Evaluation & Management (E/M) Coding Flashcards

Which E/M service category is used when a physician reviews a patient's record and provides recommendations without seeing the patient?

Answer: Interprofessional telephone/internet consultation

Interprofessional telephone/internet/electronic health record consultations (99446–99452) allow a specialist to provide recommendations without a face-to-face patient encounter.

Preventive medicine services (99381–99397) are selected based on:

Answer: The patient's age and whether they are new or established

Preventive medicine service codes are selected based on the patient's age range and whether the patient is new or established.

When providing care management for a patient with two or more chronic conditions, which code set is typically reported?

Answer: Chronic care management codes (99490–99491)

Chronic care management codes (99490–99491) are reported for patients with two or more chronic conditions expected to last at least 12 months.

Discharge day management services (99238–99239) are differentiated by:

Answer: Total time spent on the final day

Hospital discharge day management codes are differentiated by total time: 99238 for 30 minutes or less, 99239 for more than 30 minutes.

Telehealth E/M services for established patients provided via audio-visual technology are reported with:

Answer: The same office/outpatient E/M codes with modifier -95 or place of service code 02/10

Standard office/outpatient E/M codes are used for telehealth visits with modifier -95 (synchronous telemedicine) or the appropriate place of service code.

In the context of E/M coding, what does the term 'undiagnosed new problem with uncertain prognosis' represent in MDM?

Answer: Moderate complexity

An undiagnosed new problem with uncertain prognosis is classified as moderate complexity in the 'problems addressed' element of MDM.