ASCORERS STUVIA
CPMA 2024/25 LATEST EXAM UPDATE WITH MULTIPLE
CORRECTLY ANSWERED QUESTIONS ALREADY GRADED
A+ |WITH APPROPRIATE RATIONALES| (VERIFIED)
1. "Neck: No appreciable cervical adenopathy" is used for what
exam element in the 1995 Documentation Guidelines?
A. Neck
B. Musculoskeletal
C. Skin
D. Lymphatic ...ANS: D. Lymphatic
Rationale: When determining the level of exam under the 1995 CMS
Documentation Guidelines, make sure to read the information
documented instead of relying on the headings of the documentation.
What is documented for neck in the question is counted for lymphatic
(organ system) rather than neck (body area).
2. 65 year-old was admitted in the hospital two days ago and is
being examined today by his primary care physician, who has
been seeing him since he has been admitted. Primary care
physician is checking for any improvements or if the condition is
worsening.
CHIEF COMPLAINT: CHF
INTERVAL HISTORY: CHF symptoms worsened since yesterday.
Now has some resting dyspnea. HTN remains poorly controlled with
systolic pressure running in the 160s. Also, I'm concerned about his
CKD, which has worsened, most likely due to cardio-renal syndrome.
,ASCORERS STUVIA
REVIEW OF SYSTEMS: Positive for orthopnea and one episode of
PND. Negative for flank pain, obstructive symptoms or documented
exposure to nephrotoxins.
PHYSICAL EXAMINATION:
GENERAL: Mild respiratory distress at rest
VITAL SIGNS: BP 168/84, HR 58, temperature 98.1.
LUNGS: Worsening bibasilar crackles
CARDIOVASCULAR: RRR, no MRGs.
EXTREMITIES: Show worsening lower extremity edema.
LABS: BU ...ANS: Subsequent Hospital Visit (99231-99233)
Rationale: This is a subsequent hospital visit which is reported with
code range 99231-99233. The patient was admitted in the hospital
two days ago and the primary care physician has been seeing the
patient since he has been admitted to the hospital. Initial Hospital
Visit (99221-99223) is when the doctor is initially admitting the
patient to the hospital. Inpatient Consultation (99251-99255) is
when the provider requests for another provider to see the patient to
recommend care for a specific condition or to accept ongoing
management for the patient's condition. Established Patient
Office/Outpatient Visit (99211-99215) is when the patient is being
seen in the office setting, not the hospital.
3. 72-year-old was admitted in the hospital three days ago and is
being examined today by his primary care physician, who has
been seeing him since his admission. Te primary care physician
is checking for any improvements or if the condition is
worsening.
CHIEF COMPLAINT: CHFINTERVAL HISTORY: CHF symptoms
worsened since yesterday.
,ASCORERS STUVIA
Now has some resting dyspnea. HTN remains poorly controlled with
systolic pressure running in the 160s. Also, I'm concerned about his
CKD, which has worsened, most likely due to cardio-renal syndrome.
REVIEW OF SYSTEMS: Positive for orthopnea and one episode of
PND. Negative for fank pain, obstructive symptoms, or documented
exposure to nephrotoxins.
PHYSICAL EXAMINATION:GENERAL: Mild respiratory distress at
restVITAL SIGNS: BP 168/84, HR 58, temperature 98.1. LUNGS:
Worsening bibasilar crackles
CARDIOVASCULAR: RRR, no MRGs.EXTREMITIES: Show worsening
lower extremity edema. LABS: BUN 56, ...ANS: C. Subsequent
Hospital Visit
Rationale: The patient was admitted to the hospital three days ago
and the primary care physician has been seeing the patient since the
patient has been admitted to the hospital. Te primary care physician
will report a subsequent hospital visit E/M code.
