Test Bank Docx Ch.23 Cpt Evaluation And Management Coding

Let’s Code It!, 1e (Safian)

Chapter 23 CPT Evaluation and Management Coding

1) What services do Evaluation and Management codes report?

A) Laboratory test

B) Chest x-ray

C) Physician encounter

D) Biopsy

2) In what section of the CPT code book are the E/M codes listed?

A) Medicine

B) Surgery

C) Evaluation and Management

D) Anesthesiology

3) To assign a correct E/M code, you must know:

A) the patient's name.

B) the diagnosis code.

C) the physician's name.

D) the location of the encounter.

4) Initial Hospital Care E/M service codes range from:

A) 99231–99233.

B) 99221–99223.

C) 99218–99220.

D) 99224–99226.

5) An established patient is defined as:

A) a patient who has never been seen before by the provider.

B) a patient who was seen four years ago.

C) a patient who was seen five years ago.

D) a patient who has been seen within the last three years.

6) A consultation is defined as when a physician ________ at the request of another physician.

A) assumes full care of the patient

B) admits a patient

C) provides advice or an opinion on a patient's treatment

D) performs surgery

7) A patient history may consist of:

A) a chief complaint.

B) a history of present illness.

C) a review of systems.

D) All of these

8) The amount of detail involved in the documentation of the patient history that has been taken during this encounter will identify the:

A) level of patient history.

B) place of service.

C) consultation given.

D) medical decision-making.

9) What does the acronym PFSH stand for?

A) Present, Family, and Social History

B) Past, Friend, and System History

C) Past, Family, and Social History

D) Present, Friend, and System History

10) The CPT book categorizes:

A) 11 body areas and six organ systems.

B) five body areas and seven organ systems.

C) seven body areas and 11 organ systems.

D) nine body areas and 12 organ systems.

11) What does the level of medical decision-making describe?

A) How much time and expertise the provider used to determine the diagnosis and treatment plan

B) How much knowledge and expertise the provider used to determine the diagnosis and treatment plan

C) How much knowledge and time the provider used to determine the diagnosis and treatment plan

D) How much time the provider used to determine the diagnosis and treatment plan

12) An E/M code to report an office visit with a new patient requires:

A) two of the three key components.

B) one of the three key components.

C) three of the three key components.

D) two of the two key components.

13) Time can be used to determine an E/M code when:

A) more than 25 percent of the total time is spent counseling the patient.

B) more than 30 percent of the total time is spent counseling the patient.

C) more than 20 percent of the total time is spent counseling the patient.

D) more than 50 percent of the total time is spent counseling the patient.

14) Consultations requested by a patient looking for a second opinion are coded from which section of the CPT book?

A) 99201–99205

B) 99221–99226

C) 99251–99255

D) 99241–99245

15) What code is reported for a physician who provided discharge services for a patient who is being discharged from observation care after a two-day stay?

A) 99224

B) 99217

C) 99354

D) 99236

16) A patient came in to see the specialist in your office for the first time. What is this patient's relationship?

A) Initial visit

B) Subsequent visit

C) New patient

D) Established patient

17) A patient was admitted into the hospital by Dr. Alaska. He has been in to see her every day. What would the code range be for his visit on day three?

A) 99218-99220

B) 99224-99226

C) 99221-99223

D) 99231-99233

18) An example of an organ system is:

A) genitalia.

B) neurologic.

C) neck.

D) head.

19) An example of a body area is the:

A) abdomen.

B) skin.

C) eyes.

D) ears.

20) When a patient requires more time than would regularly be spent (at least 30 minutes more), from what code range would a second code be applied in addition to the first-listed E/M code?

A) 99201–99205

B) 99211–99215

C) 99224–99226

D) 99354–99359

21) A patient was admitted and discharged on the same date of service. From what range will the physician's E/M services be reported?

A) 99217–99226

B) 99221–99223

C) 99234–99236

D) 99231–99233

22) A patient comes in with one or two possible diagnoses, is on no medication, and has no other co-morbidities. The level of decision making would be:

A) straightforward.

B) low complexity.

C) moderate complexity.

D) high complexity.

23) When a patient has several possible diagnoses and has a high risk of significant complications from the standard treatment, the MDM would fall into which category?

A) Straightforward

B) Low complexity

C) Moderate complexity

D) High complexity

24) The patient comes in with a broken bone sticking out from his arm. The level of MDM for the physician to determine what to do next is:

A) straightforward.

B) low complexity.

C) moderate complexity.

D) high complexity.

25) When a patient has a detailed history, the review of systems must fall into which category?

A) No review of systems

B) Problem-pertinent review of systems

C) Extended problem-pertinent review of systems

D) Complete review of systems

26) An E/M code is determined first by the encounter's:

A) level of history.

B) location.

C) physician's specialty.

D) time of day.

