Certified Medical Coding Specialist (CCS) Practice Test –
Questions 1– 200
1. A 45-year-old patient presents with severe abdominal pain. Imaging confirms acute
appendicitis with rupture. A laparoscopic appendectomy is performed. Which of the following is
the correct primary procedure code for this encounter?
A) 44950 – Appendectomy, primary.
B) 44970 – Laparoscopic appendectomy.
✅ C) 44960 – Appendectomy; for ruptured appendix with abscess or generalized peritonitis.
D) 44955 – Appendectomy, when performed as an additional procedure.
2. A patient is admitted with diabetic ketoacidosis (DKA) and later diagnosed with Type 1
diabetes mellitus. Which ICD-10-CM code should be used as the principal diagnosis?
A) E11.65 – Type 2 diabetes with hyperglycemia.
B) E10.9 – Type 1 diabetes without complications.
✅ C) E10.10 – Type 1 diabetes with ketoacidosis without coma.
D) E13.10 – Other specified diabetes with ketoacidosis.
3. A 30-year-old female patient undergoes a cesarean delivery due to cephalopelvic
disproportion after attempted vaginal birth. Which CPT code correctly represents this procedure?
A) 59510 – Routine obstetric care including cesarean delivery.
B) 59620 – Cesarean delivery following attempted vaginal delivery.
✅ C) 59618 – Cesarean delivery only, following attempted vaginal delivery after previous
cesarean.
D) 59514 – Cesarean delivery only.
4. A 60-year-old male with a history of chronic obstructive pulmonary disease (COPD) is
admitted with an acute lower respiratory tract infection. Which coding sequence is correct?
A) J44.0 (COPD with acute lower respiratory infection), J20.9 (Acute bronchitis).
✅ B) J44.0 (COPD with acute lower respiratory infection), B97.89 (Viral infection).
C) J44.1 (COPD with exacerbation), J22 (Unspecified acute lower respiratory infection).
D) J44.9 (COPD unspecified), J18.9 (Pneumonia).
5. A diagnostic colonoscopy is performed on a patient with a personal history of colon polyps.
During the procedure, no abnormalities are found. Which code would you assign?
,A) 45378 – Diagnostic colonoscopy, with findings.
✅ B) 45378 – Diagnostic colonoscopy.
C) 45380 – Colonoscopy with biopsy.
D) 45385 – Colonoscopy with polypectomy.
6. A patient is treated for a fractured radius with manipulation and cast application. Which
coding approach is correct?
A) Only code the cast application.
B) Only code the fracture diagnosis.
✅ C) Code both the fracture diagnosis and the closed reduction procedure.
D) Code the fracture diagnosis and the cast application only.
7. A 28-year-old woman undergoes a total abdominal hysterectomy (removal of the uterus
including cervix). Which CPT code applies?
A) 58150 – Total abdominal hysterectomy.
✅ B) 58150 – Hysterectomy, total, abdominal approach.
C) 58200 – Total vaginal hysterectomy.
D) 58570 – Laparoscopic hysterectomy.
8. Which ICD-10-CM code represents a malignant neoplasm of the upper lobe of the right lung?
A) C34.10 – Malignant neoplasm of upper lobe, unspecified lung.
✅ B) C34.11 – Malignant neoplasm of upper lobe, right lung.
C) C34.12 – Malignant neoplasm of upper lobe, left lung.
D) C34.9 – Malignant neoplasm of unspecified lung.
9. A patient undergoes a lumbar puncture for cerebrospinal fluid (CSF) analysis. Which CPT
code best describes this procedure?
A) 62270 – Spinal puncture, lumbar, therapeutic.
✅ B) 62270 – Spinal puncture, lumbar, diagnostic.
C) 62272 – Spinal puncture, therapeutic injection.
D) 62273 – Epidural blood patch.
10. A physician documents “rule out myocardial infarction.” According to official coding
guidelines, how should this be coded for an inpatient setting?
A) Do not code suspected conditions.
✅ B) Code as if the myocardial infarction is confirmed.
,C) Assign Z03.89 – Observation for other suspected diseases.
D) Code the symptoms only (e.g., chest pain).
11. A patient with chronic kidney disease stage 4 is treated for hypertensive kidney disease.
Which ICD-10-CM coding sequence is correct?
A) N18.4 (CKD stage 4), I12.9 (Hypertensive CKD without heart failure).
✅ B) I12.9 (Hypertensive CKD with stage 1–4), N18.4 (CKD stage 4).
C) I10 (Essential hypertension), N18.4 (CKD stage 4).
D) I13.0 (Hypertensive heart and CKD), N18.4 (CKD stage 4).
12. A 40-year-old patient is diagnosed with adenocarcinoma of the sigmoid colon. Which ICD-
10-CM code should be assigned?
A) C18.1 – Malignant neoplasm of appendix.
B) C18.2 – Malignant neoplasm of ascending colon.
✅ C) C18.7 – Malignant neoplasm of sigmoid colon.
D) C18.9 – Malignant neoplasm of colon, unspecified.
13. A patient undergoes removal of a benign tumor in the left kidney. Which CPT code should
be selected?
