| Course | HI255 Medical Coding II |
|---|---|
| Unit | Unit 5 |
| Paper type | Procedure coding set |
| Length | About 910 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Health Information Management |
| Updated | October 2026 |
Free sample paper for HI255 Unit 5
The Code That Was Nearly Chosen: A Unit 5 Procedure Coding Set Working Five Outpatient Surgery Reports, From an Excised Diameter With Margins to a Biopsy and a Snare on Different Polyps
[Student Name]
Purdue University Global
HI255: Medical Coding II
Unit 5 Procedure Coding Set
[Instructor Name]
[Date]
The reports and measurements are composite and illustrative; the CPT descriptors, NCCI policies and sources cited are real and follow the 2026 code set.
Answer Format
Each answer gives the selected code and its descriptor, the measurements or phrases that support it, the rejected alternative and the reason it lost. The descriptors and their guidelines come from the current CPT book (American Medical Association, 2025), and the pairing rules come from the national correct coding policy manual (Centers for Medicare & Medicaid Services, 2025). All measurements are composite.
Report 1: A Benign Lesion of the Forearm
The surgeon excised a raised lesion from the left forearm, measuring 1.2 cm across, with a 0.3 cm margin of normal skin on each side, and closed the defect with simple sutures. Pathology reported a benign intradermal nevus. Selected: 11402, the benign excision code for a limb or trunk site in the band just above one centimeter and up to two. Support: CPT sizes an excision by the lesion's widest span added to the narrowest margin taken at each edge, here 1.2 plus 0.3 plus 0.3, which is 1.8 cm. The benign family was chosen after pathology returned, not from the clinical impression. Rejected: 11401, the band one step smaller, which would be correct only if the lesion alone had been measured. The simple closure is included in the excision and is not reported. The lesion was 1.2 cm, and the code is for 1.8 cm. The margins are part of what was cut out, so they are part of what is coded.
Report 2: Two Lacerations
After a fall from a bicycle onto a curb, a teenager had a 4.0 cm scalp laceration closed in layers after irrigation and a 2.5 cm laceration of the right hand closed with simple sutures. Selected: 12032, the layered closure code for a body group that takes in the scalp but leaves out hands and feet, sized for wounds longer than 2.5 cm and up to 7.5 cm, listed first; and 12001, the simple closure code for the broad group that does include the hands, sized for a total up to 2.5 cm, listed second with the payer's multiple procedure modifier. Support: lengths are added only when the repairs share both a complexity and an anatomic group. The scalp repair is layered, which makes it intermediate, and the hand repair is simple, so the two are reported apart and the more complex repair goes first. Rejected: one simple repair code for a combined 6.5 cm. That total would only be right if both wounds had been closed the same way.
Report 3: A Colonoscopy With Two Techniques
During a screening colonoscopy, a flat 4 mm lesion in the ascending colon was sampled with cold biopsy forceps and left in place, and a separate 9 mm polyp in the sigmoid colon was removed by snare. Selected: 45385 for the snared polyp and 45380 for the forceps sample, with modifier XS or 59 on the biopsy line to show a separate lesion. Support: the policy manual allows both when the biopsy and the snare removal are performed on different lesions, and the report names two locations. Rejected: 45385 alone. That would be correct if the biopsy had been taken from the same polyp before it was snared, since a biopsy of a lesion later removed is not reported separately.
Report 4: A Knee Arthroscopy
Arthroscopy of the right knee found a torn posterior horn of the medial meniscus, trimmed back to a stable rim, and a grade 3 cartilage lesion of the medial femoral condyle that was shaved smooth. The lateral meniscus was inspected and intact. Selected: 29881, the knee scope code for trimming one meniscus, whose wording already folds in any cartilage smoothing done anywhere in the joint. Support: one meniscus was trimmed, and the descriptor already includes the chondroplasty. Rejected: 29880, which requires work on both menisci, and a separate chondroplasty code, which the descriptor absorbs.
Report 5: A Carpal Tunnel Release
Through a single portal at the wrist crease, the surgeon passed an endoscope and divided the transverse carpal ligament under direct view. Selected: 29848, endoscopy of the wrist with release of the transverse carpal ligament. Support: the report describes an endoscope and a single small portal. Rejected: 64721, the open neuroplasty of the median nerve at the carpal tunnel. The two codes describe the same objective, and one word, endoscopy, decides between them. A conversion to a palm incision partway through would leave only the open code on the claim.
Summary
The set also shows why each answer names a loser. A coder who can say why the neighboring code fails has read the descriptor to its last word, and a grader can see that the correct code was not a lucky guess. Two of the five answers turned on measurement, one on the number of lesions and two on a single descriptor term. None turned on the procedure's name. That pattern matches what reviews of coding error report, where the detail in the body of a record, not its heading, is where accuracy is won or lost (Cheng et al., 2009).
