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

A cardiac surgeon performs coronary artery bypass using three separate saphenous vein grafts to three coronary targets. No arterial conduits are used. Which CPT® code is reported?

33533
33511
33512
33513
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Certified Professional Coder (CPC) Quiz

Certified Professional Coder (CPC) Quiz: Code Cardiovascular Procedures

Practice Code Cardiovascular 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 Cardiovascular 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 cardiac surgeon performs coronary artery bypass using three separate saphenous vein grafts to three coronary targets. No arterial conduits are used. Which CPT® code is reported?

  1. 33533
  2. 33511
  3. 33512 (correct answer)
  4. 33513
Explanation: CPT® 33512 describes coronary artery bypass using three venous grafts — the correct code when three vein conduits are anastomosed to three coronary targets without any arterial grafts. Code 33533 describes CABG using a single arterial graft; the saphenous vein is venous, not arterial. Code 33511 describes CABG using two venous grafts; three grafts were performed here. Code 33513 describes CABG using four venous grafts. Venous graft CABG codes increase in one-graft increments: 33510 (one), 33511 (two), 33512 (three), 33513 (four), 33514 (five), and 33516 (six or more). Correctly counting the number of grafts and identifying the conduit type (venous) selects 33512.

Question 2

A cardiologist performs percutaneous transluminal coronary balloon angioplasty of the right coronary artery. No stent is deployed and no atherectomy device is used. Which CPT® code is reported?

  1. 92928
  2. 92933
  3. 92920 (correct answer)
  4. 92924
Explanation: CPT® 92920 describes percutaneous transluminal coronary angioplasty (PTCA) using a balloon catheter in a single major coronary artery, without stent placement and without atherectomy — the correct code when balloon dilation alone achieves the therapeutic result. Code 92928 describes PCI with intracoronary stent placement (with or without angioplasty); no stent was deployed in this case. Code 92933 describes PCI with atherectomy and stent placement in a single vessel; neither atherectomy nor stent was used here. Code 92924 describes PTCA with atherectomy but without stent; no atherectomy device was used. Balloon-only PTCA without stenting (92920) must be clearly distinguished from stent-based PCI (92928) on the basis of whether a stent was deployed.

Question 3

A cardiologist performs rotational atherectomy followed by intracoronary stent placement in the circumflex artery during the same session. No other vessels are treated. Which CPT® code is reported?

  1. 92920
  2. 92928
  3. 92924
  4. 92933 (correct answer)
Explanation: CPT® 92933 describes percutaneous transcatheter coronary revascularization with atherectomy (open or rotational) and intracoronary stent placement in a single major coronary artery — the correct code when both atherectomy and stent placement are performed in the same vessel during the same session. Code 92920 describes PTCA (balloon only) without atherectomy or stent; both atherectomy and stent were used here. Code 92928 describes PCI with stent placement only, without atherectomy; rotational atherectomy was performed prior to stenting, requiring the atherectomy code upgrade. Code 92924 describes atherectomy with balloon angioplasty but without stent placement; a stent was deployed. When both atherectomy and stent placement are performed in a single coronary artery, 92933 captures both components and supersedes the stent-only (92928) or atherectomy-only (92924) codes.

Question 4

A cardiologist performs a percutaneous coronary intervention with balloon angioplasty and intracoronary stent placement in the left anterior descending artery. No atherectomy is performed. Which CPT® code is reported?

  1. 92920
  2. 92933
  3. 92928 (correct answer)
  4. 92924
Explanation: CPT® 92928 describes percutaneous transcatheter placement of an intracoronary stent with coronary angioplasty when performed, for a single major coronary artery or branch — the correct code when a stent is placed in one coronary artery without atherectomy. Code 92920 describes percutaneous transluminal coronary angioplasty (PTCA) with balloon only, without stent placement; a stent was deployed in this case, so 92920 is insufficient. Code 92933 describes PCI with atherectomy and intracoronary stent in a single vessel; no atherectomy was performed here. Code 92924 describes PTCA with atherectomy but without stent placement. The combination of stent placement without atherectomy in a single vessel identifies 92928.

