CPC PRACTICE EXAM 2 PRACTICE
TEST 2024/2025 LATEST UPDATE
QUESTIONS AND ANSWERS
PRE OP DIAGNOSIS: Left Breast Abnormal MMG or Palpable Mass; Other Disorders of Breast
PROCEDURE: Automated Stereotactic Biopsy Left Breast FINDINGS: Lesion is located in the lateral region,
just at or below the level of the nipple on the 90 degree lateral view. There is a subglandular implant in
place. I discussed the procedure with the patient today including risks, benefits and alternatives.
Specifically discussed was the fact that the implant would be displaced out of the way during this biopsy
procedure. Possibility of injury to the implant was discussed with the patient. Patient has signed the
consent form and wishes to proceed with the biopsy. The patient was placed prone on the stereotactic
table; the left breast was then imaged from the inferior approach. The lesion of interest is in the anterior
portion of the breast away from the implant which was displaced back toward the chest wall. After
imaging was obt - Correct answer.To start narrowing your choices was the biopsy performed
percutaneously or by an open incision? The operative note documents that a "SenoRx needle" was used
to obtain the biopsy, which is percutaneous. Because there was a biopsy and a placement of a
localization device (clip), you eliminate multiple choice B. Code 19283 is reported only for the placement
of the localization device. Stereotactic image was used to perform the needle biopsy and placement of
the clip. This eliminates multiple choice D, because code 19100 is for needle biopsy without imaging
guidance. Code 19081 is the only code reported for the operative note because its code description
reports both the biopsy and the placement of the clip under stereotactic imaging, eliminating multiple
choice C. Answer A
Question 2
53 year-old male is in the dermatologist's office for removal of 2 lesions located on his lower lip and
nose. Lesions were identified and marked. The lower lip lesion of 4mm in size was shaved to the level of
the superficial dermis. Utilizing a 3-mm punch, a biopsy was taken of the left supratip nasal area. What
are the CPT® codes for these procedures?
A. 11100, 11101
B. 11310, 11100-59
C. 17000, 17003
D. 11440, 11100-59 - Correct answer.The first procedure performed was the lesion on the lower lip
removed by the shaving technique. Reported with code 11310. The punch biopsy is performed on the
lesion located on the nose. Reported with code 11100. Modifier 59 indicates that the biopsy was totally
separate performed on another lesion, otherwise it is bundled with 11310. Answer B
,76 year-old has dermatochalasis on bilateral upper eyelids. A blepharoplasty will be performed on the
eyelids. A lower incision line was marked at approximately 5 mm above the lid margin along the crease.
Then using a pinch test with forceps the amount of skin to be resected was determined and marked. An
elliptical incision was performed on the left eyelid and the skin was excised. In a similar fashion the same
procedure was performed on the right eye. The wounds were closed with sutures. The correct CPT®
code(s) is/are?
A. 15822, 15823-51
B. 15823-50
C. 15822-50
D. 15820-LT, 15820-RT - Correct answer.Patient is having a blepharoplasty done on the upper eyelids,
eliminating multiple choice answer D. There is no indication in the scenario that excessive skin weighing
down the lid had to be excised, eliminating multiple choice answers A and B. Modifier 50 is appended to
indicate the procedure was performed on both eyelids. Answer C
42 year-old male has a frozen left shoulder. An arthroscope was inserted in the posterior portal in the
glenohumeral joint. The articular cartilage was normal except for some minimal grade III-IV changes,
about 5% of the humerus just adjacent to the rotator cuff insertion of the supraspinatus. The biceps was
inflamed, not torn at all. The superior labrum was not torn at all, the labrum was completely intact. The
rotator cuff was completely intact. An anterior portal was established high in the rotator interval. The
rotator interval was very thick and contracted. Adhesions were destroyed with electrocautery and the
Bovie. The superior glenohumeral ligament, the middle glenohumeral ligament and the tendinous
portion of the subscapularis were released. The arthroscope was placed anteriorly, adhesions were
destroyed and the shaver was used to debride some of the posterior capsule and the posterior capsule
was released in - Correct answer.To narrow down your choices decide if the procedure is an open
procedure or performed with an arthroscope? It was performed with an arthroscope, eliminating
multiple choice answers A and B. The diagnostic arthroscopy (29805) is a separate procedure, and
according to CPT® Surgery Guidelines: The codes designated as "separate procedure" should not be
reported in addition to the code for the total procedure or service of which it is considered an integral
component. Meaning code 29806 already includes the diagnostic arthroscopy code, so you only report
code 29806. Code 29806 represents suturing of the capsule (capsulorrhaphy); however, this was not the
procedure performed. The procedure performed was a lysis of adhesions for a frozen shoulder (29825)
noted in multiple choice answer D.
