CPC Evaluation and Management Coding 4

Question 1

A physician provides prolonged office services beyond the typical time for a 99215 (54 minutes). The physician spends a total of 80 minutes. Which additional code is reported?

Accepted Answer

99417

Answer

99417 is reported for each 15 minutes of prolonged office/outpatient E/M service beyond the minimum time for 99215 under 2021 guidelines.

Question 2

Which of the following scenarios qualifies as 'high complexity' medical decision making?

Accepted Answer

Drug therapy requiring intensive monitoring for toxicity

Answer

High complexity MDM includes high risk situations such as drug therapy requiring intensive monitoring for toxicity.

Question 3

For subsequent nursing facility care, which key components are required?

Accepted Answer

At least two of three key components

Answer

Subsequent nursing facility care codes (99307–99310) require at least two of three key components to be met or exceeded.

Question 4

A physician performs a home visit for an established patient with an expanded problem focused history, expanded problem focused exam, and low complexity MDM. Which code applies?

Accepted Answer

99347

Answer

99347 is the established patient home visit code requiring at least two of three key components at problem focused/expanded problem focused/straightforward-to-low complexity.

Question 5

A patient's mother calls the office and the physician spends 8 minutes on the phone addressing a new problem. The decision was made to see the patient. Which code applies?

Accepted Answer

No code — telephone services are bundled

Answer

Telephone E/M codes are not reported if the call results in a decision to see the patient within 24 hours, as the call is bundled into the visit.

CPC - Certified Professional Coder Practice Test

CPC - Certified Professional Coder Practice Test

CPC Evaluation and Management Coding 4