CPC Practice Exam 1
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 - -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.
Answer C
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 - -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. Answer C
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.
, CPC Practice Exam 1
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 - -To start narrowing your choices down, the hand and
foot were closed with adhesive strips. The Section Guidelines in the CPT® manual 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). Answer D
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 - -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. Answer C
PREOPERATIVE DIAGNOSIS: Right scaphoid fracture. TYPE OF PROCEDURE: Open
reduction and internal fixation of right scaphoid fracture. DESCRIPTION OF PROCEDURE:
The patient was brought to the operating room; anesthesia having been administered. The
right upper extremity was prepped and draped in a sterile manner. The limb was elevated,
exsanguinated, and a pneumatic arm tourniquet was elevated. An incision was made over
the dorsal radial aspect of the right wrist. Skin flaps were elevated. Cutaneous nerve
branches were identified and very gently retracted. The interval between the second and
, CPC Practice Exam 1
third dorsal compartment tendons was identified and entered. The respective tendons
were retracted. A dorsal capsulotomy incision was made, and the fracture was visualized.
There did not appear to be any type of significant defect at the fracture site. A 0.045
Kirschner wire was then used as a guidewire, extending from the proximal - -Patient
had an open reduction, meaning an incision was made to get to the fracture, eliminating
multiple choice answer B. The fracture site was the scaphoid of the wrist (carpal),
eliminating multiple choices C and D. Answer A
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 - -Your keywords in the scenario to narrow your choices down to code
27485 are: "distal femur,""genu valgum," and "hemiepiphysiodesis." Answer D
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 - -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. Answer C
