CPC PRACTICE EXAM A TEST QUESTIONS WITH ACCURATE SOLUTIONS
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 a full excision of an 8 cm lesion. Layered closure was performed after
the removal. The specimen was sent for permanent histopathologic examination.
What is the CPT code(s) for this procedure?
11626, 12044-51
Rationale :
11620 - 11626 refers to the excision of a malignant lesion located on the scalp, neck,
hands, feet, & genitalia. As the excision (margins included) was a total of 8.5 cm, 11626 is
most appropriate.
As the repair was layered, it thus qualifies as an intermediate repair and in accordance with
CPT Guidelines must be reported separately. 12041-12047 refers to the intermediate repair
of wounds of the neck, scalp, hands feet, and/or genitals ; the 8.5 cm repair makes 12044
most appropriate, and the modifier "-51" is applied to indicate multiple procedures.
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?
11044
Rationale :
11042 - 11047 refers to debridement, reported by depth & surface area of tissue removed.
As the patient's foot was debrided to the bone with a surface area of 15 sq cm, 11044 is the
most appropriate choice.
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.
99283-25, 12053, 12034-59
Rationale :
The section guidelines in the CPT Codebook for Repair (Closure) states: "Wound closure
utilizing adhesive strips as the sole repair material should be coded using the appropriate
E/M code." 99283 is most appropriate due to moderate complexity of medical decision, and
modifier "-25" is added to indicate separately identifiable e/m service related to the reason
of the visit.
,The lacerations on the face are intermediate repairs, because of noted debridement and
removal of glass debris. The guidelines in the CPT Codebook for Repair (Closure) states:
"Single-layer closure of heavily contaminated wounds that have required extensive
cleaning or removal of particulate matter also constitutes intermediate repair."
The intermediate repair of the lacerations to the face totaled 6 cm (12053). The right arm
and left leg had cuts measuring 5 cm each which totaled 10 cm requiring intermediate
repair (12034), with modifier "-59" added to indicate distinct procedural service.
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-CM codes are reported?
47562, K81.1
Rationale :
Laparoscopic cholecystectomies are coded 47562 - 4747579 ; as no corresponding
procedures are noted, 47562 is the most accurate option.
In the ICD-10-CM Alphabetic Index, chronic cholecystitis is coded K81.1 ; as there is no
noted acuteness or similar complications, K81.1 is the correct code.
, 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?
49652
Rationale :
According to CPT Guidelines, 49652 includes mesh insertion & doesn't require additional
codes.
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:
44970
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 a full excision of an 8 cm lesion. Layered closure was performed after
the removal. The specimen was sent for permanent histopathologic examination.
What is the CPT code(s) for this procedure?
11626, 12044-51
Rationale :
11620 - 11626 refers to the excision of a malignant lesion located on the scalp, neck,
hands, feet, & genitalia. As the excision (margins included) was a total of 8.5 cm, 11626 is
most appropriate.
As the repair was layered, it thus qualifies as an intermediate repair and in accordance with
CPT Guidelines must be reported separately. 12041-12047 refers to the intermediate repair
of wounds of the neck, scalp, hands feet, and/or genitals ; the 8.5 cm repair makes 12044
most appropriate, and the modifier "-51" is applied to indicate multiple procedures.
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?
11044
Rationale :
11042 - 11047 refers to debridement, reported by depth & surface area of tissue removed.
As the patient's foot was debrided to the bone with a surface area of 15 sq cm, 11044 is the
most appropriate choice.
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.
99283-25, 12053, 12034-59
Rationale :
The section guidelines in the CPT Codebook for Repair (Closure) states: "Wound closure
utilizing adhesive strips as the sole repair material should be coded using the appropriate
E/M code." 99283 is most appropriate due to moderate complexity of medical decision, and
modifier "-25" is added to indicate separately identifiable e/m service related to the reason
of the visit.
,The lacerations on the face are intermediate repairs, because of noted debridement and
removal of glass debris. The guidelines in the CPT Codebook for Repair (Closure) states:
"Single-layer closure of heavily contaminated wounds that have required extensive
cleaning or removal of particulate matter also constitutes intermediate repair."
The intermediate repair of the lacerations to the face totaled 6 cm (12053). The right arm
and left leg had cuts measuring 5 cm each which totaled 10 cm requiring intermediate
repair (12034), with modifier "-59" added to indicate distinct procedural service.
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-CM codes are reported?
47562, K81.1
Rationale :
Laparoscopic cholecystectomies are coded 47562 - 4747579 ; as no corresponding
procedures are noted, 47562 is the most accurate option.
In the ICD-10-CM Alphabetic Index, chronic cholecystitis is coded K81.1 ; as there is no
noted acuteness or similar complications, K81.1 is the correct code.
, 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?
49652
Rationale :
According to CPT Guidelines, 49652 includes mesh insertion & doesn't require additional
codes.
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:
44970
