Certified Professional Coder (CPC) Quiz: Assign Fracture And Orthopedic Codes
20 questions · exam conditions
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Assign Fracture And Orthopedic CodesQuestion 1 of 20

A surgeon performs percutaneous pin fixation of a displaced supracondylar humerus fracture in a child. Which CPT® code covers percutaneous skeletal fixation of a supracondylar humeral fracture?

24500
24505
24516
24538
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Certified Professional Coder (CPC) Quiz

Certified Professional Coder (CPC) Quiz: Assign Fracture And Orthopedic Codes

Practice Assign Fracture And Orthopedic Codes 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 Assign Fracture And Orthopedic Codes, 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 surgeon performs percutaneous pin fixation of a displaced supracondylar humerus fracture in a child. Which CPT® code covers percutaneous skeletal fixation of a supracondylar humeral fracture?

  1. 24500
  2. 24505
  3. 24516
  4. 24538 (correct answer)
Explanation: CPT® 24538 covers percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension. Code 24500 covers closed treatment without manipulation; 24505 covers closed treatment with manipulation without anesthesia; 24516 covers treatment with manipulation with anesthesia. Percutaneous pinning is a distinct technique from closed manipulation — pins are placed through skin into bone without an open incision, coded with 24538.

Question 2

A surgeon performs a total shoulder arthroplasty replacing both the humeral head and the glenoid surface. Which CPT® code covers total shoulder arthroplasty?

  1. 23470
  2. 23472 (correct answer)
  3. 23480
  4. 23400
Explanation: CPT® 23472 covers total shoulder arthroplasty — replacement of both the humeral and glenoid components. Code 23470 covers hemiarthroplasty (humeral head prosthesis only); 23480 covers osteotomy of the clavicle; 23400 covers scapulothoracic fusion. When both prosthetic components are implanted, 23472 is used to distinguish total shoulder replacement from hemiarthroplasty.

Question 3

A surgeon performs open reduction and internal fixation of a displaced distal radial extra-articular fracture. Which CPT® code covers open treatment of a distal radial extra-articular fracture with internal fixation?

  1. 25607 (correct answer)
  2. 25605
  3. 25600
  4. 25609
Explanation: CPT® 25607 covers open treatment of distal radial extra-articular fracture with internal fixation. Code 25605 covers closed treatment with manipulation; 25600 covers closed treatment without manipulation; 25609 covers open treatment of an intra-articular distal radial fracture. The distinction between extra-articular and intra-articular involvement, combined with open vs. closed treatment, drives code selection within the distal radius fracture range.

Question 4

A patient sustains a displaced femoral neck fracture and undergoes hemiarthroplasty with a femoral head prosthesis (partial hip replacement). Which CPT® code covers hip hemiarthroplasty?

  1. 27130
  2. 27134
  3. 27125 (correct answer)
  4. 27235
Explanation: CPT® 27125 covers hemiarthroplasty of the hip, partial (femoral head prosthesis). Code 27130 covers total hip arthroplasty; 27134 covers revision of total hip arthroplasty, both components; 27235 covers open treatment of femoral fracture with internal fixation. Hemiarthroplasty replaces only the femoral head, making 27125 the correct code.

Question 5

A surgeon performs posterior lumbar interbody fusion at L4–L5 and places pedicle screws with rods for segmental stabilization. Which CPT® add-on code covers posterior segmental instrumentation for 3–6 vertebral segments?

  1. 22614
  2. 22630
  3. 22842 (correct answer)
  4. 22612
Explanation: CPT® 22842 covers posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks, three or more claw configurations), 3–6 vertebral segments — reported as an add-on code. Code 22840 covers posterior non-segmental instrumentation; 22614 is an add-on for each additional interspace in fusion; 22630 covers posterior lumbar interbody fusion. Spinal instrumentation add-on codes are always reported in addition to the primary arthrodesis code.

Question 6

A patient's tibia fracture healed, but the bone united in a significantly angulated position. At a subsequent encounter, the physician documents "malunion." Which ICD-10-CM 7th character designates a subsequent encounter for fracture with malunion?

  1. G
  2. D
  3. P (correct answer)
  4. M
Explanation: ICD-10-CM 7th character 'P' designates a subsequent encounter for fracture with malunion — the fracture healed but in an abnormal or angulated position. Character 'G' designates delayed healing; 'D' designates routine subsequent encounter (healing progressing normally); 'M' designates subsequent encounter for open fracture type I or II with nonunion. For a closed fracture that has healed in malposition, 'P' is the correct 7th character. Malunion (P) and nonunion (K for closed fractures) are frequently tested distinctions in ICD-10-CM fracture coding.