4. A 10 year-old girl is scheduled for her yearly physical with her
pediatrician. At the time of the visit, the patient complains of
watery eyes, scratchy throat and stuffy nose for the past two
days. The provider performs the physical. He also performs an
expanded problem history and exam and treats the patient for a
URI. What CPT® code(s) is/are reported for this visit?
a. 99393-25, 99213
b. 99393, 99213-25
c. 99393
d. 99213 ...ANS: b. 99393, 99213-25
5. A 25 year-old male is brought by EMS to the Emergency
Department for nausea and vomiting. Patient has elevated blood
, ASCORERS STUVIA
sugars and the ED provider is unable to get a history due to
patient's altered mental status. An eight organ system exam is
performed. The MDM is high complexity. The patient was
stabilized and transferred to ICU. The ED provider documents
total critical care time 25 minutes. What CPT® code is reported?
a. 99285
b. 99223
c. 99291
d. 99236 ...ANS: a. 99285
Rationale: According to CPT® Critical Care Services guidelines:
"99291 is used to report the first 30-74 minutes of critical care on a
given date. Critical care of less than 30 minutes of total duration on a
given date is reported with the appropriate E/M code." For this
encounter the provider is short 5 minutes of 30 minutes needed to
bill the critical care code. The encounter takes place in the emergency
department. In the CPT® Index look for Evaluation and
Management/Emergency Department. You are referred to 99281-
99285. For emergency room services, three out of three key
components are required. In this case, the provider is unable to
obtain a history due to the patient's condition. According to the CMS
Documentation Guidelines, the provider must indicate the reason
they could not obtain a history. The level is determined by the exam
and MDM. The exam is comprehensive (eight organ systems) and
MDM is hig
6. A 28 year-old female patient is returning to her provider's
office with complaints of RLQ pain and heartburn with a
temperature of 100.2. The provider performs a detailed history,
detailed exam and determines the patient has mild appendicitis.
The provider prescribes antibiotics to treat the appendicitis in
hopes of avoiding an appendectomy. What are the correct CPT®
and ICD-10-CM codes for this encounter?
a. 99202, R10.31, K37
b. 99214, K37, R12
c. 99203, R50.9, R12, R10.31, K37
CPMA 2024/25 LATEST EXAM UPDATE WITH MULTIPLE
CORRECTLY ANSWERED QUESTIONS ALREADY GRADED
A+ |WITH APPROPRIATE RATIONALES| (VERIFIED)
1. "Neck: No appreciable cervical adenopathy" is used for what
exam element in the 1995 Documentation Guidelines?
A. Neck
B. Musculoskeletal
C. Skin
D. Lymphatic ...ANS: D. Lymphatic
Rationale: When determining the level of exam under the 1995 CMS
Documentation Guidelines, make sure to read the information
documented instead of relying on the headings of the documentation.
What is documented for neck in the question is counted for lymphatic
(organ system) rather than neck (body area).
2. 65 year-old was admitted in the hospital two days ago and is
being examined today by his primary care physician, who has
been seeing him since he has been admitted. Primary care
physician is checking for any improvements or if the condition is
worsening.
CHIEF COMPLAINT: CHF
INTERVAL HISTORY: CHF symptoms worsened since yesterday.
Now has some resting dyspnea. HTN remains poorly controlled with
systolic pressure running in the 160s. Also, I'm concerned about his
CKD, which has worsened, most likely due to cardio-renal syndrome.
,ASCORERS STUVIA
REVIEW OF SYSTEMS: Positive for orthopnea and one episode of
PND. Negative for flank pain, obstructive symptoms or documented
exposure to nephrotoxins.
PHYSICAL EXAMINATION:
GENERAL: Mild respiratory distress at rest
VITAL SIGNS: BP 168/84, HR 58, temperature 98.1.
LUNGS: Worsening bibasilar crackles
CARDIOVASCULAR: RRR, no MRGs.
EXTREMITIES: Show worsening lower extremity edema.
