NPMA CPPS Certification | Verified Questions
& Correct Answers | Latest A+ Grade
2025/2026
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 full excision of an 8 cm lesion. Layered closure was performed after the
removal. The specimen was sent for permanent histopathologic examination. What are the
CPT® code(s) for this procedure?
A. 11626
B. 11626, 12004-51
C. 11626, 12044-51
D. 11626, 13132-51, 13133 - AnswerC. 11626, 12044-51
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?
A. 11043
B. 11012
C. 11044
D. 11042 - AnswerC. 11044
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
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,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.
A. 99283-25, 12014, 12034-59, 12002-59, 11042-51
B. 99283-25, 12053, 12034-59, 12002-59
C. 99283-25, 12014, 12034-59, 11042-51
D. 99283-25, 12053, 12034-59 - AnswerD. 99283-25, 12053, 12034-59
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?
A. 21932, D17.39
B. 21935, D17.1
C. 21931, D17.1
D. 21925, D17.9 - AnswerC. 21931, D17.1
Question 5
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 having 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 t - AnswerA. 25628-RT
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,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 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?
A. 27470-50
B. 27475-50
C. 27477-50
D. 27485-50 - AnswerD. 27485-50
The patient is a 67-year-old gentleman with metastatic colon cancer recently operated on for
a brain metastasis, now for placement of an Infuse-A-Port for continued chemotherapy. The
left subclavian vein was located with a needle and a guide wire placed. This was confirmed
to be in the proper position fluoroscopically. A transverse incision was made just inferior to
this and a subcutaneous pocket created just inferior to this. After tunneling, the introducer
was placed over the guide wire and the power port line was placed with the introducer and
the introducer was peeled away. The tip was placed in the appropriate position under
fluoroscopic guidance and the catheter trimmed to the appropriate length and secured to
the power port device. The locking mechanism was fully engaged. The port was placed in
the subcutaneous pocket and everything sat very nicely fluoroscopically. It was secured to
the underlying soft tissue - AnswerC. 36561, 77001-26
Question 8
A CT scan identified moderate-sized right pleural effusion in a 50 year-old male. This was
estimated to be 800 cc in size and had an appearance of fluid on the CT Scan. A needle is
used to puncture through the chest tissues and enter the pleural cavity to insert a guidewire
under ultrasound guidance. A pigtail catheter is then inserted at the length of the guidewire
and secured by stitches. The catheter will remain in the chest and is connected to drainage
system to drain the accumulated fluid. The CPT® code is:
A. 32557
B. 32555
C. 32556
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, D. 32550 - AnswerA. 32557
The patient is a 59-year-old white male who underwent carotid endarterectomy for
symptomatic left carotid stenosis a year ago. A carotid CT angiogram showed a recurrent
90% left internal carotid artery stenosis extending into the common carotid artery. He is
taken to the operating room for re-do left carotid endarterectomy. The left neck was
prepped and the previous incision was carefully reopened. Using sharp dissection, the
common carotid artery and its branches were dissected free. The patient was systematically
heparinized and after a few minutes, clamps were applied to the common carotid artery and
its branches. A longitudinal arteriotomy was carried out with findings of extensive layering of
intimal hyperplasia with no evidence of recurrent atherosclerosis. A silastic balloon-tip shunt
was inserted first proximally and then distally, with restoration of flow. Several layers of
intima were removed and the endart - AnswerB. 35301, 35390
A 52-year-old patient is admitted to the hospital for chronic cholecystitis for which a
laparoscopic cholecystectomy will be performed. A transverse infraumbilical incision was
made sharply dissecting to the subcutaneous tissue down to the fascia using access under
direct vision with a Vesi-Port and a scope was placed into the abdomen. Three other ports
were inserted under direct vision. The fundus of the gallbladder was grasped through the
lateral port, where multiple adhesions to the gallbladder were taken down sharply and
bluntly: The gallbladder appeared chronically inflamed. Dissection was carried out to the
right of this identifying a small cystic duct and artery, was clipped twice proximally, once
distally and transected. The gallbladder was then taken down from the bed using
electrocautery, delivering it into an endo-bag and removing it from the abdominal cavity
with the umbilical port. What CPT® and ICD-10-C - AnswerB. 47562, K81.1
A 70-year-old female who has a history of symptomatic ventral hernia was advised to
undergo laparoscopic evaluation and repair. An incision was made in the epigastrium and
dissection was carried down through the subcutaneous tissue. Two 5-mm trocars were
placed, one in the left upper quadrant and one in the left lower quadrant and the
laparoscope was inserted. Dissection was carried down to the area of the hernia where a
small defect was clearly visualized. There was some omentum, which was adhered to the
hernia and this was delivered back into the peritoneal cavity. The mesh was tacked on to
cover the defect. What procedure code(s) is (are) reported?
A. 49560, 49568
B. 49652
C. 49653
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& Correct Answers | Latest A+ Grade
2025/2026
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 full excision of an 8 cm lesion. Layered closure was performed after the
removal. The specimen was sent for permanent histopathologic examination. What are the
CPT® code(s) for this procedure?
