AAPC CPC Practice Questions and Answer’s Graded A
A 46-year-old female had a previous biopsy that layer closure, 6-0 Prolene sutures. The arm and
indicated positive malignant margins anteriorly leg were repaired by layered closure, 6-0 Vicryl
on the right side of her neck. A 0.5 cm margin subcutaneous sutures and Prolene sutures on
was drawn out and a 15 blade scalpel was used the skin. The hand and foot were closed with
for full excision of an 8 cm lesion. Layered adhesive strips. Select the appropriate procedure
closure was performed after the removal. The codes for this visit.
specimen was sent for permanent A. 99283-25, 12014, 12034-59, 12002-59,
histopathologic examination. What are the CPT® 11042-51
code(s) for this procedure? B. 99283-25, 12053, 12034-59, 12002-59
A. 11626 C. 99283-25, 12014, 12034-59, 11042-51
B. 11626, 12004-51 D. 99283-25, 12053, 12034-59 - ANSWER -
C. 11626, 12044-51 D. 99283-25, 12053, 12034-59
D. 11626, 13132-51, 13133 - ANSWER -C.
11626, 12044-51
A 52-year-old female has a mass growing on her
right flank for several years. It has finally gotten
A 30-year-old female is having 15 sq cm significantly larger and is beginning to bother her.
debridement performed on an infected ulcer with She is brought to the Operating Room for
eschar on the right foot. Using sharp dissection, definitive excision. An incision was made directly
the ulcer was debrided all the way to down to the overlying the mass. The mass was down into the
bone of the foot. The bone had to be minimally subcutaneous tissue and the surgeon
trimmed because of a sharp point at the end of encountered a well encapsulated lipoma
the metatarsal. After debriding the area, there approximately 4 centimeters. This was excised
was minimal bleeding because of very poor primarily bluntly with a few attachments divided
circulation of the foot. It seems that the toes next with electrocautery. What CPT® and ICD-10-CM
to the ulcer may have some involvement and codes are reported?
cultures were taken. The area was dressed with A. 21932, D17.39
sterile saline and dressings and then wrapped. B. 21935, D17.1
What CPT® code should be reported? C. 21931, D17.1
A. 11043 D. 21925, D17.9 - ANSWER -C. 21931,
B. 11012 D17.1
C. 11044
D. 11042 - ANSWER -C. 11044
Question 5
PREOPERATIVE DIAGNOSIS: Right scaphoid
A 64-year-old female who has multiple sclerosis fracture. TYPE OF PROCEDURE: Open
fell from her walker and landed on a glass table. reduction and internal fixation of right scaphoid
She lacerated her forehead, cheek and chin and fracture. DESCRIPTION OF PROCEDURE: The
the total length of these lacerations was 6 cm. patient was brought to the operating room;
Her right arm and left leg had deep cuts anesthesia having been administered. The right
measuring 5 cm on each extremity. Her right upper extremity was prepped and draped in a
hand and right foot had a total of 3 cm sterile manner. The limb was elevated,
lacerations. The ED physician repaired the exsanguinated, and a pneumatic arm tourniquet
lacerations as follows: The forehead, cheek, and was elevated. An incision was made over the
chin had debridement and cleaning of glass dorsal radial aspect of the right wrist. Skin flaps
debris with the lacerations being closed with one were elevated. Cutaneous nerve branches were
,AAPC CPC Practice Questions and Answer’s Graded A
identified and very gently retracted. The interval length and secured to the power port device. The
between the second and third dorsal locking mechanism was fully engaged. The port
compartment tendons was identified and was placed in the subcutaneous pocket and
entered. The respective tendons were retracted. everything sat very nicely fluoroscopically. It was
A dorsal capsulotomy incision was made, and secured to the underlying soft tissue -
the fracture was visualized. There did not appear ANSWER -C. 36561, 77001-26
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. Question 8
25628-RT 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
An infant with genu valgum is brought to the appearance of fluid on the CT Scan. A needle is
operating room to have a bilateral medial distal used to puncture through the chest tissues and
femur hemiepiphysiodesis done. On each knee, enter the pleural cavity to insert a guidewire
the C-arm was used to localize the growth plate. under ultrasound guidance. A pigtail catheter is
With the growth plate localized, an incision was then inserted at the length of the guidewire and
made medially on both sides. This was taken secured by stitches. The catheter will remain in
down to the fascia, which was opened. The the chest and is connected to drainage system to
periosteum was not opened. The Orthofix® drain the accumulated fluid. The CPT® code is:
figure-of-eight plate was placed and checked A. 32557
with X-ray. We then irrigated and closed the B. 32555
medial fascia with 0 Vicryl suture. The skin was C. 32556
closed with 2-0 Vicryl and 3-0 Monocryl®. What D. 32550 - ANSWER -A. 32557
procedure code is reported?
