Instructions: Select the most appropriate response. Be sure to refer to both textbook content and CPT Evaluation and Management section guidelines and notes.
1) A 54-year-old patient registers at an urgent care center for COVID-19 testing due to aching, coughing, fatigue, and fever. From which Evaluation and Management category would the code for this encounter be selected?
• Preventive medicine services
• Emergency department services
• Office or other outpatient services
• Consultations
2) An established patient receives hospital inpatient discharge day management services from the provider. From which Evaluation and Management subcategory of the hospital inpatient and observation care services category would the code for this encounter be selected?
• Hospital inpatient or observation discharge services
• Hospital inpatient or observation care services (including admission and discharge services)
• Initial hospital inpatient or observation care
• Subsequent hospital inpatient or observation care
3) On January 10, a physician provided office E/M services to a 72-year-old patient who is recuperating at home after left hip replacement surgery, and that same physician created an initial home health care plan on the same date. That physician also prepared a subsequent care plan on January 22 to increase the frequency of physical therapy services provided to the patient. Reporting codes from the Care Plan Oversight Services for January 10 and January 22 care plan oversight services is appropriate because
• the same physician reported care plan oversight services during a 30-day period.
• work involved in providing care plan oversight services is not included in office visit codes.
• level of medical decision making for care plan oversight services determines code selection.
• care plan oversight services are reported instead of office or other outpatient services codes.
4) A patient was seen in consultation with a hematology specialist for post-COVID recurrent blood clots, and the specialist assumed responsibility for the patient's care after initial consultation. Subsequent office encounters with the specialist should be reported with codes from the __________ category or subcategory.
• special evaluation and management services
• office or other outpatient services
• office or other outpatient consultations
• transitional care management services
5) A patient underwent emergency appendectomy as a hospital inpatient and was discharged home for recuperation. The patient then returned to the hospital, seeking immediate medical attention due to surgical staples separating at the site of incision. From which Evaluation and Management category would the code be selected?
• Prolonged services
• Emergency department services
• Care management services
• Office or other outpatient services
6) A 40-year-old patient was admitted to the hospital by the primary care provider (PCP) to control type II diabetes mellitus and to evaluate possible gangrene, left foot. The PCP ordered inpatient consultation services from an orthopedic surgeon, who provided level 4 E/M inpatient consultation services. The orthopedic surgeon told the patient and the PCP that immediate surgical debridement was necessary. Which Evaluation and Management code is assigned for the consultation service?
• 99244 57
• 99254 57
• 99244
• 99254
7) The physician reviewed and revised the hospice agency care plan for an 84-year-old patient with Alzheimer's disease. For care plan oversight services requiring 25 minutes of the physician's time, CPT code __________ is reported.
• 99375
• 99374
• 99378
• 99377
8) The physician provided 70 minutes of hospital inpatient discharge day management services to a 104-year-old patient who was transferred to an assisted living facility. Orders for pain management were provided to the facility. Which Evaluation and Management code(s) are assigned?
• 99239
• 99238, 99239
• 99238
• 99222
9) A patient with a heart condition is scheduled to undergo a cesarean section. Due to the high-risk nature of the delivery, the attending physician requests standby service from a cardiac surgeon, and 30 minutes later the patient delivers a healthy newborn with no complications. Which Evaluation and Management code is reported by the cardiac surgeon?
• 99026
• 99027
• 99464
• 99360
10) The physician had a 20-minute encounter with an established patient to report the results of blood tests, provide instructions to the patient about lowering the Coumadin dosage, and answer the patient's questions. A medically appropriate history was documented. The physician’s office followed up four days later by calling to confirm that the patient had started the lower-dosage Coumadin medication. Which Evaluation and Management code is reported?
• 99499 95
• 99417 95
• 99422 95
• 99213