Question 5

A cardiac electrophysiologist implants a new dual-chamber (AV) permanent pacemaker system, placing transvenous electrodes in both the right atrium and right ventricle along with a new pulse generator. Which CPT® code is reported?

  1. 33206
  2. 33207
  3. 33212
  4. 33208 (correct answer)
Explanation: CPT® 33208 describes insertion of a new permanent pacemaker system with transvenous electrodes in both the atrium and ventricle (AV or dual-chamber) — the correct code when both an atrial and a ventricular lead are placed along with a pulse generator. Code 33206 describes insertion of an atrial single-chamber pacemaker with a transvenous electrode (atrial lead only). Code 33207 describes insertion of a ventricular single-chamber pacemaker with a transvenous electrode (ventricular lead only). Code 33212 describes insertion of a pulse generator only with an existing single lead — no new leads are placed with 33212. The dual-lead (AV) pacemaker system requires 33208, which should be distinguished from single-chamber atrial (33206) and single-chamber ventricular (33207) systems.

Question 6

A cardiac surgeon performs coronary artery bypass using the left internal mammary artery (LIMA) and right internal mammary artery (RIMA), each anastomosed to a separate coronary target. No venous conduits are used. Which CPT® code is reported?

  1. 33534 (correct answer)
  2. 33533
  3. 33511
  4. 33510
Explanation: CPT® 33534 describes coronary artery bypass using two arterial grafts — the correct code when two arterial conduits (LIMA and RIMA in this case) are anastomosed to two separate coronary targets with no venous grafts. Code 33533 describes CABG using a single arterial graft; two arterial grafts are performed here. Code 33511 describes CABG using two venous grafts; both conduits here are arterial (internal mammary arteries), not venous. Code 33510 describes CABG using a single venous graft — incorrect on both conduit type (venous) and count. Internal mammary arteries are arterial conduits; correctly identifying both the conduit type (arterial) and count (two) selects 33534.

Question 7

A vascular surgeon performs an open carotid endarterectomy via a neck incision, removing atheromatous plaque from the internal carotid artery and closing the arteriotomy with a patch graft. Which CPT® code is reported?

  1. 35475
  2. 37215
  3. 37216
  4. 35301 (correct answer)
Explanation: CPT® 35301 describes thromboendarterectomy (including patch graft if performed) of the carotid artery via a neck incision — the correct code for open surgical carotid endarterectomy with plaque removal and patch angioplasty closure. Code 35475 describes percutaneous transluminal balloon angioplasty of the brachiocephalic trunk or branches; the procedure here is an open surgical endarterectomy, not a percutaneous balloon dilation. Code 37215 describes transcatheter placement of an intravascular stent in the cervical carotid artery with distal embolic protection — an endovascular technique (carotid artery stenting), not open endarterectomy. Code 37216 describes carotid stenting without distal embolic protection — also endovascular. Open endarterectomy (35301) and endovascular stenting (37215/37216) are distinct procedures for carotid artery disease.

Question 8

A cardiologist performs right heart catheterization, left heart catheterization, selective coronary angiography, and intraprocedural left ventriculography in the same session. No bypass graft angiography is performed. Which CPT® code is reported?

  1. 93460 (correct answer)
  2. 93456
  3. 93461
  4. 93458
Explanation: CPT® 93460 describes combined right and left heart catheterization with coronary angiography, including intraprocedural injection for left ventriculography when performed — the correct code when both right and left heart catheterizations are performed with coronary angiography and ventriculography, but without bypass graft angiography. Code 93456 describes coronary angiography with right heart catheterization only — no left heart cath is included in 93456. Code 93461 adds bypass graft angiography to the full right and left heart cath; no bypass graft angiography was performed here. Code 93458 describes coronary angiography with left heart cath and ventriculography but without right heart cath; both right and left heart caths were performed here. The simultaneous presence of right AND left heart catheterization distinguishes 93460 from 93456 and 93458.

