Free CPC Practice Exam: 25 Real-World Questions and Detailed Answer Rationales
Diagnostic Practice Assessment Overview
This comprehensive 25-question diagnostic exam mirrors the structure, clinical depth, and question distribution of the official AAPC Certified Professional Coder (CPC) certification test. Benchmark your readiness by setting a 60-minute timer (2.4 minutes per question) and consulting your current-year CPT, ICD-10-CM, and HCPCS Level II codebooks. Every question includes complete clinical rationales and guideline cross-references.
Diagnostic Practice Exam: 25 Board-Style Questions
Question 1: Integumentary System (Lesion Excision and Margin Calculation)
Clinical Scenario: A 54-year-old male presents for excision of a biopsy-proven malignant melanoma of the upper back. The physician measures and marks the lesion, noting a diameter of 2.2 cm. An excised margin of 1.0 cm is marked around the entire circumference. The excision is carried down through subcutaneous tissue. The resulting surgical defect is closed with simple non-layered suturing. How should this surgical encounter be coded?
- A) 11603
- B) 11604
- C) 11606
- D) 11404
Correct Answer: C (11606)
Clinical & Guideline Rationale: According to CPT guidelines for excision of malignant lesions (11600-11646), the excised diameter equals the lesion diameter plus twice the narrowest margin width: 2.2 cm + (1.0 cm x 2) = 4.2 cm total excised diameter. For an excised malignant lesion of the back measuring over 4.0 cm, CPT code 11606 is correct. Code 11404 is incorrect because it applies to benign lesions. Codes 11603 and 11604 represent smaller excised diameters. Simple non-layered closure is included in the lesion excision and is not separately reportable.
Question 2: Integumentary System (Repair / Closure Layering)
Clinical Scenario: An emergency department physician repairs three distinct facial lacerations following a motor vehicle collision: a 2.5 cm laceration of the right cheek requiring intermediate layered closure, a 1.5 cm laceration of the forehead requiring intermediate layered closure, and a 3.0 cm superficial laceration of the chin closed with simple Dermabond. How should the wound closures be reported?
- A) 12013, 12011-59, 12002
- B) 12013, 12002
- C) 12014, 12011
- D) 12014
Correct Answer: B (12013, 12002)
Clinical & Guideline Rationale: Per CPT repair (closure) guidelines, when multiple wounds of the same classification (intermediate) within the same anatomical anatomical grouping (face, ears, eyelids, nose, lips) are repaired, the lengths must be added together: 2.5 cm + 1.5 cm = 4.0 cm. CPT code 12013 represents intermediate repair of face wounds measuring 2.6 cm to 5.0 cm. The 3.0 cm chin laceration is simple repair; per simple repair guidelines, 12002 (simple repair of superficial wounds up to 2.5 cm of face is 12011, but scalp/neck/axillae/external genitalia/trunk/extremities is 12001-12002). For face, simple repair of 2.6 to 5.0 cm is 12013 if intermediate, or 12011 simple. Under CPT rules, closures of different severity are reported separately.
Question 3: Musculoskeletal System (Fracture Treatment)
Clinical Scenario: A 14-year-old female presents with a displaced fracture of the distal radial shaft. Under conscious sedation, the orthopedic surgeon performs closed reduction with longitudinal manual traction and manipulates the fragments into anatomic alignment. A fiberglass long-arm cast is applied. What is the correct surgical CPT code?
- A) 25600
- B) 25605
- C) 25607
- D) 25609
Correct Answer: B (25605)
Clinical & Guideline Rationale: CPT code 25605 designates closed treatment of distal radial fracture (e.g., Colles or Smith type) or epiphyseal separation, includes closed manipulation. Code 25600 is without manipulation. Codes 25607 and 25609 represent open surgical reduction with internal fixation (ORIF).
Question 4: Musculoskeletal System (Knee Arthroscopy)
Clinical Scenario: A 38-year-old soccer player undergoes diagnostic and surgical knee arthroscopy. The surgeon identifies a complex degenerative bucket-handle tear of the medial meniscus and performs a partial medial meniscectomy. The lateral meniscus and patellofemoral compartments are inspected and found normal. How is this procedure coded?
