Evaluation and Management Coding Flashcards
7 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 7 Evaluation and Management Coding flashcards as text
A surgeon sees a patient in the office 10 days after an appendectomy. This visit is within the global period. How should this visit be coded?
Answer: No separate code — the visit is included in the global surgical package
Routine follow-up visits within the global surgical period are included in the surgical package and are not coded separately.
Which E/M code is used when a physician provides transitional care management services with moderate medical complexity, with a face-to-face visit occurring within 14 days of discharge?
Answer: 99495
99495 covers transitional care management with moderate medical complexity when the required face-to-face visit occurs within 14 days of discharge.
A physician documents a chief complaint, history of present illness (4 elements), review of 2 organ systems, and no past/family/social history. What level of history is documented?
Answer: Expanded problem focused
An expanded problem focused history includes brief HPI (1-3 elements) or extended, problem pertinent ROS (1-2 systems), and no PFSH — but extended HPI with 2-system ROS also meets expanded problem focused.
Which of the following is NOT a recognized setting for E/M services coded with office visit codes (99202–99215)?
Answer: Hospital inpatient room
Hospital inpatient services use inpatient hospital care codes (99221–99223 initial, 99231–99233 subsequent), not office visit codes.
A physician provides care and coordination for a patient with two or more chronic conditions via chronic care management. The physician spends 25 minutes in a calendar month. Which code is reported?
Answer: 99490
99490 is reported for the first 20 minutes of clinical staff time for CCM services in a calendar month for patients with 2+ chronic conditions.
When coding an inpatient admission on the same day as an outpatient E/M visit at the same facility, how should the services be reported?
Answer: Report only the initial hospital care code (99221–99223), incorporating all services from that date
When a patient is admitted the same day as an outpatient visit, all services are combined and only the initial inpatient code is reported.
A physician performs a 60-minute online digital E/M visit (patient-initiated) through a secure portal for an established patient. Which code is most appropriate?
Answer: 99423
99423 covers online digital E/M services for established patients requiring 21 or more minutes of cumulative physician/QHP time.