[Aug 14, 2026] CPC Ultimate Study Guide - PDF4Test
Ultimate Guide to Prepare CPC Certification Exam for Certified Professional Coder in 2026
NEW QUESTION # 174
A patient with malignant lymphoma is administered the antineoplastic drug Rituximab 800 mg and then 100 mg of Benadryl.
Which HCPCS Level II codes are reported for both drugs administered intravenously?
- A. J9312 x 80, 00163 x 2
- B. J9312, Q0163
- C. J9312 x 80, J1200 x 2
- D. J9312, J1200
Answer: D
Explanation:
The patient with malignant lymphoma is administered Rituximab (800 mg) and Benadryl (100 mg) intravenously.
Procedure Description:
Administration of Rituximab (800 mg) intravenously.
Administration of Benadryl (100 mg) intravenously.
HCPCS Level II Coding:
J9312: Injection, Rituximab, 10 mg.
For 800 mg, report 80 units of J9312.
J1200: Injection, Diphenhydramine HCl, up to 50 mg.
For 100 mg, report 2 units of J1200.
HCPCS Level II Code Book (current year).
HCPCS Level II coding guidelines for intravenous drug administration.
NEW QUESTION # 175
Which one of the following is a commercial or private payer?
- A. Medicare
- B. Veterans Health Administration (VHA)
- C. Blue Cross Blue Shield
- D. Medicaid
Answer: C
Explanation:
Blue Cross Blue Shield is a commercial or private payer, which means it is an insurance company that provides health insurance plans to individuals and groups. In contrast, Medicare and Medicaid are government programs, and the Veterans Health Administration (VHA) is a federal healthcare system for military veterans.
AMA's CPT Professional Edition (current year), Appendix B: Payers and Reimbursement.
NEW QUESTION # 176
View MR 005398
MR 005398
Operative Report
Preoperative Diagnosis: Nonfunctioning right kidney with ureteral stricture.
Postoperative Diagnosis: Nonfunctioning right kidney with ureteral stricture.
Procedure: Right nephrectomy with partial ureterectomy.
Findings and Procedure: Under satisfactory general anesthesia, the patient was placed in the right flank position. Right flank and abdomen were prepared and draped out of the sterile field. Skin incision was made between the 11th and 12th ribs laterally. The incision was carried down through the underlying subcutaneous tissues, muscles, and fascia. The right retroperitoneal space was entered. Using blunt and sharp dissection, the right kidney was freed circumferentially. The right artery, vein, and ureter were identified. The ureter was dissected downward where it is completely obstructed in its distal extent. The ureter was clipped and divided distally. The right renal artery was then isolated and divided between 0 silk suture ligatures. The right renal vein was also ligated with suture ligatures and 0 silk ties. The right kidney and ureter were then submitted for pathologic evaluation. The operative field was inspected, and there was no residual bleeding noted, and then it was carefully irrigated with sterile water. Wound closure was then undertaken using 0 Vicryl for the fascial layers, 0 Vicryl for the muscular layers, 2-0 chromic for subcutaneous tissue, and clips for the skin. A Penrose drain was brought out through the dependent aspect of the incision. The patient lost minimal blood and tolerated the procedure well.
What CPT coding is reported for this case?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
Explanation:
The procedure involves a right nephrectomy with partial ureterectomy for a nonfunctioning right kidney with ureteral stricture.
Procedure Description:
Right nephrectomy (removal of the kidney).
Partial ureterectomy (removal of part of the ureter).
CPT Coding:
50220: Nephrectomy, including partial ureterectomy, any open approach.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on nephrectomy procedures.
NEW QUESTION # 177
View MR 099405
MR 099405
CC: Shortness of breath
HPI: 16-year-old female comes into the ED for shortness of breath for the last two days. She is an asthmatic.
Current medications being used to treat symptoms is Advair, which is not working and breathing is getting worse. Does not feel that Advair has been helping. Patient tried Albuterol for persistent coughing, is not helping. Coughing 10-15 minutes at a time. Patient has used the Albuterol 3x in the last 16 hrs. ED physician admits her to observation status.
ROS: No fever, no headache. No purulent discharge from the eyes. No earache. No nasal discharge or sore throat. No swollen glands in the neck. No palpitations. Dyspnea and cough. Some chest pain. No nausea or vomiting. No abdominal pain, diarrhea, or constipation.
PMH: Asthma
SH: Lives with both parents.
FH: Family hx of asthma, paternal side
ALLERGIES: PCN-200 CAPS. Allergies have been reviewed with child's family and no changes reported.
PE: General appearance: normal, alert. Talks in sentences. Pink lips and cheeks. Oriented. Well developed.