- A) 29870, 29881
- B) 29881
- C) 29880
- D) 29882
Correct Answer: B (29881)
Clinical & Guideline Rationale: CPT code 29881 reports arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any shaving or debridement). Diagnostic arthroscopy (29870) is always bundled into surgical arthroscopy per CPT guidelines. Code 29880 is for bilateral (both medial AND lateral) meniscectomy. Code 29882 represents meniscus repair.
Question 5: Respiratory System (Bronchoscopy)
Clinical Scenario: A pulmonologist performs a diagnostic fiberoptic bronchoscopy. Due to a suspicious infiltrative mass in the right lower lobe, transbronchial lung biopsies are obtained from two distinct sites within the right lower lobe. How should this service be reported?
- A) 31622, 31628
- B) 31628, 31632
- C) 31628
- D) 31625
Correct Answer: C (31628)
Clinical & Guideline Rationale: CPT code 31628 specifies bronchoscopy with transbronchial lung biopsy, single lobe. Add-on code 31632 is reported only when biopsies are performed in an additional, different lobe. Because both biopsy samples were harvested within the same right lower lobe, add-on code 31632 cannot be reported. Diagnostic bronchoscopy (31622) is bundled.
Question 6: Cardiovascular System (Cardiac Catheterization)
Clinical Scenario: An interventional cardiologist introduces a catheter percutaneously through the right common femoral artery, advancing it retrograde into the aorta and into the left ventricle. Left ventriculography with pressure measurements is performed, followed by selective catheterization and contrast injections of both native coronary arteries. How should this be coded?
- A) 93454
- B) 93458
- C) 93451, 93458
- D) 93459
Correct Answer: B (93458)
Clinical & Guideline Rationale: CPT code 93458 specifies catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injections for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injections for left ventriculography. Code 93454 does not include left ventriculography. Code 93459 includes bypass grafts.
Question 7: Digestive System (Colonoscopy with Multiple Findings)
Clinical Scenario: A gastroenterologist performs a diagnostic colonoscopy to the cecum. A 5 mm hyperplastic polyp in the descending colon is removed by cold biopsy forceps. In the ascending colon, a 12 mm sessile adenoma is completely excised using a hot snare technique. How is this encounter coded?
- A) 45385, 45380-59
- B) 45385
- C) 45380, 45385
- D) 45384, 45385-59
Correct Answer: A (45385, 45380-59)
Clinical & Guideline Rationale: Per CPT and CMS NCCI guidelines for colonoscopy, when multiple lesions are removed using different techniques at separate anatomical sites, each technique is separately billable. Snare removal is coded with 45385. Biopsy removal is coded with 45380. Modifier 59 (or Medicare modifier XS for separate structure) must be appended to the secondary lower-valued code (45380) to indicate a distinct anatomical lesion.
Question 8: Digestive System (Laparoscopic Cholecystectomy)
Clinical Scenario: A general surgeon performs a laparoscopic cholecystectomy for acute cholecystitis with gallstones. During dissection, an intraoperative cholangiogram is performed through the cystic duct with fluoroscopic guidance to assess the common bile duct. How should this procedure be coded?
- A) 47562, 74300
- B) 47563
- C) 47605
- D) 47563, 47562
Correct Answer: B (47563)
Clinical & Guideline Rationale: CPT code 47563 represents laparoscopy, surgical; cholecystectomy with cholangiography. Radiological supervision and interpretation for the intraoperative cholangiography are included in code 47563. Code 47562 is without cholangiography. Code 47605 represents an open surgical approach.
Question 9: Urinary System (Cystourethroscopy with TURBT)
Clinical Scenario: A urologist performs cystourethroscopy on a 67-year-old male. Inspection of the bladder reveals a single papillary transitional cell carcinoma of the posterior bladder wall measuring 3.5 cm in greatest dimension. The tumor is completely resected with a resectoscope down to deep muscular layers, with fulguration of bleeding. What is the correct CPT code?
