Free Certified Professional Coder Questions and Answers — Questions and Answers
Question 1: Third-degree burns totaling 18 sq cm are being treated on a patient's left arm and leg. Three incisions are made with a #11 scalpel after the burns have been scrubbed clean and given anesthesia. After that, sterile gauze is used to redress the burns. <br> What CPT code(s) ought to the doctor use?
- 97602
- 16030, 16035, 16036 x2
- 97597
- 16035, 16036 x2 (Correct answer)
Correct answer: 16035, 16036 x2
The patient has third-degree burns totaling 18 sq cm on the left arm and leg, with three incisions made. CPT code 16035 is for escharotomy, initial incision, which covers the first incision. CPT code 16036 is for each additional escharotomy incision. Since there are three incisions total, one is covered by 16035, and the remaining two are coded with 16036 x2.
Question 2: A 35-year-old man who has internal hemorrhoids visits the doctor to have the hemorrhoids removed. Through an anoscope, the ligator and alligator forceps have been inserted. The doctor locates the largest hemorrhage and uses a rubber band to ligate it at the base. <br> Which CPT code is appropriate to use?
- 46999
- 46250
- 46255
- 46221 (Correct answer)
Correct answer: 46221
CPT code 46221 specifically describes 'Hemorrhoidectomy, internal, by rubber band ligation(s); one or more hemorrhoids.' The scenario details the use of a ligator and alligator forceps to ligate the largest hemorrhage with a rubber band, which perfectly matches this code. This code covers the procedure regardless of the number of hemorrhoids ligated in a single session.
Question 3: To alter refractive error, a procedure is carried out in which corneal tissue from a donor is frozen, reshaped, and implanted into the recipient's anterior corneal stroma. <br> This describes what CPT code?
- 65765 (Correct answer)
- 65710
- 65770
- 65760
Correct answer: 65765
The description 'corneal tissue from a donor is frozen, reshaped, and implanted into the recipient's anterior corneal stroma to alter refractive error' precisely matches the definition of CPT code 65765. This code is for 'Keratomileusis; allogenic, frozen tissue.' This procedure involves reshaping donor corneal tissue and implanting it to correct refractive errors.
Question 4: Due to a ruptured tubal pregnancy, a pregnant woman who is 17 weeks along is hurried into the operating room. She experiences an urgent laparoscopic tubal ligation that necessitates anesthesia because she is hemorrhaging severely. <br> What CPT code(s) needs to be used by the doctor?
- 01965-P5
- 00880-P5, 99140 (Correct answer)
- 00851-P4, 99140
- 00880-P4
Correct answer: 00880-P5, 99140
The patient is 17 weeks pregnant with a ruptured tubal pregnancy requiring emergency laparoscopic tubal ligation due to severe hemorrhage. CPT code 00880 is for anesthesia for procedures on the female genital system. The P5 modifier indicates a moribund patient, appropriate for severe hemorrhage, and 99140 is used for qualifying circumstances for anesthesia, specifically for emergency procedures.
Question 5: A manometric study is carried out because there may be a gastric outlet obstruction. The doctor uses nuclear medicine to track how long it takes food to move through the patient's stomach, how long it takes for the stomach to empty completely into the small intestine, and how quickly it empties. <br> What CPT code(s) ought to be applied?
- 91010, 91013
- 91022
- 91020 (Correct answer)
- 91010
Correct answer: 91020
CPT code 91020 specifically describes a 'Gastric emptying study, solid, with small bowel transit, with drug administration for acceleration or deceleration when performed.' This code accurately reflects the nuclear medicine study performed to track food movement, stomach emptying time, and emptying speed, which are all components of a gastric emptying study. The other options are incorrect because 91010 is for esophageal motility, 91013 is an add-on for esophageal pH monitoring, and 91022 is for duodenal motility, none of which match the described gastric emptying study.
Question 6: Which organ system does the spleen belong to?
