cm dermis laceration on his scalp with two 0.5 cm lacerations on his face. His right arm had a
5 cm laceration and right leg has a 5cm laceration. The physician stapled the laceration for the scalp.
Physician used steri-strips (adhesive strips) to close the wounds on the face. The legs and arms were
cleaned by heavily irrigating them with normal saline and removal of embedded debris performed on
both wounds, followed with a single-layer closure. Select the repair codes to report.
A. 12032, 12032-59, 12011-59, 12002-59
B. 12002, 12002-59, 12011-59, 12002-59
C. 12005, 11042-59
D. 12034, 12002-59 - Answer-D. 12034, 12002-59
The two face lacerations were closed with steri-strips (adhesive strips). When adhesive strips are the
only repair material used to close an open wound a repair code is not reported. According to CPT®
subsection guidelines for Repair (Closure), when wound closure uses adhesive strips as the only repair
material it should be coded using the appropriate E/M service. Code 12011 is inappropriate to report for
this scenario, eliminating multiple choices A and B. The repairs for the wounds on the arm and leg are
intermediate closures. According to CPT® subsection guidelines for Repair (Closure), single-layer closure
of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter
also constitutes intermediate repair. This eliminates multiple choice C. To report multiple wounds that
are repaired in the same classification and from the anatomic sites that are grouped together into the
same code descriptor, add together the length of the wounds. The subsection guidelines also indicates
when more than one classification of wounds is repaired, append modifier 59 to the least complicated
repair(s).
,A 55-year-old male presents in the office with an ingrown toenail on the right and left foot. The
procedure was discussed in detail and the patient elected to have it performed. The right foot was
prepped and draped in sterile fashion. The right great toe was anesthetized with 50/50 solution of 2
percent lidocaine and .05 percent Marcaine. A mini-tourniquet was placed around the toe for
hemostasis in which part of the nail plate and maxtrixectomy were performed. Phenol was then applied,
the toe was then flushed. Tourniquet was released and dressing applied. At this time the patient elected
to only have one performed and will return in two weeks for the left foot. Code the procedure.
A. 11765-T5
B. 11750-T5
C. 11752-T5
D. 11740-T5 - Answer-B. 11750-T5
This patient is coming in to have an in-grown toe nail removed, eliminating multiple choice answer D
(Evacuation of Subungual Hematoma), which is evacuating blood from under the nail. You are now left
with choices A, B, and C that involves the removal of an ingrown toenail. Code 11752 is not correct. The
scenario does not mention an amputation. The clue to help you narrow down between the codes 11765
and 11750 is that there is a partial removal of the nail and nail matrix (matrixectomy).
Procedure Diagnosis: Basal cell carcinoma, left chin. Procedure:Wide local excision of 3.0 cm with 0.3 cm
margin basal cell carcinoma of the left chin with a 4 cm closure. Procedure: The patient's left chin was
examined. The site of intended excision was marked out. The site was then prepped. The patient was
then prepped and draped in the usual fashion. A 15 blade scalpel was then used to make an incision in
the previously marked site. It was carried down to the subcuticular fat. The lesion was then sharply
dissected off underlying tissue bed using a 15-blade scalpel. It was tagged for pathologic orientation. The
hyfrecator was used for hemostasis. The wound was then closed by advancing the tissue surrounding
the lesion and closing in layers with 3-0 Vicryl for the deep layer, followed by 5-0 Prolene for the skin.
The skin closure was in a running subcuticular fashion. Steri-Strips were then applied. What are the pro -
Answer-A. 11644, 12052-51, 173.31
You need to first find out if this lesion is benign or malignant. For this scenario the patient has a basal
cell carcinoma. This falls under malignant lesion, which eliminates multiple choice codes C and D as they
deal with benign lesions. Now you need to find out where the lesion is located and the size of the
removal. The malignant lesion is on the chin (face) and the size is 3.0 cm + .3 cm + .3 cm = 3.6 cm,
leading you to code 11644. CPT® subsection guidelines for Excision-Malignant Lesions state: For excision
of malignant lesion(s) requiring intermediate or complex closures should be reported separately. For this
, scenario the wound was closed in two layers qualifying the closure to be coded with an intermediate
repair of the chin (4 cm), 12052. The diagnosis, basal cell carcinoma of the chin, is indexed in the ICD-9-
CM codebook in the Neoplasm Table, under Skin/face NEC/basal cell carcinoma.
The physician removes a tumor from the patient's neck using the Mohs micrographic surgery technique.
During the first stage, the physician takes four tissue blocks and reviews them under a microscope. The
exam of the tissue blocks reveals a second stage is necessary to remove areas where the tumor is still
present. The physician removes two additional tissue blocks. What are the appropriate CPT® codes for
reporting the procedure?
A. 17311, 17312, 17315
B. 17313, 17315
C. 17313, 17314, 17315
D. 17311, 17312 - Answer-D. 17311, 17312
For narrowing down to the correct procedure code for the Mohs micrographic surgery, you should find
out where on the body the tumor was removed. For this scenario, it is the neck; eliminating multiple
choice codes B and C, which involve the trunk, arms or legs. The tissue block removals were performed
in two stages, coding 17311 and 17312. Code 17315 is not coded for this scenario, because the physician
would have to remove more than five tissue blocks in any stage. There were only four tissue blocks
removed in the first stage and two tissue blocks removed in the second stage, both falling short of six or
more tissue blocks removed in either stage.
This 45-year-old male presents to the operating room with a painful mass of the right upper arm.
General anesthesia was induced. Soft tissue dissection was carried down thru the proximal aspect of the
teres minor muscle. Upon further dissection a large mass was noted just distal of the IGHL(inferior
glenohumeral ligament), which appeared to be benign in nature. With blunt dissection and
electrocautery, the 4.5 cm mass was removed en bloc and sent to pathology. The wound was irrigated,
and repair of the teres minor with subcutaneous tissue was then closed with triple-0 Vicryl. Skin was
closed with double-0 Prolene in a subcuticular fashion. What is the correct CPT® code for this service?
A. 23076
B. 23066
C. 23075
D. 23077 - Answer-A. 23076