27) The relationship between provider and patient, as described by E/M codes, may be a(n):

A) established patient.

B) new patient.

C) consultation.

D) Any of these

28) Key components of some E/M codes include a(n):

A) location.

B) new patient.

C) level of examination.

D) chief complaint.

29) Locations that will help determine an E/M code include all of the following except:

A) surgical operating room.

B) home services.

C) hospital inpatient.

D) office or other outpatient services.

30) George sees Dr. Mallard in his office. Dr. Mallard sends George immediately to be admitted into the hospital. The E/M code will be chosen from subsection:

A) office visit.

B) initial hospital care.

C) subsequent hospital care.

D) emergency department services.

31) Darlene has not seen Dr. Curtis in four years. Today's visit will be coded as a(n):

A) initial visit.

B) subsequent visit.

C) new patient.

D) established patient.

32) Dr. Getter spent one hour with Nancy, 40 minutes of which he spent counseling her on keeping her diabetes under control. The primary factor for this E/M code is the:

A) level of history.

B) level of exam.

C) level of medical decision making.

D) time.

33) PFSH includes all of these components except:

A) past history.

B) family history.

C) systems history.

D) social history.

34) All of these body areas are recognized by CPT, except the:

A) skin.

B) neck.

C) abdomen.

D) back.

35) One of the organ systems recognized by CPT is the:

A) abdomen.

B) psychiatric.

C) neck.

D) genitalia.

36) Levels of history obtained include:

A) straightforward.

B) low complexity.

C) moderate complexity.

D) comprehensive.

37) Consultation services are coded based upon who requested the service and the:

A) length of time of the exam.

B) age of the patient.

C) office or hospital location.

D) initial or subsequent visit.

38) E/M services provided to an assisted living facility resident are coded:

A) new patient.

B) office or hospital.

C) domiciliary subsection.

D) special services.

39) A consultation requested by the patient is coded as a(n):

A) new patient visit.

B) established patient visit.

C) initial consultation.

D) home services.

40) A consultation requested by another physician is coded as a(n):

A) new patient visit.

B) established patient visit.

C) consultation.

D) home service.

41) Emergency department E/M codes are determined by:

A) time.

B) new or established patient.

C) two key components.

D) three key components.

42) Dr. Cook spends 45 minutes preparing the papers to discharge Kyle from the hospital. Dr. Cook's evaluation and management services are coded:

A) 99239.

B) 99292.

C) 99238.

D) 99223.

43) Levels of medical decision-making include all of the following except:

A) straightforward.

B) low complexity.

C) comprehensive.

D) high complexity.

44) A general multisystem examination is described as:

A) problem-focused.

B) expanded problem-focused.

C) detailed.

D) comprehensive.

45) A small number of possible diagnoses and treatment options are described as medical decision-making that is:

A) straightforward.

B) low complexity.

C) moderate complexity.

D) high complexity.

46) The amount of time spent may be used as the key element to determine an E/M code when counseling takes more than:

A) 25 percent.

B) 50 percent.

C) 75 percent.

D) 80 percent.

47) Dr. Fawzi saw Harrison, his long-time patient, in his home after Harrison's release from the hospital. This E/M service will be coded from the range of:

A) 99231–99233.

B) 99298–99300.

C) 99324–99328.

D) 99347–99350.

48) Medical decision-making is measured by the:

A) number of possible diagnoses.

B) number of possible treatments.

C) number of organ systems reviewed.

D) number of possible diagnoses and the number of possible treatments.

49) A consultation requested by another physician, occurring in the hospital, is coded from what range?

A) 99251–99255

B) 99241–99245

C) 99201–99205

D) 99221–99223

50) Dr. Brady saw Lee Ann in the hospital for the second day in a row. This visit will be coded from:

A) 99221–99223.

B) 99231–99233.

C) 99234–99236.

D) 99251–99255.

51) An 18-year-old female went to visit Dr. Green for her annual physical. She has seen Dr. Green every year for her physical since the age of 12. What is the appropriate code to use for this visit?

A) 99384

B) 99395

C) 99385

D) 99394

52) Anticipatory guidance is normally found in which section of the CPT codes?

A) Counseling Risk Factor Reduction and Behavior Change Intervention

B) Newborn Care Services

C) Preventive Medicine Services

D) Care Management Services

53) Giving a patient a prescription for a smoking cessation patch falls into which of the following categories?

A) Counseling

B) Anticipatory guidance

C) Consultation

D) Risk-factor reduction intervention

54) Preventive medicine exam codes are based on whether the patient is a new or established patient and:

A) the patient's age.

B) the severity of the illness.

C) the amount of time spent with the patient.

D) the level of history taken.

55) Dr. Smith counseled Mr. Jackson for 30 minutes regarding smoking cessation. What is the appropriate code to use?

