AAPC CPC STUDY GUIDE MEDICAL CODING GUIDELINES
Questions with Correct Answers (Grade A+)
Question 1: Patient has basal cell carcinoma on his upper back. A map was prepared to correspond to
the area of skin where the excisions of the tumor will be performed using Mohs micrographic surgery
technique. There were three tissue blocks that were prepared for cryostat, sectioned, and removed in
the first stage. Then a second stage had six tissue blocks which were also cut and stained for
microscopic examination. The entire base and margins of the excised pieces of tissue were examined by
the surgeon. No tumor was identified after the final stage of the microscopically controlled surgery.
What procedure codes are reported?
A. 17313, 17314, 17314
B. 17313, 17315
C. 17260, 17313, 17314
D. 17313,17314, 17315
Answer: D. 17313,17314, 17315
Question 2: A 45-year-old male is in outpatient surgery to excise a basal cell carcinoma of the right nose
and have reconstruction with an advancement flap. The 1.2 cm lesion with an excised diameter of 1.5
cm was excised with a 15-blade scalpel down to the level of the subcutaneous tissue, totaling a primary
defect of 1.8 cm. Electrocautery was used for hemostasis. An adjacent tissue transfer of 3 sq cm was
taken from the nasolabial fold and was advanced into the primary defect. Which CPT® code(s) is (are)
reported?
A. 14060
B. 11642, 14060
C. 11642, 15115
D. 15574
Answer: A. 14060
Question 3: A 24-year-old patient had an abscess by her vulva which burst. She has developed a soft
tissue infection caused by gas gangrene. The area was debrided of necrotic infected tissue. All of the pus
was removed and irrigation was performed with a liter of saline until clear and clean. The infected area
was completely drained and the wound was packed gently with sterile saline moistened gauze and pads
were placed on top of this. The correct CPT® code is:
A. 56405
B. 10061
C. 11004
D. 11042
Answer: C. 11004
Page 1
,Question 4: A 76-year-old female had a recent mammographic and ultrasound abnormality in the 6
o'clock position of the left breast. She underwent core biopsies which showed the presence of a
papilloma. The plan now is for needle localization with excisional biopsy to rule out occult malignancy.
After undergoing preoperative needle localization with hookwire needle injection with methylene blue,
the patient was brought to the operating room and was placed on the operating room table in the
supine position where she underwent laryngeal mask airway (LMA) anesthesia. The left breast was
prepped and draped in a sterile fashion. A radial incision was then made in the 6 o'clock position of the
left breast corresponding to the tip of the needle localizing wire. Using blunt and sharp dissection, we
performed a generous excisional biopsy around the needle localizing wire including all of the methylene
blue-stained tissues. The specimen wa
Answer: D. 19125, D24.2
Question 5: The patient is a 66-year-old female who presents with Dupuytren's disease in the right palm
and ring finger. This results in a contracture of the ring digit MP joint. She is having a subtotal palmar
fasciectomy for Dupuytren's disease right ring digit and palm. An extensile Brunner incision was then
made beginning in the proximal palm and extending to the ring finger PIP crease. This exposed a large
pretendinous cord arising from the palmar fascia extending distally over the flexor tendons of the ring
finger. The fascial attachments to the flexor tendon sheath were released. At the level of the
metacarpophalangeal crease, one band arose from the central pretendinous cord-one coursing toward
the middle finger. The digital nerve was identified, and this diseased fascia was also excised. What
procedure code(s) is (are) used?