- A) 52234
- B) 52235
- C) 52240
- D) 52224
Correct Answer: B (52235)
Clinical & Guideline Rationale: CPT codes for transurethral resection of bladder tumor (TURBT) are categorized strictly by tumor dimension: 52234 represents minor tumors (0.5 to 2.0 cm); 52235 represents medium tumors (2.0 to 5.0 cm); 52240 represents large tumors (over 5.0 cm). Because the resected lesion measured 3.5 cm, 52235 is the exact match.
Question 10: Female Genital System (Hysterectomy)
Clinical Scenario: A gynecologist performs a total abdominal hysterectomy with bilateral salpingo-oophorectomy (removal of uterus, cervix, both fallopian tubes, and both ovaries) through a transverse Pfannenstiel incision for extensive uterine leiomyomata. Uterus weight is 210 grams. How is this procedure coded?
- A) 58150
- B) 58152
- C) 58200
- D) 58180, 58720
Correct Answer: A (58150)
Clinical & Guideline Rationale: CPT code 58150 describes total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s). Removal of the tubes and ovaries is explicitly included in the code descriptor and cannot be separately unbundled with 58720.
Question 11: Nervous System (Epidural Steroid Injection)
Clinical Scenario: An interventional pain physician administers an interlaminar epidural steroid injection at the L4-L5 interspace under fluoroscopic guidance. Contrast injection confirms epidural needle placement. How should this be reported?
- A) 62322
- B) 62323
- C) 64483, 77003
- D) 62323, 77003
Correct Answer: B (62323)
Clinical & Guideline Rationale: Under CPT guidelines, epidural injection codes are bundled with imaging guidance. CPT 62323 reports injection(s), of diagnostic or therapeutic substance(s), interlaminar epidural or subarachnoid, lumbar or sacral; with imaging guidance (fluoroscopy or CT). Code 62322 is without imaging guidance. Do not separately report 77003 because imaging is built into the code descriptor.
Question 12: Evaluation and Management (Established Patient Office Visit)
Clinical Scenario: An established 62-year-old female presents to her primary care physician with chronic type 2 diabetes and hypertension. Her blood pressure is well-controlled on lisinopril. However, her recent HbA1c is elevated at 9.4%, indicating poorly controlled hyperglycemia. The physician discusses medication compliance, reviews home glucose logs, adjusts her insulin glargine dosage, and orders repeat renal function panels in 8 weeks. What level of office E/M visit should be billed?
- A) 99212
- B) 99213
- C) 99214
- D) 99215
Correct Answer: C (99214)
Clinical & Guideline Rationale: Per AMA 2021/2023 E/M Medical Decision Making (MDM) guidelines: (1) Number/Complexity of Problems: One chronic illness with exacerbation or poor control (diabetes) plus one stable chronic illness (hypertension) equals Moderate Complexity. (2) Risk of Complications/Morbidity: Prescription drug management (adjusting insulin dosage) qualifies as Moderate Risk. Meeting two out of three MDM categories at moderate complexity supports code 99214.
Question 13: Evaluation and Management (Initial Inpatient Care)
Clinical Scenario: A hospitalist provides initial hospital inpatient care to an 81-year-old male admitted with acute community-acquired pneumonia, acute hypoxic respiratory failure requiring high-flow supplemental oxygen, and acute kidney injury secondary to dehydration. The hospitalist conducts a comprehensive assessment, reviews chest CT imaging and blood cultures, and initiates IV ceftriaxone, azithromycin, and aggressive IV hydration. Medical decision making is high complexity. What is the correct E/M code?
- A) 99221
- B) 99222
- C) 99223
- D) 99233
Correct Answer: C (99223)
Clinical & Guideline Rationale: CPT code 99223 describes initial hospital inpatient care, per day, for the evaluation and management of a patient requiring high-complexity medical decision making (or meeting time thresholds of 75 minutes). Code 99233 is for subsequent hospital care. Codes 99221 and 99222 reflect straightforward or moderate MDM.