Question 9

An electrophysiologist implants a new permanent pacemaker system with a single transvenous electrode placed in the right ventricular apex and a pulse generator. No atrial lead is placed. Which CPT® code is reported?

  1. 33206
  2. 33207 (correct answer)
  3. 33208
  4. 33212
Explanation: CPT® 33207 describes insertion of a new permanent pacemaker with a single transvenous ventricular electrode — the correct code for a single-chamber ventricular pacemaker system (generator plus one ventricular lead). Code 33206 describes insertion of a permanent pacemaker with a single transvenous atrial electrode; the lead here is placed in the right ventricular apex, not the atrium. Code 33208 describes insertion of a dual-chamber (AV) pacemaker with both atrial and ventricular transvenous electrodes; only one ventricular lead is placed here. Code 33212 describes insertion of a pulse generator only with a pre-existing single lead; the lead is newly placed in this case. The chamber(s) in which leads are placed — atrial only (33206), ventricular only (33207), or both (33208) — distinguish new pacemaker system codes.

Question 10

A cardiac surgeon performs coronary artery bypass using four arterial conduits — the LIMA, RIMA, and two radial artery segments — each anastomosed to a separate coronary target. No venous grafts are used. Which CPT® code is reported?

  1. 33536 (correct answer)
  2. 33535
  3. 33534
  4. 33533
Explanation: CPT® 33536 describes coronary artery bypass using four or more arterial grafts — the correct code when four arterial conduits (LIMA, radial artery, RIMA, and a second radial artery segment) are each anastomosed to separate coronary targets with no venous grafts. Code 33535 describes CABG using three arterial grafts; four arterial grafts are used here. Code 33534 describes CABG using two arterial grafts. Code 33533 describes CABG using a single arterial graft. The arterial CABG codes increase in one-graft increments: 33533 (one), 33534 (two), 33535 (three), and 33536 (four or more). Identifying all four conduits as arterial conduits and counting them accurately selects 33536.

Question 11

A cardiac electrophysiologist removes an ICD pulse generator and replaces it with a new device. The patient has a single pre-existing ICD lead, which is retained and reconnected. No new leads are implanted. Which CPT® code is reported?

  1. 33249
  2. 33263
  3. 33264
  4. 33262 (correct answer)
Explanation: CPT® 33262 describes removal of an ICD pulse generator with replacement in a single-lead system — the correct code when the existing generator is exchanged and only one pre-existing ICD lead is connected to the new device. Code 33263 describes ICD generator replacement in a dual-lead system; this patient has a single lead. Code 33264 describes ICD generator replacement in a multiple-lead (three or more) system. Code 33249 describes insertion or replacement of a complete ICD system including transvenous lead placement; since no new lead is placed, 33249 is incorrect. Accurate lead counting — single (33262), dual (33263), or multiple/three or more (33264) — is the critical distinction among ICD generator replacement codes.

Question 12

An electrophysiologist removes a patient's permanent pacemaker pulse generator and replaces it with a new generator. The patient has two pre-existing pacemaker leads, which are retained and reconnected. No new leads are placed. Which CPT® code is reported?

  1. 33212
  2. 33228 (correct answer)
  3. 33227
  4. 33229
Explanation: CPT® 33228 describes removal of a permanent pacemaker pulse generator with replacement in a dual-lead system — the correct code when an existing pacemaker generator is removed and a new one is inserted connected to two pre-existing leads. Code 33212 describes insertion of a new pulse generator only with existing dual leads; this code does not include the removal component, whereas 33228 covers both the removal and the replacement. Code 33227 describes removal with replacement in a single-lead system; this patient has two leads. Code 33229 describes removal with replacement in a multiple-lead (more than two) system. The number of pre-existing leads — one (33227), two (33228), or more than two (33229) — is the differentiating factor among pacemaker generator removal-with-replacement codes.