- Hemic and Lymphatic (Correct answer)
- Nervous
- Endocrine
- Digestive
Correct answer: Hemic and Lymphatic
The spleen is a vital organ that plays a crucial role in the body's immune system and blood filtration. It is responsible for filtering blood, removing old or damaged red blood cells, and storing platelets and white blood cells. Therefore, the spleen belongs to the Hemic and Lymphatic organ system, which encompasses components involved in blood formation and immunity.
Question 7: How certain conditions with an underlying etiology and multiple body system manifestations as a result of the underlying etiology should be coded during procedures. The ICD-10-CM has a coding convention for these conditions that mandates the underlying condition be
- sequenced last, if applicable, followed by the manifestation
- sequenced first, if applicable, followed by the manifestation (Correct answer)
- ignored
- none of the above
Correct answer: sequenced first, if applicable, followed by the manifestation
According to ICD-10-CM coding guidelines, when a condition has an underlying etiology and multiple body system manifestations, the underlying condition must be sequenced first. This 'code first' convention ensures that the primary cause of the patient's illness is identified and reported before the resulting manifestations. This guideline is crucial for accurate data collection and understanding disease progression.
Question 8: Since his surgery 4 months ago, a patient has been complaining of pain. When the doctor checks the shoulder, he or she finds a metal clamp that was left over from a previous surgery. For an arthroscopy, the doctor sends him to a surgeon who works outside of a hospital. The doctor takes the clamp off and closes the hole. <br> <br> What CPT code(s) needs to be used by the doctor?
- 29819 (Correct answer)
- 29819-78
- 29805, 23333
- 29805, 29819
Correct answer: 29819
CPT code 29819 describes an 'Arthroscopy, shoulder, surgical; with removal of loose body or foreign body.' The scenario clearly states the doctor performs an arthroscopy to remove a metal clamp (foreign body) from the shoulder. Therefore, 29819 is the most appropriate code for this procedure. Modifier -78 is not needed as this is a new procedure by a different surgeon, and the other codes (29805, 23333) do not accurately represent an arthroscopic foreign body removal.
Question 9: A 22-year-old female with AIDS who was experiencing dyspnea in the hospital was ventilator-dependent. With general anesthesia, the doctor takes a sample of a mass or nodule in the lung with a rigid or flexible fiberoptic endoscope. The doctor gives her a thoracoscopy to check if she has pneumonia. After seeing the test results, the doctor told the patient that he or she had Pneumocystis Carinii Pneumonia. <br> <br> What CPT code(s) and ICD-10-CM code(s) are given?
- 32601, B59, B20
- 32608-50, B20, B59 (Correct answer)
- 32608, B20, B59
- 32601, B59
Correct answer: 32608-50, B20, B59
CPT code 32608 represents a 'Thoracoscopy, diagnostic (separate procedure); with biopsy(s), lung, mediastinal pleural and/or thoracic lymph node(s).' The scenario describes a thoracoscopy with a biopsy of a lung mass/nodule. For the diagnoses, B20 is the code for Human Immunodeficiency Virus (HIV) disease, and B59 is for Pneumocystis carinii pneumonia, which is a manifestation of AIDS. According to ICD-10-CM guidelines, B20 (AIDS) is sequenced first, followed by B59 (PCP) as the manifestation. While the question doesn't specify bilateral, the inclusion of modifier -50 in the correct answer implies a bilateral procedure, which would be reported if biopsies were taken from both lungs during the same session.
Question 10: A 38-year-old woman goes to the doctor because she has been bleeding from her uterus for 17 days. The doctor discovered a mass that was 3 x 4 cm in size. On the right vaginal mucosa, the mass was firm and irregular. A biopsy was done, and a small piece of the mass's tissue was taken out and sent to the lab. <br> <br> What CPT code is needed?
- 57105
- 56605
- 58100
- 57100 (Correct answer)
Correct answer: 57100
CPT code 57100 is for a 'Biopsy of vaginal mucosa; incisional (separate procedure).' The scenario describes a biopsy of a 3x4 cm mass on the right vaginal mucosa, where a small piece of tissue was taken. This precisely matches the description for an incisional biopsy of the vaginal mucosa. The other codes (57105, 56605, 58100) are for more extensive vaginal procedures, vulvar biopsies, or endometrial biopsies, respectively, and are not appropriate here.
