Question 1

Services provided to a patient in order to maintain health and prevent disease are called:

Accepted Answer

Preventive services are designed to help people maintain their health and avoid diseases, through measures such as vaccinations, screenings, and health education.

Question 2

Select the statement that is not true regarding critical care code selection:

Accepted Answer

Time spent outside the unit is generally not considered in the time documentation for critical care code selection.

Question 3

In the Exam component, organ system element, a detailed exam is made up of _______ body areas and/or organ systems:

Accepted Answer

A detailed exam in the Exam component, organ system element, typically consists of 5-7 body areas and/or organ systems.

Question 4

An unrelated E/M service by the same physician during a postoperative period is described by modifier:

Accepted Answer

Modifier 24 is used to indicate an unrelated evaluation and management service by the same physician during a postoperative period.

Question 5

Code range 99291-99292 is used to describe:

Accepted Answer

Code range 99291-99292 is specifically used to describe Critical Care services. These codes are utilized for billing purposes to indicate when a healthcare provider delivers critical care services to a patient.

Question 6

Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services (99466-99486) include all of the following except:

Accepted Answer

Outpatient neonatal care is not included in the CPT codes 99466-99486, which are specifically designed for inpatient neonatal and pediatric critical care services, including initial and continuing intensive care, as well as transportation services for critically ill pediatric patients.

Question 7

The E/M section is often the most difficult for coders to understand and use correctly because:

Accepted Answer

The E/M (Evaluation and Management) section is challenging because it requires coders to apply specific measurements and criteria to evaluate the provider's work, which can be complex and nuanced.

Question 8

Select the correct steps to determining a code for an E/M service, listed in correct order:

Accepted Answer

The correct steps to determining a code for an Evaluation and Management (E/M) service start with determining the patient's chief complaint, then identifying the place of service, followed by identifying the type of service, and finally identifying the status of the patient. This sequence ensures that the context and specifics of the patient's visit are fully understood before assigning a code.

Question 9

In the E/M section, a 2 in the fourth place identifies:

Accepted Answer

A 2 in the fourth place of an E/M (Evaluation and Management) code typically identifies an initial inpatient service.

Question 10

A critical care service is identified by a ____ fourth digit:

Accepted Answer

The answer of A critical care service is identified by...

Question 11

In the E/M section, an 8 in the fourth place identifies:

Accepted Answer

An 8 in the fourth place of the E/M section identifies an emergency service.

Question 12

Location, duration, quality, and severity are all subelements of which element?

Accepted Answer

Location, duration, quality, and severity are all subelements of the history of present illness (HPI). These subelements help in detailing a patient's current complaint or symptoms.

Question 13

Which of the following is not included in the Moderate decision making subelement of the Medical decision making element?

Accepted Answer

The Moderate decision making subelement of the Medical decision making element includes considerations like moderate risk of complications, moderate amount of data reviewed, and multiple diagnosis and management options. A high risk of complications would fall under a higher level of decision making, not the moderate category.

Question 14

A patient who has not received face-to-face services from the physician or another physician of the exact same specialty and subspecialty in the same group within the past three years is a(n):

Accepted Answer

A new patient is defined as someone who has not received any face-to-face services from the physician, or another physician of the exact same specialty and subspecialty within the same group, in the past three years.

Question 15

Established patient office visit codes are included in the range:

Accepted Answer

Established patient office visit codes are in the range of 99211-99215, according to the Current Procedural Terminology (CPT) coding system used in the United States for billing various medical services.

Question 16

The _______ documentation guidelines are followed for the CPC exam:

Accepted Answer

The answer of The _______ documentation guidelines are followed for...

Question 17

One who has been formally admitted to a healthcare facility is:

Accepted Answer

An inpatient is someone who has been formally admitted to a healthcare facility, typically for at least one overnight stay, under the care of a physician.

Question 18

A consultation service in the hospital is represented by a _____ fourth digit:

Accepted Answer

The answer of A consultation service in the hospital is...

Question 19

How many key components must be met in order to select a code from the Established Patient 99211-99215 code range?

Accepted Answer

For the Established Patient 99211-99215 code range, two key components must be met out of the three (history, examination, and medical decision making) for a particular level of care to be selected, except for 99211, where the presence of the physician is not required.

Question 20

All of the following are included in CPT critical care codes except:

Accepted Answer

Pulmonary function testing is not included in CPT critical care codes. Critical care codes typically cover services that are directly related to the care of a critically ill or critically injured patient, such as vascular access procedures, gastric intubation, and pulse oximetry, but not routine diagnostic tests like pulmonary function testing.

Quiz 5: Evaluation and Management