CPC Practice Exam A
Question 1
Indication: Patient has a hypertrophic scar on the posterior side of the left leg, at the level of the knee.
This has begun to restrict his mobility. His physical therapy trial was unsuccessful. Procedure: After the
proper induction of anesthesia, the subcutaneous tissue of the patient’s left leg beneath the scar was
infiltrated with crystalloid solution containing epinephrine to minimize blood loss. The scar was then
excised down to viable dermis. Hemostasis was obtained with epinephrine soaked pads. Skin was
harvested from the patient’s thigh in a split thickness fashion and was used to cover the 90 sq cm defect
created by the surgery. The graft was secured with skin staples, and then dressed with fine mesh gauze
followed by medication-soaked gauze. The donor site was dressed with mesh followed by Adaptic™,
followed by a dry dressing and an Ace wrap. What are the CPT® codes?
A. 15110-52, 15002
B. 15100, 11406
C. 15100, 15002
D. 15110, 15002
Question 2
The physician is called in to perform repairs for a 17 year-old girl involved in a motor vehicle accident.
She sustained an 8.6 cm laceration to her forehead, a 5.5 cm laceration to her right cheek, a 4 cm
laceration to her left cheek, a 4 cm laceration across her chin, and a 12.5 cm laceration to her chest. The
wound on her chin required a layered closure. All other wounds required complex closure. The
CPT® codes to report are:
A. 13132, 13133 x 4, 13101, 12052
B. 13132, 13133 x 3, 13133-52, 13101, 13102, 12052
C. 13132, 13133 x 3, 13101, 13102, 12052
D. 13131, 13132, 13133 x 3, 13101, 13102, 12052
Question 3
A 36-year-old male presents to have multiple lesions destroyed. Three benign lesions on his face are
destroyed and five actinic keratoses on his left arm are destroyed. The CPT® code(s) to report is (are):
A. 17000, 17003
B. 17000, 17003 x 4, 17110
C. 17110
D. 17260 x 5, 17110 x 3
Question 4
Patient is having ongoing back and hip pain. The physician elects to perform a sacroiliac injection at an
ambulatory surgery center. After sterile prep, the patient is placed prone position. A needle is placed
under fluoroscopic guidance into the SI joint and a mixture of 20 mg of Celestone and Marcaine is
injected for pain relief. Report the CPT® code(s).
A. 27096, 77003-26
B. 20611
C. 20552
, D. 27096
Question 5
Patient is seen in the hospital’s outpatient surgical area with a diagnosis of a displaced comminuted
closed fracture of the lateral condyle, right elbow. An ORIF procedure was performed, which included the
following techniques: An incision was made in the area of the lateral epicondyle. This was carried through
subcutaneous tissue, and the fracture site was easily exposed. Inspection revealed the fragment to be
rotated in two places, about 90 degrees. It was possible to manually reduce this quite easily, and the
manipulation resulted in an almost anatomic reduction. This was fixed with two pins driven across the
humerus. The pins were cut off below skin level. The wound was closed with plain catgut subcutaneously
and 5-0 nylon for the skin. Dressings and a long arm cast were applied. Which is the correct ICD-10-CM
and CPT® code assignment?
A. 24579-RT, 29065-51-RT, S42.451B
B. 24577-RT, S42.451A
C. 24579-RT, S42.451A
D. 24575-RT, S42.451B
Question 6
A 35-year-old female patient presents with acute onset of severe pain since October. Her workup has
revealed evidence of disk herniation with loss of lordosis at the C5-C6. Intraoperative findings were
consistent with two large fragments of free disk fragments in the foramen at C5-C6 on the right side. After
general anesthesia, the patient was placed on the operative table in the supine position. All pressure
points were cushioned and a transverse skin incision was fashioned under fluoroscopic guidance over the
C5-C6 disc space. Dissection through the platysma eventually allowed for exposure of the anterior
entrance to the vertebral body of C5 and C6 and retractors were inserted to maintain adequate exposure.
The operating microscope was brought into the field. Caspar posts were placed and slight distraction
allowed exposure. A complete discectomy was performed at C5-C6 by using endplate curets pituitary
rongeurs and Kerrison rongeurs. The posterior longitudinal ligament was resected and beneath the
posterior longitudinal ligament, two significant sized disc fragments were noted in the foramen at C5-C6.
