Week 1 E/M Coding Quiz Lab

1 A new patient presents to the physician's office at which time the physician provides a comprehensive history and exam with a high complexity MDM. CPT Code:

2 An initial inpatient consultation with a detailed history, detailed exam, and MDM of low complexity. CPT Code:

3 A 40-year-old established patient presents to the physician office for a preventive care exam.

4 History and exam of the normal newborn infant born in a hospital setting.

5 2 pts Dr. Martin provided 1 hour and 20 minutes of critical care services to Jack Smithton (age 64), who is in the intensive care unit with acute respiratory distress syndrome.

6 2 pts The code range for Home Services is

WRONG 7 AN ESTABLISHED PATIENT GOES TO THEIR PCP OFFICE AND SEES THE APRN FOR A FLU SHOT.

8 2 pts The physician documented that he performed 90 minutes of complex chronic care management.

9 A 15 year-old boy who is an established patient presents to his PCP office for his scheduled annual physical.

10 A 17 year-old girl presented with new lesions on her arms and legs to her annual dermatology visit with Dr. Jekyll. The physician does an expanded problem focused history and exam and the MDM was straightforward.

11 Denise returns to her Infectious Disease doctor for a follow up on her open wound. The physician becomes concerned with the extent of the wound since the last visit. He performs a problem focused history and a comprehensive exam. His MDM is of high complexity.

12 PAOLA HURT HER ANKLE FROM KICKING A CUSTOMER IS THE FACE FOR BEING HARASSING AND AGGRESSIVE. WHEN SHE PRESENTED TO THE ED THE PHYSICIAN DID AN EXPANDED PROBLEM FOCUSED HISTORY AND EXAM. HIS MDM WAS OF LOW COMPLEXITY AND HE GAVE HER A HIGH FIVE HER ON THE WAY OUT.

13 Lilliana was working at a nursing home who cares for patients of all ages but primarily geriatrics. Lilliana was happy to get a job working in the billing and coding department because she loves to help the elderly. Today alone she billed for 9 residents all for the same service. It was the annual nursing facility assessment. She billed which CPT code for each of the patients?

14 Shenell went to a new doctor for her recent sudden onset of headaches presenting as migraines. Her PCP sent her to a neurologist group and told her to see anybody there. The patient made an appointment with Janice Lombardi, MD. Shenell was looking for any relief at all and was hoping Dr. Lombardi might have hope for her today. After a detailed history and exam the doctor came to a decision relatively quickly. Dr. Lombardi's MDM was of low complexity. She advised Shenell that with the constant taking of selfies the cellular beams are causing headaches and advises that she instead, perhaps, takes out the school books for a little while and put the phone away?

15 Lynnette works for Dr. Olen who is a Cardiologist. Dr. Olen studied very hard and went to school for 12 more years after high school graduation. She was always studying and had many awards and achievements hanging on her wall putting all of her patient's fears at ease regarding her ability since she looked so young. Today Jennifer comes in for her appointment with Dr. Olen. Dr. Lombardi called Dr. Olen and asked her to please see her patient Jennifer. She said that she really wants Dr. Olen's professional opinion and advice for her long term patient. Dr. Olen's documentation in the medical record states that while seeing Jennifer for the first time on day four of her hospital admission that she performed a comprehensive history and exam and the MDM was of high complexity. Dr. Olen ordered many tests and not only documented this in the record she wrote a note back to Dr. Lombardi with her comprehensive plan to treat Jennifer.

16 The ED doctor transferred three patients to Observation department after determining the patients don't need to be in the ED but are not quite well enough to go home. Dr. Oyola visits the three patients Ammu, Naomi and Ayesha in Observation. The patients told Dr. Oyola that they were out celebrating together after passing their CPC credentialing exam. The doctor performs a comprehensive history and exam on all three patients and the MDM was straightforward. After some IV fluids for dehydration all three patients were discharged on the same day just three hours later and ordered to go home get plenty of rest and drink lots of fluids. The doctor also privately Congratulated each of them on their Victory on her way out. She gave them her business card and advised them to call for an interview.

17 Ivette presents to the ED after donating blood at school and fainting. Dr. Oyola performs a problem focused history and exam and then her MDM was straigtforward. Ivette was advised to keep on donating.

18 The patient was admitted into the hospital after being electrocuted at work while working on a tank. Dr. Suarez sees the patient, Coreen, for the third time on her four day admission. Dr. Suarez performs an expanded problem focused interval history and an expanded problem focused exam as well as the MDM being of moderate complexity.

19 Tash went to her doctor for a follow up visit after her car accident. The doctor thought Tash was doing great because she has no residual affects. She comments that Tash is a strong woman. After the doctor performed a problem focused history and exam the MDM was straightforward so Khadijah billed what CPT code to the insurance company.

20 Taylor is coding a medical record for Dr. Ward in her orthopaedic practice. The new patient is Wanda who came in to have her back examined. She told the doctor that she goes to school for coding and billing and she threw her back out carrying her heavy coding books. Wanda continued to tell Dr. Ward that she and a fellow student, Annette, collided in the hallway dropping their books. When Wanda was picking up her books she felt something "pop". She now struggles to stand straight and is increasing pain. Taylor notes that the physician has documented for a comprehensive hx and exam and the MDM was of moderate complexity.

21 Nathalie is a 24 yea-old new patient presenting for a routine physical.