AAPC CPC EXAMS PRACTICE A FINAL PAPER Questions with
Correct Answers (Grade A+)
Question 1: 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.
Answer: C. 21931, D17.1
Question 2: 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.
Answer: A. 25628-RT
Question 3: 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.
Answer: D. 27485-50
Page 1
,Question 4: 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.
Answer: C. 36561, 77001-26
Question 5: 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
D. 32550.
Answer: A. 32557
Question 6: 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.
Answer: B. 35301, 35390
Page 2
,Question 7: 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.
Answer: B. 47562, K81.1
Question 8: 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
D. 49652, 49568.
Answer: B. 49652
Question 9: The patient is a 50-year-old gentleman who presented to the emergency room with signs
and symptoms of acute appendicitis with possible rupture. He has been brought to the operating room.
An infraumbilical incision was made which a 5-mm VersaStep™ trocar was inserted. A 5-mm 0- degree
laparoscope was introduced. A second 5-mm trocar was placed suprapubically and a 12-mm trocar in
the left lower quadrant. A window was made in the mesoappendix using blunt dissection with no
rupture noted. The base of the appendix was then divided and placed into an Endo- catch bag and the
12-mm defect was brought out. Select the appropriate code for this procedure:
A. 44970
B. 44950
C. 44960
D. 44979.
Answer: A. 44970
Page 3
, Question 10: A 45-year-old male is going to donate his kidney to his son. Operating ports where placed
in standard position and the scope was inserted. Dissection of the renal artery and vein was performed
isolating the kidney. The kidney was suspended only by the renal artery and vein as well as the ureter.
A stapler was used to divide the vein just above the aorta and three clips across the ureter, extracting
the kidney. This was placed on ice and sent to the recipient room. The correct CPT® code is:
A. 50543
B. 50547
C. 50300
D. 50320.
Answer: B. 50547
Question 11: A 67-year-old female having urinary incontinence with intrinsic sphincter deficiency is
having a cystoscopy performed with a placement of a sling. An incision was made over the mid urethra
dissected laterally to urethropelvic ligament. Cystoscopy revealed no penetration of the bladder. The
edges of the sling were weaved around the junction of the urethra and brought up to the suprapubic
incision. A hemostat was then placed between the sling and the urethra, ensuring no tension. What
CPT® code(s) is (are) reported?
A. 57288
B. 57287
C. 57288, 52000-51
D. 51992, 52000-51.
Answer: A. 57288
Question 12: A 16-day-old male baby is in the OR for a repeat circumcision due to redundant foreskin
that caused circumferential scarring from the original circumcision. Anesthetic was injected and an
incision was made at base of the foreskin. Foreskin was pulled back and the excess foreskin was taken
off and the two raw skin surfaces were sutured together to create a circumferential anastomosis. Select
the appropriate code for this surgery:
A. 54150
B. 54160
C. 54163
D. 54164.
Answer: C. 54163
Page 4
Correct Answers (Grade A+)
Question 1: 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.
Answer: C. 21931, D17.1
Question 2: 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.
Answer: A. 25628-RT
Question 3: 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.
Answer: D. 27485-50
Page 1
,Question 4: 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.
Answer: C. 36561, 77001-26
Question 5: 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
D. 32550.
Answer: A. 32557
Question 6: 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.
Answer: B. 35301, 35390
Page 2
,Question 7: 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.
Answer: B. 47562, K81.1
Question 8: 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
D. 49652, 49568.
Answer: B. 49652
Question 9: The patient is a 50-year-old gentleman who presented to the emergency room with signs
and symptoms of acute appendicitis with possible rupture. He has been brought to the operating room.
An infraumbilical incision was made which a 5-mm VersaStep™ trocar was inserted. A 5-mm 0- degree
laparoscope was introduced. A second 5-mm trocar was placed suprapubically and a 12-mm trocar in
the left lower quadrant. A window was made in the mesoappendix using blunt dissection with no
rupture noted. The base of the appendix was then divided and placed into an Endo- catch bag and the
12-mm defect was brought out. Select the appropriate code for this procedure:
A. 44970
B. 44950
C. 44960
D. 44979.
Answer: A. 44970
Page 3
, Question 10: A 45-year-old male is going to donate his kidney to his son. Operating ports where placed
in standard position and the scope was inserted. Dissection of the renal artery and vein was performed
isolating the kidney. The kidney was suspended only by the renal artery and vein as well as the ureter.
A stapler was used to divide the vein just above the aorta and three clips across the ureter, extracting
the kidney. This was placed on ice and sent to the recipient room. The correct CPT® code is:
A. 50543
B. 50547
C. 50300
D. 50320.
Answer: B. 50547
Question 11: A 67-year-old female having urinary incontinence with intrinsic sphincter deficiency is
having a cystoscopy performed with a placement of a sling. An incision was made over the mid urethra
dissected laterally to urethropelvic ligament. Cystoscopy revealed no penetration of the bladder. The
edges of the sling were weaved around the junction of the urethra and brought up to the suprapubic
incision. A hemostat was then placed between the sling and the urethra, ensuring no tension. What
CPT® code(s) is (are) reported?
A. 57288
B. 57287
C. 57288, 52000-51
D. 51992, 52000-51.
Answer: A. 57288
Question 12: A 16-day-old male baby is in the OR for a repeat circumcision due to redundant foreskin
that caused circumferential scarring from the original circumcision. Anesthetic was injected and an
incision was made at base of the foreskin. Foreskin was pulled back and the excess foreskin was taken
off and the two raw skin surfaces were sutured together to create a circumferential anastomosis. Select
the appropriate code for this surgery:
A. 54150
B. 54160
C. 54163
D. 54164.
Answer: C. 54163
Page 4
