CPC Evaluation and Management Coding 5

Question 1

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?

Accepted Answer

No separate code — the visit is included in the global surgical package

Answer

Routine follow-up visits within the global surgical period are included in the surgical package and are not coded separately.

Question 2

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?

Accepted Answer

99495

Answer

99495 covers transitional care management with moderate medical complexity when the required face-to-face visit occurs within 14 days of discharge.

Question 3

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?

Accepted Answer

Expanded problem focused

Answer

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.

Question 4

Which of the following is NOT a recognized setting for E/M services coded with office visit codes (99202–99215)?

Accepted Answer

Hospital inpatient room

Answer

Hospital inpatient services use inpatient hospital care codes (99221–99223 initial, 99231–99233 subsequent), not office visit codes.

Question 5

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?

Accepted Answer

99490

Answer

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.

CPC - Certified Professional Coder Practice Test

CPC - Certified Professional Coder Practice Test

CPC Evaluation and Management Coding 5