EVALUATION & MANAGEMENT III
1. In the hospital setting the physician
continues anticoagulant management on an outpatient who has an embolism of the
femoral vein, 90 days following the initiation of the therapy in the hospital
setting. The physician provides a review and interpretation of four INR
measurements and provides instructions regarding a dosage adjustment. What are
the procedure and diagnosis codes for the outpatient visit?
a) 99363, 99364, I82.91
b) 99363, I82.409
c) 99364, I82.419
d) 99363, 99364, I82.409
2. Mr.Thomas has got admitted in the
hospital on 2/1/2011 by Dr.Jim for Mild heart attack.On the second day 2/2 Jim
has requested the cardiologist of the hospital to visit his patient.After
evaluating the patient by performing detailed hx,detailed examination &
Moderate complexity MDM.The cardiologist has sent a report to Dr.Jim.Which code
should the cardiologist report for 2/2/2011(Scenario 1)
a) 99233
b) 99243
c) 99253
d) 99232
3. Mr.Thomas has got admitted in the
hospital on 2/1/2011 by Dr.Jim for Mild heart attack.On the second day 2/2 Jim
has requested the cardiologist of the hospital to visit his patient.After
evaluating the patient by performing detailed hx,detailed examination &
Moderate complexity MDM.The cardiologist has sent a report to Dr.Jim.The
cardiologist has repeated the same consultation on 2/3/2011 &
2/4/2011.Which code should the cardiologist report for 2/3 & 2/4?
a) 99253, 99253
b) 99233, 99233
c) 99253, 99233
c) 99253, 99263
4. Select the purpose of E/M service observation
status.
a) To determine the need for further
treatment or for inpatient admission
b) To determine the need to call in
further assistance in the care of a patient who is admitted into the hospital
due to critical health issues (e.g., congestive heart failure)
c) To evaluate the progress of an ongoing
care management plan
d) To develop a definitive diagnosis in a
patient with chronic health problems presenting with an illness that may or may
not be related to the chronic condition
5. A patient presents to the office with
Severe Nausea & Vomiting fo r the first time. After performing EPF history,
EPF examination & low complexity MDM, it was decided to admit the patient
for observation at 9.30pm.The patient has been continuosly monitored and was
discharged at 12.30am.During observation detailed history, detailed exam&
Moderate MDM has been performed? What are the CPT codes should be reported by
the physician?
a) 99202, 99218, 99217
b) 99218, 99217
c) 99202, 99232, 99217
d) 99218, 99232, 99217
6. A patient presents to the emergency
department complaining of a migraine headache which has persisted for two days.
The patient also complains of nausea and
vomiting. The ED physician performs a detailed history, expanded problem
focused exam and arrives at a moderate level of decision making. The physician
administers Imitrex to the patient and sends the patient home.What is the
correct E/M service for the ED physician?
a) 99284
b) 99214
c) 99283
d) 99213
7. According to CPT guidelines for
critical care services: The physician reports the time spent with the patient
when providing critical care services. Where the critical care services must be
provided in order to count toward the time reported?
a) Time spent engaged in work at the
bedside only
b) Time spent engaged in work in the
emergency room only
c) Time spent in work at the bedside or
elsewhere in the unit, as long as the care is directly related to the
individual patient
d) Time spent at the bedside or elsewhere
in the unit, exclusive of the time it takes to document critical care services
in the medical record
8. The provider provides subsequent
hospital care per day on a newborn. The CPT code is,
a) 99465
b) 99463
c) 99460
d) 99462
9. The provider provided two hours of
critical care for an adult. The correct CPT code is:
a) 99291, 99354
b) 99291, 99292 x 2
c) 99291, 99292
d) 99291, 99355 x 2
10. The provider discharged a patient from
the hospital inpatient unit (admitted day before) in less than 30 minutes. The
correct CPT code is:
a) 99238
b) 99239
c) 99217
d) 99231
11. What level of history of present
illness (HPI) is the following report? “I saw Mr. Smith at the memorial
hospital wound center. He is 85 years old. He comes to me for a wound to his
right ankle. It has been present for about 3 months. He was seen at another
facility then and had several unsuccessful debridements. He has an Unna boot
after getting antibiotics by Dr. James. He is having mild to moderate pain in
that region” which is very sharp in nature.
a) Brief
b) Not enough information to determine
c) Extended with four elements
d) Extended with more than four elements
12. How does the CPT Professional Edition
define a new patient?
a. A new patient is one who has not
received any professional services from the physician or another physician of
the same specialty who belongs to the same group practice, within the past two
years.
b. A new patient is one who has not
received any professional services from the physician or another physician of
the same specialty who belongs to the same group practice, within the past
three years.
c. A new patient is one who has received
professional services from the physician or another physician of the same
specialty within the last two years for the same problem.
d. A new patient is one who has received
hospital services but has never been seen in the clinic by the reporting
physician.
13. James, a 35-year-old new patient,
received 45 minutes of counseling and risk factor reduction intervention
services from Dr. Kelly. Dr. Kelly talked to James about how to avoid sports
injuries. Currently, James does not have any symptoms or injuries and wants to
maintain this status would you report this.This was the only service rendered.