Well nourished. Well hydrated.
Eyes: normal. External eye: no hyperemia of the conjunctiva. No discharge from the conjunctiva Ears: general/bilateral. TM: normal. Nose: rhinorrhea. Pharynx/Oropharynx: normal. Neck: normal.
Lymph nodes: normal.
Lungs: before Albuterol neb, mode air entry b/l. No rales, rhonchi or wheezes. After Albuterol neb.
improvement of air entry b/l. Respiratory movements were normal. No intercostals inspiratory retraction was observed.
Cardiovascular system: normal. Heart rate and rhythm normal. Heart sounds normal. No murmurs were heard.
GI: abdomen normal with no tenderness or masses. Normal bowel sounds. No hepatosplenomegaly Skin: normal warm and dry. Pink well perfused Musculoskeletal system patient indicates lower to mid back pain when she lies down on her back and when she rolls over. No CVA tenderness.
Assessment: Asthma, acute exacerbation
Plan: Will keep her in observation overnight. Will administer oral steroids and breathing treatment. CXR ordered and to be taken in the morning.
What E/M code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: C
Explanation:
* 99222: This code is used for initial hospital care, per day, for the evaluation and management of a patient, which requires a detailed or comprehensive history, a detailed or comprehensive examination, and medical decision making of moderate complexity.
* The documentation shows a detailed history (including HPI, ROS, PMH, SH, and FH) and a detailed examination (covering multiple organ systems). The medical decision making involves the management of an acute asthma exacerbation, which includes admitting the patient to observation status, administering oral steroids, and planning for further diagnostic testing.
References:
* CPT Professional Edition, AMA
NEW QUESTION # 178
A 64-year-old with congestive heart failure (CHF) has pericardial effusion. The provider inserts a needle under ultrasound guidance, aspirating the fluid from the pericardial sac.
What CPT coding is reported?
- A. 0
- B. 33017, 76942
- C. 33016, 76942
- D. 1
Answer: D
Explanation:
33016 = Pericardiocentesis, including imaging guidance (e.g., ultrasound) when performed.Because the code already includes imaging guidance, you do not separately report 76942.So the correct coding is 33016 only # B).
NEW QUESTION # 179
Ten-year-old boy has a painful felon abscess of the deep tissues of the palmar surface of his right thumb. The provider makes an incision on one side of the nail and then across the fingertip parallel to the end of the nail. He identifies the area of abscess and drains it. A drainage tube is inserted.
What CPT and ICD-10-CM is reported?
- A. 10140-F5, L02.511
- B. 10061-F5, L03.011
- C. 26011-F5, L03.011
- D. 26010-F5, L02.511
Answer: D
Explanation:
1. Procedure and CPT Code Selection:
The procedure involves an incision and drainage (I&D) of a deep abscess (felon) on the palmar surface of the right thumb. A felon is an abscess in the pulp of the fingertip, often involving deep tissue.
Code 26010 is specific for incision and drainage of a finger abscess, which includes the thumb. This code applies to cases where the abscess is drained from a deep tissue level.
Code 26011 is similar but involves the use of extensive drainage or debridement, which is not indicated in this case. Therefore, 26011 is not appropriate here.
Code 10061 refers to incision and drainage of abscesses at different locations on the body but not for specific areas such as the thumb, making it inappropriate in this context.
Code 10140 pertains to the evacuation of hematoma, seroma, or fluid but does not apply to abscesses, so it is not suitable for this scenario.
2. Modifier:
Modifier F5 is added to specify that the procedure was performed on the right thumb.
3. Diagnosis and ICD-10-CM Code Selection:
ICD-10-CM Code L02.511 is appropriate for cutaneous abscess of the right finger, as it accurately describes the diagnosis of a felon on the thumb.
L03.011 would represent cellulitis but does not specify an abscess, making it less precise for this case.
4. AAPC and CPT Coding Guidelines:
The AAPC guidelines for coding finger abscess drainage emphasize the selection of specific codes for deep tissue drainage procedures in extremities. Additionally, correct laterality should be included with the use of modifiers and specific ICD-10-CM codes for an accurate representation of the site and nature of the condition.
Thus, based on the coding standards and guidelines, the verified answer is B. 26010-F5, L02.511.
NEW QUESTION # 180
An abdominal X-ray includes decubitus, supine, and erect views.
What CPT code is reported?
- A. 74022-26
- B. 74021-26
- C. 74018-26
- D. 74019-26
Answer: B
Explanation:
74021 = Abdomen, complete, including decubitus and erect views
-26 = Professional component
NEW QUESTION # 181
Which is a malignant neoplasm originating in the skin?