Question 13

A vascular specialist performs transcatheter placement of an intravascular stent in the cervical carotid artery. A distal embolic protection filter wire is deployed to capture debris during the procedure. Which CPT® code is reported?

  1. 35301
  2. 37216
  3. 37215 (correct answer)
  4. 35475
Explanation: CPT® 37215 describes transcatheter placement of an intravascular stent in the cervical carotid artery with distal embolic protection — the correct code when a carotid stent is placed percutaneously and an embolic protection device (filter wire) is deployed to capture debris. Code 37216 describes carotid artery stenting without distal embolic protection; an embolic protection device was used here, requiring 37215. Code 35301 describes open carotid endarterectomy via neck incision — an open surgical procedure, not a percutaneous stenting technique. Code 35475 describes percutaneous balloon angioplasty of the brachiocephalic trunk or branches without stent placement; a stent is placed here. The presence or absence of a distal embolic protection device is the sole differentiator between 37215 and 37216.

Question 14

A cardiologist performs selective coronary angiography, left heart catheterization, and intraprocedural left ventriculography. No right heart catheterization or bypass graft angiography is performed. Which CPT® code is reported?

  1. 93458 (correct answer)
  2. 93454
  3. 93460
  4. 93456
Explanation: CPT® 93458 describes catheter placement in a coronary artery for coronary angiography with concomitant left heart catheterization, including intraprocedural injection for left ventriculography — the correct code when coronary angiography, left heart catheterization, and left ventriculography are all performed without right heart catheterization or bypass graft angiography. Code 93454 describes coronary angiography only, without any left or right heart catheterization or ventriculography; since left heart catheterization and ventriculography were performed here, 93454 is incorrect. Code 93460 describes the same services as 93458 but adds right heart catheterization; no right heart cath was performed in this case. Code 93456 describes coronary angiography with right heart catheterization only (no left heart cath or ventriculography). The components performed — coronary angiography, left heart cath, and left ventriculography — precisely define 93458.

Question 15

A cardiologist performs right heart catheterization, left heart catheterization, selective coronary angiography, left ventriculography, and bypass graft angiography in a patient with prior CABG. All five components are documented. Which CPT® code is reported?

  1. 93461 (correct answer)
  2. 93460
  3. 93459
  4. 93457
Explanation: CPT® 93461 describes combined right and left heart catheterization with coronary angiography, intraprocedural injection for left ventriculography, and catheter placement in bypass grafts for bypass graft angiography — the most comprehensive cardiac catheterization code, applied when all five components are performed. Code 93460 describes right and left heart catheterization with coronary angiography and ventriculography but without bypass graft angiography; bypass graft angiography was performed here. Code 93459 describes coronary angiography with left heart cath, ventriculography, and bypass graft angiography but without right heart catheterization; right heart cath was performed here. Code 93457 describes coronary angiography with bypass graft angiography and right heart cath but without left heart cath or ventriculography. All five components together define 93461.

Question 16

A cardiologist performs selective coronary angiography combined with hemodynamic right heart catheterization. No left heart catheterization or left ventriculography is performed. Which CPT® code is reported?

  1. 93456 (correct answer)
  2. 93454
  3. 93460
  4. 93458
Explanation: CPT® 93456 describes coronary angiography with right heart catheterization — the correct code when both selective coronary angiography and hemodynamic right heart catheterization are performed, without any left heart catheterization or left ventriculography. Code 93454 describes coronary angiography only; since right heart catheterization was also performed, 93454 is insufficient. Code 93460 describes right AND left heart catheterization with coronary angiography and left ventriculography; no left heart catheterization was performed here. Code 93458 describes coronary angiography with left heart catheterization and ventriculography; only right heart catheterization was performed in this case. The presence of right heart catheterization without left heart catheterization, combined with coronary angiography, defines 93456.

Question 17

An electrophysiologist removes a patient's permanent pacemaker pulse generator and replaces it with a new generator. The patient has a single pre-existing pacemaker lead, which is retained and reconnected. No new leads are placed. Which CPT® code is reported?

