1|Page
CCS PRACTICE EXAM REAL QUESTIONS WITH
VERIFIED ACTUAL ANSWERS /A+ GRADE ASSURED
A 12-year-old boy was seen in an ambulatory surgical center for pain in his right
arm. The x-ray showed fracture of ulna. Patient underwent closed reduction of
fracture right proximal ulna and an elbow-to-finger cast was applied. What
diagnostic and procedure codes should be assigned?
S52.101AUnspecified fracture of upper end of right radius, initial encounter for
closed fracture
S52.101BUnspecified fracture of upper end of right radius, initial encounter for
open fracture
S52.001AUnspecified fracture of upper end of right ulna, initial encounter for
closed fracture
S52.001BUnspecified fracture of upper end of right ulna, initial encounter for
open fracture
0PSH0ZZReposition right radius, open approach
0PSK0ZZReposition right ulna, open approach
24670Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid
process(es) ); without manipulation
24675Closed treatment of ulnar fracture, proximal end (eg - (answers)Correct
Answer: D
The patient has a fracture of the right proximal ulna and closed reduction is
necessary. In the ICD-10-CM Code Book, under Fracture, ulna, proximal, the coder
is referred to Fracture, ulna, upper end. The term "manipulation" is used to
indicate reduction in CPT. According to CPT guidelines, cast application or
strapping (including removal) is only reported as a replacement procedure or
,2|Page
when the cast application or strapping is an initial service performed without a
restorative treatment or procedure (AMA CPT Professional Edition 2020, 182).
(Note: Since this is an ambulatory surgery center case, CPT codes are assigned
rather than ICD-10-PCS codes.)
A laparoscopic tubal ligation is completed. What is the correct CPT code
assignment?
49320Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or
without collection of specimen(s) by brushing or washing (separate procedure)
58662Laparoscopy, surgical; with fulguration or excision of lesions of the ovary,
pelvic viscera, or peritoneal surface by any method
58670Laparoscopy, surgical; with fulguration of oviducts (with or without
transection)
58671Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip,
or Falope ring)
a. 49320, 58662
b. 58670
c. 58671
d. 49320 - (answers)Correct Answer: B
The code that best reports the tubal ligation is 58670 Laparoscopy, surgical; with
fulguration of oviducts because there are no clips or excision of lesion completed
during the procedure (CPT Assistant Nov. 1999, 29; March 2000, 10).
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Normal twin delivery at 30 weeks. Both babies were delivered vaginally and were
liveborn. What conditions should have codes assigned?
O30.003Twin pregnancy, unspecified number of placenta and unspecified number
of amniotic sacs, third trimester
O30.009Twin pregnancy, unspecified number of placenta and unspecified number
of amniotic sacs, unspecified trimester
O60.14X0Preterm labor third trimester with preterm delivery third trimester, not
applicable or unspecified
O60.14X1 Preterm labor third trimester with preterm delivery third trimester,
fetus 1
O60.14X2Preterm labor third trimester with preterm delivery third trimester,
fetus
2O80Encounter for full-term uncomplicated delivery
Z3A.3030 weeks gestation of pregnancy
Z37.0Single live birth
Z37.2Twins, both liveborn
a. O80, Z3A.30, Z37.0
b. O30.003, O60.14X0, Z3A.30, Z37.2
c. O60.14X1, O60.14X2 O30.003, Z3A.30, Z37.2
d. O80, O30.009, Z3A.30, Z37.2 - (answers)Correct Answer: C
A code for preterm labor and delivery is assigned for each fetus since both babies
were born preterm as noted in Coding Clinic. Additionally, a code from category
O30, Multiple gestations, must be assigned (Leon-Chisen 2020, 325; AHA Coding
Clinic 2016 2nd Quarter, 10-11).
, 4|Page
A patient with acute respiratory failure, hypertension, and congestive heart
failure is admitted for intubation and ventilation. The patient's heart failure is
stable on current medications. What are the correct diagnosis codes and
sequencing?
I10Essential hypertension
I11.0Hypertensive heart with heart failure
I50.9Heart failure, unspecified
J96.00Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.20Acute and chronic respiratory failure, unspecified whether with hypoxia or
hypercapnia
a. J96.00, I11.0, I50.9
b. I50.9, J96.00, I10
c. J96.20, I10, I50.9
d. I50.9, J96.20, I11.0 - (answers)Correct Answer: A
The patient was admitted and treated for respiratory failure. The other conditions
present are also coded. The classification presumes a causal relationship between
hypertension and congestive heart failure unless the physician documents
otherwise (Leon-Chisen 2020, 228-231; CMS 2020a, Section I.C.10.b., 53, Section
I.C.9.a, 46; AHA Coding Clinic 2017 1st Quarter, 47).
A 64-year-old female was discharged with the final diagnosis of acute renal failure
and hypertension. What coding guideline applies?
