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Evaluation and Management (E/M) Coding for Medical Services Quiz

#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
Explanation

Time 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
Explanation

Chief 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
Explanation

E/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
Explanation

Age 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
Explanation

History 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
Explanation

E/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
Explanation

Modifier 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
Explanation

Past 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
Explanation

Established 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.
Explanation

Medical 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.
Explanation

Time 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.
Explanation

Consultation 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.
Explanation

Medical Necessity is service appropriateness; Medical Decision Making is decision complexity.

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