A. 27470-50
B. 27475-50 The patient is a 59-year-old white male who
C. 27477-50 underwent carotid endarterectomy for
D. 27485-50 - ANSWER -D. 27485-50 symptomatic left carotid stenosis a year ago. A
carotid CT angiogram showed a recurrent 90%
left internal carotid artery stenosis extending into
The patient is a 67-year-old gentleman with the common carotid artery. He is taken to the
metastatic colon cancer recently operated on for operating room for re-do left carotid
a brain metastasis, now for placement of an endarterectomy. The left neck was prepped and
Infuse-A-Port for continued chemotherapy. The the previous incision was carefully reopened.
left subclavian vein was located with a needle Using sharp dissection, the common carotid
and a guide wire placed. This was confirmed to artery and its branches were dissected free. The
be in the proper position fluoroscopically. A patient was systematically heparinized and after
transverse incision was made just inferior to this a few minutes, clamps were applied to the
and a subcutaneous pocket created just inferior common carotid artery and its branches. A
to this. After tunneling, the introducer was placed longitudinal arteriotomy was carried out with
over the guide wire and the power port line was findings of extensive layering of intimal
placed with the introducer and the introducer was hyperplasia with no evidence of recurrent
peeled away. The tip was placed in the atherosclerosis. A silastic balloon-tip shunt was
appropriate position under fluoroscopic guidance inserted first proximally and then distally, with
and the catheter trimmed to the appropriate restoration of flow. Several layers of intima were
,AAPC CPC Practice Questions and Answer’s Graded A
removed and the endart - ANSWER -B.
35301, 35390
The patient is a 50-year-old gentleman who
presented to the emergency room with signs and
A 52-year-old patient is admitted to the hospital symptoms of acute appendicitis with possible
for chronic cholecystitis for which a laparoscopic rupture. He has been brought to the operating
cholecystectomy will be performed. A transverse room. An infraumbilical incision was made which
infraumbilical incision was made sharply a 5-mm VersaStep™ trocar was inserted. A 5-
dissecting to the subcutaneous tissue down to mm 0- degree laparoscope was introduced. A
the fascia using access under direct vision with a second 5-mm trocar was placed suprapubically
Vesi-Port and a scope was placed into the and a 12-mm trocar in the left lower quadrant. A
abdomen. Three other ports were inserted under window was made in the mesoappendix using
direct vision. The fundus of the gallbladder was blunt dissection with no rupture noted. The base
grasped through the lateral port, where multiple of the appendix was then divided and placed into
adhesions to the gallbladder were taken down an Endo-catch bag and the 12-mm defect was
sharply and bluntly: The gallbladder appeared brought out. Select the appropriate code for this
chronically inflamed. Dissection was carried out procedure:
to the right of this identifying a small cystic duct A. 44970
and artery, was clipped twice proximally, once B. 44950
distally and transected. The gallbladder was then C. 44960
taken down from the bed using electrocautery, D. 44979 - ANSWER -A. 44970
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. A 45-year-old male is going to donate his kidney
47562, K81.1 to his son. Operating ports where placed in
standard position and the scope was inserted.