A. 11626
B. 11626, 12004-51
C. 11626, 12044-51
D. 11626, 13132-51, 13133 - AnswerC. 11626, 12044-51
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?
A. 11043
B. 11012
C. 11044
D. 11042 - AnswerC. 11044
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
mailto:https://www.stuvia.com/en-us/user/stuviaguider?page=3&vakfilter=
,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.
A. 99283-25, 12014, 12034-59, 12002-59, 11042-51
B. 99283-25, 12053, 12034-59, 12002-59
C. 99283-25, 12014, 12034-59, 11042-51
D. 99283-25, 12053, 12034-59 - AnswerD. 99283-25, 12053, 12034-59
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?
A. 21932, D17.39
B. 21935, D17.1
C. 21931, D17.1
D. 21925, D17.9 - AnswerC. 21931, D17.1
Question 5
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 having 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 t - AnswerA. 25628-RT
mailto:https://www.stuvia.com/en-us/user/stuviaguider?page=3&vakfilter=
,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 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?
A. 27470-50
B. 27475-50
C. 27477-50
D. 27485-50 - AnswerD. 27485-50
The patient is a 67-year-old gentleman with metastatic colon cancer recently operated on for
a brain metastasis, now for placement of an Infuse-A-Port for continued chemotherapy. The
left subclavian vein was located with a needle and a guide wire placed. This was confirmed
to be in the proper position fluoroscopically. A transverse incision was made just inferior to
this and a subcutaneous pocket created just inferior to this. After tunneling, the introducer
was placed over the guide wire and the power port line was placed with the introducer and
the introducer was peeled away. The tip was placed in the appropriate position under
fluoroscopic guidance and the catheter trimmed to the appropriate length and secured to
the power port device. The locking mechanism was fully engaged. The port was placed in
the subcutaneous pocket and everything sat very nicely fluoroscopically. It was secured to
the underlying soft tissue - AnswerC. 36561, 77001-26
Question 8
A CT scan identified moderate-sized right pleural effusion in a 50 year-old male. This was
estimated to be 800 cc in size and had an appearance of fluid on the CT Scan. A needle is
used to puncture through the chest tissues and enter the pleural cavity to insert a guidewire
under ultrasound guidance. A pigtail catheter is then inserted at the length of the guidewire
and secured by stitches. The catheter will remain in the chest and is connected to drainage
system to drain the accumulated fluid. The CPT® code is:
A. 32557
B. 32555
C. 32556
mailto:https://www.stuvia.com/en-us/user/stuviaguider?page=3&vakfilter=
, D. 32550 - AnswerA. 32557
The patient is a 59-year-old white male who underwent carotid endarterectomy for
symptomatic left carotid stenosis a year ago. A carotid CT angiogram showed a recurrent
90% left internal carotid artery stenosis extending into the common carotid artery. He is
taken to the operating room for re-do left carotid endarterectomy. The left neck was
prepped and the previous incision was carefully reopened. Using sharp dissection, the
common carotid artery and its branches were dissected free. The patient was systematically
heparinized and after a few minutes, clamps were applied to the common carotid artery and
its branches. A longitudinal arteriotomy was carried out with findings of extensive layering of
intimal hyperplasia with no evidence of recurrent atherosclerosis. A silastic balloon-tip shunt
was inserted first proximally and then distally, with restoration of flow. Several layers of
intima were removed and the endart - AnswerB. 35301, 35390
A 52-year-old patient is admitted to the hospital for chronic cholecystitis for which a
laparoscopic cholecystectomy will be performed. A transverse infraumbilical incision was
made sharply dissecting to the subcutaneous tissue down to the fascia using access under
direct vision with a Vesi-Port and a scope was placed into the abdomen. Three other ports
were inserted under direct vision. The fundus of the gallbladder was grasped through the
lateral port, where multiple adhesions to the gallbladder were taken down sharply and
bluntly: The gallbladder appeared chronically inflamed. Dissection was carried out to the
right of this identifying a small cystic duct and artery, was clipped twice proximally, once
distally and transected. The gallbladder was then taken down from the bed using
electrocautery, delivering it into an endo-bag and removing it from the abdominal cavity
with the umbilical port. What CPT® and ICD-10-C - AnswerB. 47562, K81.1
A 70-year-old female who has a history of symptomatic ventral hernia was advised to
undergo laparoscopic evaluation and repair. An incision was made in the epigastrium and
dissection was carried down through the subcutaneous tissue. Two 5-mm trocars were
placed, one in the left upper quadrant and one in the left lower quadrant and the
laparoscope was inserted. Dissection was carried down to the area of the hernia where a
small defect was clearly visualized. There was some omentum, which was adhered to the
hernia and this was delivered back into the peritoneal cavity. The mesh was tacked on to
cover the defect. What procedure code(s) is (are) reported?
A. 49560, 49568
B. 49652
C. 49653
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