After adequate anesthesia was obtained the patient was turned prone in a kneeling position on the
spinal table. A lower midline lumbar incision was made and the soft tissues divided down to the spinous
processes. The soft tissues were stripped away from the lamina down to the facets and discectomies and
laminectomies were then carried out at L3-4, L4-5 and L5-S1. Interbody fusions were set up for the lower
three levels using the Danek allografts and augmented with structural autogenous bone from the iliac
crest. The posterior instrumentation of a 5.5 mm diameter titanium rod was then cut to the appropriate
length and bent to confirm to the normal lordotic curve. It was then slid immediately onto the bone
, screws and at each level compression was carried out as each of the two bolts were tightened so that
the interbody fusions would be snug and as tight as possible. Select the appropriate CPT® codes for this
visit?
A. - Correct answer.To start narrowing the correct arthrodesis code to report, you first need to
determine the surgical approach. The scenario tells us that the patient was placed in prone position
(lying face down) on the table and a lumbar incision was made indicating a posterior approach,
eliminating multiple choices B and D. The next bit of information to look for is the technique that was
used for the arthrodesis, which was the interbody fusion technique guiding you to code 22630. Answer C
PREOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna.
POSTOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna. OPERATIVE
PROCEDURE: Reduction with application of an external fixation system, left wrist fracture FINDINGS: The
patient is a 46 year-old right-hand-dominant female who fell off stairs 4 to 5 days ago sustaining an
impacted distal radius fracture with possible intraarticular component and an associated ulnar styloid
fracture. Today in surgery, fracture was reduced anatomically and an external fixation system was
applied. PROCEDURE: Under satisfactory general anesthesia, the fracture was manipulated and C-arm
images were checked. The left upper extremity was prepped and draped in the usual sterile orthopedic
fashion. Two small incisions were made over the second metacarpal and after removing soft tissues
including tendinous structures out of - Correct answer.In the body of the note after the Procedure
heading it states, "the fracture was manipulated", eliminating multiple choice answer A. Was the
fracture treatment opened or closed? There is no indication in the operative note that the patient was
surgically opened at the fracture site to treat it, eliminating multiple choice answer D. The key words to
choose the correct code between B and C are external fixation system and external fixator; where pins
are connected to bone and to an external fixator to help the fracture heal. The fixator was a uniplane
system as only one external fixator was applied in one plane (20690). Answer B
79 year-old male with symptomatic bradycardia and syncope is taken to the Operating Suite where an
insertion of a DDD pacemaker will be performed. After the anesthesiologist provided moderate sedation,
the cardiologist performed a left subclavian venipuncture was carried out. A guide wire was passed
through the needle, and the needle was withdrawn. A second subclavian venipuncture was performed, a
second guide wire was passed and the second needle was withdrawn. An oblique incision in the
deltopectoral area incorporating the wire exit sites. A subcutaneous pocket was created with the cautery
on the pectoralis fascia. An introducer dilator was passed over the first wire and the wire and dilator
were withdrawn. A ventricular lead was passed through the introducer, and the introducer was broken
away in the routine fashion. A second introducer dilator was passed over the second guide wire and the
wire and dilator were wi - Correct answer.The patient is having an insertion of a pace maker, eliminating
multiple choice answers C and D. A subcutaneous pocket was created for the pacemaker generator and
the leads connected to the generator were placed in the atrium and ventricle leading you to multiple
choice answer A. Flouroscopy is included and should not be reported separately. Answer A
TEST 2024/2025 LATEST UPDATE
QUESTIONS AND ANSWERS
PRE OP DIAGNOSIS: Left Breast Abnormal MMG or Palpable Mass; Other Disorders of Breast
PROCEDURE: Automated Stereotactic Biopsy Left Breast FINDINGS: Lesion is located in the lateral region,
just at or below the level of the nipple on the 90 degree lateral view. There is a subglandular implant in
place. I discussed the procedure with the patient today including risks, benefits and alternatives.
