1.
63-year-old man is coming in for a
second opinion for his sleep apnea. He has had it for the past five months.
Sleep is disrupted by frequent awakenings and getting worse due to anxiety and
snoring. He feels tired all the time, has some joint stiffness and night
sweats; all other systems were negative. He is going through a divorce which is
causing him anxiety and had a hernia repair two month ago. Doctor performs a
comprehensive exam and orders labs and a sleep study test. Prescription was
given to help with the anxiety. What CPT® code should be reported?
a)
99203
b)
99204
c)
99244
d)
99214
2.
A 55-year-old established patient is
coming in for a pre-op visit; he is getting a liver transplant due to
cirrhosis. The physician performs an expanded problem focused history, detailed
examination, and moderate MDM. Patient agrees with his physician’s
recommendations and the transplantation will take place as scheduled. After the
evaluation, the patient expresses a number of concerns and questions for the
prospective liver transplant. Physician spends an additional 30 minutes,
excluding the time spent in doing the E/M service, in counseling and answering
questions regarding the surgery and discussing possible outcomes. What CPT®
codes should be reported?
a)
99213, 99354
b)
99214, 99358
c)
99213, 99358
d)
99214, 99354
3.
Physician performs a medical review and
documentation on an 83-year-old patient still hospitalized for confusion for
the last two days. She is alert and oriented x 3 today. Reviewing her labs from
yesterday, her BNP was elevated suspecting her confusion is due to congestive
heart failure. An echocardiogram is ordered and treatment will be for
congestive heart failure. Patient is not safe to return home. What CPT® code
should be reported?
a)
99231
b)
99221
c)
99218
d)
99232
4.
A plastic surgeon is called to the ED
at the request of the emergency department physician to evaluate a patient that
arrived with multiple facial fractures after being in an automobile accident
for her opinion on the need for reconstructive surgery. The plastic surgeon arrives
at the ED, obtains a history of present illness including an extended history
of present illness; a system review, including constitutional, musculoskeletal,
integumentary, neurologic, and EENMT; and the patient’s social history and past
medical history. The plastic surgeon then performs a physical exam including
respiratory, cardiovascular, and an extended examination of the skin and bony
structures of the patient’s face. The plastic surgeon performs moderate medical
decision making, including deciding the patient needs major surgery to repair
the injuries. The plastic surgeon schedules the patient for surgery the next
day and documents her full note with findings in the ED chart.
a)
99284-57
b)
99244
c)
99243-57
d)
99221
5.
At the request of the mother’s obstetrician,
the physician was called to attend the birth of an infant being delivered at 29
weeks gestation. During delivery, the neonate was pale and bradycardic.
Suctioning and bag ventilation on this 1000 gram neonate was performed with 100
percent oxygen. Brachycardia worsened; endotracheal intubation was performed
and insertion of an umbilical line for fluid resuscitation.Later this
critically ill neonate was moved from the delivery room and admitted to the
NICU with severe respiratory distress and continued hypotension. What are the
appropriate procedure codes?
a)
99465, 99468
b)
99465, 99464, 99468-25, 31500, 36510-51
c)
99468, 99464
d)
99465, 99468-25, 31500-59, 36510-59
6.
38-year-old female initial visit, just
moved from out of state, has neck and back pain for the last year and is
getting worse. Pain is exacerbated when she drives, bends, or changes
positions, and moderately alleviated with ibuprofen. Positive for aches and
weakness in her muscles and tingling and numbness of the arms and hands, as
well as headaches. All other systems are reviewed and are negative. She has had
a partial hysterectomy and is divorced. Her mother has a history of breast
cancer. The physician performs an exam on the following systems:
constitutional, eyes, ENT, respiratory, cardiovascular, gastrointestinal,
musculoskeletal, and neurologic. X-rays of the cervical and lumbar spine were
taken. Will be sending her to get a MRI and to start physical therapy.
Prescription was given for muscle relaxer. Select the appropriate CPT® code for
this visit?
a)
99203
b)
99204
c)
99214
d)
99244
7.
An initial office visit was made by a
16 year old female with a four day history of abdominal pain with occasional
vomiting. Mother states the patient has not had fever. A detailed history is
obtained. A detailed exam is performed including GI system, GU system with
pelvic, chest, heart, lungs and skin. Vaginal and cervical cultures were
obtained. She was asked to collect stool specimens for culture over the next
few days. Medical decision making is of moderate complexity. Code this
scenario.
a)
99282
b)
99384
c)
99203
d)
99202
8.
A 55 year old male patient recently
moved to phoenix and is seeing his new internist for the first time. He has had
a long history of gouty arthropathy, but he presents today to his new
internist’s office for his annual preventive medical reevaluation and
management. Patient has been controlled on diet for three years. A
comprehensive history and physical is performed and the patient is counseled
regarding diet and exercise. Appropriate blood work is ordered. Code this
scenario.
a)
99204
b)
99223
c)
99205
d)
99386
9.
