Evaluation and Management Coding Flashcards
7 cards from real COBGC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Evaluation and Management Coding flashcards as text
Which CPT code represents antepartum-only care when a provider furnishes 7 or more visits but does not perform the delivery or postpartum care?
Answer: 59426
CPT 59426 covers antepartum-only care of 7 or more visits when another provider will handle delivery and postpartum services.
Modifier 24 appended to an E&M service code during the global OB period indicates that the service is:
Answer: An unrelated E&M performed during a postoperative global period
Modifier 24 signals that the E&M service is unrelated to the original procedure or delivery and is performed during the postoperative or global period.
A patient who delivered vaginally is seen six weeks later for her postpartum check-up only, and the delivering physician is reporting this visit separately. Which CPT code applies?
Answer: 59430
CPT 59430 is reported for postpartum care only when billed separately from the global OB package.
A patient who had a cesarean delivery is seen two weeks postoperatively for treatment of a urinary tract infection unrelated to her surgery. The appropriate modifier to append to the E&M code is:
Answer: Modifier 24
Modifier 24 is required to indicate that the E&M service (UTI management) is unrelated to the global surgical/OB period.
Under the standard prenatal care schedule, the global OB package (e.g., 59400) typically encompasses approximately how many antepartum visits?
Answer: 13
The global OB package includes approximately 13 antepartum visits following the standard schedule of monthly visits early in pregnancy, bi-weekly around 28–36 weeks, and weekly near term.
Provider A manages a patient's antepartum care for 5 visits and then transfers care. Provider B completes the remaining antepartum visits, delivers the baby, and provides postpartum care. Which code should Provider A report?
Answer: 59425
CPT 59425 (antepartum care only, 4–6 visits) is reported by Provider A because they delivered 4–6 antepartum visits and did not perform the delivery or postpartum care.
Since Medicare stopped recognizing consultation codes in 2010, how should a maternal-fetal medicine specialist report an inpatient consultation for a high-risk pregnancy with high-complexity MDM?
Answer: 99223
Medicare requires inpatient consultations to be reported using the appropriate initial hospital care code; 99223 corresponds to high-complexity MDM.