1. A patient comes into her doctor’s office for her weekly blood sugar check. Her blood is drawn by the LPN on staff, the visit takes about 5 minutes total.

 

a. 99201

b. 99212

c. 99211

d. 93792

 

2. A three year old child is brought into the ER after swallowing a penny. A detailed history and exam are taken on the child and medical decision making is of moderate complexity. The child is admitted to observation for three hours and is then discharged home.

 

a. 99218

b. 99235

c. 99218; 99217

d. 99234

 

3. A 20 month old child is admitted to the hospital with pneumonia and acute respiratory distress. The physician spends 3 minutes intubating the child and spends 90 minutes of Critical Care time stabilizing the patient.

 

a. 99291, 99292-25, 31500

b. 99471-25, 31500

c. 99291-25, 99292-25, 31500

d. 99471

 

4. At the request of a physician who is delivering for a high risk pregnancy, Dr. Smith, a pediatrician, is present in the delivery room to assist the infant if needed. After thirty minutes the infant is born, but is not breathing. The delivering physician hands the infant to Dr. Smith who provides chest compressions and resuscitates the infant. The pediatrician then performs the initial evaluation and management and admits the healthy newborn to the nursery. What codes should Dr. Smith submit on a claim?

 

a. 99360, 99465

b. 99465, 99460

c. 99360, 99460

d. 99360, 99465, 99460

 

5. Mr. Johnson is a 79 year old established male patient that is seen by Dr. Anderson for his annual physical exam. During the examination Dr. Anderson notices a suspicious mole on Mr. Johnson’s back. The Doctor completes the annual exam and documents a detailed history and exam and the time discussing the patient’s need to quit smoking. Dr. Anderson then turns his attention to the mole and does a complete work up. He documents a comprehensive history and examination and medical decision making of moderate complexity. He also called a local dermatologist and made an appointment for Mr. Johnson to see him the next day for an evaluation and biopsy.

 

a. 99387, 99205

b. 99387, 99215

c. 99397, 99205

d. 99397, 99215

 

6. An E/M is made up of seven components six of which are used in defining the levels of E/M services. The seven components include History, Exam, Medical Decision Making, Counseling, Coordination of Care, Nature of Presenting Problem, and Time. Which six of these seven parts help define the level of the E/M service?

 

a. History, Exam, Medical Decision Making, Coordination of Care, Nature of Presenting Problem, and Time b. History, Exam, Medical Decision Making, Counseling, Nature of Presenting Problem, and Time

c. History, Exam, Medical Decision Making, Counseling, Coordination of Care, and Nature of Presenting Problem

d. History, Exam, Medical Decision Making, Counseling, Coordination of Care, and Time

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7. Subjective: Six-year-old girl twisted her arm on the play ground. She is seen in the ED complaining of pain in her wrist. Objective: Vital Signs: stable. Wrist: Significant tenderness laterally. X-ray is normal Assessment: Wrist sprain Plan: Over the counter Anaprox. give twice daily with hot packs. Recheck if no improvement. What is the E/M code for this visit?

a. 99221

b. 99284

c. 99241

d. 99281

 

8. An infant is born six weeks premature in rural Arizona and the pediatrician in attendance intubates the child and administers surfactant in the ET tube while waiting in the ER for the air ambulance. During the 45 minute wait, he continues to bag the critically ill patient on 100 percent oxygen while monitoring VS, ECG, pulse oximetry and temperature. The infant is in a warming unit and an umbilical vein line was placed for fluids and in case of emergent need for medications. How is this coded?

 

a. 99291

b. 99471

c. 99291, 31500, 36510, 94610

d. 99471, 94610, 36510

 

 

9. Mr. Trumph loses his yacht in a poker game and experiences a sudden onset of chest pain which radiates down his left arm. The paramedics are called to the casino he owns in Atlantic City to stabilize him and transport him to the hospital. Dr. H. Art is in the ER to direct the activities of the paramedics. He spends 30 minutes in two-way communication directing the care of Mr. Trumph. When EMS reached the hospital Emergency Department, Mr. Trumph is in full arrest with torsades de pointes (ventricular tachycardia). Dr. H. Art spends another hour stabilizing the patient and performing CPR. What are the appropriate procedure codes for this encounter?

 

a. 99288,99291, 92950

b. 99291,99292

c. 99288, 99291

d. 99291, 92950, 92960

 

10. Patient comes in today at four months of age for a checkup. She is growing and developing well. Her mother is concerned because she seems to cry a lot when lying down but when she is picked up she is fine. She is on breast milk but her mother has returned to work and is using a breast pump, but hasn’t seemed to produce enough milk.

 

PHYSICAL EXAM:

Weight 12 lbs 11 oz,

Height 25in., OFC 41.5 cm.

HEENT: Eye: Red reflex normal. Right eardrum is minimally pink, left eardrum is normal.

