#1
Which of the following elements is not considered when determining the level of an Evaluation and Management (E/M) code?
Time spent on documentation
ExplanationTime spent on documentation is not a factor in determining E/M code level.
#2
In E/M coding, what does 'E' stand for?
Evaluation
Explanation'E' stands for Evaluation in E/M coding.
#3
When coding an E/M service, what does the 'chief complaint' refer to?
The primary reason for the patient's visit
ExplanationChief complaint refers to the main reason for the patient's visit.
#4
What is the purpose of using E/M codes in medical billing and documentation?
To establish the level of complexity and resources required for patient care
ExplanationE/M codes determine the complexity and resources needed for patient care.
#5
Which of the following factors is not typically considered when determining the level of an E/M code?
Age and gender of the patient
ExplanationAge and gender of the patient are not factors in E/M code level determination.
#6
Which documentation component includes a review of systems and a chief complaint?
History
ExplanationHistory includes review of systems and chief complaint in documentation.
#7
What is the correct order of levels for an E/M code, from lowest to highest complexity?
Level 1, Level 2, Level 3, Level 4, Level 5
ExplanationE/M codes range from Level 1 (lowest) to Level 5 (highest) complexity.
#8
Which of the following is an example of an E/M code modifier?
Modifier 25
ExplanationModifier 25 is an example of an E/M code modifier.
#9
Which of the following is not considered part of the 'Physical Examination' component in E/M coding?
Past medical history
ExplanationPast medical history is not part of the Physical Examination component.
#10
In E/M coding, what does the term 'established patient' refer to?
A patient who has visited the healthcare provider within the last three years
ExplanationEstablished patient: seen healthcare provider within the last three years.
#11
Which of the following statements is true regarding the 'Medical Decision Making' component in E/M coding?
It considers the number of diagnosis and management options, data reviewed, and risk of complications.
ExplanationMedical Decision Making component assesses diagnosis options, data reviewed, and risk.
#12
Which of the following statements is true regarding 'Time' as a component in E/M coding?
It can be used to support code selection when counseling and coordination of care dominate the encounter.
ExplanationTime can support code selection when counseling dominates the encounter.
#13
Which of the following statements is true regarding 'Consultation' codes in E/M coding?
Consultation codes are no longer valid for billing purposes.
ExplanationConsultation codes are obsolete for billing in E/M coding.
#14
What is the difference between 'Medical Necessity' and 'Medical Decision Making' in E/M coding?
Medical Necessity refers to the appropriateness of a service, while Medical Decision Making refers to the complexity of the decision-making process.
ExplanationMedical Necessity is service appropriateness; Medical Decision Making is decision complexity.