CPC Evaluation & Management (E/M) Coding

Question 1

Under the 2021 AMA E/M guidelines for office visits, what primarily drives code selection?

Accepted Answer

Medical decision making (MDM) or total time on the date of encounter

Answer

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.

Question 2

Which CPT code range covers office or other outpatient E/M services for established patients?

Accepted Answer

99211–99215

Answer

CPT codes 99211–99215 are used for established patient office or other outpatient E/M services.

Question 3

In E/M coding, what does 'MDM' stand for?

Accepted Answer

Medical decision making

Answer

MDM stands for medical decision making, one of the key components used to determine E/M code level.

Question 4

A patient presents with a new problem that requires additional workup. What level of MDM complexity does this represent?

Accepted Answer

Moderate complexity

Answer

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.

Question 5

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?

Accepted Answer

Modifier -25

Answer

Modifier -25 indicates a significant, separately identifiable E/M service was provided on the same day as a procedure.

(CPC) Certified Procedural Coder Practice Test

(CPC) Certified Procedural Coder Practice Test

CPC Evaluation & Management (E/M) Coding