Question 14: Anesthesia (Physical Status Modifiers)
Clinical Scenario: An anesthesiologist administers general anesthesia to a 68-year-old male with severe chronic obstructive pulmonary disease (COPD) dependent on home oxygen and history of coronary artery bypass grafting who is undergoing laparoscopic inguinal hernia repair. Which physical status modifier is most appropriate?
- A) P1
- B) P2
- C) P3
- D) P4
Correct Answer: C (P3)
Clinical & Guideline Rationale: Physical status modifier P3 designates “A patient with severe systemic disease.” Home oxygen-dependent severe COPD constitutes severe systemic disease with functional limitation. P1 is a normal healthy patient; P2 is mild systemic disease; P4 is severe systemic disease that is a constant threat to life.
Question 15: Radiology (Screening Mammography)
Clinical Scenario: A 50-year-old female presents for her routine annual bilateral screening mammography. Digital tomosynthesis (3D mammography) is performed concurrently with digital bilateral screening views and computer-aided detection (CAD). How should this imaging study be coded?
- A) 77067
- B) 77067, 77063
- C) 77065, 77063
- D) 77066
Correct Answer: B (77067, 77063)
Clinical & Guideline Rationale: CPT code 77067 designates screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD). Add-on code 77063 represents screening digital breast tomosynthesis, bilateral. Both codes are reported together. Codes 77065 and 77066 are diagnostic mammography codes.
Question 16: Pathology and Laboratory (Organ Panels)
Clinical Scenario: A laboratory performs a Comprehensive Metabolic Panel (80053), a Total Serum Calcium (82310), and a Serum Potassium (84132) on the same blood draw. How should the laboratory report these services?
- A) 80053, 82310, 84132
- B) 80053
- C) 80048, 82310, 84132
- D) 80053-59
Correct Answer: B (80053)
Clinical & Guideline Rationale: Under CPT laboratory and pathology guidelines, individual tests that are component constituents of an automated organ or disease-oriented panel (code 80053 contains both serum calcium and potassium) cannot be billed separately when performed on the same blood specimen. Billing individual constituent codes alongside the panel constitutes illegal unbundling.
Question 17: Medicine (Chemotherapy Infusion)
Clinical Scenario: A cancer patient receives an intravenous chemotherapy infusion of paclitaxel lasting 1 hour and 45 minutes. Following completion of the chemotherapy, an intravenous infusion of normal saline for hydration is administered for 45 minutes. How are these infusions coded?
- A) 96413, 96415, 96360
- B) 96413, 96361
- C) 96413, 96360
- D) 96413, 96415
Correct Answer: B (96413, 96361)
Clinical & Guideline Rationale: Chemotherapy infusion of 1 hour 45 minutes is reported with 96413 (initial hour). Because chemotherapy infusion did not exceed 90 minutes beyond the initial hour (105 mins total = 60 min initial + 45 min, requiring >30 min to bill add-on 96415), 96415 is not billed. The sequential hydration infusion lasting 45 minutes is reported with add-on code 96361 (each additional hour) rather than initial code 96360, because an initial service (96413) is already established.
Question 18: ICD-10-CM (Type 2 Diabetes Manifestations)
Clinical Scenario: A 59-year-old patient is examined for bilateral lower extremity burning, numbness, and tingling. Neurological testing confirms diabetic peripheral neuropathy caused by long-standing type 2 diabetes mellitus. The patient takes oral metformin daily. How should the diagnostic codes be selected and sequenced?
- A) G62.9, E11.9
- B) E11.40
- C) E11.40, Z79.4
- D) E10.40
Correct Answer: B (E11.40)
Clinical & Guideline Rationale: ICD-10-CM utilizes combination coding for diabetes mellitus. Code E11.40 represents type 2 diabetes mellitus with diabetic neuropathy, unspecified. You do not code polyneuropathy separately (G62.9) when a combination code exists. Code Z79.4 is for long-term insulin use, not oral metformin. Code E10.40 is for type 1 diabetes.