A) 50200 – Kidney biopsy.
B) 50220 – Nephrectomy, partial, open.
✅ C) 50240 – Nephrectomy, radical, open.
D) 50543 – Laparoscopic nephrectomy.
14. Which ICD-10-CM code is correct for Type 2 diabetes mellitus with diabetic nephropathy?
A) E10.21 – Type 1 diabetes with nephropathy.
✅ B) E11.21 – Type 2 diabetes with nephropathy.
C) E13.21 – Other specified diabetes with nephropathy.
D) E11.9 – Type 2 diabetes without complications.
15. Which CPT modifier should be used to indicate a significant, separately identifiable
evaluation and management (E/M) service on the same day as a minor procedure?
A) -51.
B) -25.
✅ C) -25.
D) -59.
, 16. A patient is undergoing chemotherapy for colon cancer. What is the correct sequencing for
diagnosis codes?
A) Code the chemotherapy first.
✅ B) Code the malignancy (C18.xx) first, followed by Z51.11 (Encounter for chemotherapy).
C) Code Z51.11 first, then C18.xx.
D) Only code the chemotherapy.
17. A laparoscopic cholecystectomy is converted to an open procedure due to complications.
How should this be coded?
A) Code only the laparoscopic procedure.
B) Code both laparoscopic and open.
✅ C) Code the open procedure with modifier -22 if increased work is documented.
D) Code the laparoscopic approach with modifier -52.
18. Which ICD-10-CM code should be assigned for a patient diagnosed with obesity
hypoventilation syndrome?
A) E66.1 – Drug-induced obesity.
B) E66.8 – Other obesity.
✅ C) E66.2 – Morbid (severe) obesity with alveolar hypoventilation.
D) E66.9 – Obesity unspecified.
19. Which ICD-10-PCS code would apply for a coronary artery bypass graft (CABG) involving
one site using the patient’s own internal mammary artery?
A) 02100Z9.
✅ B) 021109W – Bypass coronary artery, one site, autologous artery.
C) 02100WZ – Bypass, synthetic substitute.
D) 02100D8 – Bypass coronary artery, one site, synthetic substitute.
20. A 70-year-old patient is diagnosed with Parkinson’s disease with dementia. Which ICD-10-
CM coding sequence is correct?
A) G20 (Parkinson’s), F02.80 (Dementia in other diseases).
✅ B) G20 (Parkinson’s), F02.81 (Dementia with behavioral disturbance).
C) F01.50 (Vascular dementia), G20.
D) G21 (Secondary Parkinsonism), F02.80.
Questions 1– 200
1. A 45-year-old patient presents with severe abdominal pain. Imaging confirms acute
appendicitis with rupture. A laparoscopic appendectomy is performed. Which of the following is
the correct primary procedure code for this encounter?
A) 44950 – Appendectomy, primary.
B) 44970 – Laparoscopic appendectomy.
✅ C) 44960 – Appendectomy; for ruptured appendix with abscess or generalized peritonitis.
D) 44955 – Appendectomy, when performed as an additional procedure.
2. A patient is admitted with diabetic ketoacidosis (DKA) and later diagnosed with Type 1
diabetes mellitus. Which ICD-10-CM code should be used as the principal diagnosis?
A) E11.65 – Type 2 diabetes with hyperglycemia.
B) E10.9 – Type 1 diabetes without complications.
✅ C) E10.10 – Type 1 diabetes with ketoacidosis without coma.
D) E13.10 – Other specified diabetes with ketoacidosis.
3. A 30-year-old female patient undergoes a cesarean delivery due to cephalopelvic
disproportion after attempted vaginal birth. Which CPT code correctly represents this procedure?
A) 59510 – Routine obstetric care including cesarean delivery.
B) 59620 – Cesarean delivery following attempted vaginal delivery.
✅ C) 59618 – Cesarean delivery only, following attempted vaginal delivery after previous
cesarean.
D) 59514 – Cesarean delivery only.
4. A 60-year-old male with a history of chronic obstructive pulmonary disease (COPD) is
admitted with an acute lower respiratory tract infection. Which coding sequence is correct?
A) J44.0 (COPD with acute lower respiratory infection), J20.9 (Acute bronchitis).
✅ B) J44.0 (COPD with acute lower respiratory infection), B97.89 (Viral infection).
C) J44.1 (COPD with exacerbation), J22 (Unspecified acute lower respiratory infection).
D) J44.9 (COPD unspecified), J18.9 (Pneumonia).
5. A diagnostic colonoscopy is performed on a patient with a personal history of colon polyps.
During the procedure, no abnormalities are found. Which code would you assign?
,A) 45378 – Diagnostic colonoscopy, with findings.
✅ B) 45378 – Diagnostic colonoscopy.
C) 45380 – Colonoscopy with biopsy.
D) 45385 – Colonoscopy with polypectomy.
6. A patient is treated for a fractured radius with manipulation and cast application. Which
coding approach is correct?
A) Only code the cast application.
B) Only code the fracture diagnosis.
✅ C) Code both the fracture diagnosis and the closed reduction procedure.