A) 99402

B) 99407

C) 99411

D) 99409

56) Dr. John, a cardiologist, consults for 22 minutes with cardiology specialist Dr. Lowell over the phone regarding a critically ill hospitalized patient. What is the appropriate code to use for Dr. Lowell?

A) 99443

B) 99442

C) 99448

D) 99449

57) Care plan oversight services are reported with codes:

A) 99487–99489.

B) 98966–98968, 99441–99443.

C) 99339–99340, 99374–99380.

D) 99605–99607.

58) What type of facility provides care only for terminally ill patients?

A) Intermediate care facility

B) Assisted living facility

C) Skilled nursing facility

D) Hospice

59) Critical care service codes are determined by which criteria?

A) Time spent

B) Location

C) The age of the patient

D) Severity of injuries

60) Dr. Chou provided a total of 2 hours and 10 minutes of critical care services to Mrs. James in the coronary care unit. What is the appropriate code assignment for Dr. Chou's services?

A) 99292

B) 99291

C) 99291, 99292, 99292

D) 99291, 99292

61) Mr. Rodgers has seen his physician for management of his use of warfarin during the first 90 days of therapy. The physician took 9 INR measurements during this time. What is the appropriate code for these services?

A) 99363

B) 99366

C) 99364

D) 99444

62) Dr. Johnson performed surgery on Ms. Nelson's right foot at the ASC. One week later, she came into the office about a problem with her left leg. Which modifier would be appended to the evaluation and management code for the office visit?

A) 59

B) 26

C) 24

D) 66

63) Dr. Williams completed a physical for Mr. Jones. The physical is required by the insurance company prior to issuing a life insurance policy. What modifier should be appended to the E/M code?

A) 25

B) 22

C) 57

D) 32

64) Which modifier is used to indicate that a decision for surgery was made during an evaluation and management visit?

A) 57

B) 32

C) 25

D) 22

65) Dr. Newell meets with Ms. Dickens in his office a week after performing her appendectomy to check on her healing progress. What is the appropriate code for this follow-up evaluation and management visit?

A) 99211

B) 99024

C) 99212

D) 99213

66) The term neonate refers to a baby from the moment of birth until age:

A) 30 days old.

B) 29 days old.

C) 28 days old.

D) 31 days old.

67) Baby Jane was delivered and needed chest compressions for resuscitation by the neonatologist in the delivery room because the baby's cardiac output was insufficient. What is the appropriate code to assign for this service?

A) 99465

B) 99464

C) 99463

D) 99461

68) What code is reported for the initial hospital care for a normal newborn infant admitted and discharged on the same date?

A) 99460

B) 99461

C) 99462

D) 99463

69) The medical team conference attended by Dr. Mulford lasted 45 minutes. The patient and his wife were not present. What code is reported for Dr. Mulford?

A) 99441

B) 99363

C) 99367

D) 99448

70) Dr. Rosin meets with Mr. Barry to talk to him about the importance of testing his glucose regularly. This is coded as (a):

A) counseling.

B) risk-factor reduction intervention.

C) consultation.

D) anticipatory guidance.

71) Dr. Nelson provides medical care to Mrs. Blackberry in her home. He has been her physician for two years and obtained a problem-focused interval history, problem-focused exam. His medical decision making was straightforward. What E/M code is reported?

A) 99341

B) 99347

C) 99375

D) 99213

72) Dr. Johnson, a member of the Hill Home Healthcare Agency, provided care plan oversight services for Mr. Matthews, who is living with his daughter and diagnosed with Alzheimer's disease. He spent 55 minutes on this plan. What code is used to report these services?

A) 99340

B) 99375

C) 99378

D) 99380

73) Dr. Henderson went to see Sam Callahan, a patient living in an assisted living facility, for the first time. A comprehensive, highly complex E/M visit is reported with which code?

A) 99339

B) 99374

C) 99337

D) 99328

74) A non-face-to-face E/M service provided over the telephone is reported from which range of codes?

A) 99363–99364

B) 99366–99368

C) 99441–99443

D) 99444–99448

75) Complex chronic care coordination services totaling 75 minutes in one month are reported by which code?

A) 99443

B) 99607

C) 99363

D) 99487

76) Preventive medicine visit codes are determined by the age of the patient and:

A) length of the exam.

B) whether the patient is new or established.

C) location of the visit.

D) number of physicians involved.

77) Codes for preventive medicine visits, also known as annual physicals, include all of these factors except:

A) length of time spent face-to-face.

B) counseling.

C) anticipatory guidance.

D) risk-factor reduction intervention.

78) What do anticipatory guidance recommendations include?

A) Diagnostic testing

B) Behavior modification

C) Surgery

D) Medicine

79) During an annual well-woman examination, Dr. Komen discovered a lump in Serita's breast. Dr. Komen then documented a problem-focused E/M, which should be appended with which modifier?