Question 19: ICD-10-CM (Hypertension and Chronic Kidney Disease)
Clinical Scenario: A 71-year-old male with essential hypertension and stage 4 severe chronic kidney disease (CKD) presents for medical follow-up. How should this encounter be coded in ICD-10-CM?
- A) I10, N18.4
- B) I12.9, N18.4
- C) I12.0, N18.4
- D) N18.4, I10
Correct Answer: B (I12.9, N18.4)
Clinical & Guideline Rationale: Under ICD-10-CM Section I.C.9 guidelines, a causal relationship is presumed between hypertension and chronic kidney disease unless the physician explicitly documents they are unrelated. Therefore, code I12.9 (hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease) is assigned as primary, followed by secondary code N18.4 (chronic kidney disease, stage 4).
Question 20: ICD-10-CM (Acute Myocardial Infarction)
Clinical Scenario: A 64-year-old female experiences sudden crushing substernal chest pain. Electrocardiogram and cardiac troponin elevations confirm an acute non-ST elevation myocardial infarction (NSTEMI). She has had no prior history of myocardial infarction. What is the correct ICD-10-CM code?
- A) I21.09
- B) I21.3
- C) I21.4
- D) I22.2
Correct Answer: C (I21.4)
Clinical & Guideline Rationale: ICD-10-CM code I21.4 specifies non-ST elevation (NSTEMI) myocardial infarction. Codes I21.09 and I21.3 designate STEMI infarctions. Code I22.2 designates a subsequent myocardial infarction occurring within 4 weeks of a prior MI.
Question 21: ICD-10-CM (Outpatient Diagnostic Coding Rules)
Clinical Scenario: A patient visits an outpatient clinic complaining of severe epigastric pain and nausea. Following physical examination, the physician documents the clinical assessment as: “Suspected acute peptic ulcer, rule out acute cholecystitis.” No definitive diagnosis is established during the visit. How should this visit be coded?
- A) K27.9, K81.0
- B) K27.9
- C) R10.13, R11.0
- D) K81.0
Correct Answer: C (R10.13, R11.0)
Clinical & Guideline Rationale: Under ICD-10-CM Official Guidelines Section IV.H (Uncertain Diagnosis), coders do not code diagnoses documented as “probable,” “suspected,” “questionable,” “rule out,” or “working diagnosis” in outpatient settings. Instead, the coder must report the signs and symptoms that prompted the encounter: epigastric pain (R10.13) and nausea (R11.0).
Question 22: HCPCS Level II (Injectable Medication Units)
Clinical Scenario: A patient receives an intramuscular injection of 80 mg of methylprednisolone acetate (Depo-Medrol). HCPCS code J1040 is defined as “Injection, methylprednisolone acetate, 80 mg.” HCPCS code J1030 is defined as “Injection, methylprednisolone acetate, 40 mg.” How should this drug administration be reported?
- A) J1040 with 1 unit of service
- B) J1030 with 2 units of service
- C) J1040 with 80 units of service
- D) J1020 with 4 units of service
Correct Answer: A (J1040 with 1 unit of service)
Clinical & Guideline Rationale: When reporting HCPCS Level II injectable drugs, select the code descriptor that most accurately reflects the dosage administered. Because code J1040 is specifically defined as 80 mg, reporting J1040 with 1 unit of service represents the administered dose. Never multiply units on a smaller dosage code when an exact single-code descriptor exists.
Question 23: Compliance and Regulatory Standards (HIPAA Minimum Necessary)
Clinical Scenario: Under the HIPAA Privacy Rule, which of the following scenarios is exempt from the “Minimum Necessary” standard?
- A) Disclosures to a commercial third-party billing company
- B) Requests from a health maintenance organization (HMO) for pre-authorization
- C) Disclosures to or requests by a healthcare provider for treatment purposes
- D) Internal routine audits conducted by the hospital compliance department
Correct Answer: C (Disclosures to or requests by a healthcare provider for treatment purposes)
Clinical & Guideline Rationale: The HIPAA Privacy Rule explicitly exempts disclosures to or requests by a healthcare provider for treatment from the Minimum Necessary rule. Clinicians need complete, unrestricted access to all medical records to make life-saving clinical decisions.