- A. Lymphoma
- B. Osteosarcoma
- C. Hemangioma
- D. Melanoma
Answer: D
Explanation:
Melanoma is a malignant neoplasm of melanocytes, which are pigment-producing cells found primarily in the skin. It is one of the most serious forms of skin cancer and is classified under ICD-10-CM category C43.- (Malignant melanoma of skin).
Osteosarcoma is a malignant tumor of bone, not skin (ICD-10-CM C40-C41).
Hemangioma is a benign tumor of blood vessels and is not malignant (often coded under D18.-).
Lymphoma is a malignancy of the lymphatic system, not a primary skin neoplasm (ICD-10-CM C81-C85), though rare cutaneous lymphomas exist, they are not the standard CPC exam answer here.
NEW QUESTION # 182
The surgeon performs Roux-en-Y anastomosis of the extrahepatic biliary duct to the gastrointestinal tract on a
45-year-old patient.
What CPT code is reported?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: A
Explanation:
The Roux-en-Y anastomosis of the extrahepatic biliary duct to the gastrointestinal tract is a specific surgical procedure that involves connecting the biliary duct to the gastrointestinal tract.
Procedure Description: Roux-en-Y anastomosis of the extrahepatic biliary duct involves creating a direct connection between the biliary duct and the gastrointestinal tract.
Procedure Specificity: The procedure is complex and involves extensive surgical technique and anastomosis.
Coding Decision:
CPT 47780 specifically describes the Roux-en-Y anastomosis of the extrahepatic biliary duct to the gastrointestinal tract.
AMA's CPT Professional Edition (current year).
CPT Assistant for detailed coding guidelines on biliary and gastrointestinal procedures.
NEW QUESTION # 183
According to the Repair (Closure) CPT guidelines, what type of repair is reported when a single layer closure includes copious irrigation and extensive cleaning to remove particulate matter?
- A. Simple repair
- B. Simple repair plus a code for irrigation
- C. Complex repair
- D. Intermediate repair
Answer: D
NEW QUESTION # 184
(Full Case:Pre/Post-op diagnosis:Grade 1 endometrial cancer.Procedure:Radical hysterectomy and pelvic lymph node sampling.Anesthesia:General.EBL:400 mL.Complications:None.Specimens:pelvic washings; uterus; tubes; ovaries; pelvic lymph nodes.Fluids:2 L crystalloid.Operative details:frog-leg position; perineum prepped sterile; Foley placed; midline vertical incision umbilicus to symphysis; exploration shows normal upper abdomen and bowel; no paraaortic adenopathy; pelvis/perineum normal; washings collected; round ligaments transected; retroperitoneal spaces opened; ureters visualized; ovarian vessels isolated/ligated; bladder flap taken down; uterine arteries, uterosacral and cardinal ligaments clamped/ligated; uterus removed; vagina closed; lymph node sampling left then right with removal of lymphatic tissue from external/internal iliac bifurcation to circumflex iliac vein and down to obturator nerve; tumor ~40% endometrial surface with
<50% myometrial invasion; closure in layers; patient tolerated well.Question:What CPT codes are reported?)
- A. 0
- B. 58210, 38770
- C. 1
- D. 58548, 38770
Answer: B
Explanation:
The operative note describes anopen radical hysterectomyfor endometrial cancer with removal of theuterus, tubes, and ovaries(specimens listed) and extensive dissection ofuterine arteries, uterosacral and cardinal ligaments, consistent with aradicalprocedure. The approach is clearlyabdominal/open(midline vertical incision and abdominal entry), not laparoscopic, so a laparoscopic radical hysterectomy code (such as 58548) is not appropriate. In the answer set,58210represents aradical abdominal hysterectomy(with appropriate extent for malignancy management). In addition, the surgeon performedpelvic lymph node samplingbilaterally, removing lymphatic tissue along the iliac vessels to the obturator nerve region. The correct code in the choices for pelvic lymphadenectomy/sampling is38770. Pelvic washings and extensive exploration are included in the primary surgical service and do not add separate CPT codes in this scenario. Therefore, the correct coding combination is58210 and 38770.
NEW QUESTION # 185
Patient has cervical spondylosis with myelopathy. The surgeon performed a bilateral posterior laminectomy with facetectomies at each level and foraminotomies performed between interspaces C5-C6 and C6-C7. Bilateral decompression of the nerve roots is achieved.
What CPT coding is reported?
- A. 63045, 63048
- B. 0
- C. 63040-50, 63043, 63043
- D. 63050-50
Answer: A
NEW QUESTION # 186
A patient arrived at the emergency department experiencing pain in both legs. The ED physician ordered a comprehensive duplex scan of the arteries in both lower extremities to rule out arteriosclerosis.
