CPT: Evaluation and Management Codes
UPDATED ACTUAL Questions and
CORRECT Answers
Standby - CORRECT ANSWER - A service that is requested by one physician to another
to provide prolonged attendance without direct face-to-face patient contact.
Care plan oversight - CORRECT ANSWER - Non face-to-face services provided on a
monthly basis, timed, for patients in a hospice, home health, or nursing home setting.
Established patient - CORRECT ANSWER - A patient who has been seen by the same
provider or another provider of the same specialty and subspecialty who belongs to the same
group practice.
Admitting physician - CORRECT ANSWER - A physician who is allowed to bill the
initial hospital care codes 99221-99223
Chief complaint - CORRECT ANSWER - Patient's explanation to the physician of why he
or she needs to be seen
Consultation - CORRECT ANSWER - The situation in which a physician provides an
opinion or advice on a patient and does not take over the care of the patient
New patient - CORRECT ANSWER - Patient who has not been seen by the physician for
3 years
Contributory component - CORRECT ANSWER - Nature of the presenting problem
Observation Care - CORRECT ANSWER - The situation in which a patient is sent to the
hospital for care, but is not admitted to the hospital
, Roll-Up rule - CORRECT ANSWER - Guideline for a coding situation in which, after
being treated in the office, the patient is sent to the
hospital to be admitted, and only an admission code is reported for service provided at both
locations
Direct care - CORRECT ANSWER - Type of face-to-face care provided by a physician to
a pediatric patient in transport from one facility
to another
Category - CORRECT ANSWER - Type of E/M grouping called office or outpatient
consultations
Review of Systems (ROS) - CORRECT ANSWER - An element of the history key
component
Preventive Medicine - CORRECT ANSWER - Type of care for a patient who is evaluated
by a physician without a specific diagnosis, illness, or
condition being reported for that evaluation
Moderate Complexity - CORRECT ANSWER - A level of medical decision making
(MDM)
Which code is used for the initial office visit of a patient with a 2-day history of lower abdominal
pain and occasional vomiting in which the physician obtains a detailed history and detailed
examination and does low MDM? - CORRECT ANSWER - 99203
An internist asks an endocrinologist to give an opinion on a diabetic patient's bilateral lower
extremity neuropathy. In his office, the endocrinologist provides a detailed history, an expanded
problem-focused exam, and moderate medical decision making. The endocrinologist writes a
letter to the internist indicating his findings. Which code is used? - CORRECT ANSWER -
99242
UPDATED ACTUAL Questions and
CORRECT Answers
Standby - CORRECT ANSWER - A service that is requested by one physician to another
to provide prolonged attendance without direct face-to-face patient contact.
Care plan oversight - CORRECT ANSWER - Non face-to-face services provided on a
monthly basis, timed, for patients in a hospice, home health, or nursing home setting.
Established patient - CORRECT ANSWER - A patient who has been seen by the same
provider or another provider of the same specialty and subspecialty who belongs to the same
group practice.
Admitting physician - CORRECT ANSWER - A physician who is allowed to bill the
initial hospital care codes 99221-99223
Chief complaint - CORRECT ANSWER - Patient's explanation to the physician of why he
or she needs to be seen
Consultation - CORRECT ANSWER - The situation in which a physician provides an
opinion or advice on a patient and does not take over the care of the patient
New patient - CORRECT ANSWER - Patient who has not been seen by the physician for
3 years
Contributory component - CORRECT ANSWER - Nature of the presenting problem
Observation Care - CORRECT ANSWER - The situation in which a patient is sent to the
hospital for care, but is not admitted to the hospital
, Roll-Up rule - CORRECT ANSWER - Guideline for a coding situation in which, after
being treated in the office, the patient is sent to the
hospital to be admitted, and only an admission code is reported for service provided at both
locations
Direct care - CORRECT ANSWER - Type of face-to-face care provided by a physician to
a pediatric patient in transport from one facility
to another
Category - CORRECT ANSWER - Type of E/M grouping called office or outpatient
consultations
Review of Systems (ROS) - CORRECT ANSWER - An element of the history key
component
Preventive Medicine - CORRECT ANSWER - Type of care for a patient who is evaluated
by a physician without a specific diagnosis, illness, or
condition being reported for that evaluation
Moderate Complexity - CORRECT ANSWER - A level of medical decision making
(MDM)
Which code is used for the initial office visit of a patient with a 2-day history of lower abdominal
pain and occasional vomiting in which the physician obtains a detailed history and detailed
examination and does low MDM? - CORRECT ANSWER - 99203
An internist asks an endocrinologist to give an opinion on a diabetic patient's bilateral lower
extremity neuropathy. In his office, the endocrinologist provides a detailed history, an expanded
problem-focused exam, and moderate medical decision making. The endocrinologist writes a
letter to the internist indicating his findings. Which code is used? - CORRECT ANSWER -
99242