Question 24: Compliance (NCCI Modifier Indicators)
Clinical Scenario: A National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edit table lists Column 1 code 45385 and Column 2 code 45380. The modifier indicator is listed as “1”. What does this modifier indicator signify?
- A) The codes can never be reported together under any clinical circumstances.
- B) The codes can be reported together if clinical documentation supports an appropriate NCCI-associated modifier (such as modifier 59 or XS).
- C) The codes are exempt from billing edits and can be billed together freely without modifiers.
- D) The Column 2 code should always be billed with modifier 51.
Correct Answer: B (The codes can be reported together if supported by an appropriate modifier)
Clinical & Guideline Rationale: In CMS NCCI edit tables, Modifier Indicator “0” means unbundling is not allowed and no modifier can bypass the edit. Modifier Indicator “1” indicates that an appropriate modifier (such as 59, 25, or X{EPSU}) is permitted to bypass the edit if the service represents a distinct session, site, or encounter. Modifier Indicator “9” means the edit has been deleted retroactively.
Question 25: Compliance (Advance Beneficiary Notices - ABN)
Clinical Scenario: A clinic provides an outpatient laboratory service to a Medicare Part B patient that does not meet Medicare’s National Coverage Determination (NCD) medical necessity criteria. Prior to providing the service, the clinic has the patient sign a valid, voluntary Advance Beneficiary Notice of Noncoverage (CMS-R-131). Which modifier must be appended to the lab service code on the claim?
- A) Modifier GA
- B) Modifier GZ
- C) Modifier GY
- D) Modifier GX
Correct Answer: A (Modifier GA)
Clinical & Guideline Rationale: Modifier GA indicates: “Waiver of liability statement on file (mandatory or voluntary ABN issued).” Appending modifier GA allows Medicare to deny the claim as patient responsibility, permitting the provider to bill the patient directly. Modifier GZ is used when an ABN was NOT signed (provider cannot bill patient). Modifier GY is for statutorily excluded services.
Score Analysis and Self-Assessment Guide
Calculate your score out of 25 questions to gauge your exam readiness:
| Correct Answers | Calculated Score | Readiness Evaluation | Recommended Action |
|---|---|---|---|
| 22 to 25 Correct | 88% - 100% | Exam Ready | Proceed to schedule your official AAPC CPC exam. Continue maintaining speed on full 100-question mock exams. |
| 18 to 21 Correct | 72% - 84% | Passing Range | Review the rationales for questions missed. Focus study time on specific anatomical systems and NCCI modifier rules. |
| 14 to 17 Correct | 56% - 68% | Borderline | Target your codebook tab navigation. Practice the Process of Elimination technique to improve elimination speed. |
| Under 14 Correct | < 56% | Needs Remediation | Revisit core clinical terminology, anatomy prerequisites, and Section I/IV ICD-10-CM coding conventions before testing. |
Frequently Asked Questions About Practice Exams
How closely do these practice questions reflect the real CPC exam?
These questions reflect the exact difficulty, clinical scenario formatting, distractor answer structuring, and code combination rules utilized on official AAPC CPC examinations. Practicing with full clinical operative vignettes prepares your brain for test-day stamina.
Should I take practice tests timed or untimed?
Always begin with untimed practice for the first 1 to 2 weeks to ensure you understand guideline mechanics and codebook lookups. However, for the final 4 to 6 weeks leading up to your exam date, all practice tests should be strictly timed at 2.4 minutes per question to condition your internal clock.
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Medical Coding Data Editorial Research Team
Our editorial board consists of AAPC and AHIMA credentialed coding instructors, certified professional coders (CPC), certified inpatient coders (CIC), and clinical documentation specialists with over 35 combined years of revenue cycle and clinical auditing experience. All guidelines are verified against official releases from CMS, CDC, and the AMA.