  1. 33212
  2. 33227 (correct answer)
  3. 33208
  4. 33228
Explanation: CPT® 33227 describes removal of a permanent pacemaker pulse generator with replacement in a single-lead system — the correct code when an existing generator is removed and a new one is connected to one pre-existing lead without placing any new leads. Code 33212 describes insertion of a new pulse generator only with an existing single lead; unlike 33227, code 33212 does not include the removal step and is not the appropriate code when the old generator is also explanted. Code 33208 describes insertion of a new complete dual-chamber pacemaker system with transvenous electrodes — this patient has a single-lead system and no new leads are placed. Code 33228 describes removal with replacement in a dual-lead system; this is a single-lead system. The number of pre-existing leads — one (33227), two (33228), or more than two (33229) — determines the correct removal-with-replacement pacemaker code.

Question 18

A cardiac surgeon performs coronary artery bypass using the left internal mammary artery (LIMA) to the LAD and two saphenous vein grafts to the RCA and obtuse marginal branch (3 total bypasses). Which CPT® codes are reported for the bypass grafting?

  1. 33510
  2. 33511
  3. 33533 and 33518 (correct answer)
  4. 33534
Explanation: When CABG uses both arterial and venous conduits, the arterial graft code (33533–33536) is the primary code and the venous graft add-on codes (33517–33523) are reported additionally. One LIMA plus two saphenous vein grafts requires: 33533 (CABG using one arterial graft, primary code) plus add-on code 33518 (CABG using two venous grafts). Code 33510 describes single-venous-graft CABG reported alone and ignores the arterial conduit entirely. Code 33511 describes two-venous-graft CABG reported alone — also omits the arterial conduit. Code 33534 describes two-arterial-graft CABG only and would ignore the venous conduits. Reporting a single code for a mixed-conduit CABG constitutes incorrect coding; the arterial primary code and the appropriate venous add-on code must always be reported together when both conduit types are used.

Question 19

A cardiologist performs selective coronary angiography only, with catheter placement in the coronary arteries. No left or right heart catheterization and no left ventriculography are performed. Which CPT® code is reported?

  1. 93458
  2. 93454 (correct answer)
  3. 93460
  4. 93456
Explanation: CPT® 93454 describes catheter placement in the coronary arteries for coronary angiography alone — the correct code when selective coronary injections are the only service performed, with no left or right heart catheterization and no ventriculography. Code 93458 describes coronary angiography with left heart catheterization including left ventriculography; neither left heart cath nor ventriculography was performed here. Code 93460 describes right AND left heart catheterization with coronary angiography and ventriculography; neither form of heart catheterization was performed. Code 93456 describes coronary angiography with right heart catheterization; no right heart cath was performed. When coronary angiography is performed without any hemodynamic left or right heart catheterization, 93454 is the correct selection.

Question 20

A cardiologist performs left heart catheterization, selective coronary angiography, left ventriculography, and bypass graft angiography in a patient with prior CABG. No right heart catheterization is performed. Which CPT® code is reported?

  1. 93460
  2. 93459 (correct answer)
  3. 93461
  4. 93458
Explanation: CPT® 93459 describes coronary angiography with left heart catheterization including left ventriculography, and catheter placement in bypass grafts for bypass graft angiography — the correct code when left heart catheterization, coronary angiography, left ventriculography, and bypass graft angiography are all performed without right heart catheterization. Code 93460 describes right AND left heart catheterization with coronary angiography and ventriculography, but does not include bypass graft angiography and requires both right and left heart cath. Code 93461 adds bypass graft angiography to the combined right and left heart cath; no right heart catheterization was performed here. Code 93458 describes coronary angiography with left heart cath and ventriculography but does not include bypass graft angiography, which was performed here. The addition of bypass graft angiography to a left-heart-cath-only procedure upgrades the code from 93458 to 93459.