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

A spine surgeon performs a laminectomy at two lumbar vertebral segments for lumbar spinal stenosis, without facetectomy, foraminotomy, or discectomy. Which CPT® code is reported?

63012
63030
63005
63047
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Certified Professional Coder (CPC) Quiz

Certified Professional Coder (CPC) Quiz: Assign Neurosurgical Codes

Practice Assign Neurosurgical 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 Neurosurgical 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 spine surgeon performs a laminectomy at two lumbar vertebral segments for lumbar spinal stenosis, without facetectomy, foraminotomy, or discectomy. Which CPT® code is reported?

  1. 63012
  2. 63030
  3. 63005 (correct answer)
  4. 63047
Explanation: CPT® 63005 describes laminectomy with exploration and/or decompression of the spinal cord and/or cauda equina at 1 or 2 lumbar vertebral segments, without facetectomy, foraminotomy, or discectomy — the standard code for straightforward lumbar stenosis decompression without the additional steps. Code 63012 is specifically for spondylolisthesis (Gill procedure) and requires removal of abnormal facets or pars inter-articularis. Code 63047 includes facetectomy and foraminotomy, which are not performed here. Code 63030 is a laminotomy for herniated disc, not stenosis without disc work.

Question 2

A physician injects a corticosteroid into the left L3-L4 zygapophyseal (facet) joint under fluoroscopic guidance. Which CPT® code is reported for a lumbar facet joint injection with imaging guidance?

  1. 64490
  2. 64493 (correct answer)
  3. 64479
  4. 64483
Explanation: CPT® 64493 describes a diagnostic or therapeutic injection into a paravertebral facet (zygapophyseal) joint or the nerves innervating it at the lumbar or sacral level, single level, with imaging guidance. Code 64490 describes the same facet joint injection but at the cervical or thoracic level; L3-L4 is lumbar. Code 64479 describes a transforaminal epidural injection at the cervical or thoracic level — a different anatomic target (the epidural space via the foramen) rather than the facet joint itself. Code 64483 describes a transforaminal epidural injection at the lumbar or sacral level — also a different target than the facet joint. Distinguishing facet joint injections (64490/64493) from transforaminal epidural injections (64479/64483) is a high-frequency error in spine coding.

Question 3

A 6-year-old child with communicating hydrocephalus undergoes placement of a new ventriculoperitoneal shunt. Which CPT® code describes creation of a shunt to the peritoneal cavity?

  1. 62223 (correct answer)
  2. 62220
  3. 62225
  4. 62230
Explanation: CPT® 62223 describes creation of a ventriculoperitoneal, ventriculopleural, or other terminus shunt — the correct code when the distal end of the shunt terminates in the peritoneum. Code 62220 describes creation of a ventriculoatrial or ventriculojugular shunt, where the terminus is a cardiac chamber or jugular vein; the terminus distinguishes it from 62223. Code 62225 covers replacement or irrigation of a ventricular catheter in an existing shunt system, not creation of a new shunt. Code 62230 covers replacement or revision of an obstructed shunt, not a new shunt placement.

Question 4

A physician injects a local anesthetic into the greater occipital nerve for the treatment of occipital neuralgia. Which CPT® code is reported?

  1. 64405 (correct answer)
  2. 64450
  3. 64400
  4. 64413
Explanation: CPT® 64405 covers injection, anesthetic agent, greater occipital nerve — the dedicated code for an occipital nerve block. Because 64405 exists as a named nerve code, it must be used in preference to the non-specific code 64450. Code 64450 covers injection of other peripheral nerves or branches not specifically named elsewhere in CPT® and would only be appropriate when no specific code exists for the nerve being injected. Code 64400 describes injection of the trigeminal nerve or one of its named divisions — a different cranial nerve in a different anatomic location. Code 64413 describes injection of the cervical plexus, which provides sensory and motor innervation to the neck and is distinct from the occipital nerve. When a named CPT® code exists for the specific nerve injected, it always takes precedence over 64450.

Question 5

A surgeon places a percutaneous neurostimulator electrode array in the epidural space for spinal cord stimulation. Which CPT® code describes percutaneous epidural electrode implantation?

  1. 63655
  2. 63685
  3. 63650 (correct answer)
  4. 64555
Explanation: CPT® 63650 describes percutaneous implantation of a neurostimulator electrode array in the epidural space — the correct code for spinal cord stimulation when the electrode is placed percutaneously. Code 63655 describes open implantation of a plate or paddle electrode via laminectomy — the approach (open vs. percutaneous) and electrode type (paddle vs. wire array) distinguish it from 63650. Code 63685 describes insertion of the spinal neurostimulator pulse generator or receiver, which is a separate, additionally reportable code. Code 64555 describes percutaneous implantation of an electrode array for a peripheral nerve, not the epidural spinal cord.

