Certified Professional Coder (CPC) Quiz: Apply Lymphatic Coding Rules
20 questions · exam conditions
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Apply Lymphatic Coding RulesQuestion 1 of 20

A patient with sickle cell disease develops splenic sequestration crisis requiring emergent splenectomy. Which ICD-10-CM category covers sickle cell disease?

D56
D57
D58
D59
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Certified Professional Coder (CPC) Quiz

Certified Professional Coder (CPC) Quiz: Apply Lymphatic Coding Rules

Practice Apply Lymphatic Coding Rules in Certified Professional Coder (CPC) with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Apply Lymphatic Coding Rules, giving you a quick way to practice the rules, question types, and explanations that matter most for Certified Professional Coder (CPC).

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

A patient with sickle cell disease develops splenic sequestration crisis requiring emergent splenectomy. Which ICD-10-CM category covers sickle cell disease?

  1. D56
  2. D57 (correct answer)
  3. D58
  4. D59
Explanation: ICD-10-CM category D57 covers sickle cell disorders. Specific subcategories distinguish sickle cell disease (D57.0-D57.2), sickle cell trait (D57.3), and other sickle cell disorders (D57.8). The acute splenic sequestration would be captured in the specific sickle cell disease code (e.g., D57.02 — sickle cell disease with splenic sequestration). Accurate subcategory selection requires documentation of the specific sickle cell crisis type.

Question 2

A surgeon performs drainage of a lymphocele following a pelvic lymph node dissection. Which CPT® code range is appropriate for lymphocele drainage?

  1. 38300-38382 (correct answer)
  2. 38999
  3. 38500-38530
  4. 38550-38564
Explanation: CPT® codes 38300-38382 cover drainage of lymph node abscesses and lymphocele procedures. Code 38300 covers drainage of a lymph node abscess or lymphocele, simple; 38305 covers extensive drainage. These codes cover percutaneous or open drainage of lymphatic fluid collections. The lymphocele drainage is distinct from lymph node biopsy or dissection procedures.

Question 3

A patient with Hodgkin lymphoma is coded using ICD-10-CM. Which code category covers Hodgkin lymphoma?

  1. C81 (correct answer)
  2. C82
  3. C83
  4. C85
Explanation: ICD-10-CM category C81 covers Hodgkin lymphoma. The subcategory is determined by the histologic type (e.g., C81.0 for nodular lymphocyte predominant Hodgkin lymphoma; C81.1 for nodular sclerosis; C81.7 for other classical Hodgkin lymphoma). Non-Hodgkin lymphomas are found in categories C82-C86. Correctly distinguishing Hodgkin from non-Hodgkin is essential for accurate lymphoma coding.

Question 4

A patient is diagnosed with follicular lymphoma, grade 1, involving multiple lymph node sites. Which ICD-10-CM code category covers follicular lymphoma?

  1. C81
  2. C82 (correct answer)
  3. C83
  4. C84
Explanation: ICD-10-CM category C82 covers follicular lymphoma. Subcategories reflect the grade and affected site: C82.0 covers follicular lymphoma grade I; C82.1 covers grade II; C82.2 covers grade IIIa. The site of involvement (specific lymph node region) provides the final character in the code. Follicular lymphoma is a type of non-Hodgkin lymphoma classified separately from other NHL types in C83-C86.

Question 5

A surgeon performs a radical neck dissection for squamous cell carcinoma of the tongue, removing lymph nodes from the ipsilateral neck. Which CPT® code covers a radical neck dissection?

  1. 38700
  2. 38720 (correct answer)
  3. 38724
  4. 38740
Explanation: CPT® 38720 covers cervical lymphadenectomy (complete). Code 38700 covers superficial cervical lymphadenectomy; 38724 covers cervical lymphadenectomy (modified radical neck dissection). Code 38720 is the complete (radical) dissection. The extent of the dissection — superficial, modified radical, or radical — determines the correct code within the cervical lymphadenectomy range.

Question 6

A patient is seen for chronic lymphedema of the left lower extremity following lymph node dissection for ovarian cancer treatment. Which ICD-10-CM code is reported for the lymphedema?

  1. I89.0 (correct answer)
  2. Q82.0
  3. I97.2
  4. I89.1
Explanation: ICD-10-CM I89.0 covers lymphedema, not elsewhere classified, and is the appropriate code for chronic lymphedema following lymph node dissection that is not related to mastectomy. Code I97.2 (postmastectomy lymphedema syndrome) is specifically restricted to lymphedema occurring as a consequence of mastectomy — it does not apply to lymphedema following other lymph node dissections such as those performed for ovarian cancer staging or treatment. Q82.0 is hereditary lymphedema; I89.1 is lymphangitis, not lymphedema.