Dissection of the renal artery and vein was
A 70-year-old female who has a history of performed isolating the kidney. The kidney was
symptomatic ventral hernia was advised to suspended only by the renal artery and vein as
undergo laparoscopic evaluation and repair. An well as the ureter. A stapler was used to divide
incision was made in the epigastrium and the vein just above the aorta and three clips
dissection was carried down through the across the ureter, extracting the kidney. This was
subcutaneous tissue. Two 5-mm trocars were placed on ice and sent to the recipient room. The
placed, one in the left upper quadrant and one in correct CPT® code is:
the left lower quadrant and the laparoscope was A. 50543
inserted. Dissection was carried down to the area B. 50547
of the hernia where a small defect was clearly C. 50300
visualized. There was some omentum, which D. 50320 - ANSWER -B. 50547
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 A 67-year-old female having urinary incontinence
code(s) is (are) reported? with intrinsic sphincter deficiency is having a
A. 49560, 49568 cystoscopy performed with a placement of a
B. 49652 sling. An incision was made over the mid urethra
C. 49653 dissected laterally to urethropelvic ligament.
D. 49652, 49568 - ANSWER -B. 49652 Cystoscopy revealed no penetration of the
, AAPC CPC Practice Questions and Answer’s Graded A
bladder. The edges of the sling were weaved undergoing a removal of a previously implanted
around the junction of the urethra and brought up Medtronic pain pump and catheter due to a
to the suprapubic incision. A hemostat was then possible infection. The back was incised;
placed between the sling and the urethra, dissection was carried down to the previously
ensuring no tension. What CPT® code(s) is (are) placed catheter. There was evidence of infection
reported? with some fat necrosis in which cultures were
A. 57288 taken. The intrathecal portion of the catheter was
B. 57287 removed. Next the pump pocket was incised and
C. 57288, 52000-51 the pump was dissected from the anterior fascia.
D. 51992, 52000-51 - ANSWER -A. 57288 A 7-mm Blake drain was placed in the pump
pocket through a stab incision and secured to the
skin with interrupted Prolene. The pump pocket
A 16-day-old male baby is in the OR for a repeat was copiously irrigated with saline and closed in
circumcision due to redundant foreskin that two layers. What are the CPT® and ICD-10-CM
caused circumferential scarring from the original codes for this procedure?
circumcision. Anesthetic was injected and an A. 62365, 62350-51, T85.898A, Z46.2
incision was made at base of the foreskin. B. 62360, 62355-51, T85.79XA
Foreskin was pulled back and the excess C. 62365, 62355-51, T85.79XA
foreskin was taken off and the two raw skin D. 36590, I97.42, T85.898A - ANSWER -C.
surfaces were sutured together to create a 62365, 62355-51, T85.79XA
circumferential anastomosis. Select the
appropriate code for this surgery:
A. 54150 The patient is a 73 year-old gentleman who was
B. 54160 noted to have progressive gait instability over the
C. 54163 past several months. Magnetic resonance
D. 54164 - ANSWER -C. 54163 imaging demonstrated a ventriculomegaly. It was
recommended that the patient proceed forward
with right frontal ventriculoperitoneal shunt
5 year-old female has a history of post void placement with Codman® programmable valve.
dribbling. She was found to have extensive labial What is the correct code for this surgery?
adhesions, which have been unresponsive to A. 62220
topical medical management. She is brought to B. 62223
the operating suite in a supine position. Under C. 62190
general anesthesia the labia majora is retracted D. 62192 - ANSWER -B. 62223
and the granulating chronic adhesions were
incised midline both anteriorly and posteriorly.
The adherent granulation tissue was excised on What is the CPT® code for the decompression of
either side. What code should be used for this the median nerve found in the space in the wrist
procedure? on the palmar side?