A) 22

B) 24

C) 25

D) 26

80) Dr. Thomas Matthews did a thorough E/M of Suzette Connors at her home. Dr. Matthews has not seen Suzette in five years. What range of codes should be used for the visit?

A) 99341–99345

B) 99201–99205

C) 99347–99350

D) 99211–99215

81) Dr. Olsen evaluates Frank Harrison, currently in the ICU. Mr. Harrison was in a single-engine airplane crash and is in a coma. Dr. Olsen is with Frank for 45 minutes. What is the appropriate CPT code?

A) 99291

B) 99292

C) 92953

D) 94662

82) Maribelle Longene is being discharged today from the Health Center nursing home. Dr. Kenmore spent 20 minutes completing the discharge process (final exam, discussion, etc.). What code is used for nursing home discharge services?

A) 99215

B) 99310

C) 99315

D) 99316

83) Dr. Garner performs a history and exam on Robert Peter Cohen, born 1 hour ago in the hospital delivery room. Happily, Robert is perfectly normal. This is reported with what code?

A) 99381

B) 99397

C) 99460

D) 99205

84) Dr. Suarez performs a basic disability exam on Zena McIntire. This is coded from which subsection?

A) Risk-factor reduction

B) Special evaluation and management services

C) Preventive medicine

D) New patient, office/outpatient visit

85) To report E/M services provided by a physician to a patient in a nursing home, the coder must first determine:

A) whether the patient is new or established.

B) the length of time spent.

C) whether it is initial or subsequent care.

D) the age of the patient.

86) E/M services provided by a physician to a critically ill patient are coded by:

A) whether the patient is new or established.

B) the length of time spent.

C) whether it is initial or subsequent care.

D) the age of the patient.

87) Inpatient neonatal critical care services are coded by the patient's age and:

A) whether the patient is new or established.

B) the length of time spent.

C) whether it is initial or subsequent care.

D) the age of the patient.

88) Subsequent intensive care services to low birth weight (LBW), VLBW, and recovering neonates are coded by:

A) the age of the infant.

B) the length of time spent.

C) whether the patient is new or established.

D) the present body weight.

89) Dr. Baez phoned Judy Calder to discuss a new therapy he researched for her 5-year-old son. The call lasted 15 minutes. Judy said she would discuss this with her husband and let him know. Dr. Baez saw the patient two weeks ago. This is coded:

A) 99441

B) 99442

C) 99443

D) 99444

90) Dr. Mohammed supervised a hospice patient's care and provided care plan oversight services lasting 25 minutes. This is reported with:

A) 99350

B) 99377

C) 99337

D) 99362

91) Dr. Schillinger first saw Mary Lou Renney at the hospital last week, the day she was born. Her mom brings her in today for a checkup. History, exam, and medical decision making are documented. This is coded as a(n):

A) new patient.

B) established patient.

C) initial care.

D) subsequent care.

92) David, 23 months old, is critically ill, in the NICU at City Hospital. Dr. Katzman provides critical care services, including endotracheal intubation and an umbilical arterial catheter. He saw David yesterday when he admitted him. How are Dr. Katzman's services coded?

A) 99469

B) 99471

C) 99472

D) 99476

93) Codes 99324–99340 are used for reporting services to patients in all except:

A) assisted living facilities.

B) domiciliaries.

C) long-term care facilities.

D) Alzheimer's facilities.

94) Services reported with codes 99304–99318 identify the location of care as all except a(n):

A) skilled nursing facility.

B) custodial care center.

C) intermediate care facility.

D) psychiatric residential treatment center.

95) A physician spent 45 minutes counseling on healthy diet and the importance of exercise to a patient with a family history of diabetes. How are the physician's services coded?

A) 99401

B) 99402

C) 99403

D) 99406

96) Today, Dr. Nepal discharged Emil Stanton from the hospital and admitted him to a nursing facility for continued care. How will Dr. Nepal's services for today be coded?

A) Hospital discharge service + initial nursing facility care

B) Initial nursing facility care only

C) Hospital discharge service only

D) Subsequent hospital care

97) Critical care services, first day, provided to a patient who is 3 years old will be reported with code:

A) 99296.

B) 99298.

C) 99292.

D) 99475.

98) Care plan oversight services provided to a nursing facility resident, 1 hour total for the month of May, are reported with code:

A) 99318.

B) 99307.

C) 99304.

D) 99380.

99) Dr. Kennedy has been treating Paul Fried for six months. Today the doctor performed a medical disability exam; developed a treatment plan; and completed the documentation, certificate of disability, and a report. This is reported with code:

A) 99455.

B) 99456.

C) 99450.

D) 99215.

100) Pediatric critical care codes are measured by:

A) minutes.

B) hours.

C) days.

D) total length of stay.