These were removed using pituitary and Decker instruments. The endplates were then decorticated so
that they were parallel to each other and a midline keel was performed on AP and lateral fluoroscopy. A
size #1 by 5 mm interbody Kineflex-C device was placed under fluoroscopic guidance. Satisfied with the
positioning of the device, the decision was made to close. What is the correct CPT® code for this
procedure?
A. 63075
B. 63081
C. 22856
D. 22554
Question 7
OPERATION: Dual chamber transvenous implantable pacing cardioverter-defibrillator system
implantation with leads. INDICATIONS: A 67 year-old, white gentleman has significant underlying
ischemic cardiomyopathy with EF of 25 percent, prior infarcts, remote history of syncope, and at a high
risk for malignant ventricular arrhythmias. He has had a recent T wave alternans test which was clearly
abnormal. He has had episodes of resting bradycardia, also noted. He meets Madit II criteria for insertion
of a transvenous implantable pacing cardioverter-defibrillator (ICD). PROCEDURE: After informed
consent had been obtained, the patient was brought to the outpatient hospital lab in the fasting state. The
left anterior chest was prepped and draped in a sterile fashion. Intravenous sedation and local anesthetic
were given. After local anesthetic, a 5 cm incision was made at the left deltopectoral groove. With blunt
dissection and cautery, this was carried down through the prepectoralis fascia. The cephalic vein was
identified and ligated distally. Through the venotomy, a subclavian venogram was performed to provide a
roadmap. The atrial and ventricular leads were then advanced into the vessel to the level of the right
,atrium under fluoroscopic guidance. The ventricular lead was maneuvered to the right ventricular outflow
tract, and then through the RV apex where it was actively fixed. Good sensing and pacing thresholds
were demonstrated. The lead was anchored to the pre-pectoralis fascia with interrupted 2-0 Tycron
sutures. 10-volt pacing did not result in diaphragmatic capture. The atrial lead was maneuvered to the
anterolateral right atrial wall where it was actively fixed. Good sensing and pacing thresholds were
demonstrated. The lead was anchored to the pre-pectoralis fascia with interrupted 2-0 Tycron sutures.
10-volt pacing did not result in diaphragmatic capture. A subcutaneous pocket was c reated with good
hemostasis achieved. The pocket was subsequently irrigated with solution of Bacitracin. The generator
was connected to the lead, and then placed in the pocket with no tension on the lead. The deep fascial
layer was closed with interrupted 2-0 Vicryl suture. The subcutaneous closure was made with running 3-0
Vicryl suture. Subcuticular closure was made with running 4-0 Vicryl suture. Steri-strips were applied.
Ventricular fibrillation was induced with a T wave shock. This was successfully sensed and terminated
with a 15 joule shock to sinus rhythm. High voltage impedance was 39 ohms. Dry dressing was placed
over the wound. The patient returned to the floor in stable condition without apparent complications.
Which of the following CPT® code(s) accurately describes the basic procedure summarized in this
report?
A. 33208
B. 33249, 76000-26
C. 33241, 33243, 33249
D. 33249
Question 8
The patient comes in today to have an arteriovenous fistula created to facilitate dialysis. The surgeon
performs an upper arm basilic vein transposition based on the patient’s previous arterial duplex scan.
Which is the appropriate CPT® code for this procedure?
A. 36825
B. 36830
C. 36818
D. 36819
Question 9
A 56-year-old with lung cancer developed an effusion that is suspicious for malignancy. Needle aspiration
is performed to obtain a sample of the fluid for pathological examination. A needle is inserted between the
ribs and into the pleural space, and the fluid is withdrawn. The specimen is sent to pathology. Choose the
CPT® code that reports the procedure described.
A. 32554
B. 32555
C. 32551
D. 32400
Question 10
A 67-year-old male patient is referred for a flex sigmoidoscopy exam to remove polyps. The physician
found three polyps in the rectosigmoid junction. They were removed by hot biopsy forceps. The path
report indicated the polyps were benign. What is the CPT® code to report for this encounter?
