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COC – Certified Outpatient Coder | Final Exam Practice (100 Questions) – CPT & ICD-10-CM Coding | Medical Billing – 2025/2026 | Surgery, Radiology, Pathology, ED Scenarios – For AHIMA/AAPC Exams

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This document is a complete and exam-focused preparation resource designed for candidates pursuing the Certified Outpatient Coder (COC) credential. It contains 100 high-yield practice questions with detailed answers, closely aligned with the structure and rigor of the 2025/2026 COC final exam. Each case scenario includes accurate CPT and ICD-10-CM codes, reflecting real-world outpatient coding practices across various clinical settings. Covered content includes coding for: Outpatient surgeries (e.g., hernia repair, skin grafts, endoscopy) Radiology and diagnostic imaging (MRI, Doppler studies, myelography) Pathology and laboratory testing (biopsies, cultures, genetic screening) Emergency department services and trauma scenarios Chemotherapy, pain management, and anesthesia services E/M coding, procedural modifiers, and outpatient reimbursement rules This resource is suitable for students and professionals in: Health Information Management (HIM) Medical Billing and Coding programs Outpatient Coding Certificate Courses Clinical Documentation Improvement (CDI) training Allied Health, Nursing, and Pre-Med Tracks with a focus on coding Whether you are enrolled in a degree or certificate program, this document is especially relevant for students from institutions like DeVry University, Southern New Hampshire University (SNHU), Pima Medical Institute, Penn Foster College, and others offering recognized medical coding education. It can also support independent learners preparing for certification through AAPC or AHIMA. Keywords: COC final exam, CPT coding questions, ICD-10-CM case studies, outpatient coding practice, medical billing and coding exam, radiology coding, emergency department coding, surgery coding, pathology CPT codes, outpatient facility coding, E/M coding scenarios, AHIMA exam prep, AAPC COC review, diagnostic coding, procedural coding

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2025/2026
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COC 2020 - FINAL EXAM STUDY
QUESTIONS (SET 3) 2025/2026 EXAM
QUESTIONS AND ANSWERS | 100%
PASS



A patient is diagnosed with pressure ulcers on each heel. Each heel

displays bone involvement with evidence of necrosis and is identified as

stage 4. Select the diagnosis code(s): - 🧠 ANSWER ✔✔L89.614,L89.624


A patient is given Xylocaine, a local anesthetic, by injection in the thigh

above the site to be biopsied. A small bore needle is then introduced into

the muscle, about 3 inches deep, and a muscle biopsy is taken. What CPT

code is reported for this service? - 🧠 ANSWER ✔✔20206


A patient is having a decompression of the nerve root involving two

segments of the lumbar spine via transpedicular approach. Report the

CPT® code(s). - 🧠 ANSWER ✔✔63056, 63057

,A patient is having phacoemulsification ofan age-related nuclear cataract of

the left eye. What ICD-10-CM code is reported? - 🧠 ANSWER ✔✔H25.12


A patient is having surgery to repair a recurrent left inguinal hernia without

obstruction. What ICD-10-CM code is reported? - 🧠 ANSWER ✔✔K40.91


A patient is in outpatient surgery for a laparoscopic oophorectomy for a

right ovarian cyst. After admission, the anesthesiologist discovered the

patient had an upper respiratory infection and the surgery was cancelled.

Applying the coding concept from ICD-10-CM guideline IV.A.I, what is the

appropriate ICD-10-CM code selection? - 🧠 ANSWER ✔✔N83.201, J06.9,

Z53.09

A patient is in the hospital for a hysterosalpingogram due to her infertility for

10 years. She has no history of pelvic infection or surgery. A 5-F

hysterosalpingogram catheter was used. The catheter balloon was inflated

in the lower uterine segment. Contrast was administered through the

catheter and multiple images were taken. Findings were possible right

cornual contour abnormality manifested by focal extravasation and minimal

intravasation of undetermined etiology. Recommend endovaginal

ultrasound for further evaluation. What are the CPT ® and ICD-10-CM

codes reported? - 🧠 ANSWER ✔✔58340, 74740, N97.9

,A patient is in the outpatient radiology department of the hospital for an

MRI of the brain to rule out stroke. His symptoms are slurred speech and

headache. The ventricles and sulci are seen within the brain. There is no

evidence of space-occupying lesion or intracranial hemorrhage. No

abnormal extra-axial cerebral fluid collections are identified. Diffusion

weighting imaging shows no abnormality. Impression is negative. What

CPT ® and ICD-10-CM codes are reported by the facility? - 🧠 ANSWER

✔✔70551, R47.81, R51


A patient is receiving pain management treatment for chronic cervical pain

caused by a motor vehicle accident. Report the ICD-10-CM code(s). - 🧠

ANSWER ✔✔G89.21, M54.2, V49.9XXA


A patient is referred to the hospital radiology clinic for numbness and

tingling in the arms. The radiologist performs a Doppler analog waveform

analysis, a volume plethysmography and a flow velocity signal of the

arteries of both arms. What procedure and diagnosis codes are reported for

the facility services? - 🧠 ANSWER ✔✔93922, R20.0, R20.2


A patient is respirator dependent and has a tracheostomy in need of

revision due to redundant scar tissue formation surrounding the site. Under

general anesthesia and establishing the airway to maintain ventilation, the

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, scar tissue is resected and then repair is accomplished using a layered

closure. What CPT ® and ICD-10-CM codes are reported? - 🧠 ANSWER

✔✔31830, L90.5, Z43.0, Z99.11


A patient is scheduled for closure of a cystostomy. The patient has a

personal history of bladder carcinoma. After removing the sutures that

secured the cystostomy tube to the skin and bladder, the surgeon removed

the cystostomy tube and sutured the bladder musculature to repair the

opening. The physician placed a drain tube, brought it out through a

separate stab incision in the skin, and performed a layered closure. What

CPT ® and ICD-10-CM codes are reported? - 🧠 ANSWER ✔✔51880,

Z43.5, Z85.51

A patient is seen in the outpatient clinic for pain and the physician gives a

series of 6 injections for the following muscles on the right side of the back:

the rhomboid (1), trapezius (3), and latissimus dorsi (2). Report the CPT®

code(s) for the trigger point injections. - 🧠 ANSWER ✔✔20553


A patient is seen in the emergency department to treat a second-degree

burn to his right arm (9 percent) and third-degree burns on his chest and

left arm (25 percent). Select the diagnosis codes. - 🧠 ANSWER

✔✔T21.31XA, T22.30XA, T22.20XA, T31.32

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