Certified Professional Coder (CPC) Quiz: Code Abdominal Surgery Procedures
20 questions · exam conditions
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Code Abdominal Surgery ProceduresQuestion 1 of 20

A surgeon performs a laparoscopic resection of a segment of the small intestine for Crohn's disease, with laparoscopic anastomosis. Which CPT® code is reported?

44120
44202
44205
44204
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Certified Professional Coder (CPC) Quiz

Certified Professional Coder (CPC) Quiz: Code Abdominal Surgery Procedures

Practice Code Abdominal Surgery Procedures 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 Code Abdominal Surgery Procedures, 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 a laparoscopic resection of a segment of the small intestine for Crohn's disease, with laparoscopic anastomosis. Which CPT® code is reported?

  1. 44120
  2. 44202 (correct answer)
  3. 44205
  4. 44204
Explanation: CPT® 44202 describes laparoscopic resection of the small intestine (single resection) — the correct code for a laparoscopic small bowel resection when the anastomosis is performed at the time of resection. Code 44120 describes open (not laparoscopic) small bowel resection with anastomosis. Code 44205 describes laparoscopic colectomy, partial — the primary organ here is the small intestine, not the large bowel. Code 44204 describes laparoscopic partial colectomy (large intestine primary). Identifying the primary organ resected — small bowel (44202) vs. large bowel (44204) — is essential for accurate laparoscopic intestinal resection coding.

Question 2

A surgeon performs an open repair of a primary (initial) umbilical hernia in a 35-year-old patient. The defect measures 4 cm and is reducible. Which CPT® code is reported?

  1. 49591
  2. 49594
  3. 49592 (correct answer)
  4. 49593
Explanation: CPT® 49592 describes open repair of a reducible initial anterior abdominal hernia with a defect measuring 3 to 10 cm — the 2023 code that replaced the deleted 49585. Under the current CPT anterior abdominal hernia framework, umbilical, epigastric, incisional, ventral, and spigelian hernias are all classified together and coded based on hernia status (initial vs. recurrent) and defect size. Code 49591 covers open initial anterior hernia repair for defects less than 3 cm. Code 49593 covers open initial anterior hernia repair for defects greater than 10 cm. Code 49594 covers open recurrent (not initial) anterior hernia repair, less than 3 cm. A 4 cm initial umbilical defect falls in the 3-10 cm tier (49592).

Question 3

A surgeon performs a laparoscopic left inguinal hernia repair. The operative note confirms no prior hernia repairs on this side. Which CPT® code is reported?

  1. 49650 (correct answer)
  2. 49651
  3. 49505
  4. 49520
Explanation: CPT® 49650 describes laparoscopic inguinal hernia repair for an initial (first-occurrence) hernia — the correct code for a minimally invasive inguinal repair when no prior repair has been performed on that side. Code 49651 describes laparoscopic inguinal hernia repair for a recurrent hernia; the note confirms no prior repairs, so 49651 is incorrect. Code 49505 describes open (not laparoscopic) initial inguinal hernia repair. Code 49520 describes open recurrent inguinal hernia repair. The approach (laparoscopic vs. open) and hernia status (initial vs. recurrent) together determine the correct inguinal hernia code.

Question 4

A surgeon performs a laparoscopic repair of an initial anterior abdominal hernia at a previous trocar site. The defect measures 6 cm and is reducible. Which CPT® code is reported?

  1. 49652
  2. 49592
  3. 49653 (correct answer)
  4. 49655
Explanation: CPT® 49653 describes laparoscopic or robotic repair of a reducible initial anterior abdominal hernia with a defect measuring 3 to 10 cm — the correct code for a minimally invasive initial repair of this size. Under the 2023 anterior abdominal hernia framework, the approach (open vs. laparoscopic/robotic), hernia status (initial vs. recurrent), and defect size (<3 cm, 3-10 cm, or >10 cm) determine code selection. Code 49652 covers laparoscopic initial anterior hernia repair for defects less than 3 cm. Code 49592 covers open (not laparoscopic) initial anterior hernia repair, 3-10 cm. Code 49655 covers laparoscopic recurrent (not initial) anterior hernia repair, 3-10 cm. A 6 cm initial trocar-site hernia repaired laparoscopically falls in 49653.

Question 5

A general surgeon performs a laparoscopic appendectomy for acute, non-ruptured appendicitis. Which CPT® code is reported?