A. 26123-RT, 26125-F7
B. 26121-RT
C. 26035-RT
D. 26040-RT
Answer: A. 26123-RT, 26125-F7
Question 6: This is a 32-year-old female who presents today with sacroilitis. On the physical exam there
was pain on palpation of the left and right sacroiliac joint and fluoroscopic guidance was done for the
needle positioning. Then 80 mg of Depo-Medrol and 1 mL of bupivacaine at 0.5% was injected into the
left and right sacroiliac joint with a 22 gauge needle. The patient was able to walk from the exam room
without difficulty. Follow up will be as needed. The correct CPT® code(s) is (are):
A. 20611
B. 27096-50, 77012
C. 27096-50
D. 27096, 27096-51, 77012
Answer: C. 27096-50
Page 2
, Question 7: PREOPERATIVE DIAGNOSIS: Medial meniscus tear, right knee POSTOPERATIVE
DIAGNOSIS: Medial meniscus tear, extensive synovitis with an impingement medial synovial plica,
right knee TITLE OF PROCEDURE: Diagnostic operative arthroscopy, partial medial meniscectomy
and synovectomy, right knee The patent was brought to the operating room, placed in the supine
position after which he underwent general anesthesia. The right knee was then prepped and draped in
the usual sterile fashion. The arthroscope was introduced through an anterolateral portal, interim
portal created anteromedially. The suprapatellar pouch was inspected. The findings on the patella and
the femoral groove were as noted above. An intra-articular shaver was introduced to debride the loose
fibrillated articular cartilage from the medial patellar facet. The hypertrophic synovial scarring
between the patella and the femoral groove was debrided. The hypertrophic
Answer:
1. C. 29881-RT
2. M23.221
3. M65.861
4. M94.261
5. M22.41
Question 8: A 61-year-old gentleman with a history of a fall while intoxicated suffered a blow to the
forehead and imaging revealed a posteriorly displaced odontoid fracture. The patient was taken into
the Operating Room, and placed supine on the operating room table. Under mild sedation, the patient
was placed in Gardner-Wells tongs and gentle axial traction under fluoroscopy was performed to
gently try to reduce the fracture. It did reduce partially without any change in the neurologic
examination. More manipulation would be necessary and it was decided to intubate and use fiberoptic
technique. The anterior neck was prepped and draped and an incision was made in a skin crease
overlying the C4-C5 area. Using hand-held retractors, the ventral aspect of the spine was identified and
the C2-C3 disk space was identified using lateral fluoroscopy. Using some pressure upon the ventral
aspect of the C2 body, we were able to achieve a s
Answer: D. 22318
Question 9: The patient is a 51-year-old gentleman who has end-stage renal disease. He was in the OR
yesterday for a revision of his AV graft. The next day the patient had complications of the graft failing.
The patient was back to the operating room where an open thrombectomy was performed on both sides
getting good back bleeding, good inflow. Select the appropriate code for performing the procedure in a
post-operative period:
A. 36831-76
B. 36831
C. 36831-78
D. 36831-58
Answer: C. 36831-78
Question 10: The patient is a 77-year-old white female who has been having right temporal pain and
headaches with some visual changes and has a sed rate of 51. She is scheduled for a temporal artery
biopsy to rule out temporal arteritis. A Doppler probe was used to isolate the temporal artery and using
a marking pen the path of the artery was drawn. Lidocaine 1% was used to infiltrate the skin, and
Page 3
Questions with Correct Answers (Grade A+)
Question 1: Patient has basal cell carcinoma on his upper back. A map was prepared to correspond to
the area of skin where the excisions of the tumor will be performed using Mohs micrographic surgery
technique. There were three tissue blocks that were prepared for cryostat, sectioned, and removed in
the first stage. Then a second stage had six tissue blocks which were also cut and stained for
microscopic examination. The entire base and margins of the excised pieces of tissue were examined by
the surgeon. No tumor was identified after the final stage of the microscopically controlled surgery.
What procedure codes are reported?
A. 17313, 17314, 17314
B. 17313, 17315
C. 17260, 17313, 17314
D. 17313,17314, 17315
Answer: D. 17313,17314, 17315
Question 2: A 45-year-old male is in outpatient surgery to excise a basal cell carcinoma of the right nose
and have reconstruction with an advancement flap. The 1.2 cm lesion with an excised diameter of 1.5
cm was excised with a 15-blade scalpel down to the level of the subcutaneous tissue, totaling a primary
defect of 1.8 cm. Electrocautery was used for hemostasis. An adjacent tissue transfer of 3 sq cm was
taken from the nasolabial fold and was advanced into the primary defect. Which CPT® code(s) is (are)
reported?
A. 14060
B. 11642, 14060
C. 11642, 15115
D. 15574
Answer: A. 14060
Question 3: A 24-year-old patient had an abscess by her vulva which burst. She has developed a soft
tissue infection caused by gas gangrene. The area was debrided of necrotic infected tissue. All of the pus
was removed and irrigation was performed with a liter of saline until clear and clean. The infected area
was completely drained and the wound was packed gently with sterile saline moistened gauze and pads
were placed on top of this. The correct CPT® code is:
A. 56405
B. 10061
C. 11004
D. 11042
Answer: C. 11004
Page 1
,Question 4: A 76-year-old female had a recent mammographic and ultrasound abnormality in the 6
o'clock position of the left breast. She underwent core biopsies which showed the presence of a
papilloma. The plan now is for needle localization with excisional biopsy to rule out occult malignancy.
