AAPC CPC Practice Exam A Questions
And Answers.
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 -
\C. 11626, 12044-51
According to CPT® guidelines "Repair of an excision of a malignant lesion requiring
intermediate or complex closure should be reported separately". The intermediate repair
code is reported because it was a layered closure.
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 -
\C. 11044
Debridement is not being performed on an open fracture/open dislocation eliminating
multiple choice answer B. The ulcer was debrided all the way to the bone of the foot,
making multiple choice answer C, the correct procedure.
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 -
\99283-25, 12053, 12034-59
To start narrowing your choices, the hand and foot were closed with adhesive strips.
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." Eliminating multiple choice answers A and B. The lacerations on
the face are intermediate repairs, because debridement and glass debris was removed.
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." Eliminating multiple choice
answer C. 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).
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 -
\C. 21931, D17.1
The mass growing turned out to be a lipoma found in the subcutaneous tissue of the
flank. In the ICD-10-CM Alphabetic Index, look for Lipoma/subcutaneous/trunk. You are
referred to code D17.1, eliminating multiple choice answers A and D. Because the 4 cm
tumor was found in the subcutaneous tissue code 21931 is the correct CPT® code to
report.
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 -
\D. 27485-50
Your keywords in the scenario to narrow your choices down to code 27485 are: "distal
femur,""genu valgum," and "hemiepiphysiodesis."
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 -
\C. 36561, 77001-26
Patient is having an Infuse-A-Port put in his chest to receive chemotherapy. The
subclavian vein (central venous) is being tunneled for the access device, eliminating
multiple choices A and D. The patient had a subcutaneous pocket created to insert the
power port, eliminating multiple choice answer B. Code 77001 reports fluoroscopic
guidance for a central venous access device. Modifier 26 denotes the professional
service.
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 -
\A. 32557
The drainage of fluid from the pleural cavity was performed via needle (percutaneous)
with insertion of an indwelling catheter to drain the fluid, eliminating multiple choice
answers B and D. The procedure was performed under ultrasound guidance,
eliminating multiple choice answer C.
And Answers.
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 -
\C. 11626, 12044-51
According to CPT® guidelines "Repair of an excision of a malignant lesion requiring
intermediate or complex closure should be reported separately". The intermediate repair
code is reported because it was a layered closure.
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 -
\C. 11044
Debridement is not being performed on an open fracture/open dislocation eliminating
multiple choice answer B. The ulcer was debrided all the way to the bone of the foot,
making multiple choice answer C, the correct procedure.
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 -
\99283-25, 12053, 12034-59
To start narrowing your choices, the hand and foot were closed with adhesive strips.
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." Eliminating multiple choice answers A and B. The lacerations on
the face are intermediate repairs, because debridement and glass debris was removed.
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." Eliminating multiple choice
answer C. 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).
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 -
\C. 21931, D17.1
The mass growing turned out to be a lipoma found in the subcutaneous tissue of the
flank. In the ICD-10-CM Alphabetic Index, look for Lipoma/subcutaneous/trunk. You are
referred to code D17.1, eliminating multiple choice answers A and D. Because the 4 cm
tumor was found in the subcutaneous tissue code 21931 is the correct CPT® code to
report.
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 -
\D. 27485-50
Your keywords in the scenario to narrow your choices down to code 27485 are: "distal
femur,""genu valgum," and "hemiepiphysiodesis."
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 -
\C. 36561, 77001-26
Patient is having an Infuse-A-Port put in his chest to receive chemotherapy. The
subclavian vein (central venous) is being tunneled for the access device, eliminating
multiple choices A and D. The patient had a subcutaneous pocket created to insert the
power port, eliminating multiple choice answer B. Code 77001 reports fluoroscopic
guidance for a central venous access device. Modifier 26 denotes the professional
service.
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 -
\A. 32557
The drainage of fluid from the pleural cavity was performed via needle (percutaneous)
with insertion of an indwelling catheter to drain the fluid, eliminating multiple choice
answers B and D. The procedure was performed under ultrasound guidance,
eliminating multiple choice answer C.
