Question

Coding Evaluation and Management Services

Supply the correct E/M CPT codes for the following procedures and services.

A. L0 5.4–5.6 Office visit, new patient; detailed history and examination, low complexity medical decision making

B. L0 5.4–5.6 Hospital visit, new patient; comprehensive history and examination, highly complex case

C. L0 5.4–5.6 Office consultation by the physician assistant for established patient; comprehensive history and examination, moderately complex medical decision making

D. L0 5.4–5.6 Initial comprehensive physical examination for sixty-four-year-old new patient

E. L0 5.4–5.6 Medical disability examination by treating physician

F. L0 5.4–5.6 Hospital visit to previously admitted patient; expanded problem-focused history and examination, twenty-five minutes spent at bedside

G. L0 5.4–5.6 Hospital emergency department call for established patient with cardiac infarction; detailed history and examination, moderately complex decision making

H. L0 5.4–5.6 Third visit to established, stable patient in nursing facility, medical record and patient’s status reviewed, no change made to medical plan

I. L0 5.4–5.6 Home visit for new patient, straightforward case, problem-focused history and examination

J. L0 5.4–5.6 Five-minute medical discussion telephone call to an established patient

Answer 1

A. 99203

Evaluation and Management; Office and Other Outpatient

Note: The presenting problem is of moderate severity and for a new patient.

B. 99223

Evaluation and Management; Hospital

Note: This visit is initial hospital care of high severity.

C. 99244

Evaluation and Management; Consultation

Note: The office consultation is of moderate to high severity.

D. 99386

Preventive Medicine; New Patient

Note: The new patient is between 40 and 64 years old.

E. 99455

Disability Evaluation Services; Examination

Note: The evaluation was performed by the treating physician.

F. 99232

Evaluation and Management; Hospital

Note: This service is subsequent hospital care for a patient who has developed a minor complication.

G. 99284

Evaluation and Management; Emergency Department

Note: The presenting problem for this emergency service is of high severity.

H. 99307

Evaluation and Management; Nursing Facility; Subsequent Care

Note: This nursing facility care is for a patient in stable condition.

I. 99341

Evaluation and Management; Home Services

Note: The home services are of low severity and for a new patient.

J. 99441

Evaluation and Management; Telephone Services

Note: The service was within 5-10 minutes of medical discussion.