Question 1

The _______ documentation guidelines are followed for the CPC exam:

Accepted Answer

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

Question 2

Which of the following is not a true statement?

Accepted Answer

For critical care codes, emergency department services, and care management codes, the distinction between new and established patients is not relevant. However, in the outpatient and inpatient settings, the distinction between new and established patients is important for coding and billing purposes, making option B incorrect.

Question 3

An established patient service in the office is indicated by a ______ fourth place digit:

Accepted Answer

The established patient service in the office is indicated by a "1" as the fourth place digit in medical billing and coding, particularly in the context of CPT (Current Procedural Terminology) codes.

Question 4

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 who belongs to the same group practice within the past three years.

Question 5

If a patient is admitted into observation status and then is admitted to inpatient status on the same day, the coder may:

Accepted Answer

When a patient is admitted to observation and then changes to inpatient status on the same day, the correct coding procedure is to assign only an Initial Hospital Care code. This is because the inpatient admission supersedes the observation status for coding purposes.

Question 6

To obtain a level 99222 or 99223 code, a(n) __________ exam must have been performed and documented.

Accepted Answer

To obtain a level 99222 or 99223 code, a comprehensive exam must have been performed and documented. These codes are used in medical billing to indicate the complexity and thoroughness of the examination for inpatient hospital care, with a comprehensive exam being the most detailed level of examination.

Question 7

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 because critical care codes are designed to cover services that are directly related to the care of a critically ill or critically injured patient, and pulmonary function testing is typically considered a diagnostic procedure rather than a direct critical care service.

Question 8

All of the following are true of Initial Hospital Care (99221-99223) codes except:

Accepted Answer

Time is not a mandatory element for selecting Initial Hospital Care codes (99221-99223); these codes are primarily based on the complexity of the visit, which includes key components such as history, examination, and medical decision making.

Question 9

Past, family, and social history (PFSH) encompasses which of the following:

Accepted Answer

Past, family, and social history (PFSH) includes a patient's past medical and surgical history, allergies, and family health history, which are all mentioned in option A.

Question 10

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 involves applying specific criteria and measurements to assess the provider's work, which can be complex and nuanced.

Quiz 5: Evaluation and Management