  1. 44950
  2. 44970 (correct answer)
  3. 44960
  4. 44150
Explanation: CPT® 44970 describes laparoscopic appendectomy — the correct code for any laparoscopic removal of the appendix, whether performed for simple or complicated appendicitis. Code 44950 describes open (not laparoscopic) appendectomy for a simple, non-ruptured appendix. Code 44960 describes open appendectomy for a ruptured appendix with abscess or generalized peritonitis; the case here has neither rupture nor peritonitis, and the approach was laparoscopic. Code 44150 describes open total abdominal colectomy, which involves removal of the colon — an entirely different organ. Approach (laparoscopic vs. open) is the primary axis for appendectomy coding.

Question 6

A hepatic surgeon performs a total right hepatic lobectomy, removing segments V through VIII of the right lobe for hepatocellular carcinoma. Which CPT® code is reported?

  1. 47120
  2. 47125
  3. 47130 (correct answer)
  4. 47122
Explanation: CPT® 47130 describes total right hepatic lobectomy — the correct code when the entire right lobe of the liver (segments V through VIII) is removed. Code 47120 describes partial hepatectomy, which is used for resections of less than a full anatomic lobe; removal of the entire right lobe requires the total lobectomy code. Code 47125 describes total left hepatic lobectomy (segments II, III, and IV); the right lobe, not the left, is removed here. Code 47122 describes trisegmentectomy (extended resection involving three or more segments from both lobes), which applies when the resection crosses beyond one anatomic lobe. When a complete, single anatomic lobe is removed, the total lobectomy code (47130 for right, 47125 for left) is correct.

Question 7

A surgeon performs a laparoscopic cholecystectomy for symptomatic cholelithiasis. The operative note states no cholangiogram was performed. Which CPT® code is reported?

  1. 47563 (correct answer)
  2. 47564
  3. 47600
  4. 47605
Explanation: CPT® 47563 describes laparoscopic cholecystectomy without intraoperative cholangiography — the correct code because the approach is laparoscopic and the operative note explicitly states that no cholangiogram was performed. Code 47564 describes laparoscopic cholecystectomy with intraoperative cholangiography; since no cholangiogram was obtained, 47564 is incorrect. Code 47600 describes open cholecystectomy without cholangiography — correct on cholangiography status but wrong approach. Code 47605 describes open cholecystectomy with cholangiography — wrong on both counts. The surgeon's decision not to perform a cholangiogram, combined with the laparoscopic approach, makes 47563 the only correct selection.

Question 8

A surgeon creates a diverting sigmoid colostomy as a separate, staged procedure for a patient with obstructing rectal cancer. No bowel resection is performed at this session. Which CPT® code is reported?

  1. 44140
  2. 44143
  3. 44320 (correct answer)
  4. 44204
Explanation: CPT® 44320 describes creation of a colostomy or skin-level cecostomy as a separate procedure — the correct code when a diverting stoma is constructed without concurrent bowel resection. Code 44140 describes open partial colectomy (resection with anastomosis), which involves removing a segment of bowel — not performed here. Code 44143 describes partial colectomy with end colostomy and closure of the distal segment (Hartmann's procedure), which includes a simultaneous bowel resection — no colonic resection was performed. Code 44204 describes laparoscopic partial colectomy; the approach here was open. When only a stoma is created without resection, 44320 is the correct code.

Question 9

A surgeon performs a pancreaticoduodenectomy (Whipple procedure) for pancreatic head adenocarcinoma, including total duodenectomy, partial gastrectomy, choledochoenterostomy, and pancreatojejunostomy. Which CPT® code is reported?

  1. 48100
  2. 48140
  3. 48146
  4. 48150 (correct answer)
Explanation: CPT® 48150 describes a pancreaticoduodenectomy (proximal subtotal pancreatectomy with total duodenectomy, partial gastrectomy, choledochoenterostomy, and gastrojejunostomy — Whipple procedure) with pancreatojejunostomy; this matches all components described in the operative note. Code 48100 describes a pancreatic biopsy only — far less extensive than a Whipple resection. Code 48140 describes a distal pancreatectomy (removal of the pancreatic tail), which is the opposite end of the pancreas from the head. Code 48146 describes a pancreatectomy with islet cell preservation. The Whipple procedure (48150) is one of the most complex abdominal operations and must be distinguished from partial or distal pancreatectomy codes.

Question 10

A surgeon performs an open cholecystectomy for acute cholecystitis. The operative note states that no intraoperative cholangiogram was performed. Which CPT® code is reported?

