COC Evaluation and Management Coding 2 — Questions and Answers
Question 1: Which modifier is appended to an E/M code to indicate the service is unrelated to a postoperative period?
- -24 (Correct answer)
- -25
- -57
- -58
Correct answer: -24
Modifier -24 is used when an unrelated E/M service is provided by the same physician during a postoperative period.
Question 2: What distinguishes a consultation from a new patient visit in E/M coding?
- Consultations require a request from another provider and a written report back (Correct answer)
- Consultations are only for specialist physicians
- New patient visits always use lower-level codes
- Consultations do not count toward global period
Correct answer: Consultations require a request from another provider and a written report back
A consultation requires a written or verbal request from another provider and mandates that the consultant render a written opinion or report back to the requesting provider.
Question 3: Under the 2021 E/M guidelines, which level of MDM corresponds to a straightforward problem with minimal data and minimal risk?
- Straightforward (Correct answer)
- Low
- Moderate
- High
Correct answer: Straightforward
Straightforward MDM applies when there is a minimal number of problems, minimal or no data reviewed, and minimal risk of complications.
Question 4: An established patient is seen in the office, and the physician makes an independent interpretation of an EKG during the visit. How is this reflected in MDM?
- Counted as data reviewed under the 'amount and/or complexity of data' element (Correct answer)
- Reported as a separate CPT code only
- Counted under risk
- Does not affect MDM level
Correct answer: Counted as data reviewed under the 'amount and/or complexity of data' element
Independent interpretation of tests (such as an EKG) by the treating physician is counted as data reviewed under the MDM data element.
Question 5: Which scenario best supports reporting modifier -57 with an E/M code?
- E/M the same day as decision for major surgery (Correct answer)
- E/M during a minor procedure global period
- E/M unrelated to postoperative care
- E/M for a new patient requiring preventive care
Correct answer: E/M the same day as decision for major surgery
Modifier -57 indicates that the E/M service resulted in the initial decision to perform a major surgical procedure (90-day global period).
Question 6: For office E/M codes, which of the following is NOT a recognized category of problems under the 2021 MDM guidelines?
- Chronic illness with only marginal follow-up (Correct answer)
- Acute, uncomplicated illness
- Stable chronic illness with treatment adjustment
- Undiagnosed new problem with uncertain prognosis
Correct answer: Chronic illness with only marginal follow-up
'Chronic illness with only marginal follow-up' is not one of the defined MDM problem categories; recognized categories include stable chronic illness, acute illness/injury, and new undiagnosed problems.
COC Evaluation and Management Coding 2
Which modifier is appended to an E/M code to indicate the service is unrelated to a postoperative period?