A. 45333
B. 45315
C. 45384
, D. 45346
Question 11
Name of Procedure: Endoscopic retrograde cholangiopancreatogram with stent placement and antral
biopsy. Indications: 50 year-old male who underwent liver transplantation for end-stage liver disease
secondary to chronic hepatitis C and hepatocellular carcinoma in 01/2007. The patient has cholestatic
liver enzymes, requiring ERCP before placement of a 7-French 12 cm stent and to evaluate the biliary
system. Description of Procedure: The patient was taken to the fluoroscopy suite in the GI lab where he
was found to be alert and oriented x 3. After discussing risks and benefits of the procedure, informed
consent was obtained. Patient was kept in the semi prone position. After adequate conscious sedation,
an Olympus side-viewing therapeutic scope was inserted through the mouth all the way to the second
portion of the duodenum. Then, the common bile duct was cannulated and the cholangiogram was
obtained. After the fluoroscopy evaluation of the cholangiogram a 12 cm stent was deployed for biliary
drainage. A biopsy from the antrum was obtained. The patient tolerated the procedure well. There were
no immediate complications.
Which CPT® codes should be reported?
A. 43276, 43261-51
B. 43274, 43261-51
C. 43266, 43239-51
D. 43212, 43202-51
Question 12
A patient with rectal bleeding underwent a proctosigmoidoscopy that showed she had two internal
hemorrhoids. The anus was prepped and draped. A field block with Marcaine 0.25% was then placed.
There was an internal prolapsing hemorrhoid in the anterior midline. This was rubber band ligated by
applying two bands. In the posterior midline, there was another internal hemorrhoid that was banded in
the same manner. Code the procedure.
A. 0249T
B. 46221
C. 46945
D. 46930
Question 13
A neonatal male had an elective circumcision before being discharged home from the newborn nursery.
The physician uses a ring block for the local anesthetic and the foreskin is placed over the glans. A clamp
is selected for the size of the glans and a constricting circular ring is placed over the foreskin to compress
and devascularize the foreskin. The devascularized foreskin is excised with a scalpel and the clamp is left
in place. Which CPT® code should be used?
A. 54150
B. 54160
C. 54161
D. 54150-52
Question 14
Question 1
Indication: Patient has a hypertrophic scar on the posterior side of the left leg, at the level of the knee.
This has begun to restrict his mobility. His physical therapy trial was unsuccessful. Procedure: After the
proper induction of anesthesia, the subcutaneous tissue of the patient’s left leg beneath the scar was
infiltrated with crystalloid solution containing epinephrine to minimize blood loss. The scar was then
excised down to viable dermis. Hemostasis was obtained with epinephrine soaked pads. Skin was
harvested from the patient’s thigh in a split thickness fashion and was used to cover the 90 sq cm defect
created by the surgery. The graft was secured with skin staples, and then dressed with fine mesh gauze
followed by medication-soaked gauze. The donor site was dressed with mesh followed by Adaptic™,
followed by a dry dressing and an Ace wrap. What are the CPT® codes?
A. 15110-52, 15002
B. 15100, 11406
C. 15100, 15002
D. 15110, 15002
Question 2
The physician is called in to perform repairs for a 17 year-old girl involved in a motor vehicle accident.
She sustained an 8.6 cm laceration to her forehead, a 5.5 cm laceration to her right cheek, a 4 cm
laceration to her left cheek, a 4 cm laceration across her chin, and a 12.5 cm laceration to her chest. The
wound on her chin required a layered closure. All other wounds required complex closure. The
CPT® codes to report are:
A. 13132, 13133 x 4, 13101, 12052
B. 13132, 13133 x 3, 13133-52, 13101, 13102, 12052
C. 13132, 13133 x 3, 13101, 13102, 12052
D. 13131, 13132, 13133 x 3, 13101, 13102, 12052
Question 3
A 36-year-old male presents to have multiple lesions destroyed. Three benign lesions on his face are
destroyed and five actinic keratoses on his left arm are destroyed. The CPT® code(s) to report is (are):
A. 17000, 17003
B. 17000, 17003 x 4, 17110
C. 17110
D. 17260 x 5, 17110 x 3
Question 4
Patient is having ongoing back and hip pain. The physician elects to perform a sacroiliac injection at an
ambulatory surgery center. After sterile prep, the patient is placed prone position. A needle is placed
under fluoroscopic guidance into the SI joint and a mixture of 20 mg of Celestone and Marcaine is
injected for pain relief. Report the CPT® code(s).