A. 58660 A. 64704
B. 58740 B. 64713
C. 57061 C. 64721
D. 56441 - ANSWER -D. 56441 D. 64719 - ANSWER -C. 64721
The patient is a 64 year-old female who is A 2-year-old male has a chalazion on both upper
A 46-year-old female had a previous biopsy that layer closure, 6-0 Prolene sutures. The arm and
indicated positive malignant margins anteriorly leg were repaired by layered closure, 6-0 Vicryl
on the right side of her neck. A 0.5 cm margin subcutaneous sutures and Prolene sutures on
was drawn out and a 15 blade scalpel was used the skin. The hand and foot were closed with
for full excision of an 8 cm lesion. Layered adhesive strips. Select the appropriate procedure
closure was performed after the removal. The codes for this visit.
specimen was sent for permanent A. 99283-25, 12014, 12034-59, 12002-59,
histopathologic examination. What are the CPT® 11042-51
code(s) for this procedure? B. 99283-25, 12053, 12034-59, 12002-59
A. 11626 C. 99283-25, 12014, 12034-59, 11042-51
B. 11626, 12004-51 D. 99283-25, 12053, 12034-59 - ANSWER -
C. 11626, 12044-51 D. 99283-25, 12053, 12034-59
D. 11626, 13132-51, 13133 - ANSWER -C.
11626, 12044-51
A 52-year-old female has a mass growing on her
right flank for several years. It has finally gotten
A 30-year-old female is having 15 sq cm significantly larger and is beginning to bother her.
debridement performed on an infected ulcer with She is brought to the Operating Room for
eschar on the right foot. Using sharp dissection, definitive excision. An incision was made directly
the ulcer was debrided all the way to down to the overlying the mass. The mass was down into the
bone of the foot. The bone had to be minimally subcutaneous tissue and the surgeon
trimmed because of a sharp point at the end of encountered a well encapsulated lipoma
the metatarsal. After debriding the area, there approximately 4 centimeters. This was excised
was minimal bleeding because of very poor primarily bluntly with a few attachments divided
circulation of the foot. It seems that the toes next with electrocautery. What CPT® and ICD-10-CM
to the ulcer may have some involvement and codes are reported?
cultures were taken. The area was dressed with A. 21932, D17.39
sterile saline and dressings and then wrapped. B. 21935, D17.1
What CPT® code should be reported? C. 21931, D17.1
A. 11043 D. 21925, D17.9 - ANSWER -C. 21931,
B. 11012 D17.1
C. 11044
D. 11042 - ANSWER -C. 11044
Question 5
PREOPERATIVE DIAGNOSIS: Right scaphoid
A 64-year-old female who has multiple sclerosis fracture. TYPE OF PROCEDURE: Open
fell from her walker and landed on a glass table. reduction and internal fixation of right scaphoid
She lacerated her forehead, cheek and chin and fracture. DESCRIPTION OF PROCEDURE: The
the total length of these lacerations was 6 cm. patient was brought to the operating room;
Her right arm and left leg had deep cuts anesthesia having been administered. The right
measuring 5 cm on each extremity. Her right upper extremity was prepped and draped in a
hand and right foot had a total of 3 cm sterile manner. The limb was elevated,
lacerations. The ED physician repaired the exsanguinated, and a pneumatic arm tourniquet
lacerations as follows: The forehead, cheek, and was elevated. An incision was made over the
chin had debridement and cleaning of glass dorsal radial aspect of the right wrist. Skin flaps
debris with the lacerations being closed with one were elevated. Cutaneous nerve branches were
,AAPC CPC Practice Questions and Answer’s Graded A
identified and very gently retracted. The interval length and secured to the power port device. The
between the second and third dorsal locking mechanism was fully engaged. The port
compartment tendons was identified and was placed in the subcutaneous pocket and
entered. The respective tendons were retracted. everything sat very nicely fluoroscopically. It was
A dorsal capsulotomy incision was made, and secured to the underlying soft tissue -
the fracture was visualized. There did not appear ANSWER -C. 36561, 77001-26
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. Question 8
25628-RT 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
An infant with genu valgum is brought to the appearance of fluid on the CT Scan. A needle is
operating room to have a bilateral medial distal used to puncture through the chest tissues and
femur hemiepiphysiodesis done. On each knee, enter the pleural cavity to insert a guidewire
the C-arm was used to localize the growth plate. under ultrasound guidance. A pigtail catheter is
With the growth plate localized, an incision was then inserted at the length of the guidewire and
made medially on both sides. This was taken secured by stitches. The catheter will remain in
down to the fascia, which was opened. The the chest and is connected to drainage system to
periosteum was not opened. The Orthofix® drain the accumulated fluid. The CPT® code is:
figure-of-eight plate was placed and checked A. 32557
with X-ray. We then irrigated and closed the B. 32555
medial fascia with 0 Vicryl suture. The skin was C. 32556
closed with 2-0 Vicryl and 3-0 Monocryl®. What D. 32550 - ANSWER -A. 32557
procedure code is reported?
