Certified Medical Coding Specialist CPT Procedure Coding 3

Question 1

In CPT, Evaluation and Management (E/M) documentation requirements since 2021 for office visits are based on:

Accepted Answer

Medical decision making or total time on the date of the encounter

Answer

Since the 2021 E/M revisions, office and outpatient visit levels are determined by either medical decision making (MDM) or total time on the date of the encounter.

Question 2

CPT code 99213 represents which level of office visit?

Accepted Answer

Established patient, low level of medical decision making

Answer

CPT 99213 is an established patient office visit with a low level of medical decision making (or 20–29 minutes total time).

Question 3

Which code set is used to report supplies and equipment not covered by other CPT codes?

Accepted Answer

HCPCS Level II codes (A–V codes)

Answer

HCPCS Level II codes are alphanumeric codes (A through V) used to report drugs, supplies, equipment, and services not described in CPT.

Question 4

What is the purpose of CPT modifier -59?

Accepted Answer

To indicate a distinct procedural service that is separate from other services performed on the same day

Answer

Modifier -59 is used to identify procedures/services not normally reported together that are appropriate under the circumstances (distinct procedural service).

Question 5

Anesthesia CPT codes are reported using which unit-based formula?

Accepted Answer

(Base units + Time units + Modifying units) × Conversion factor

Answer

Anesthesia payment is calculated using base units assigned to the procedure plus time units (per 15-minute increments) plus modifying units, multiplied by the payer's conversion factor.

Certified Medical Coding Specialist Practice Test

Certified Medical Coding Specialist Practice Test

Certified Medical Coding Specialist CPT Procedure Coding 3