A. 27096, 77003-26
B. 20611
C. 20552
, D. 27096
Question 5
Patient is seen in the hospital’s outpatient surgical area with a diagnosis of a displaced comminuted
closed fracture of the lateral condyle, right elbow. An ORIF procedure was performed, which included the
following techniques: An incision was made in the area of the lateral epicondyle. This was carried through
subcutaneous tissue, and the fracture site was easily exposed. Inspection revealed the fragment to be
rotated in two places, about 90 degrees. It was possible to manually reduce this quite easily, and the
manipulation resulted in an almost anatomic reduction. This was fixed with two pins driven across the
humerus. The pins were cut off below skin level. The wound was closed with plain catgut subcutaneously
and 5-0 nylon for the skin. Dressings and a long arm cast were applied. Which is the correct ICD-10-CM
and CPT® code assignment?
A. 24579-RT, 29065-51-RT, S42.451B
B. 24577-RT, S42.451A
C. 24579-RT, S42.451A
D. 24575-RT, S42.451B
Question 6
A 35-year-old female patient presents with acute onset of severe pain since October. Her workup has
revealed evidence of disk herniation with loss of lordosis at the C5-C6. Intraoperative findings were
consistent with two large fragments of free disk fragments in the foramen at C5-C6 on the right side. After
general anesthesia, the patient was placed on the operative table in the supine position. All pressure
points were cushioned and a transverse skin incision was fashioned under fluoroscopic guidance over the
C5-C6 disc space. Dissection through the platysma eventually allowed for exposure of the anterior
entrance to the vertebral body of C5 and C6 and retractors were inserted to maintain adequate exposure.
The operating microscope was brought into the field. Caspar posts were placed and slight distraction
allowed exposure. A complete discectomy was performed at C5-C6 by using endplate curets pituitary
rongeurs and Kerrison rongeurs. The posterior longitudinal ligament was resected and beneath the
posterior longitudinal ligament, two significant sized disc fragments were noted in the foramen at C5-C6.
These were removed using pituitary and Decker instruments. The endplates were then decorticated so
that they were parallel to each other and a midline keel was performed on AP and lateral fluoroscopy. A
size #1 by 5 mm interbody Kineflex-C device was placed under fluoroscopic guidance. Satisfied with the
positioning of the device, the decision was made to close. What is the correct CPT® code for this
procedure?
A. 63075
B. 63081
C. 22856
D. 22554
Question 7
OPERATION: Dual chamber transvenous implantable pacing cardioverter-defibrillator system
implantation with leads. INDICATIONS: A 67 year-old, white gentleman has significant underlying
ischemic cardiomyopathy with EF of 25 percent, prior infarcts, remote history of syncope, and at a high
risk for malignant ventricular arrhythmias. He has had a recent T wave alternans test which was clearly
abnormal. He has had episodes of resting bradycardia, also noted. He meets Madit II criteria for insertion
of a transvenous implantable pacing cardioverter-defibrillator (ICD). PROCEDURE: After informed
consent had been obtained, the patient was brought to the outpatient hospital lab in the fasting state. The
left anterior chest was prepped and draped in a sterile fashion. Intravenous sedation and local anesthetic
were given. After local anesthetic, a 5 cm incision was made at the left deltopectoral groove. With blunt
dissection and cautery, this was carried down through the prepectoralis fascia. The cephalic vein was
identified and ligated distally. Through the venotomy, a subclavian venogram was performed to provide a
roadmap. The atrial and ventricular leads were then advanced into the vessel to the level of the right
,atrium under fluoroscopic guidance. The ventricular lead was maneuvered to the right ventricular outflow
tract, and then through the RV apex where it was actively fixed. Good sensing and pacing thresholds
were demonstrated. The lead was anchored to the pre-pectoralis fascia with interrupted 2-0 Tycron
sutures. 10-volt pacing did not result in diaphragmatic capture. The atrial lead was maneuvered to the
anterolateral right atrial wall where it was actively fixed. Good sensing and pacing thresholds were
demonstrated. The lead was anchored to the pre-pectoralis fascia with interrupted 2-0 Tycron sutures.
