CPC Coding Cases Practice Questions
Coding Cases makes up 3 of every 50 questions on a Tigertest CPC practice test. Here are 10 of the 12 questions on it, each with the answer and the reason.
Updated by the Tigertest team. Based on AAPC's published CPC exam areas, the ICD-10-CM Official Guidelines, CMS rules and CPT conventions. Original questions; no code-book lookups.
1. An established patient has a skin lesion removed. The physician also evaluates and changes treatment for poorly controlled hypertension. How is this reported?
- A.Procedure with modifier 22
- B.Procedure plus E/M with 25
- C.Procedure only
- D.E/M with modifier 57
Answer: B. The hypertension work is significant and separately identifiable, so the E/M is reported with modifier 25. Modifier 57 applies to major surgery.
2. An ED physician repairs a 2.5 cm simple laceration of the forearm and a 3.0 cm simple laceration of the thigh. How are they reported?
- A.One intermediate repair of 5.5 cm
- B.One simple repair of 3.0 cm
- C.Simple repairs of 2.5 and 3.0 cm
- D.One simple repair of 5.5 cm
Answer: D. Both are simple repairs in the same anatomic group (extremities), so their lengths are added and one code is reported.
3. A patient has a 2 cm intermediate repair of the cheek and a 4 cm simple repair of the hand. How are they reported?
- A.Both; the intermediate one first
- B.Both, with the simple repair listed first
- C.Only the intermediate repair
- D.One combined 6 cm repair
Answer: A. Different classifications are not added. CPT lists the more complicated repair as primary and the other as secondary with modifier 59.
4. An office note reads: cough and fever, rule out pneumonia; chest X-ray pending. Which diagnoses are coded?
- A.Pneumonia, cough and fever
- B.History of pneumonia
- C.Cough and fever
- D.Pneumonia
Answer: C. In the outpatient setting, rule out diagnoses are not coded. Code the documented signs and symptoms.
5. A type 2 diabetic on insulin has diabetic chronic kidney disease, stage 3a. Which approach is correct?
- A.CKD stage first, then diabetes
- B.Combination code alone
- C.Combination code, CKD stage, insulin
- D.Diabetes without complication code only
Answer: C. Use the diabetes with CKD combination code, then the instructed additional code for the CKD stage, plus Z79.4 for long-term insulin.
6. Three weeks after ED treatment of a wrist fracture, the patient returns for a routine cast check. Which 7th character applies?
- A.D for routine healing
- B.G for delayed healing
- C.S for a sequela
- D.A for initial encounter
Answer: A. D is a subsequent encounter with routine healing. A is for active treatment, which is over.
7. Two days after a laparoscopic cholecystectomy, the same surgeon takes the patient back to the OR to control port-site bleeding. Which modifier applies?
- A.Modifier 76
- B.Modifier 79
- C.Modifier 58
- D.Modifier 78
Answer: D. An unplanned return to the OR for a related complication in the global period takes modifier 78.
8. Anesthesia starts at 08:10 and ends at 09:25. Using 15-minute units, how many time units are reported?
- A.75
- B.5
- C.4
- D.6
Answer: B. 08:10 to 09:25 is 75 minutes, and 75 divided by 15 is 5 units.
9. A patient prepped for a diagnostic colonoscopy has a stricture, and the scope cannot pass the splenic flexure. How does the physician report it?
- A.Colonoscopy with modifier 59
- B.Colonoscopy with modifier 53
- C.Sigmoidoscopy with no modifier
- D.Colonoscopy with modifier 22
Answer: B. CPT says that when a planned colonoscopy cannot reach the cecum because of unforeseen circumstances, report the diagnostic colonoscopy with modifier 53 and document why.
10. A patient is seen for chest pain. The physician documents that the pain is due to gastroesophageal reflux. How is it coded?
- A.Chest pain, then reflux
- B.Reflux, then chest pain
- C.Chest pain only
- D.Reflux only
Answer: D. A symptom routinely linked to a confirmed diagnosis is not coded separately.
Practice all 12 coding cases questions, and the rest of the 200-question bank, in the free CPC training sets. Questions you miss come back until you have mastered them.
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