COBGC Evaluation and Management Coding 3

Question 1

A patient is classified as 'established' for E&M purposes if she has received professional services from the same physician or a physician of the same specialty in the same group within the past:

Accepted Answer

3 years

Answer

CPT guidelines define an established patient as one who has received professional services from the physician/qualified clinician or group within the past three years.

Question 2

Under the 2021 revised E&M guidelines, which of the following lists the Medical Decision Making complexity levels in correct ascending order?

Accepted Answer

Straightforward, Low, Moderate, High

Answer

The four MDM levels in ascending order are Straightforward, Low, Moderate, and High complexity.

Question 3

A patient returns to an OB/GYN practice for the first time in four years. She is best classified as:

Accepted Answer

New patient, because more than three years have passed

Answer

If more than three years have elapsed since the patient received professional services from any physician of that specialty in the group, she is classified as a new patient.

Question 4

Which initial hospital care code requires high-complexity Medical Decision Making or 75 or more minutes of physician time?

Accepted Answer

99223

Answer

CPT 99223 represents initial hospital care requiring high-complexity MDM or 75+ minutes of total physician time on the date of service.

Question 5

A new OB/GYN patient visit documents 45 minutes of total physician time on the date of service. Based on time alone under 2021 guidelines, which code should be reported?

Accepted Answer

99204

Answer

CPT 99204 covers new patient office/outpatient visits when total time on the date of service is 45–59 minutes.

(COBGC) Certified Obstetrics Gynecology Coder Practice Test

(COBGC) Certified Obstetrics Gynecology Coder Practice Test

COBGC Evaluation and Management Coding 3