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Evaluation and Management Coding Flashcards

7 cards from real CPC 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

  1. A physician performs a comprehensive history, comprehensive examination, and medical decision making of high complexity for a new patient in the office. Which E/M code is most appropriate?

    Answer: 99205

    99205 is used for new office patients requiring comprehensive history, comprehensive exam, and high complexity MDM.

  2. Under the 2021 E/M guidelines, which element is NO longer required to select the level of an office/outpatient E/M visit?

    Answer: Physical examination

    Under 2021 AMA guidelines, the physical examination component was removed as a factor for selecting office/outpatient E/M level.

  3. A patient is seen in the emergency department and the physician documents a detailed history, detailed examination, and moderate complexity MDM. Which ED E/M code applies?

    Answer: 99284

    99284 corresponds to an ED visit with detailed history, detailed exam, and moderate complexity MDM.

  4. Which of the following correctly describes 'straightforward' medical decision making?

    Answer: One self-limited or minor problem

    Straightforward MDM involves a minimal number of diagnoses/problems, such as one self-limited or minor problem.

  5. A cardiologist provides inpatient subsequent hospital care, reviewing a problem focused interval history, expanded problem focused exam, and low complexity MDM. Which code is used?

    Answer: 99231

    99231 is the subsequent hospital care code requiring at least two of three key components at problem focused/expanded problem focused/low complexity MDM.

  6. When time is used to select the level of a 2021 office/outpatient E/M visit, what does 'total time' include?

    Answer: All time on the date of the encounter related to that visit, including pre- and post-service work

    Under 2021 guidelines, total time includes all physician/QHP time on the date of encounter related to the visit, not just face-to-face time.

  7. Which modifier is appended to an E/M code to indicate that a significant, separately identifiable E/M service was performed on the same day as a procedure?

    Answer: -25

    Modifier -25 indicates a significant, separately identifiable E/M service was performed by the same physician on the same day as a minor procedure.