  1. 47600 (correct answer)
  2. 47605
  3. 47563
  4. 47564
Explanation: CPT® 47600 describes open cholecystectomy without intraoperative cholangiography — the correct code when an open approach is used and no fluoroscopic imaging of the bile ducts is performed. Code 47605 describes open cholecystectomy with intraoperative cholangiography; the operative note explicitly states no cholangiogram was performed, making 47605 incorrect. Code 47563 describes laparoscopic cholecystectomy without cholangiography; the approach here is open, not laparoscopic. Code 47564 describes laparoscopic cholecystectomy with cholangiography — wrong on both approach and cholangiography status. The approach (open vs. laparoscopic) and cholangiography status (with vs. without) are the two axes that differentiate all four cholecystectomy codes.

Question 11

A trauma surgeon attempts splenorrhaphy for a lacerated spleen but ultimately performs an open total splenectomy when hemorrhage cannot be controlled. No other organ resections are performed. Which CPT® code is reported for the splenectomy?

  1. 38120
  2. 38100 (correct answer)
  3. 38115
  4. 38102
Explanation: CPT® 38100 describes total splenectomy as a separate procedure — the correct code when the spleen is removed in its entirety through an open approach without accompanying en bloc resection of adjacent organs. Code 38120 describes laparoscopic total splenectomy; the approach here is open laparotomy. Code 38115 describes splenorrhaphy (attempted first in this case), but the final procedure is total splenectomy; splenorrhaphy is not additionally reportable when the surgeon proceeds to splenectomy. Code 38102 describes total splenectomy en bloc for extensive disease performed in conjunction with another procedure — no other organ was resected here. The open approach (38100) vs. laparoscopic approach (38120) is the key differentiator.

Question 12

A surgeon performs a laparoscopic cholecystectomy and obtains an intraoperative cholangiogram to evaluate the bile ducts. Which CPT® code is reported?

  1. 47564 (correct answer)
  2. 47563
  3. 47605
  4. 47600
Explanation: CPT® 47564 describes laparoscopic cholecystectomy with intraoperative cholangiography — the correct code when a laparoscopic approach is used and fluoroscopic imaging of the bile ducts is obtained during the same session. Code 47563 describes laparoscopic cholecystectomy without cholangiography; since a cholangiogram was explicitly performed here, 47563 is incorrect. Code 47605 describes open cholecystectomy with cholangiography (not laparoscopic). Code 47600 describes open cholecystectomy without cholangiography. The two axes — approach (laparoscopic vs. open) and cholangiography (with vs. without) — create four distinct cholecystectomy codes.

Question 13

A surgeon performs a laparoscopic total splenectomy for immune thrombocytopenic purpura (ITP) refractory to medical management. Which CPT® code is reported?

  1. 38100
  2. 38102
  3. 38115
  4. 38120 (correct answer)
Explanation: CPT® 38120 describes laparoscopic total splenectomy — the correct code for minimally invasive removal of the entire spleen, which is the standard surgical treatment for ITP when medical therapy fails. Code 38100 describes open total splenectomy (not laparoscopic) as a separate procedure. Code 38102 describes open total splenectomy en bloc for extensive disease, performed in conjunction with another procedure — the additional complexity and open approach make this incorrect. Code 38115 describes splenorrhaphy (repair of a ruptured spleen), not removal. The laparoscopic approach is the critical differentiator between 38120 and the open codes 38100/38102.

Question 14

A colorectal surgeon performs an open sigmoid colectomy for diverticular disease, resecting the sigmoid segment of the colon with primary anastomosis via open laparotomy. Which CPT® code is reported?

  1. 44204
  2. 44150
  3. 44140 (correct answer)
  4. 44210
Explanation: CPT® 44140 describes open partial colectomy — the correct code for any open resection of a segment of the large bowel (including sigmoid colectomy, right or left hemicolectomy) with anastomosis. Code 44204 describes laparoscopic partial colectomy; the approach here is open laparotomy. Code 44150 describes open total abdominal colectomy, which removes the entire colon from cecum to rectum — only the sigmoid colon is removed here. Code 44210 describes laparoscopic total colectomy — incorrect on both approach and extent. The distinction between total (44150) and partial (44140) colectomy, and between open (44140) and laparoscopic (44204) approach, determines the correct code.

Question 15

A surgeon simultaneously repairs bilateral inguinal hernias via an open approach in a 60-year-old patient. Both hernias are first-occurrence. Which CPT® code is reported?

  1. 49505
  2. 49650
  3. 49520
  4. 49507 (correct answer)
Explanation: CPT® 49507 describes open repair of bilateral initial inguinal hernias — the specific code for simultaneous bilateral open inguinal hernia repair at the first occurrence. Code 49505 describes open unilateral initial inguinal hernia repair; when both sides are repaired at the same session, the bilateral code (49507) is used rather than reporting 49505 twice with a modifier. Code 49650 describes laparoscopic (not open) initial inguinal hernia repair, unilateral. Code 49520 describes open recurrent inguinal hernia repair; both hernias here are first-occurrence. CPT® provides specific bilateral codes for common hernia procedures; 49507 should be used rather than 49505 with modifier -50 for bilateral open inguinal repairs.