After undergoing preoperative needle localization with hookwire needle injection with methylene blue,
the patient was brought to the operating room and was placed on the operating room table in the
supine position where she underwent laryngeal mask airway (LMA) anesthesia. The left breast was
prepped and draped in a sterile fashion. A radial incision was then made in the 6 o'clock position of the
left breast corresponding to the tip of the needle localizing wire. Using blunt and sharp dissection, we
performed a generous excisional biopsy around the needle localizing wire including all of the methylene
blue-stained tissues. The specimen wa
Answer: D. 19125, D24.2
Question 5: The patient is a 66-year-old female who presents with Dupuytren's disease in the right palm
and ring finger. This results in a contracture of the ring digit MP joint. She is having a subtotal palmar
fasciectomy for Dupuytren's disease right ring digit and palm. An extensile Brunner incision was then
made beginning in the proximal palm and extending to the ring finger PIP crease. This exposed a large
pretendinous cord arising from the palmar fascia extending distally over the flexor tendons of the ring
finger. The fascial attachments to the flexor tendon sheath were released. At the level of the
metacarpophalangeal crease, one band arose from the central pretendinous cord-one coursing toward
the middle finger. The digital nerve was identified, and this diseased fascia was also excised. What
procedure code(s) is (are) used?
A. 26123-RT, 26125-F7
B. 26121-RT
C. 26035-RT
D. 26040-RT
Answer: A. 26123-RT, 26125-F7
Question 6: This is a 32-year-old female who presents today with sacroilitis. On the physical exam there
was pain on palpation of the left and right sacroiliac joint and fluoroscopic guidance was done for the
needle positioning. Then 80 mg of Depo-Medrol and 1 mL of bupivacaine at 0.5% was injected into the
left and right sacroiliac joint with a 22 gauge needle. The patient was able to walk from the exam room
without difficulty. Follow up will be as needed. The correct CPT® code(s) is (are):
A. 20611
B. 27096-50, 77012
C. 27096-50
D. 27096, 27096-51, 77012
Answer: C. 27096-50
Page 2
, Question 7: PREOPERATIVE DIAGNOSIS: Medial meniscus tear, right knee POSTOPERATIVE
DIAGNOSIS: Medial meniscus tear, extensive synovitis with an impingement medial synovial plica,
right knee TITLE OF PROCEDURE: Diagnostic operative arthroscopy, partial medial meniscectomy
and synovectomy, right knee The patent was brought to the operating room, placed in the supine
position after which he underwent general anesthesia. The right knee was then prepped and draped in
the usual sterile fashion. The arthroscope was introduced through an anterolateral portal, interim
portal created anteromedially. The suprapatellar pouch was inspected. The findings on the patella and
the femoral groove were as noted above. An intra-articular shaver was introduced to debride the loose
fibrillated articular cartilage from the medial patellar facet. The hypertrophic synovial scarring
between the patella and the femoral groove was debrided. The hypertrophic
Answer:
1. C. 29881-RT
2. M23.221
3. M65.861
4. M94.261
5. M22.41
Question 8: A 61-year-old gentleman with a history of a fall while intoxicated suffered a blow to the
forehead and imaging revealed a posteriorly displaced odontoid fracture. The patient was taken into
the Operating Room, and placed supine on the operating room table. Under mild sedation, the patient
was placed in Gardner-Wells tongs and gentle axial traction under fluoroscopy was performed to
gently try to reduce the fracture. It did reduce partially without any change in the neurologic
examination. More manipulation would be necessary and it was decided to intubate and use fiberoptic
technique. The anterior neck was prepped and draped and an incision was made in a skin crease
overlying the C4-C5 area. Using hand-held retractors, the ventral aspect of the spine was identified and
the C2-C3 disk space was identified using lateral fluoroscopy. Using some pressure upon the ventral
aspect of the C2 body, we were able to achieve a s
Answer: D. 22318
Question 9: The patient is a 51-year-old gentleman who has end-stage renal disease. He was in the OR
yesterday for a revision of his AV graft. The next day the patient had complications of the graft failing.
The patient was back to the operating room where an open thrombectomy was performed on both sides
getting good back bleeding, good inflow. Select the appropriate code for performing the procedure in a
post-operative period:
A. 36831-76
B. 36831
C. 36831-78
D. 36831-58
Answer: C. 36831-78
Question 10: The patient is a 77-year-old white female who has been having right temporal pain and
headaches with some visual changes and has a sed rate of 51. She is scheduled for a temporal artery
biopsy to rule out temporal arteritis. A Doppler probe was used to isolate the temporal artery and using
a marking pen the path of the artery was drawn. Lidocaine 1% was used to infiltrate the skin, and
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