Question 7

A surgical oncologist performs a sentinel lymph node biopsy (SLNB) for staging of melanoma using radioisotope injection and intraoperative gamma probe detection. Which CPT® code is reported for the SLNB?

  1. 38500
  2. 38525 (correct answer)
  3. 38792
  4. 38900
Explanation: CPT® 38525 covers open biopsy of deep axillary node(s) and is the correct code for the excision of the sentinel lymph node from the axillary basin. For SLNB, 38525 reports the actual biopsy/excision performed by the surgeon. Code 38792 covers only the pre-operative injection of the radioactive tracer — a separate service typically performed by nuclear medicine before the patient reaches the OR. Code 38900 is an add-on code for intraoperative identification of the sentinel node (gamma probe or blue dye) and is reported in addition to the primary biopsy code when performed.

Question 8

During a laparoscopic splenectomy, the surgeon inadvertently injures the splenic hilum and must convert to an open splenectomy to complete hemostasis. Which CPT® code is reported?

  1. 38100 (correct answer)
  2. 38120
  3. 38120-22
  4. 38120 and 38100-51
Explanation: When a laparoscopic procedure is converted to an open procedure, only the open procedure code is reported. CPT® 38100 (splenectomy, total, open) is the correct code. The laparoscopic attempt is not separately reported. This is consistent with the general CPT® guideline that conversion to open surgery is reported with the open procedure code only.

Question 9

A surgeon performs a modified radical neck dissection, preserving the sternocleidomastoid muscle, internal jugular vein, and spinal accessory nerve, while removing cervical lymph nodes. Which CPT® code is most appropriate?

  1. 38700
  2. 38720
  3. 38724 (correct answer)
  4. 38740
Explanation: CPT® 38724 covers cervical lymphadenectomy (modified radical neck dissection). The preservation of key structures — sternocleidomastoid muscle, internal jugular vein, or spinal accessory nerve — distinguishes a modified radical neck dissection (38724) from a complete/radical dissection (38720). Documentation of which structures are preserved drives the code selection.

Question 10

A patient is seen for evaluation of swollen cervical lymph nodes. The physician documents "reactive lymphadenopathy." Which ICD-10-CM code captures this condition?

  1. C77.0
  2. R59.0
  3. R59.1 (correct answer)
  4. L04.0
Explanation: ICD-10-CM R59.1 covers generalized enlarged lymph nodes; R59.0 covers localized enlarged lymph nodes. For localized cervical lymphadenopathy documented as reactive, R59.0 is appropriate. L04.0 covers acute lymphadenitis of face, head, and neck (infectious/inflammatory — more specific). C77.0 is secondary malignant neoplasm of lymph nodes of head and neck — not appropriate for benign reactive lymphadenopathy.

Question 11

A patient undergoes both bone marrow aspiration and needle biopsy during the same session for diagnostic workup of a hematologic disorder. Which CPT® code is reported?

  1. 38220 and 38221-51
  2. 38220 and 38221-59
  3. 38222 (correct answer)
  4. 38220 only
Explanation: CPT® 38222 covers bone marrow biopsy and aspiration performed together at the same session. When both procedures are performed, the combination code 38222 is reported rather than reporting 38220 and 38221 separately. This is an example of a combination code that replaces the individual component codes.

Question 12

A patient undergoes a laparoscopic splenectomy. The CPT® description for laparoscopic splenectomy includes "with or without drain placement." Does this mean the drain placement is always separately reportable?

  1. Yes — any drain placed during surgery is a separately billable service
  2. No — the code descriptor explicitly includes drain placement, so it is bundled into the laparoscopic splenectomy code (correct answer)
  3. Yes, with modifier -51 on the drain placement code
  4. Only if the drain was placed in a different anatomical compartment
Explanation: When a CPT® code descriptor includes the phrase "with or without" a particular service (such as drain placement), that service is bundled into the primary code regardless of whether it is performed. Reporting a separate code for drain placement in this scenario constitutes unbundling. Always review the full code descriptor before reporting additional codes for components that may be included.

Question 13

A pathologist performs intraoperative consultation on a lymph node specimen using frozen section analysis. Which CPT® code covers this intraoperative pathology service?

  1. 88300
  2. 88302
  3. 88329
  4. 88331 (correct answer)
Explanation: CPT® 88331 covers pathologic examination of a surgical specimen using frozen section technique, first tissue block. Intraoperative frozen section consultation allows the surgeon to receive real-time pathologic feedback during the procedure. Code 88329 covers consultation during surgery — pathologic examination, gross and microscopic. Code 88300 and 88302 are for routine surgical pathology, not frozen sections.