LABS: BU ...ANS: Subsequent Hospital Visit (99231-99233)
Rationale: This is a subsequent hospital visit which is reported with
code range 99231-99233. The patient was admitted in the hospital
two days ago and the primary care physician has been seeing the
patient since he has been admitted to the hospital. Initial Hospital
Visit (99221-99223) is when the doctor is initially admitting the
patient to the hospital. Inpatient Consultation (99251-99255) is
when the provider requests for another provider to see the patient to
recommend care for a specific condition or to accept ongoing
management for the patient's condition. Established Patient
Office/Outpatient Visit (99211-99215) is when the patient is being
seen in the office setting, not the hospital.
3. 72-year-old was admitted in the hospital three days ago and is
being examined today by his primary care physician, who has
been seeing him since his admission. Te primary care physician
is checking for any improvements or if the condition is
worsening.
CHIEF COMPLAINT: CHFINTERVAL HISTORY: CHF symptoms
worsened since yesterday.
,ASCORERS STUVIA
Now has some resting dyspnea. HTN remains poorly controlled with
systolic pressure running in the 160s. Also, I'm concerned about his
CKD, which has worsened, most likely due to cardio-renal syndrome.
REVIEW OF SYSTEMS: Positive for orthopnea and one episode of
PND. Negative for fank pain, obstructive symptoms, or documented
exposure to nephrotoxins.
PHYSICAL EXAMINATION:GENERAL: Mild respiratory distress at
restVITAL SIGNS: BP 168/84, HR 58, temperature 98.1. LUNGS:
Worsening bibasilar crackles
CARDIOVASCULAR: RRR, no MRGs.EXTREMITIES: Show worsening
lower extremity edema. LABS: BUN 56, ...ANS: C. Subsequent
Hospital Visit
Rationale: The patient was admitted to the hospital three days ago
and the primary care physician has been seeing the patient since the
patient has been admitted to the hospital. Te primary care physician
will report a subsequent hospital visit E/M code.
4. A 10 year-old girl is scheduled for her yearly physical with her
pediatrician. At the time of the visit, the patient complains of
watery eyes, scratchy throat and stuffy nose for the past two
days. The provider performs the physical. He also performs an
expanded problem history and exam and treats the patient for a
URI. What CPT® code(s) is/are reported for this visit?
a. 99393-25, 99213
b. 99393, 99213-25
c. 99393
d. 99213 ...ANS: b. 99393, 99213-25
5. A 25 year-old male is brought by EMS to the Emergency
Department for nausea and vomiting. Patient has elevated blood
, ASCORERS STUVIA
sugars and the ED provider is unable to get a history due to
patient's altered mental status. An eight organ system exam is
performed. The MDM is high complexity. The patient was
stabilized and transferred to ICU. The ED provider documents
total critical care time 25 minutes. What CPT® code is reported?
a. 99285
b. 99223
c. 99291
d. 99236 ...ANS: a. 99285
Rationale: According to CPT® Critical Care Services guidelines:
"99291 is used to report the first 30-74 minutes of critical care on a
given date. Critical care of less than 30 minutes of total duration on a
given date is reported with the appropriate E/M code." For this
encounter the provider is short 5 minutes of 30 minutes needed to
bill the critical care code. The encounter takes place in the emergency
department. In the CPT® Index look for Evaluation and
Management/Emergency Department. You are referred to 99281-
99285. For emergency room services, three out of three key
components are required. In this case, the provider is unable to
obtain a history due to the patient's condition. According to the CMS
Documentation Guidelines, the provider must indicate the reason
they could not obtain a history. The level is determined by the exam
and MDM. The exam is comprehensive (eight organ systems) and
MDM is hig
6. A 28 year-old female patient is returning to her provider's
office with complaints of RLQ pain and heartburn with a
temperature of 100.2. The provider performs a detailed history,
detailed exam and determines the patient has mild appendicitis.
The provider prescribes antibiotics to treat the appendicitis in
hopes of avoiding an appendectomy. What are the correct CPT®
and ICD-10-CM codes for this encounter?
a. 99202, R10.31, K37
b. 99214, K37, R12
c. 99203, R50.9, R12, R10.31, K37