A. 27470-50
B. 27475-50 The patient is a 59-year-old white male who
C. 27477-50 underwent carotid endarterectomy for
D. 27485-50 - ANSWER -D. 27485-50 symptomatic left carotid stenosis a year ago. A
carotid CT angiogram showed a recurrent 90%
left internal carotid artery stenosis extending into
The patient is a 67-year-old gentleman with the common carotid artery. He is taken to the
metastatic colon cancer recently operated on for operating room for re-do left carotid
a brain metastasis, now for placement of an endarterectomy. The left neck was prepped and
Infuse-A-Port for continued chemotherapy. The the previous incision was carefully reopened.
left subclavian vein was located with a needle Using sharp dissection, the common carotid
and a guide wire placed. This was confirmed to artery and its branches were dissected free. The
be in the proper position fluoroscopically. A patient was systematically heparinized and after
transverse incision was made just inferior to this a few minutes, clamps were applied to the
and a subcutaneous pocket created just inferior common carotid artery and its branches. A
to this. After tunneling, the introducer was placed longitudinal arteriotomy was carried out with
over the guide wire and the power port line was findings of extensive layering of intimal
placed with the introducer and the introducer was hyperplasia with no evidence of recurrent
peeled away. The tip was placed in the atherosclerosis. A silastic balloon-tip shunt was
appropriate position under fluoroscopic guidance inserted first proximally and then distally, with
and the catheter trimmed to the appropriate restoration of flow. Several layers of intima were
,AAPC CPC Practice Questions and Answer’s Graded A
removed and the endart - ANSWER -B.
35301, 35390
The patient is a 50-year-old gentleman who
presented to the emergency room with signs and
A 52-year-old patient is admitted to the hospital symptoms of acute appendicitis with possible
for chronic cholecystitis for which a laparoscopic rupture. He has been brought to the operating
cholecystectomy will be performed. A transverse room. An infraumbilical incision was made which
infraumbilical incision was made sharply a 5-mm VersaStep™ trocar was inserted. A 5-
dissecting to the subcutaneous tissue down to mm 0- degree laparoscope was introduced. A
the fascia using access under direct vision with a second 5-mm trocar was placed suprapubically
Vesi-Port and a scope was placed into the and a 12-mm trocar in the left lower quadrant. A
abdomen. Three other ports were inserted under window was made in the mesoappendix using
direct vision. The fundus of the gallbladder was blunt dissection with no rupture noted. The base
grasped through the lateral port, where multiple of the appendix was then divided and placed into
adhesions to the gallbladder were taken down an Endo-catch bag and the 12-mm defect was
sharply and bluntly: The gallbladder appeared brought out. Select the appropriate code for this
chronically inflamed. Dissection was carried out procedure:
to the right of this identifying a small cystic duct A. 44970
and artery, was clipped twice proximally, once B. 44950
distally and transected. The gallbladder was then C. 44960
taken down from the bed using electrocautery, D. 44979 - ANSWER -A. 44970
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. A 45-year-old male is going to donate his kidney
47562, K81.1 to his son. Operating ports where placed in
standard position and the scope was inserted.