Question 7

A surgeon performs a single-level anterior cervical discectomy and fusion (ACDF) at C5-C6 with interbody cage placement. Which CPT® code covers anterior cervical interbody fusion with discectomy?

  1. 22551 (correct answer)
  2. 22552
  3. 22554
  4. 22556
Explanation: CPT® 22551 covers arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy, and decompression, cervical below C2. Code 22552 is the add-on for each additional interspace; 22554 covers anterior interbody fusion without discectomy; 22556 covers anterior thoracic interbody fusion. Single-level ACDF with discectomy at C5-C6 is reported with 22551.

Question 8

A surgeon performs intramedullary nailing with interlocking screws for a displaced femoral shaft fracture. Which CPT® code covers open treatment of a femoral shaft fracture with intramedullary fixation?

  1. 27506 (correct answer)
  2. 27507
  3. 27510
  4. 27514
Explanation: CPT® 27506 covers open treatment of femoral shaft fracture, with or without external fixation, using any type of implant including intramedullary nail with interlocking screws. Code 27507 covers open treatment with plate(s) and screws only, without an intramedullary device; 27510 covers closed treatment with manipulation; 27514 covers ORIF of the distal femur. For intramedullary nailing of a femoral shaft fracture, 27506 is the correct code.

Question 9

A physician performs a closed reduction of a glenohumeral dislocation in the emergency department without general anesthesia. Which CPT® code covers closed treatment of shoulder dislocation with manipulation, without anesthesia?

  1. 23655
  2. 23650 (correct answer)
  3. 23600
  4. 23615
Explanation: CPT® 23650 covers closed treatment of shoulder dislocation with manipulation, without anesthesia. Code 23655 covers the same procedure requiring anesthesia; 23600 covers closed treatment of proximal humeral fracture without manipulation; 23615 covers open treatment of proximal humeral fracture. When a shoulder dislocation is reduced with manipulation and no anesthesia is required, 23650 is the correct code.

Question 10

A surgeon performs open treatment of a displaced femoral neck fracture with internal fixation using cancellous lag screws. Which CPT® code covers open treatment of a femoral neck fracture with internal fixation?

  1. 27230
  2. 27232
  3. 27240
  4. 27236 (correct answer)
Explanation: CPT® 27236 covers open treatment of femoral neck fracture with internal fixation or prosthetic replacement. Code 27230 covers closed treatment without manipulation; 27232 covers closed treatment with manipulation; 27240 covers treatment of intertrochanteric fracture. Open surgical fixation of the femoral neck — as opposed to closed manipulation — is specifically reported with 27236.

Question 11

A patient treated for a femur fracture by one physician is seen by a second physician who applies a long-leg walking cast. Which CPT® code covers application of a long-leg walking cast?

  1. 29358
  2. 29365
  3. 29405
  4. 29355 (correct answer)
Explanation: CPT® 29355 covers application of a long-leg cast (thigh to toes), walking. When a provider who did not perform the fracture treatment applies the cast, the cast application code is separately reportable. Code 29358 covers a non-walking long-leg cast; 29365 covers a long-leg cylinder cast; 29405 covers a short-leg cast. The walking designation and cast length determine the specific cast application code.

Question 12

A surgeon performs a posterior spinal fusion and harvests autologous iliac crest bone graft through a separate incision. Is the bone graft harvest separately reportable?

  1. No — autologous bone graft is always bundled into spinal fusion codes
  2. Yes — iliac crest harvest through a separate incision is separately reportable using an add-on code (correct answer)
  3. Yes, with modifier -51 appended to the graft harvest code
  4. No — only allografts from a tissue bank are separately reportable
Explanation: Autologous iliac crest bone graft harvesting through a separate incision is separately reportable using CPT® add-on code 20937 (autograft, morselized) or 20938 (structural graft). These are reported in addition to the primary fusion code. Grafts harvested from the primary wound without a separate incision are not separately reportable. The separate incision justifies the additional code.

Question 13

A surgeon performs a primary open repair of an acute Achilles tendon rupture with direct end-to-end suture. Which CPT® code covers primary repair of a ruptured Achilles tendon?

  1. 27652
  2. 27654
  3. 27650 (correct answer)
  4. 27680
Explanation: CPT® 27650 covers repair, primary, open or percutaneous, ruptured Achilles tendon. Code 27652 covers Achilles repair with graft (augmented repair); 27654 covers repair of neglected or chronic Achilles rupture; 27680 covers tenolysis of the Achilles tendon. For an acute primary repair without graft, 27650 is the correct code, distinguishing it from augmented or delayed repairs.