Specifically discussed was the fact that the implant would be displaced out of the way during this biopsy
procedure. Possibility of injury to the implant was discussed with the patient. Patient has signed the
consent form and wishes to proceed with the biopsy. The patient was placed prone on the stereotactic
table; the left breast was then imaged from the inferior approach. The lesion of interest is in the anterior
portion of the breast away from the implant which was displaced back toward the chest wall. After
imaging was obt - Correct answer.To start narrowing your choices was the biopsy performed
percutaneously or by an open incision? The operative note documents that a "SenoRx needle" was used
to obtain the biopsy, which is percutaneous. Because there was a biopsy and a placement of a
localization device (clip), you eliminate multiple choice B. Code 19283 is reported only for the placement
of the localization device. Stereotactic image was used to perform the needle biopsy and placement of
the clip. This eliminates multiple choice D, because code 19100 is for needle biopsy without imaging
guidance. Code 19081 is the only code reported for the operative note because its code description
reports both the biopsy and the placement of the clip under stereotactic imaging, eliminating multiple
choice C. Answer A
Question 2
53 year-old male is in the dermatologist's office for removal of 2 lesions located on his lower lip and
nose. Lesions were identified and marked. The lower lip lesion of 4mm in size was shaved to the level of
the superficial dermis. Utilizing a 3-mm punch, a biopsy was taken of the left supratip nasal area. What
are the CPT® codes for these procedures?
A. 11100, 11101
B. 11310, 11100-59
C. 17000, 17003
D. 11440, 11100-59 - Correct answer.The first procedure performed was the lesion on the lower lip
removed by the shaving technique. Reported with code 11310. The punch biopsy is performed on the
lesion located on the nose. Reported with code 11100. Modifier 59 indicates that the biopsy was totally
separate performed on another lesion, otherwise it is bundled with 11310. Answer B
,76 year-old has dermatochalasis on bilateral upper eyelids. A blepharoplasty will be performed on the
eyelids. A lower incision line was marked at approximately 5 mm above the lid margin along the crease.
Then using a pinch test with forceps the amount of skin to be resected was determined and marked. An
elliptical incision was performed on the left eyelid and the skin was excised. In a similar fashion the same
procedure was performed on the right eye. The wounds were closed with sutures. The correct CPT®
code(s) is/are?
A. 15822, 15823-51
B. 15823-50
C. 15822-50
D. 15820-LT, 15820-RT - Correct answer.Patient is having a blepharoplasty done on the upper eyelids,
eliminating multiple choice answer D. There is no indication in the scenario that excessive skin weighing
down the lid had to be excised, eliminating multiple choice answers A and B. Modifier 50 is appended to
indicate the procedure was performed on both eyelids. Answer C
42 year-old male has a frozen left shoulder. An arthroscope was inserted in the posterior portal in the
glenohumeral joint. The articular cartilage was normal except for some minimal grade III-IV changes,
about 5% of the humerus just adjacent to the rotator cuff insertion of the supraspinatus. The biceps was
inflamed, not torn at all. The superior labrum was not torn at all, the labrum was completely intact. The
rotator cuff was completely intact. An anterior portal was established high in the rotator interval. The
rotator interval was very thick and contracted. Adhesions were destroyed with electrocautery and the
Bovie. The superior glenohumeral ligament, the middle glenohumeral ligament and the tendinous
portion of the subscapularis were released. The arthroscope was placed anteriorly, adhesions were
destroyed and the shaver was used to debride some of the posterior capsule and the posterior capsule
was released in - Correct answer.To narrow down your choices decide if the procedure is an open
procedure or performed with an arthroscope? It was performed with an arthroscope, eliminating
multiple choice answers A and B. The diagnostic arthroscopy (29805) is a separate procedure, and
according to CPT® Surgery Guidelines: The codes designated as "separate procedure" should not be
reported in addition to the code for the total procedure or service of which it is considered an integral
component. Meaning code 29806 already includes the diagnostic arthroscopy code, so you only report
code 29806. Code 29806 represents suturing of the capsule (capsulorrhaphy); however, this was not the
procedure performed. The procedure performed was a lysis of adhesions for a frozen shoulder (29825)
noted in multiple choice answer D.