Dissection of the renal artery and vein was
A 70-year-old female who has a history of performed isolating the kidney. The kidney was
symptomatic ventral hernia was advised to suspended only by the renal artery and vein as
undergo laparoscopic evaluation and repair. An well as the ureter. A stapler was used to divide
incision was made in the epigastrium and the vein just above the aorta and three clips
dissection was carried down through the across the ureter, extracting the kidney. This was
subcutaneous tissue. Two 5-mm trocars were placed on ice and sent to the recipient room. The
placed, one in the left upper quadrant and one in correct CPT® code is:
the left lower quadrant and the laparoscope was A. 50543
inserted. Dissection was carried down to the area B. 50547
of the hernia where a small defect was clearly C. 50300
visualized. There was some omentum, which D. 50320 - ANSWER -B. 50547
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 A 67-year-old female having urinary incontinence
code(s) is (are) reported? with intrinsic sphincter deficiency is having a
A. 49560, 49568 cystoscopy performed with a placement of a
B. 49652 sling. An incision was made over the mid urethra
C. 49653 dissected laterally to urethropelvic ligament.
D. 49652, 49568 - ANSWER -B. 49652 Cystoscopy revealed no penetration of the
, AAPC CPC Practice Questions and Answer’s Graded A
bladder. The edges of the sling were weaved undergoing a removal of a previously implanted
around the junction of the urethra and brought up Medtronic pain pump and catheter due to a
to the suprapubic incision. A hemostat was then possible infection. The back was incised;
placed between the sling and the urethra, dissection was carried down to the previously
ensuring no tension. What CPT® code(s) is (are) placed catheter. There was evidence of infection
reported? with some fat necrosis in which cultures were
A. 57288 taken. The intrathecal portion of the catheter was
B. 57287 removed. Next the pump pocket was incised and
C. 57288, 52000-51 the pump was dissected from the anterior fascia.
D. 51992, 52000-51 - ANSWER -A. 57288 A 7-mm Blake drain was placed in the pump
pocket through a stab incision and secured to the
skin with interrupted Prolene. The pump pocket
A 16-day-old male baby is in the OR for a repeat was copiously irrigated with saline and closed in
circumcision due to redundant foreskin that two layers. What are the CPT® and ICD-10-CM
caused circumferential scarring from the original codes for this procedure?
circumcision. Anesthetic was injected and an A. 62365, 62350-51, T85.898A, Z46.2
incision was made at base of the foreskin. B. 62360, 62355-51, T85.79XA
Foreskin was pulled back and the excess C. 62365, 62355-51, T85.79XA
foreskin was taken off and the two raw skin D. 36590, I97.42, T85.898A - ANSWER -C.
surfaces were sutured together to create a 62365, 62355-51, T85.79XA
circumferential anastomosis. Select the
appropriate code for this surgery:
A. 54150 The patient is a 73 year-old gentleman who was
B. 54160 noted to have progressive gait instability over the
C. 54163 past several months. Magnetic resonance
D. 54164 - ANSWER -C. 54163 imaging demonstrated a ventriculomegaly. It was
recommended that the patient proceed forward
with right frontal ventriculoperitoneal shunt
5 year-old female has a history of post void placement with Codman® programmable valve.
dribbling. She was found to have extensive labial What is the correct code for this surgery?
adhesions, which have been unresponsive to A. 62220
topical medical management. She is brought to B. 62223
the operating suite in a supine position. Under C. 62190
general anesthesia the labia majora is retracted D. 62192 - ANSWER -B. 62223
and the granulating chronic adhesions were
incised midline both anteriorly and posteriorly.
The adherent granulation tissue was excised on What is the CPT® code for the decompression of
either side. What code should be used for this the median nerve found in the space in the wrist
procedure? on the palmar side?
A. 58660 A. 64704
B. 58740 B. 64713
C. 57061 C. 64721
D. 56441 - ANSWER -D. 56441 D. 64719 - ANSWER -C. 64721
The patient is a 64 year-old female who is A 2-year-old male has a chalazion on both upper