Question 16

A surgeon performs a laparoscopic total abdominal colectomy for familial adenomatous polyposis, removing the entire colon laparoscopically. Which CPT® code is reported?

  1. 44150
  2. 44204
  3. 44140
  4. 44210 (correct answer)
Explanation: CPT® 44210 describes laparoscopic total abdominal colectomy — the correct code because the entire colon was removed using a laparoscopic approach. Code 44150 describes open total abdominal colectomy; the approach here is laparoscopic. Code 44140 describes open partial colectomy — wrong on both approach (open) and extent (partial). Code 44204 describes laparoscopic partial colectomy; the extent here is total, not partial. Both axes — approach (laparoscopic vs. open) and extent (total vs. partial) — must be confirmed to distinguish among the four colectomy codes: 44140 (open partial), 44150 (open total), 44204 (lap partial), 44210 (lap total).

Question 17

A hepatic surgeon performs an open partial hepatic lobectomy, resecting segment VI of the right lobe while preserving the remaining hepatic parenchyma. Which CPT® code is reported?

  1. 47125
  2. 47120 (correct answer)
  3. 47130
  4. 47122
Explanation: CPT® 47120 describes hepatectomy with partial lobectomy — the correct code for any open resection of less than an entire lobe, including single-segment or limited resections that preserve the remaining hepatic parenchyma. Code 47125 describes total left hepatic lobectomy, which removes the entire left lobe — not applicable here. Code 47130 describes total right hepatic lobectomy, removing the entire right lobe — the right lobe is preserved except for segment VI in this case. Code 47122 describes trisegmentectomy (three-segment resection); only one segment is resected here. Partial lobectomy (47120) is appropriate whenever less than a complete anatomic lobe is removed.

Question 18

A surgeon performs an open resection of a segment of the jejunum for a small bowel obstruction with primary anastomosis. Which CPT® code is reported?

  1. 44202
  2. 44120 (correct answer)
  3. 44140
  4. 44205
Explanation: CPT® 44120 describes open resection of the small intestine (single resection) with anastomosis — the correct code for an open small bowel resection when the gastrointestinal tract is restored in the same operation. Code 44202 describes laparoscopic small intestine resection; the note specifies an open laparotomy. Code 44140 describes open partial colectomy (resection of the large intestine, not small intestine); the jejunum is small bowel. Code 44205 describes laparoscopic colectomy, partial — also incorrect on both organ (colon vs. small bowel) and approach. Distinguishing between small bowel (44120) and large bowel (44140) resection is fundamental to abdominal surgery coding.

Question 19

A surgeon performs an open right inguinal hernia repair in a 45-year-old patient. This is the patient's first inguinal hernia repair on this side. Which CPT® code is reported?

  1. 49520
  2. 49507
  3. 49650
  4. 49505 (correct answer)
Explanation: CPT® 49505 describes open repair of an initial (not recurrent) inguinal hernia in a patient older than 5 years — the standard code for a first-time open inguinal hernia repair in an adult. Code 49520 describes open repair of a recurrent inguinal hernia; the case specifies this is a first occurrence, making 49520 incorrect. Code 49507 describes open bilateral inguinal hernia repair (initial); only the right side is repaired here, not both sides. Code 49650 describes laparoscopic inguinal hernia repair (initial); the approach here is open, not laparoscopic. The three differentiating axes are laterality (unilateral vs. bilateral), recurrence (initial vs. recurrent), and approach (open vs. laparoscopic).

Question 20

A colorectal surgeon performs an open total abdominal colectomy for refractory ulcerative colitis, removing the entire colon via an open laparotomy incision. Which CPT® code is reported?

  1. 44140
  2. 44204
  3. 44150 (correct answer)
  4. 44210
Explanation: CPT® 44150 describes open total abdominal colectomy — the appropriate code when the entire colon is removed via an open laparotomy incision. Code 44140 describes open partial colectomy, which resects only a segment of the colon, not the entire organ. Code 44204 describes laparoscopic partial colectomy; this case is both open and total. Code 44210 describes laparoscopic total colectomy; while the extent is correct, the approach is open, not laparoscopic. Both the extent of resection (partial vs. total) and the surgical approach (open vs. laparoscopic) must be identified to select the correct colectomy code.