Nose: slight mucous Throat with slight thrush on the inside of the cheeks and on the tongue.

LUNGS: clear. HEART: w/o murmur.

 

ABDOMEN: soft. Hip exam normal.

GENITALIA normal although her mother says there was a diaper rash earlier in the week.

 

ASSESSMENT Four month old well check Cold Mild thrush Diaper rash

 

PLAN: Okay to advance to baby foods Okay to supplement with Similac Nystatin suspension for the thrush and creams for the diaper rash if it recurs Mother will bring child back after the cold symptoms resolve for her DPT, HIB and polio What E/M code(s) is/are reported?

 

a. 99212

b. 99391

c. 99391, 99212-25

d. 99213

 

11. 28-year-old female patient is returning to her physician’s office with complaints of RLQ pain and heartburn with a temperature of 100.2. The physician performs a detailed history, detailed exam and determines the patient has mild appendicitis. The physician prescribes antibiotics to treat the appendicitis in hopes of avoiding an appendectomy. What are the correct CPT® and ICD-9-CM codes for this encounter?

 

a. 99214

b. 99202

c. 99213

d. 99203

 

12. Dr. Inez discharges Mr. Blancos from the pulmonary service after a bout of pneumococcal pneumonia. She spends 45 minutes at the bedside explaining to Mr. Blancos and his wife the medications and IPPB therapy she ordered. Mr. Blancos is a resident of the Shady Valley Nursing Home due to his advanced Alzheimer’s disease and will return to the nursing home after discharge. On the same day Dr. Inez readmits Mr. Blancos to the nursing facility. She obtains a detailed interval history, does comprehensive examination and the medical decision making is moderate complexity. What is/are the appropriate evaluation and management code(s) for this visit?

 

a. 99238, 99305

b. 99238

c. 99239

d. 99239, 99304

 

13. 37-year-old female is seen in the clinic for follow-up of lower extremity swelling. HPI: Patient is here today for follow-up of bilateral lower extremity swelling. The swelling responded to hydrochlorothiazide. DATA REVIEW: I reviewed her lab and echocardiogram. The patient does have moderate pulmonary hypertension.

 

Exam: Patient is in no acute distress.

 

ASSESSMENT:

 

1. Bilateral lower extremity swelling. This has resolved with diuretics, it may be secondary to problem #2.

 

2. Pulmonary hypertension: Etiology is not clear at this time, will work up and possibly refer to a pulmonologist.

 

PLAN: Will evaluate the pulmonary hypertension. Patient will be scheduled for a sleep study.

 

a. 99213

b. 99212

c. 99214

d. 99215

 

14. 45-year-old established, female patient is seen today at her doctor’s office. She is complaining of severe dizziness and feels like the room is spinning. She has had palpitations on and off for the past 12 months. For the ROS, she reports chest tightness and dyspnea but denies nausea, edema, or arm pain. She drinks two cups of coffee per day. Her sister has WPW (Wolff-Parkinson-White) syndrome. An extended exam of five organ systems are performed. This is a new problem. An EKG is ordered and labs are drawn, and the physician documents a moderate complexity MDM. What CPT® code should be reported for this visit?

 

a. 99214

b. 99215

c. 99203

d. 99204 69.

 

15. 33 year-old male was admitted to the hospital on 12/17/XX from the ER, following a motor vehicle accident. His spleen was severely damaged and a splenectomy was performed. The patient is being discharged from the hospital on 12/20/XX. During his hospitalization the patient experienced pain and shortness of breath, but with an antibiotic regimen of Levaquin, he improved. The attending physician performed a final examination and reviewed the chest X-ray revealing possible infiltrates and a CT of the abdomen ruled out any abscess. He was given a prescription of Zosyn. The patient was told to follow up with his PCP or return to the ER for any pain or bleeding. The physician spent 20 minutes on the date of discharge. What CPT® code is reported for the 12/20 visit?

 

a. 99221

b. 99231

c. 99238

d. 99283 70.

 

16. 60-year-old woman is seeking help to quit smoking. She makes an appointment to see Dr. Lung for an initial visit. The patient has a constant cough due to smoking and some shortness of breath. No night sweats, weight loss, night fever, CP, headache, or dizziness. She has tried patches and nicotine gum, which has not helped. Patient has been smoking for 40 years and smokes 2 packs per day. She has a family history of emphysema. A limited three system exam was performed. Dr Lung discussed in detail the pros and cons of medications used to quit smoking. Counseling and education was done for 20 minutes of the 30 minute visit. Prescriptions for Chantrix and Tetracylcine were given. The patient to follow up in 1 month. A chest X-ray and cardiac work up was ordered. Select the appropriate CPT code(s) for this visit.

 

a. 99202

b. 99203

c. 99203, 99354

d. 99214, 99354

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***END OF TEST***