Question 6

A surgeon harvests a single-strand nerve graft measuring 5 cm in length and uses it to repair a nerve gap in the upper arm. Which CPT® code is reported?

  1. 64893 (correct answer)
  2. 64891
  3. 64895
  4. 64898
Explanation: CPT® 64893 covers nerve graft, single strand, arm or leg; more than 4 cm in length — the correct code for a single-strand graft in an arm or leg nerve when the graft exceeds 4 cm. Code 64898 covers a multiple-strand (cable) nerve graft for the arm or leg, more than 4 cm — the strand count (single vs. cable) is the critical differentiator between 64893 and 64898. Code 64891 covers a single-strand nerve graft for the hand or foot, more than 4 cm — the anatomic site (arm/leg vs. hand/foot) distinguishes it from 64893. Code 64895 covers a multiple-strand (cable) graft for the hand or foot. The correct code is determined by two independent axes: anatomic site (arm/leg vs. hand/foot) and strand count (single-strand vs. multi-strand cable).

Question 7

A spine surgeon performs a percutaneous kyphoplasty at a single lumbar vertebral body for an osteoporotic compression fracture. Which CPT® code is reported?

  1. 22510
  2. 22511
  3. 22513
  4. 22514 (correct answer)
Explanation: CPT® 22514 describes percutaneous vertebral augmentation (kyphoplasty) at a single lumbar vertebral body — kyphoplasty uses a balloon tamp to restore vertebral height before injecting bone cement. Code 22513 describes the same kyphoplasty procedure but at a single thoracic vertebral body; the lumbar vs. thoracic level distinction separates 22513 from 22514. Codes 22510 and 22511 describe vertebroplasty (not kyphoplasty) at the cervicothoracic and lumbosacral levels, respectively; vertebroplasty involves direct cement injection without a balloon, distinguishing it from kyphoplasty. Both the procedure type (kyphoplasty vs. vertebroplasty) and the spinal level (lumbar vs. thoracic) must be identified to select the correct code.

Question 8

A pain management physician performs a lumbar interlaminar epidural steroid injection without imaging guidance. Which CPT® code is reported?

  1. 62322 (correct answer)
  2. 62323
  3. 62320
  4. 62321
Explanation: CPT® 62322 describes a lumbar or sacral interlaminar epidural injection without imaging guidance (fluoroscopy or CT). Code 62323 is the same lumbar/sacral approach but with imaging guidance — the most common distractor because many lumbar epidurals are done under fluoroscopy. Codes 62320 and 62321 apply to the cervical or thoracic level, not the lumbar level. The two axes that distinguish these four codes are spinal level (lumbar/sacral vs. cervical/thoracic) and imaging status (with vs. without).

Question 9

A neurosurgeon performs a craniotomy and excises a glioblastoma from the right parietal lobe (supratentorial). Which CPT® code covers craniotomy for excision of a supratentorial brain tumor?

  1. 61512
  2. 61518
  3. 61521
  4. 61510 (correct answer)
Explanation: CPT® 61510 describes craniotomy or craniectomy for excision of a supratentorial brain tumor — the correct code for a general supratentorial tumor resection that is not a meningioma or brain stem tumor. Code 61512 is specifically for excision of a supratentorial meningioma; using it for a glioblastoma is incorrect. Code 61518 describes excision of an infratentorial (e.g., cerebellar) tumor; the parietal lobe is supratentorial. Code 61521 describes excision of a brain stem tumor, which is a distinct anatomic location from the parietal lobe. The tumor location and histologic type determine the correct code within this range.

Question 10

A surgeon performs an endoscopic carpal tunnel release on a patient with carpal tunnel syndrome. Which CPT® code describes endoscopic carpal tunnel release?

  1. 64721
  2. 29848 (correct answer)
  3. 64722
  4. 64726
Explanation: CPT® 29848 describes endoscopic carpal tunnel release and is located in the Musculoskeletal section. Code 64721 describes open (not endoscopic) carpal tunnel release (median nerve neuroplasty at the carpal tunnel) and is found in the Nervous System section. The surgical approach — endoscopic versus open — is the key differentiator; when the surgeon uses endoscopic technique, 29848 is correct. Codes 64722 and 64726 describe decompression of an unspecified nerve and plantar digital nerve, respectively, and do not apply to carpal tunnel release.

