Evaluation and Management Coding Flashcards
7 cards from real COBGC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Evaluation and Management Coding flashcards as text
Under the 2021 E&M guidelines, 'total time' for office/outpatient visits includes:
Answer: All physician time spent on the date of service, including pre- and post-visit activities
Total time encompasses all physician/qualified clinician time on the date of service—pre-visit preparation, the face-to-face encounter, and post-visit work such as documentation and care coordination.
An established OB/GYN patient completes a 25-minute synchronous telehealth video visit for contraceptive management. Using 2021 time-based guidelines, which code applies?
Answer: 99213
CPT 99213 covers established patient visits of 20–29 minutes; synchronous video telehealth uses the same 99211–99215 codes as in-person visits (with the appropriate telehealth modifier).
When calculating total physician time for E&M billing, which of the following does NOT count?
Answer: Time a medical assistant spends taking vital signs
Only time personally spent by the billing physician or qualified clinician counts; time spent by support staff such as medical assistants is excluded.
A new obstetrics patient's office visit requires 65 minutes of total physician time on the date of service. Which code should be reported based on time?
Answer: 99205
CPT 99205 covers new patient visits with 60–74 minutes of total physician time on the date of service.
What is the minimum total physician time required to support billing CPT 99215 for an established patient under 2021 guidelines?
Answer: 40 minutes
CPT 99215 requires 40–54 minutes of total physician time for established patients; below 40 minutes maps to 99214 (30–39 minutes).
Audio-only telephone E&M services that do not include a video component are reported using which code set?
Answer: 99441–99443
CPT codes 99441–99443 are designated for physician telephone evaluation and management services conducted without a video component.
Under the 2021 CPT E&M revisions, a new patient visit supported by Straightforward MDM maps to which office visit code?
Answer: 99202
CPT 99201 was deleted in 2021; Straightforward MDM for a new patient now maps to 99202, the lowest billable new patient office visit code.