Question 14

A surgeon performs an open biopsy of a single cervical lymph node. Which CPT® code range covers lymph node biopsy procedures?

  1. 38100-38115
  2. 38300-38382
  3. 38500-38530 (correct answer)
  4. 38700-38780
Explanation: CPT® codes 38500-38530 cover biopsy or excision of lymph nodes. Code 38500 covers open biopsy of a superficial lymph node (e.g., cervical, axillary, inguinal). Code 38505 covers needle core biopsy of a lymph node. The 38700 range covers radical neck dissection procedures, not simple biopsy.

Question 15

A bone marrow aspiration is performed on a patient with suspected leukemia. Which CPT® code covers bone marrow aspiration?

  1. 38220 (correct answer)
  2. 38221
  3. 38222
  4. 38230
Explanation: CPT® 38220 covers diagnostic bone marrow aspiration(s). Code 38221 covers diagnostic bone marrow biopsy (biopsy needle). Code 38222 covers bone marrow biopsy and aspiration performed together. Code 38230 covers bone marrow harvesting for transplantation. Aspiration alone vs. biopsy alone vs. combined aspiration and biopsy are separately defined CPT® services.

Question 16

A surgical pathologist examines a lymph node dissection specimen containing 18 lymph nodes. Which CPT® surgical pathology code level applies to lymph node dissection specimens?

  1. 88300
  2. 88302
  3. 88304
  4. 88307 (correct answer)
Explanation: CPT® 88307 covers level V surgical pathology, which includes lymph node dissection specimens. Lymph node dissection specimens are classified at the level V (88307) due to their complexity and the level of pathologic examination required. Levels are determined by the type of tissue and the complexity of examination, not the number of nodes in the specimen.

Question 17

A patient is diagnosed with secondary malignant neoplasm of a lymph node — a metastasis from a primary lung cancer. How are these conditions coded in ICD-10-CM?

  1. C77 series for the lymph node metastasis first; then C34 series for the primary lung cancer
  2. Only the primary lung cancer is coded; lymph node involvement is assumed
  3. C77 series alone — once metastasis is present, the primary is coded as historical
  4. C34 series for the primary lung cancer first; then C77 series for the lymph node metastasis (correct answer)
Explanation: Per ICD-10-CM Official Guidelines, when a patient has both a primary malignancy and a metastatic site, the primary malignancy is sequenced first unless treatment is directed solely at the metastatic site. C34 (malignant neoplasm of bronchus and lung) is followed by C77 (secondary and unspecified malignant neoplasm of lymph nodes). The lymph node involvement category and subcode reflect the specific lymph node region.

Question 18

A surgeon performs a laparoscopic splenectomy for a patient with immune thrombocytopenic purpura (ITP). Which ICD-10-CM code captures ITP?

  1. D69.3
  2. D69.6
  3. D69.41 (correct answer)
  4. D69.59
Explanation: ICD-10-CM D69.41 covers immune thrombocytopenic purpura (ITP). D69.3 covers immune thrombocytopenia; D69.6 covers thrombocytopenia, unspecified. The specific code D69.41 distinguishes ITP from other thrombocytopenias and is the most precise code when ITP is documented. Splenectomy for ITP is one of the most common surgical indications captured by this code.

Question 19

A surgeon performs an axillary lymph node dissection as part of a modified radical mastectomy. Is the axillary lymph node dissection separately reportable?

  1. Yes — axillary dissection is always a separate service
  2. No — axillary lymph node dissection is included in the modified radical mastectomy code and is not separately reportable (correct answer)
  3. Yes, with modifier -51 on the dissection code
  4. Yes, with modifier -59 to identify a separate anatomical site
Explanation: The modified radical mastectomy CPT® code (19307) includes removal of breast tissue along with axillary lymph node dissection as an integral component of the procedure. The axillary dissection is not separately reported when performed as part of the modified radical mastectomy. Reporting both constitutes unbundling.

Question 20

The operative report documents autologous bone marrow harvest for transplantation. Which CPT® code covers this harvest procedure?

  1. 38220
  2. 38230
  3. 38232 (correct answer)
  4. 38240
Explanation: CPT® 38230 covers bone marrow harvesting for transplantation, allogeneic. Code 38232 covers autologous bone marrow harvesting. For an autologous harvest (the patient's own marrow harvested for later reinfusion), 38232 is the specific code. Code 38230 is for allogeneic harvest (from a donor). The distinction between autologous and allogeneic drives code selection.