Evaluation & Management (E/M) Coding Flashcards
6 cards from real CPC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Evaluation & Management (E/M) Coding flashcards as text
Under the 2021 AMA E/M guidelines for office visits, what primarily drives code selection?
Answer: Medical decision making (MDM) or total time on the date of encounter
The 2021 AMA guidelines base office/outpatient E/M code level on either medical decision making (MDM) or total time on the date of the encounter.
Which CPT code range covers office or other outpatient E/M services for established patients?
Answer: 99211–99215
CPT codes 99211–99215 are used for established patient office or other outpatient E/M services.
In E/M coding, what does 'MDM' stand for?
Answer: Medical decision making
MDM stands for medical decision making, one of the key components used to determine E/M code level.
A patient presents with a new problem that requires additional workup. What level of MDM complexity does this represent?
Answer: Moderate complexity
A new problem to the provider that requires additional workup meets the moderate complexity level for the 'number and complexity of problems' element of MDM.
Which modifier is appended to an E/M code when a significant, separately identifiable E/M service is provided on the same day as a procedure?
Answer: Modifier -25
Modifier -25 indicates a significant, separately identifiable E/M service was provided on the same day as a procedure.
Which of the following is NOT one of the three elements of medical decision making (MDM)?
Answer: Number of organ systems examined
Number of organ systems examined is part of the physical examination component, not MDM; MDM consists of problems, data, and risk.