After adequate anesthesia was obtained the patient was turned prone in a kneeling position on the
spinal table. A lower midline lumbar incision was made and the soft tissues divided down to the spinous
processes. The soft tissues were stripped away from the lamina down to the facets and discectomies and
laminectomies were then carried out at L3-4, L4-5 and L5-S1. Interbody fusions were set up for the lower
three levels using the Danek allografts and augmented with structural autogenous bone from the iliac
crest. The posterior instrumentation of a 5.5 mm diameter titanium rod was then cut to the appropriate
length and bent to confirm to the normal lordotic curve. It was then slid immediately onto the bone
, screws and at each level compression was carried out as each of the two bolts were tightened so that
the interbody fusions would be snug and as tight as possible. Select the appropriate CPT® codes for this
visit?
A. - Correct answer.To start narrowing the correct arthrodesis code to report, you first need to
determine the surgical approach. The scenario tells us that the patient was placed in prone position
(lying face down) on the table and a lumbar incision was made indicating a posterior approach,
eliminating multiple choices B and D. The next bit of information to look for is the technique that was
used for the arthrodesis, which was the interbody fusion technique guiding you to code 22630. Answer C
PREOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna.
POSTOPERATIVE DIAGNOSIS: Displaced impacted Colles fracture, left distal radius and ulna. OPERATIVE
PROCEDURE: Reduction with application of an external fixation system, left wrist fracture FINDINGS: The
patient is a 46 year-old right-hand-dominant female who fell off stairs 4 to 5 days ago sustaining an
impacted distal radius fracture with possible intraarticular component and an associated ulnar styloid
fracture. Today in surgery, fracture was reduced anatomically and an external fixation system was
applied. PROCEDURE: Under satisfactory general anesthesia, the fracture was manipulated and C-arm
images were checked. The left upper extremity was prepped and draped in the usual sterile orthopedic
fashion. Two small incisions were made over the second metacarpal and after removing soft tissues
including tendinous structures out of - Correct answer.In the body of the note after the Procedure
heading it states, "the fracture was manipulated", eliminating multiple choice answer A. Was the
fracture treatment opened or closed? There is no indication in the operative note that the patient was
surgically opened at the fracture site to treat it, eliminating multiple choice answer D. The key words to
choose the correct code between B and C are external fixation system and external fixator; where pins
are connected to bone and to an external fixator to help the fracture heal. The fixator was a uniplane
system as only one external fixator was applied in one plane (20690). Answer B
79 year-old male with symptomatic bradycardia and syncope is taken to the Operating Suite where an
insertion of a DDD pacemaker will be performed. After the anesthesiologist provided moderate sedation,
the cardiologist performed a left subclavian venipuncture was carried out. A guide wire was passed
through the needle, and the needle was withdrawn. A second subclavian venipuncture was performed, a
second guide wire was passed and the second needle was withdrawn. An oblique incision in the
deltopectoral area incorporating the wire exit sites. A subcutaneous pocket was created with the cautery
on the pectoralis fascia. An introducer dilator was passed over the first wire and the wire and dilator
were withdrawn. A ventricular lead was passed through the introducer, and the introducer was broken
away in the routine fashion. A second introducer dilator was passed over the second guide wire and the
wire and dilator were wi - Correct answer.The patient is having an insertion of a pace maker, eliminating
multiple choice answers C and D. A subcutaneous pocket was created for the pacemaker generator and
the leads connected to the generator were placed in the atrium and ventricle leading you to multiple
choice answer A. Flouroscopy is included and should not be reported separately. Answer A