Question 11: A deep needle bone biopsy was done on the femur by a doctor. A CT scan was used to see and guide the trocar, and an interpretation was given. <br> <br> What CPT code(s) needs to be used by the doctor?
- 20225, 77021
- 20245, 77012-26
- 20225, 77012 (Correct answer)
- 20245, 76998
Correct answer: 20225, 77012
CPT code 20225 represents a 'Biopsy, bone, trocar or needle; deep (e.g., vertebral body, femur).' The scenario describes a deep needle bone biopsy on the femur. For the imaging guidance, CPT code 77012 is used for 'Computed tomography guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), radiological supervision and interpretation.' Both codes are necessary to accurately report the procedure and the imaging guidance provided.
Question 12: A 17-year-old female patient complains of nausea, vomiting, and weight gain in her family doctor's office. These symptoms have been sporadic over the past two weeks. Her sixth week of pregnancy has been confirmed by an examination of her urine, which displays a positive pregnancy test and hCG levels of 12500 mIU/ml. <br> <br> Which CPT code(s) must the physician use?
- 81025, 84704
- 81005, 84702
- 81005, 84704
- 81025, 84702 (Correct answer)
Correct answer: 81025, 84702
CPT code 81025 is for a 'Pregnancy test, urine, by visual color comparison methods.' This covers the positive urine pregnancy test. CPT code 84702 is for 'Gonadotropin, human chorionic (HCG); quantitative.' This code is used to report the hCG levels of 12500 mIU/ml, which is a quantitative measurement. Therefore, both codes are necessary to report the tests performed.
Question 13: Which act applies when health privacy and the relationship between an employer and an employee come together?
- Affordable Care Act
- No Surprises Act 2025
- Americans with Disabilities Act (Correct answer)
- Humanity in Healthcare Act 2025
Correct answer: Americans with Disabilities Act
The Americans with Disabilities Act (ADA) applies when health privacy and the relationship between an employer and an employee come together. The ADA prohibits discrimination against individuals with disabilities in employment, public services, public accommodations, and telecommunications. It includes provisions related to medical examinations and inquiries, ensuring that an employee's health information is kept confidential and only used for legitimate job-related purposes, thus impacting health privacy in the workplace.
Question 14: What part of the body is referred to as the midsagittal plane?
- Bottom
- Top
- Back
- Middle (Correct answer)
Correct answer: Middle
The midsagittal plane is an anatomical plane that divides the body into equal right and left halves. It runs vertically through the exact center of the body, passing through the midline structures. Therefore, it refers to the middle of the body.
Question 15: One of the six main scapulohumeral muscles.
- Teres (Correct answer)
- Temporalis
- Trigone
- Trapezius
Correct answer: Teres
The Teres major and Teres minor muscles are part of the six main scapulohumeral muscles, which connect the scapula (shoulder blade) to the humerus (upper arm bone). These muscles are crucial for shoulder movement and stability. The other options (Temporalis, Trigone, Trapezius) are muscles located elsewhere in the body or anatomical structures.
Question 16: What Z code may only be recognized as a first listed code?
- Z87.710
- Z.37.9
- Z00.129 (Correct answer)
- Z.37.9
Correct answer: Z00.129
Z00.129, 'Encounter for routine child health examination without abnormal findings,' is an example of a Z code that may only be recognized as a first-listed code. This is because it describes the reason for the encounter itself, indicating a routine check-up where no specific illness or injury is being treated. Other Z codes, like Z87.710 (personal history of other diseases of the digestive system), can be secondary codes.
Free Certified Professional Coder Questions and Answers
Third-degree burns totaling 18 sq cm are being treated on a patient's left arm and leg.
Three incisions are made with a #11 scalpel after the burns have been scrubbed clean and given anesthesia.
After that, sterile gauze is used to redress the burns.
What CPT code(s) ought to the doctor use?