10-volt pacing did not result in diaphragmatic capture. A subcutaneous pocket was c reated with good
hemostasis achieved. The pocket was subsequently irrigated with solution of Bacitracin. The generator
was connected to the lead, and then placed in the pocket with no tension on the lead. The deep fascial
layer was closed with interrupted 2-0 Vicryl suture. The subcutaneous closure was made with running 3-0
Vicryl suture. Subcuticular closure was made with running 4-0 Vicryl suture. Steri-strips were applied.
Ventricular fibrillation was induced with a T wave shock. This was successfully sensed and terminated
with a 15 joule shock to sinus rhythm. High voltage impedance was 39 ohms. Dry dressing was placed
over the wound. The patient returned to the floor in stable condition without apparent complications.
Which of the following CPT® code(s) accurately describes the basic procedure summarized in this
report?
A. 33208
B. 33249, 76000-26
C. 33241, 33243, 33249
D. 33249
Question 8
The patient comes in today to have an arteriovenous fistula created to facilitate dialysis. The surgeon
performs an upper arm basilic vein transposition based on the patient’s previous arterial duplex scan.
Which is the appropriate CPT® code for this procedure?
A. 36825
B. 36830
C. 36818
D. 36819
Question 9
A 56-year-old with lung cancer developed an effusion that is suspicious for malignancy. Needle aspiration
is performed to obtain a sample of the fluid for pathological examination. A needle is inserted between the
ribs and into the pleural space, and the fluid is withdrawn. The specimen is sent to pathology. Choose the
CPT® code that reports the procedure described.
A. 32554
B. 32555
C. 32551
D. 32400
Question 10
A 67-year-old male patient is referred for a flex sigmoidoscopy exam to remove polyps. The physician
found three polyps in the rectosigmoid junction. They were removed by hot biopsy forceps. The path
report indicated the polyps were benign. What is the CPT® code to report for this encounter?
A. 45333
B. 45315
C. 45384
, D. 45346
Question 11
Name of Procedure: Endoscopic retrograde cholangiopancreatogram with stent placement and antral
biopsy. Indications: 50 year-old male who underwent liver transplantation for end-stage liver disease
secondary to chronic hepatitis C and hepatocellular carcinoma in 01/2007. The patient has cholestatic
liver enzymes, requiring ERCP before placement of a 7-French 12 cm stent and to evaluate the biliary
system. Description of Procedure: The patient was taken to the fluoroscopy suite in the GI lab where he
was found to be alert and oriented x 3. After discussing risks and benefits of the procedure, informed
consent was obtained. Patient was kept in the semi prone position. After adequate conscious sedation,
an Olympus side-viewing therapeutic scope was inserted through the mouth all the way to the second
portion of the duodenum. Then, the common bile duct was cannulated and the cholangiogram was
obtained. After the fluoroscopy evaluation of the cholangiogram a 12 cm stent was deployed for biliary
drainage. A biopsy from the antrum was obtained. The patient tolerated the procedure well. There were
no immediate complications.
Which CPT® codes should be reported?
A. 43276, 43261-51
B. 43274, 43261-51
C. 43266, 43239-51
D. 43212, 43202-51
Question 12
A patient with rectal bleeding underwent a proctosigmoidoscopy that showed she had two internal
hemorrhoids. The anus was prepped and draped. A field block with Marcaine 0.25% was then placed.
There was an internal prolapsing hemorrhoid in the anterior midline. This was rubber band ligated by
applying two bands. In the posterior midline, there was another internal hemorrhoid that was banded in
the same manner. Code the procedure.
A. 0249T
B. 46221
C. 46945
D. 46930
Question 13
A neonatal male had an elective circumcision before being discharged home from the newborn nursery.
The physician uses a ring block for the local anesthetic and the foreskin is placed over the glans. A clamp
is selected for the size of the glans and a constricting circular ring is placed over the foreskin to compress
and devascularize the foreskin. The devascularized foreskin is excised with a scalpel and the clamp is left
in place. Which CPT® code should be used?
A. 54150
B. 54160
C. 54161
D. 54150-52
Question 14