Question 11

A neurosurgeon inserts a new spinal cord neurostimulator pulse generator for a patient with a previously implanted spinal cord stimulation system. Which CPT® code describes insertion of a spinal neurostimulator pulse generator?

  1. 63650
  2. 63685 (correct answer)
  3. 61885
  4. 64590
Explanation: CPT® 63685 describes insertion or replacement of a spinal neurostimulator pulse generator or receiver — the implantable power source that drives a spinal cord stimulation system. Code 63650 describes percutaneous implantation of the epidural electrode array itself; the array and the pulse generator are separately reportable, and only the generator is being placed here. Code 61885 describes insertion of a cranial neurostimulator pulse generator, not a spinal generator. Code 64590 describes insertion of a peripheral or gastric neurostimulator pulse generator. The anatomic system (spinal vs. cranial vs. peripheral) and the component type (electrode array vs. pulse generator) are the key differentiators across the neurostimulator coding family.

Question 12

A physician performs a cervical interlaminar epidural steroid injection at C6-C7 under fluoroscopic guidance. Which CPT® code is reported?

  1. 62320
  2. 62323
  3. 62321 (correct answer)
  4. 64479
Explanation: CPT® 62321 describes an interlaminar epidural injection at the cervical or thoracic level with imaging guidance (fluoroscopy or CT). Code 62320 describes the same cervical/thoracic interlaminar epidural approach but without imaging guidance — the presence of fluoroscopy elevates the code from 62320 to 62321. Code 62323 describes a lumbar or sacral interlaminar epidural with imaging guidance; the C6-C7 level is cervical, not lumbar. Code 64479 describes a transforaminal (not interlaminar) epidural injection at the cervical or thoracic level with imaging guidance — a different approach to the epidural space entirely. The spinal level and imaging status are the two critical axes for distinguishing 62320 through 62323.

Question 13

A neurosurgeon performs a posterior fossa craniectomy and excises a cerebellar tumor (not a cerebellopontine angle or brain stem tumor). Which CPT® code describes excision of an infratentorial brain tumor?

  1. 61510
  2. 61518 (correct answer)
  3. 61520
  4. 61521
Explanation: CPT® 61518 describes craniectomy for excision of an infratentorial brain tumor (e.g., cerebellar tumor) — the correct code when the tumor is in the posterior fossa but is not specifically a cerebellopontine angle or brain stem tumor. Code 61510 describes excision of a supratentorial brain tumor; the cerebellum is infratentorial, not supratentorial. Code 61520 describes excision of a cerebellopontine angle (CPA) tumor, which is a specific anatomic subset of infratentorial tumors requiring its own code; the problem states it is not a CPA tumor. Code 61521 describes excision of a brain stem tumor, also specifically carved out from the general infratentorial category. Location within the posterior fossa (general cerebellar vs. CPA vs. brain stem) determines the correct infratentorial tumor code.

Question 14

A pain specialist percutaneously implants a neurostimulator electrode array targeting a peripheral nerve (excluding the sacral nerve). Which CPT® code describes percutaneous peripheral nerve electrode implantation?

  1. 63650
  2. 64561
  3. 64555 (correct answer)
  4. 64553
Explanation: CPT® 64555 describes percutaneous implantation of a neurostimulator electrode array for a peripheral nerve, excluding the sacral nerve. Code 64561 describes percutaneous implantation specifically for the sacral nerve via a transforaminal approach, which is separately coded from other peripheral nerves. Code 64553 describes percutaneous implantation for a cranial nerve — also specifically carved out. Code 63650 describes percutaneous implantation of an epidural (spinal cord) electrode array, which is a central nervous system structure, not a peripheral nerve. The target nerve structure — epidural spinal cord vs. cranial nerve vs. sacral nerve vs. other peripheral nerve — determines which percutaneous neurostimulator code applies.

Question 15

A neurosurgeon uses a stereotactic method to create a lesion in the globus pallidus (pallidotomy) for Parkinson's disease. Which CPT® code describes creation of a stereotactic lesion in the globus pallidus or thalamus?

  1. 61750
  2. 61863
  3. 61720 (correct answer)
  4. 61885
Explanation: CPT® 61720 describes creation of a lesion by stereotactic method in the globus pallidus or thalamus (pallidotomy or thalamotomy), which ablates the target structure to treat movement disorders such as Parkinson's disease. Code 61750 describes stereotactic biopsy, aspiration, or excision of an intracranial lesion — it is used to sample or remove a pathologic lesion, not to deliberately create a therapeutic lesion in normal deep brain tissue. Code 61863 describes stereotactic implantation of a deep brain stimulation electrode array in a subcortical site such as the globus pallidus; DBS stimulates the structure rather than ablating it and uses different hardware. Code 61885 describes insertion of a cranial neurostimulator pulse generator, which is a hardware insertion code separate from the electrode placement. Pallidotomy (lesion creation) is specifically captured by 61720, not by the DBS electrode or generator codes.