CCS PRACTICE EXAM REAL QUESTIONS WITH
VERIFIED ACTUAL ANSWERS /A+ GRADE ASSURED
A 12-year-old boy was seen in an ambulatory surgical center for pain in his right
arm. The x-ray showed fracture of ulna. Patient underwent closed reduction of
fracture right proximal ulna and an elbow-to-finger cast was applied. What
diagnostic and procedure codes should be assigned?
S52.101AUnspecified fracture of upper end of right radius, initial encounter for
closed fracture
S52.101BUnspecified fracture of upper end of right radius, initial encounter for
open fracture
S52.001AUnspecified fracture of upper end of right ulna, initial encounter for
closed fracture
S52.001BUnspecified fracture of upper end of right ulna, initial encounter for
open fracture
0PSH0ZZReposition right radius, open approach
0PSK0ZZReposition right ulna, open approach
24670Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid
process(es) ); without manipulation
24675Closed treatment of ulnar fracture, proximal end (eg - (answers)Correct
Answer: D
The patient has a fracture of the right proximal ulna and closed reduction is
necessary. In the ICD-10-CM Code Book, under Fracture, ulna, proximal, the coder
is referred to Fracture, ulna, upper end. The term "manipulation" is used to
indicate reduction in CPT. According to CPT guidelines, cast application or
strapping (including removal) is only reported as a replacement procedure or
,2|Page
when the cast application or strapping is an initial service performed without a
restorative treatment or procedure (AMA CPT Professional Edition 2020, 182).
(Note: Since this is an ambulatory surgery center case, CPT codes are assigned
rather than ICD-10-PCS codes.)
A laparoscopic tubal ligation is completed. What is the correct CPT code
assignment?
49320Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or
without collection of specimen(s) by brushing or washing (separate procedure)
58662Laparoscopy, surgical; with fulguration or excision of lesions of the ovary,
pelvic viscera, or peritoneal surface by any method
58670Laparoscopy, surgical; with fulguration of oviducts (with or without
transection)
58671Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip,
or Falope ring)
a. 49320, 58662
b. 58670
c. 58671
d. 49320 - (answers)Correct Answer: B
The code that best reports the tubal ligation is 58670 Laparoscopy, surgical; with
fulguration of oviducts because there are no clips or excision of lesion completed
during the procedure (CPT Assistant Nov. 1999, 29; March 2000, 10).
,3|Page
Normal twin delivery at 30 weeks. Both babies were delivered vaginally and were
liveborn. What conditions should have codes assigned?
O30.003Twin pregnancy, unspecified number of placenta and unspecified number
of amniotic sacs, third trimester
O30.009Twin pregnancy, unspecified number of placenta and unspecified number
of amniotic sacs, unspecified trimester
O60.14X0Preterm labor third trimester with preterm delivery third trimester, not
applicable or unspecified
O60.14X1 Preterm labor third trimester with preterm delivery third trimester,
fetus 1
O60.14X2Preterm labor third trimester with preterm delivery third trimester,
fetus
2O80Encounter for full-term uncomplicated delivery
Z3A.3030 weeks gestation of pregnancy
Z37.0Single live birth
Z37.2Twins, both liveborn
a. O80, Z3A.30, Z37.0
b. O30.003, O60.14X0, Z3A.30, Z37.2
c. O60.14X1, O60.14X2 O30.003, Z3A.30, Z37.2
d. O80, O30.009, Z3A.30, Z37.2 - (answers)Correct Answer: C
A code for preterm labor and delivery is assigned for each fetus since both babies
were born preterm as noted in Coding Clinic. Additionally, a code from category
O30, Multiple gestations, must be assigned (Leon-Chisen 2020, 325; AHA Coding
Clinic 2016 2nd Quarter, 10-11).
, 4|Page
A patient with acute respiratory failure, hypertension, and congestive heart
failure is admitted for intubation and ventilation. The patient's heart failure is
stable on current medications. What are the correct diagnosis codes and
sequencing?
I10Essential hypertension
I11.0Hypertensive heart with heart failure
I50.9Heart failure, unspecified
J96.00Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.20Acute and chronic respiratory failure, unspecified whether with hypoxia or
hypercapnia
a. J96.00, I11.0, I50.9
b. I50.9, J96.00, I10
c. J96.20, I10, I50.9
d. I50.9, J96.20, I11.0 - (answers)Correct Answer: A
The patient was admitted and treated for respiratory failure. The other conditions
present are also coded. The classification presumes a causal relationship between
hypertension and congestive heart failure unless the physician documents
otherwise (Leon-Chisen 2020, 228-231; CMS 2020a, Section I.C.10.b., 53, Section
I.C.9.a, 46; AHA Coding Clinic 2017 1st Quarter, 47).
A 64-year-old female was discharged with the final diagnosis of acute renal failure
and hypertension. What coding guideline applies?