D) Code the fracture diagnosis and the cast application only.
7. A 28-year-old woman undergoes a total abdominal hysterectomy (removal of the uterus
including cervix). Which CPT code applies?
A) 58150 – Total abdominal hysterectomy.
✅ B) 58150 – Hysterectomy, total, abdominal approach.
C) 58200 – Total vaginal hysterectomy.
D) 58570 – Laparoscopic hysterectomy.
8. Which ICD-10-CM code represents a malignant neoplasm of the upper lobe of the right lung?
A) C34.10 – Malignant neoplasm of upper lobe, unspecified lung.
✅ B) C34.11 – Malignant neoplasm of upper lobe, right lung.
C) C34.12 – Malignant neoplasm of upper lobe, left lung.
D) C34.9 – Malignant neoplasm of unspecified lung.
9. A patient undergoes a lumbar puncture for cerebrospinal fluid (CSF) analysis. Which CPT
code best describes this procedure?
A) 62270 – Spinal puncture, lumbar, therapeutic.
✅ B) 62270 – Spinal puncture, lumbar, diagnostic.
C) 62272 – Spinal puncture, therapeutic injection.
D) 62273 – Epidural blood patch.
10. A physician documents “rule out myocardial infarction.” According to official coding
guidelines, how should this be coded for an inpatient setting?
A) Do not code suspected conditions.
✅ B) Code as if the myocardial infarction is confirmed.
,C) Assign Z03.89 – Observation for other suspected diseases.
D) Code the symptoms only (e.g., chest pain).
11. A patient with chronic kidney disease stage 4 is treated for hypertensive kidney disease.
Which ICD-10-CM coding sequence is correct?
A) N18.4 (CKD stage 4), I12.9 (Hypertensive CKD without heart failure).
✅ B) I12.9 (Hypertensive CKD with stage 1–4), N18.4 (CKD stage 4).
C) I10 (Essential hypertension), N18.4 (CKD stage 4).
D) I13.0 (Hypertensive heart and CKD), N18.4 (CKD stage 4).
12. A 40-year-old patient is diagnosed with adenocarcinoma of the sigmoid colon. Which ICD-
10-CM code should be assigned?
A) C18.1 – Malignant neoplasm of appendix.
B) C18.2 – Malignant neoplasm of ascending colon.
✅ C) C18.7 – Malignant neoplasm of sigmoid colon.
D) C18.9 – Malignant neoplasm of colon, unspecified.
13. A patient undergoes removal of a benign tumor in the left kidney. Which CPT code should
be selected?
A) 50200 – Kidney biopsy.
B) 50220 – Nephrectomy, partial, open.
✅ C) 50240 – Nephrectomy, radical, open.
D) 50543 – Laparoscopic nephrectomy.
14. Which ICD-10-CM code is correct for Type 2 diabetes mellitus with diabetic nephropathy?
A) E10.21 – Type 1 diabetes with nephropathy.
✅ B) E11.21 – Type 2 diabetes with nephropathy.
C) E13.21 – Other specified diabetes with nephropathy.
D) E11.9 – Type 2 diabetes without complications.
15. Which CPT modifier should be used to indicate a significant, separately identifiable
evaluation and management (E/M) service on the same day as a minor procedure?
A) -51.
B) -25.
✅ C) -25.
D) -59.
, 16. A patient is undergoing chemotherapy for colon cancer. What is the correct sequencing for
diagnosis codes?
A) Code the chemotherapy first.
✅ B) Code the malignancy (C18.xx) first, followed by Z51.11 (Encounter for chemotherapy).
C) Code Z51.11 first, then C18.xx.
D) Only code the chemotherapy.
17. A laparoscopic cholecystectomy is converted to an open procedure due to complications.
How should this be coded?
A) Code only the laparoscopic procedure.
B) Code both laparoscopic and open.
✅ C) Code the open procedure with modifier -22 if increased work is documented.
D) Code the laparoscopic approach with modifier -52.
18. Which ICD-10-CM code should be assigned for a patient diagnosed with obesity
hypoventilation syndrome?
A) E66.1 – Drug-induced obesity.
B) E66.8 – Other obesity.
✅ C) E66.2 – Morbid (severe) obesity with alveolar hypoventilation.
D) E66.9 – Obesity unspecified.
19. Which ICD-10-PCS code would apply for a coronary artery bypass graft (CABG) involving
one site using the patient’s own internal mammary artery?
A) 02100Z9.
✅ B) 021109W – Bypass coronary artery, one site, autologous artery.
C) 02100WZ – Bypass, synthetic substitute.
D) 02100D8 – Bypass coronary artery, one site, synthetic substitute.
20. A 70-year-old patient is diagnosed with Parkinson’s disease with dementia. Which ICD-10-
CM coding sequence is correct?
A) G20 (Parkinson’s), F02.80 (Dementia in other diseases).
✅ B) G20 (Parkinson’s), F02.81 (Dementia with behavioral disturbance).
C) F01.50 (Vascular dementia), G20.
D) G21 (Secondary Parkinsonism), F02.80.
