AAPC CPC PRACTICE GUIDE
QUESTIONS AND ANSWERS GRADED
A+ 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 - ANS-C. 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 - ANS-C. 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 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 - ANS-D. 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 - ANS-C. 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 - ANS-A. 25628-RT
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 - ANS-D. 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
- ANS-C. 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
D. 32550 - ANS-A. 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 - ANS-B. 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 - ANS-B. 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
D. 49652, 49568 - ANS-B. 49652
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
QUESTIONS AND ANSWERS GRADED
A+ 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 - ANS-C. 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 - ANS-C. 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 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 - ANS-D. 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 - ANS-C. 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 - ANS-A. 25628-RT
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 - ANS-D. 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
- ANS-C. 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
D. 32550 - ANS-A. 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 - ANS-B. 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 - ANS-B. 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
D. 49652, 49568 - ANS-B. 49652
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