How service?
a. 99213
b. 99203
c. 99385
d. 99403
14. Andrea, a 52-year-old patient, had a
hysterectomy on Monday morning. That afternoon, after returning to her hospital
room, she suffered a cardiac arrest. A cardiologist responded to the call and
delivered one hour and 35 minutes of critical care. During this time the
cardiologist ordered a single view chest x-ray and provided ventilation
management. How should you report the cardiologist’s services?
a. 99291, 99292
b. 99291, 99292, 71010, 94002
c. 71010, 94002, 99231
d. 99291, 99292, 99292-52
15. Brandon was seen in Dr. Shaw’s office
after falling off his bunk bed. Brandon’s mother reported that Brandon and his
sister were jumping on the beds when she heard a “thud.” Brandon complained of
knee pain and had trouble walking. Dr. Shaw ordered a knee x-ray that was done at
the imaging center across the street. The x-ray showed no fracture or
dislocations. Dr. Shaw had seen Brandon for his school physical six months ago.
Today, Dr. Shaw documented a detailed examination and decision-making of
moderate complexity. He also instructed Brandon’s mother that if Brandon had
any additional pain or trouble walking he should see an orthopedic specialist.
How should Dr. Shaw report her services from today’s visit?
a. 99204
b. 99394, 99214
c. 99214
d. 99203
16. Adam, a 48-year-old patient, presented
to Dr. Crampon’s office with complaints of fever, malaise, chills, chest pain,
and a severe cough. Dr. Crampon took a history, did an exam, and ordered a
chest xray. After reviewing the x-ray, Dr. Crampon admitted Adam to the
hospital for treatment of pneumonia. After his regular office hours, Dr.
Crampon visited Adam in the hospital where he dictated a comprehensive history,
comprehensive examination, and decision-making of moderate complexity. How
would you report Dr. Crampon’s services?
a. 99214
b. 99222
c. 99204, 99222-51
d. 99223, 99214-21
17. Why are the following codes not
reported with continuing intensive care services (99478–99480):36510, 36000,
43752, 51100, 94660, or 94375?
a. These codes are deleted from the 2008
edition.
b. These codes are included with
continuing intensive care services.
c. These codes are only add-on codes and
should be reported with a modifier -51
d. These codes are Category III Codes and
should never be reported with Category I codes.
18. Larry is being managed for his
warfarin therapy on an outpatient basis. Dr. Nancy continues to review Larry’s
INR tests, gives patient instructions, dosage adjustment as needed, and ordered
additional tests. How would you report the initial 90 days of therapy including
8 INR measurements?
a. 99363
b. 99203
c. 99214
d. This services is bundled with
evaluation and management services
19. Dr. Jane admitted a 67-year-old woman
to the coronary care unit for an acute myocardial infarction. The admission
included a comprehensive history, comprehensive examination, and high
complexity decision-making. Dr. Jane visited the patient on days two and three
and documented (each day) an expanded problem focused examination and
decision-making of moderate complexity. On day four, Dr.Jane moved the patient
to the medical floor and documented a problem focused examination
anstraightforward decision-making. Day five, Dr. Jane discharged the patient to
home. The discharge took over an hour. How would you report the services from
day one to day five?
a. 99213, 99232, 99231, 99239 x 2
b. 99221, 99222, 99223, 99238
c. 99231, 99232, 99355, 99217
d. 99223, 99232, 99232, 99231, 99239
20. Which code range would describe
services for a critically ill patient who is 23 days old as an out patient?
a. 99291–99292
b. 99466–99472
c.
99468-99476
d. 99466–99467
21. Mr. Johnson, a 38-year-old established
patient is being seen for management of his hypertension, diabetes, and weight
control. On his last visit, he was told he had a diabetic foot ulcer and needed
to be hospitalized for this condition. He decided to get a second opinion and
went to see Dr. Myers. This was the first time Dr. Myers had seen Mr. Johnson.
Dr. Myers documented a comprehensive history, comprehensive examination, and
decision-making of high complexity. He concurred with hospitalization for the
foot ulcer and sent a report back to Mr. Johnson’s primary care doctor. How
would you report Dr. Myers visit?
a. 99245
b. 99205
c. 99215
d. 99255
22. How does the CPT Professional Edition
define an emergency department?
a. An organized hospital-based facility
for the provision of unscheduled episodic services to patients who present for
immediate medical attention. The facility must be available 24 hours a day.
b. An organized hospital-based facility
for the provision of scheduled episodic services to patients who present for
immediate medical attention. The facility must be available 24 hours a day.
c. An organized hospital-based facility
for the care and treatment of chronically ill patients who present for
services. The facility must be available on weekends and holidays.
d. An organized outpatient-based facility
for the care and treatment of unscheduled patient who present for immediate
medical attention. The facility must be available 24 hours a day.
23. Lucus, a three-year-old new patient is
seen for a well-child examination. The doctor documents an age appropriate
history, examination, anticipatory guidelines, risk factor reduction
intervention, and indicates Lucus’ immunizations are up to date. How would you
report this service?
a. 99392
b. 99213-25, 99385
c. 99203
d. 99382
24. 42-year-old woman is being discharged
today, 2/5/XX. She was admitted to the hospital 2/2/XX for acute
diverticulitis. Refer to dictated notes for a detailed description of the
history, exam, and assessment and treatment protocol. Patient was also seen in
consultation by Dr Z. She was placed on intravenous antibiotics and has made
slow steady progress. Today has no abdominal pain. Labs are normal and CT of
the abdomen and pelvis showed changes consistent with diverticulitis in the
left side of colon. She was given follow up instructions of her medications,
what diet to have and to follow up with PCP in 10 to 14 days or return if pain
resumes. Total time spent with patient 40 minutes. What CPT® code(s) should be
reported?
A. 99233, 99239
B. 99217
C. 99252, 99238
D. 99239
25. An inpatient is seen in follow-up for
pelvic pain by the attending physician five days after admission. The provider
performs a problem focused history, expanded problem focused exam and arrives
at a moderate level of decision making. What is the appropriate code?
a) 99232
b) 99221
c) 99231
d) 99222
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