After being called to the emergency
room to treat one of his patients suffering from multiple injuries, a provider
is asked to examine another one of his patients already registered in the ER,
presenting with acute respiratory distress symptoms including a productive
cough. The ER is very busy, therefore the ER provider has the patient’s
provider see and treat this patient. The provider ordered a CBC and chest
x-ray. An expanded history of the present illness was taken, an expanded
problem focused examination performed and medical decision making was of
moderate complexity. Overall level of medical decision making was moderate. The
patient was given a prescription and written instructions for continued home
care and told to make an appointment in the office if the symptoms persist.
Code the provider’s service for the second patient.
a)
99212
b)
99283
c)
99284
d)
99243
10.
The patient is a 23 year old male who
needs a prescription refill for Ventolin tabs and Proventil inhaler. The patient
moved here two months ago from Florida. He was diagnosed with asthma at age
eight and he says his asthma is well controlled on his current medication
regimen. He says he usually uses the inhaler two to four times a week,
generally after performing activities like tennis or skating. Px: WDWN male in
no acute distress; temp 98.6, pulse 65, BP 110/70; respiration 18; HEENT within
normal limits; lungs clear to auscultation, no rales or wheezing. Impression:
Asthma stable on present medication Plan: Rx written for three months for
current medications; recheck in three months, sooner if problems. Patient was
advised to schedule baseline physical upon next visit. According to CPT
guidelines, which correctly reports this service?
a)
99202
b)
99211
c)
99212
d)
99201
11.
An established patient is defined as,
a)
Family member of a regularly treated
patient receiving services within past three years.
b)
Patient over the age of 21
c)
One who has received services from the
provider or another provider from the same specialty within same group practice
in the past three years
d)
Patient with verified insurance
coverage.
12.
CPT code 99382 is age related. What is
the age range designed in this code. What is the age range designated in this
code?
a)
Early childhood (age 1 through 4 years)
b)
Late childhood (age 5 through 11 years)
c)
Adolescent (age 12 through 17 years)
d)
Young adult (age 18 through 39 years)
13.
How does CPT apply the term
consultation in relation to the provider?
a)
The provider gives professional advice
ad /or instruction
b)
The provider responds to a request from
another provider for a medical evaluation, opinion, and plan of treatment
c)
The provider is part of a team of
specialists available for advice on a patient in a long-term care setting
d)
The provider is available on-call to
respond to a medical crisis that may occur in a patient with a chronic disease
14.
In clinical terms, chief complaint
refers to which of the following?
a)
Definitive diagnosis
b)
Provider documentation of medical
decision making
c)
Patient reason for seeking medical
advice
d)
Payer response to inaccurate coding on
submitted claim.
15.
Which of the following distinguishes
E/M emergency service coding:
a)
E/M emergency services must be provided
in an emergency room setting of a hospital and time is documented separately by
each provider involved in patient care.
b)
E/M emergency service must include
ambulance transport considered part of the surgical package) and place of
service at hospital-based emergency care facility.
c)
E/M emergency services must be
hospital-based and involve traumatic injury to either the new or established
patient (as distinguished in documentation)
d)
Emergency E/M service codes do not
distinguish between new or established patients and time is not considered to
be a component in the coding of the ED visit.
16.
Counseling and coordination of care
coding for billing purposes require which one of the following in terms of E/M
service patient/provider contact?
a)
Counseling and coordination of care
must constitute more than 50 percent of the face to face encounter between the
physician and patient
b)
Counseling and coordination of care
must be divided equitably among the providers involved in the patient’s care.
c)
Counseling and coordination of care
services are included in the surgical packaging of an E/M visit and never
billed separately.
d)
Counseling and coordination of care
requires a plan of care approved in advance by the payer and signed by the
physician; any services offered beyond those in the plan are automatically
denied payment.
17.
The provider has admitted a patient for
observation & got discharged on the same day. The provider has performed
detailed history, detailed examination & moderate complexity MDM .The
correct CPT code is:
a)
99234
b)
99218
c)
99218, 99217
d)
99238
18.
Inpatient neonatal care code applies to
what age of patient?
a)
29 days to 24 months of age
b)
29 days or less following premature
gestational birth
c)
28 week gestational period, birthing
age irrelevant
d)
28 days or less
19.
The provider provides a complex/lengthy
telephone call of 20 minutes to a patient regarding the results of his lab work.
The correct CPT code is:
a)
99441
b)
99442
c)
99444
d)
96161
20.
The provider provided hospital
discharge day management for 65 minutes. How do you code this discharge
management?
a)
99238, 99354
b)
99217
c)
99238, 99358
d)
99239
21.
The nurse saw an established patient in
the provider’s office and checked the patient’s blood pressure. What is the
correct CPT code?
a)
99212
b)
99211
c)
99401
d)
96160
22.
The provider admits a two-day-old
infant into the NICU and spends 2.5 hours providing critical care. What is the
correct way to code this scenario?
a)
99461, 99221
b)
99468, 99291, 99292 x 3
c)
99460, 99291, 99292 x 3
d)
99468
23.
A pediatrician performs a history,
examination and other newborn care for an infant that was delivered at home by
a mid-wife. The physician also informs the parents on how to care for the
newborn. What code would the pediatrician report for this service?
a)
99460
b)
99461
c)
99462
d)
99463
24.
What is the code for direction of EMS
service?
a)
99288
b)
99360
c)
99285
d)
99358
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