What CPT and ICD-10-CM codes are reported?
- A. 93925, M79.604. M79.605
- B. 93926 x 2. M79.604, M79.605
- C. 93926 x 2,170.303. M79.604, M79.605
- D. 93925x2.170.303
Answer: A
Explanation:
93925 - Duplex scan of arteries, bilateral lower extremities; complete
Includes both legs → do not bill twice
Diagnosis Codes:
M79.604 - Pain in right leg
M79.605 - Pain in left leg
Why others are incorrect:
93926 × 2 - Unilateral only
I70.303 - Arteriosclerosis not confirmed
NEW QUESTION # 187
A patient with a history of chronic venous embolism in the inferior vena cava has a radiographic study to visualize any abnormalities. In outpatient surgery the physician accesses the subclavian vein and the catheter is advanced to the inferior vena cava for injection and imaging. The supervision and interpretation of the images is performed by the physician.
What codes are reported for this procedure?
- A. 36010, 75825-26
- B. 36000, 75825-26
- C. 36000, 75827-26
- D. 36010, 75827-26
Answer: A
NEW QUESTION # 188
A patient undergoes lumbar puncture with catheter placement under CT guidance to drain CSF.
What CPT coding is reported?
- A. 62272, 77012
- B. 62328, 77012
- C. 0
- D. 1
Answer: A
Explanation:
62272 = Lumbar puncture with catheter for CSF drainage
77012 = CT guidance for needle placement
NEW QUESTION # 189
What is the medical term for a procedure that creates an opening between the bladder and the rectum?
- A. Cystoproctostomy
- B. Colocholecystostomy
- C. Nephropyelostomy
- D. Gastroenterocolostomy
Answer: A
Explanation:
Breaking down the term:
Cyst/o = bladder
Proct/o = rectum
-stomy = creation of an opening
Cystoproctostomy is the surgical creation of an opening between the bladder and the rectum.
The other options involve different organs:
Gastroenterocolostomy - stomach to intestine
Colocholecystostomy - colon to gallbladder
Nephropyelostomy - kidney to renal pelvis
NEW QUESTION # 190
Two weeks after removal of a 4 cm subcutaneous lipoma, the patient presents with extensive internal wound dehiscence requiring multi-layer closure in the OR.
What CPT coding is reported by the surgeon?
- A. 13160-78
- B. 13101-58
- C. 13160-58
- D. 13101-78
Answer: A
Explanation:
Repair of wound dehiscence # CPT 13160 (complex repair, secondary closure) Occurs during global period and is unplanned # Modifier -78 Modifier -58 is for staged or planned procedures.
NEW QUESTION # 191
A 25-year-old woman underwent percutaneous breast biopsy on the right breast with placement of a Gelmark clip. The procedure was performed using stereotactic imaging.
What CPTcodes will be reported?
- A. 0
- B. 19081, 19283
- C. 19101, 19283
- D. 19100, 76098
Answer: A
Explanation:
CPT code 19081 is used for percutaneous biopsy of breast(s) using stereotactic guidance, which includes the placement of a localization device and imaging of the biopsy specimen when performed. This accurately describes the procedure performed on the right breast with the placement of a Gelmark clip using stereotactic imaging. The other codes either describe open biopsies or separate procedures that are not applicable here.
References: AMA's CPTProfessional Edition (current year)
NEW QUESTION # 192
(A patient training for a marathon collapsed due to heat exhaustion on a very hot day and is treated at a nonfacility urgent care center. The physician diagnoses heat exhaustion and dehydration and begins IV therapy of normal saline (pre-packaged fluid and electrolytes). The hydration lasts1 hour and 30 minutes.
What CPT coding is reported?)
- A. 0
- B. 96360, 96361
- C. 1
- D. 96365, 96366
Answer: B
Explanation:
IV hydration is coded byduration. CPT96360is forinitial intravenous hydration(typically the first hour).
CPT96361is an add-on code foreach additional hourbeyond the initial hour, reported when the hydration time exceeds 60 minutes and meets the additional-hour threshold. The scenario documents hydration for1 hour and
30 minutes (90 minutes). That supports reporting theinitial hour(96360) plusone additional hour(96361) because the infusion extends beyond the initial hour and reaches the qualifying threshold for an additional hour as defined by CPT time rules (time is rounded/assigned based on midpoints, not per minute). The other options usetherapeutic infusioncodes (96365/96366), which are for medications/drugs, not for hydration with normal saline when the primary purpose is hydration. CPC exam tip: if the service is specifically "hydration" and the fluid is normal saline for dehydration/heat exhaustion, use96360/96361and apply time-based logic.
NEW QUESTION # 193
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