Question 16

A physician performs radiofrequency ablation (destruction by neurolytic agent) of a lumbar facet joint nerve at a single lumbar level under imaging guidance. Which CPT® code is reported?

  1. 64490
  2. 64633
  3. 64635 (correct answer)
  4. 64493
Explanation: CPT® 64635 describes destruction of a paravertebral facet joint nerve by neurolytic agent (such as radiofrequency ablation) at the lumbar or sacral level, single facet joint, with imaging guidance. Code 64633 describes the identical neurolytic destruction but at the cervical or thoracic level — the spinal level distinguishes 64633 from 64635. Codes 64490 and 64493 describe diagnostic or therapeutic injections (steroid, anesthetic) into cervical/thoracic and lumbar/sacral facet joints, respectively; these are injection codes, not destruction codes. The procedure intent (injection for relief vs. neurolytic destruction) is the primary axis separating the 6449x injection codes from the 6463x destruction codes.

Question 17

A microsurgeon performs primary suture repair of the ulnar nerve at the wrist following a laceration. Which CPT® code describes suture of the ulnar nerve at or below the wrist?

  1. 64719
  2. 64831
  3. 64718
  4. 64836 (correct answer)
Explanation: CPT® 64836 describes suture (primary repair) of the ulnar nerve at or below the wrist — the correct code for a laceration repair of the ulnar nerve at this level. Code 64719 describes neuroplasty (decompression or release) of the ulnar nerve at the wrist, which is a different procedure from primary suture repair after a laceration. Code 64718 describes neuroplasty of the ulnar nerve at the elbow (for cubital tunnel syndrome) — a different nerve level and a different procedure type. Code 64831 describes suture of a digital nerve in the hand or foot, which is a smaller nerve than the ulnar nerve proper. The distinction between neuroplasty and suture repair, and between anatomic levels, is critical when coding ulnar nerve procedures.

Question 18

A 45-year-old patient with suspected subarachnoid hemorrhage undergoes a lumbar puncture for diagnostic CSF analysis. Which CPT® code describes a diagnostic spinal puncture?

  1. 62270 (correct answer)
  2. 62272
  3. 62263
  4. 62268
Explanation: CPT® 62270 describes a spinal puncture (lumbar puncture) performed specifically for diagnostic purposes, such as CSF cell count, protein, glucose, or xanthochromia analysis. Code 62272 describes a therapeutic lumbar puncture performed to drain CSF, as in idiopathic intracranial hypertension (pseudotumor cerebri); the intent (diagnostic vs. therapeutic drainage) distinguishes these two codes. Code 62263 describes percutaneous lysis of epidural adhesions over multiple days — a completely different procedure. Code 62268 describes percutaneous aspiration of a spinal cord cyst or syrinx, not a standard lumbar puncture.

Question 19

A neurosurgeon performs an anterior cervical discectomy at C5-C6 with decompression and osteophytectomy (single cervical interspace, anterior approach). Which CPT® code is reported?

  1. 63020
  2. 63030
  3. 63081
  4. 63075 (correct answer)
Explanation: CPT® 63075 describes discectomy via an anterior approach with decompression at a single cervical interspace, including osteophytectomy — this is the anterior cervical discectomy (ACDF) procedure code. Code 63020 describes a posterior approach (laminotomy) for cervical disc herniation, not an anterior approach. Code 63030 is also a posterior laminotomy but at the lumbar level. Code 63081 describes vertebral corpectomy, which involves removal of a vertebral body — a more extensive anterior procedure than discectomy alone and only appropriate when the body itself is resected.

Question 20

A pain management physician performs a transforaminal epidural steroid injection at the lumbar level, single level, under fluoroscopic guidance. Which CPT® code is reported?

  1. 64479
  2. 64483 (correct answer)
  3. 62323
  4. 64493
Explanation: CPT® 64483 describes a transforaminal epidural injection at the lumbar or sacral level, single level, with imaging guidance (fluoroscopy or CT). Code 64479 describes the same transforaminal technique but at the cervical or thoracic level — the spinal level is the key differentiator between 64479 and 64483. Code 62323 describes an interlaminar (not transforaminal) lumbar epidural with imaging guidance; interlaminar and transforaminal are different approaches to the epidural space. Code 64493 describes an injection into the paravertebral facet (zygapophyseal) joint itself, not a transforaminal epidural injection.