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Tuesday, October 1, 2019

EVALUATION & MANAGEMENT SAMPLE QUESTIONS - 002



1.       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

2.       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

3.       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

4.       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

5.       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
6.       The provider provides subsequent hospital care per day on a newborn. The CPT code is,

a)       99465
b)       99463
c)       99460
d)       99462

7.       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

8.       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

9.       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

10.   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.

11.   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

12.   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, 71045, 94002
c)       71045, 94002, 99231
d)       99291, 99292, 99292-52

13.   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
d)       99253, 99243

14.   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

15.   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
16.   Why the following codes are 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.

17.   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

18.   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

19.   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


20.   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.
21.   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

22.   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

23.   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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