References
American Medical Association. (2025). CPT 2026 professional edition. American Medical Association.
Centers for Medicare & Medicaid Services. (2025). National Correct Coding Initiative policy manual for Medicare services. U.S. Department of Health and Human Services.
Cheng, P., Gilchrist, A., Robinson, K. M., & Paul, L. (2009). The risk and consequences of clinical miscoding due to inadequate medical documentation: A case study of the impact on health services funding. Health Information Management Journal, 38(1), 35-46. https://doi.org/10.1177/183335830903800105
Reading the HI 255 Unit 5 instructions
The fifth unit usually supplies four to eight short operative or procedure notes from an outpatient or office setting and asks for CPT codes with rationale. You are expected to read measurements carefully, apply the section guidelines for excisions and repairs, and know which endoscopic services can be reported together. Expect at least one skin excision where margins change the size range and one repair problem with different complexities or body areas. Many sets include an endoscopy with two techniques. Most prompts want the selected code, the facts that support it, and often a rejected alternative with its reason. Modifiers should be named where the rules require them. Cite the current CPT book and, where you rely on pairing rules, the national correct coding policy manual. Keep measurements labeled as given in the scenario.
How this HI255 Unit 5 example is built
An opening paragraph sets the answer format so each report reads the same way. Report 1 shows the excised diameter worked out with arithmetic and the benign family chosen after pathology. A highlighted line points out that the lesion measured 1.2 cm but the code is for 1.8. Report 2 explains why the layered scalp closure and the simple hand closure are not combined, and lists the more complex repair first. Report 3 reports both colonoscopy techniques because the report names two locations, and states when the biopsy would be dropped. Report 4 shows the meniscus code including the cartilage shaving. Report 5 decides between the endoscopic and open carpal tunnel codes on one word. A paragraph on why every answer names a loser precedes a summary linking the pattern to accuracy studies.
HI255 Unit 5 rubric: what earns full points
CPT sets in this course are typically scored per report, with most of the points on the selected code and the rest on the supporting facts and the rejected neighbor. Measurement errors are heavily penalized because they produce a valid code for the wrong size, which looks right at a glance. Instructors check that repairs are grouped by both complexity and anatomic area before lengths are added, and that the more complex repair is listed first. Endoscopy items are graded on the number of codes and the modifier that separates them. Descriptor reading counts as well: adding a separate chondroplasty code beside the meniscus code is a common deduction. Citations of the CPT book and the policy manual, along with clear formatting, earn the remaining share in most rubrics.
HI255 Unit 5 help: mistakes that cost points
Students lose the most points by sizing an excision from the lesion alone and forgetting both margins. Close behind is adding all laceration lengths together regardless of how each wound was closed. On endoscopy, some report only the snare and drop a biopsy of a separate lesion, while others report a biopsy that was taken from the same polyp later removed. Descriptor misreads are common too, such as coding both menisci when only one was trimmed, or the open carpal tunnel code for an endoscopic release. Missing modifiers on multiple procedures are another deduction. We can code your outpatient reports with the arithmetic shown and the near miss named for each. Send the reports, the measurements as given and your instructor's answer format.
Get an HI255 Unit 5 example written to your instructions
Attach the reports from your Unit 5 set, the instructions and the rubric, and mention the code book year your course uses. Each report returns with its selected code category, the measurements or phrases behind it and the alternative it defeated. Allow 24-48h; a first custom sample has no charge. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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HI255 Unit 5 questions, answered
Why does the lesion excision depend on the pathology report?
Because the benign and malignant excision codes are separate families, and the classification is made by pathology, not by the clinical impression at the time of surgery. Coders in practice often wait for the report before finalizing the claim. The sample shows the pathology line beside the answer so it is clear which fact settled the family and which measurement settled the size.
Is the same lesion biopsied and then removed coded twice?
No. When a lesion is biopsied and the same lesion is then removed during the same endoscopy, only the removal is reported, because the biopsy is part of the work of taking it out. A biopsy of a different lesion is reported in addition, with a modifier that shows it was separate. The sample's colonoscopy report is written to test exactly that distinction.
How much detail goes in the rejected-alternative line?
Usually one sentence naming the code category that was considered and the documented fact that rules it out, such as a repair described as a single-layer closure ruling out the intermediate category. More than that tends to repeat the main answer. Rubrics that ask for justification of every code are usually satisfied by this line when it cites the report directly.
Where can I find a free HI255 Unit 5 sample paper?
The finished Unit 5 procedure coding set is on this page, with five outpatient reports coded in CPT and the near-miss code named beside every answer.
How is the size of a skin lesion excision measured for CPT?
Take the lesion's widest span and add the smallest margin cut at each of its two edges. In the sample, a 1.2 cm lesion with 0.3 cm margins becomes a 1.8 cm excised diameter.