Question 14

A physician treats a nondisplaced clavicle fracture with a figure-of-eight splint. No reduction is required. Which CPT® code covers closed treatment of a clavicular fracture without manipulation?

  1. 23505
  2. 23500 (correct answer)
  3. 23515
  4. 23520
Explanation: CPT® 23500 covers closed treatment of clavicular fracture without manipulation. Code 23505 covers closed treatment with manipulation; 23515 covers open treatment with internal fixation; 23520 covers closed treatment of sternoclavicular dislocation without manipulation. The absence of manipulation is the key clinical and coding differentiator for this nondisplaced fracture.

Question 15

A patient undergoes a right total hip arthroplasty for osteoarthritis. Which ICD-10-CM code correctly identifies primary osteoarthritis of the right hip?

  1. M16.0
  2. M16.9
  3. M16.11 (correct answer)
  4. M16.12
Explanation: ICD-10-CM M16.11 covers primary osteoarthritis of the right hip. Code M16.0 covers bilateral primary hip osteoarthritis; M16.9 covers unspecified osteoarthritis of the hip; M16.12 covers primary osteoarthritis of the left hip. When the surgery is unilateral on the right, M16.11 captures the required laterality specificity. Reporting M16.9 when laterality is documented constitutes incomplete coding.

Question 16

A surgeon performs open treatment of a bimalleolar ankle fracture with internal fixation of both the medial and lateral malleoli. Which CPT® code covers open treatment of a bimalleolar ankle fracture?

  1. 27814 (correct answer)
  2. 27822
  3. 27823
  4. 27808
Explanation: CPT® 27814 covers open treatment of bimalleolar ankle fracture with internal fixation. Code 27822 covers open treatment of trimalleolar ankle fracture with or without fixation of the posterior lip; 27823 covers trimalleolar fracture with internal fixation including the posterior lip; 27808 covers closed treatment of bimalleolar fracture without manipulation. Distinguishing bimalleolar (two malleoli) from trimalleolar (three malleoli) fractures is essential for accurate code selection.

Question 17

A patient sustains a type II open femur fracture at the initial encounter. Which ICD-10-CM 7th character designates an initial encounter for an open fracture type I or II?

  1. A
  2. C
  3. D
  4. B (correct answer)
Explanation: ICD-10-CM 7th character "B" designates an initial encounter for an open fracture type I or II. The 7th character "A" is for initial encounter, closed fracture; "C" is for initial encounter, open fracture type IIIA, IIIB, or IIIC; "D" is for subsequent encounter with routine healing. The open fracture severity classification (Gustilo type I/II vs. IIIA/B/C) drives which initial encounter character is selected.

Question 18

A surgeon performs a total knee arthroplasty replacing the tibial and femoral components. Which CPT® code covers total knee replacement?

  1. 27443
  2. 27447 (correct answer)
  3. 27440
  4. 27486
Explanation: CPT® 27447 covers total knee arthroplasty, knee, tibial and femoral components with or without patellar resurfacing. Code 27443 covers arthroplasty with patellar resurfacing only; 27440 covers patellectomy; 27486 covers revision of total knee arthroplasty. Total knee replacement is specifically designated 27447, distinguishing it from partial procedures and revisions.

Question 19

A surgeon performs an arthroscopic anterior cruciate ligament (ACL) reconstruction using a patellar tendon graft. Which CPT® code covers arthroscopic ACL repair or reconstruction?

  1. 29888 (correct answer)
  2. 29889
  3. 29880
  4. 29876
Explanation: CPT® 29888 covers arthroscopy, knee, surgical, with anterior cruciate ligament (ACL) repair/augmentation or reconstruction. Code 29889 covers posterior cruciate ligament (PCL) repair; 29880 covers meniscectomy (both menisci); 29876 covers synovectomy. ACL reconstruction is specifically assigned 29888, with PCL reconstruction coded separately as 29889.

Question 20

A physician performs closed reduction (manipulation) of a Colles' fracture (distal radius) and applies a splint. Which CPT® code covers closed treatment of a distal radial fracture with manipulation?

  1. 25609
  2. 25607
  3. 25600
  4. 25605 (correct answer)
Explanation: CPT® 25605 covers closed treatment of distal radial fracture (e.g., Colles or Smith type) with manipulation. Code 25600 covers closed treatment without manipulation; 25607 covers open treatment of extra-articular distal radial fracture; 25609 covers open treatment of intra-articular distal radial fracture. Closed manipulation (no surgical incision) is the defining feature, making 25605 the correct code for a Colles' fracture with reduction.