AAPC CHAPTER 19 - EVALUATION AND
MANAGEMENT - REVIEW EXAM 2025
WITH CORRECT ANSWERS
A provider admits Mrs. Smith to the hospital. She is there for five days. The provider sees her each day sh
e's in the hospital. What subcategory of E/M codes would be used for days two, three and four? -
correct answer-Correct Answer:
c. Subsequent Hospital Care
Response Feedback:
Rationale: Codes from the Subsequent Hospital Care subcategory would be used for days two, three and f
our. The code for the first day would be from the Initial Hospital Care subcategory. Day five could be repor
ted with either subsequent hospital care or hospital care discharge depending on the role of the provider.
What modifier is used to report an evaluation and management service mandated by a court order? -
correct answer-Correct Answer:
c. 32
Response Feedback:
Rationale: Modifier 32 is used for services related to mandated consultation and/or related services by a
third-party payer, governmental, legislative or regulatory requirements.
What category of codes should be used to report an evaluation and management service provided to a p
atient in a psychiatric residential treatment center? - correct answer-Correct Answer:
c. Nursing facility services
Response Feedback:
Rationale: The guidelines for NursingZFacility ServicesZstate, "These codes should also be used to report e
valuation and management services provided to a patient in a psychiatric residential treatment center."
A patient is seen by Dr. B who is covering on call services for Dr. A. The patient is an established patient wi
th Dr. A. but she has notZbeen seen by Dr. B. before. Which E/M subcategory is appropriate to report the s
ervices provided by Dr. B? - correct answer-Correct Answer:
,c. SEstablished Spatient Soffice Svisit
Response SFeedback:
Rationale: SAccording Sto Sthe SE/M SGuideline Sfor SNew Sand SEstablished SPatient, Swhen Sa Sprovider Sis Son Scall
Sor Sc SoveringZfor Sanother Sprovider, Sthe Spatient's Sencounter Swill Sbe Sclassified Sas Sit Swould ShaveZbeen Sby
Sthe Sprovi Sder Swho Sis Snot Savailable. SIn Sthis Sinstance, SDr. SB Swould Sreport San Sestablished Spatient
Soffice Svisit.
A SPCP Stransfers Sa Spatient Sto Sa Scardiologist Sfor Smanagement Sof Sthe Spatient's Scongestive Sheart Sfailure.
SThe Sc Sardiologist Sexamines Sthe Spatient, Sdiscusses Streatment Soptions Sand Sschedules Sa Sstress StestZfor
Sthis Snew Spati Sent. SA Sreport Sis Ssent Sto Sthe SPCP Sdetailing Sthe Sfindings Sof Sthe Soffice Svisit, Sresults Sof Sthe
Sstress Stest Sand Sintent Sto Smanage Sand Streat Sthe Scongestive Sheart Sfailure. SAn SE/M Scode Swould Sbe
Sselected Sfrom Swhat Ssubcategor Sy Sfor Sthe Scardiologist? S- Scorrect Sanswer-Correct SAnswer:
a. New Spatient Soffice Svisit
Response SFeedback:
Rationale: SThe SPCP Stransferred Sthe Spatient Sto Sthe Scardiologist Sto Smanage/treat Sthe Scongestive Sheart Sfailur
e. SThe Scardiologist Saccepted Sthe Stransfer Sof Scare Sof Sthe SpatientZand Ssent Sa Sletter Sto Sthe SPCP Swith
Sfindings So Sf Sthe Sfirst Svisit Sand Sstress Stest. SThis Swould Sbe Scoded SasZa Snew Spatient Ssince Sthe
Scardiologist Saccepted Sthe Sp Satient Sand SisZtaking Sover Sthe Scare Sof Sa Sspecific Sproblem.
WhatZICD-10-CM Scode SisZreported Sfor Snausea Sand Svomiting? S- Scorrect Sanswer-Correct SAnswer:
b. R11.2
Response SFeedback:
Rationale: SLook Sin Sthe SICD-10-
CM SAlphabeticZIndex Sfor SNausea/with Svomiting Sreferring Syou Sto SR11.2. SVerify Scode Sselection Sin Sthe
STabula Sr SList.
AZpatient Sis Sdiagnosed Sas Shaving Sboth Sacute Sand Schronic Stonsillitis. SHow Sis Sthis Sreported Sin SICD-10-
CM? S- Scorrect Sanswer-Correct SAnswer:
d. SThe Sacute Stonsillitis Sis Sreported Sfirst; Sthe Schronic Stonsillitis Sis Sreported Ssecond.
Response SFeedback:
, Rationale: SCoding Sacute Sand Schronic Sconditions Sin SICD-10-
CM SfollowsZthe Scoding Sguidelines SI.B.8. SIf Sthe Ssame Scondition Sis Sdescribed Sas Sboth Sacute S(subacute) Sand Sch
Sronic, Sand Sseparate Ssubentries Sexist Sin Sthe SAlphabetic SIndex Sat Sthe Ssame Sindentation Slevel, Scode Sboth
Sand Ssequence Sthe Sacute Sor S(subacute) Scode Sfirst.
A S10-year-
old Sgirl Sis Sscheduled Sfor Sher Syearly Sphysical Swith Sher Spediatrician. SAt Sthe Stime Sof Sthe Svisit, Sthe Spatient
Scomp Slains Sof Swatery Seyes, Sscratchy Sthroat Sand Sstuffy Snose Sfor Sthe Spast Stwo Sdays. SThe Sprovider
Sperforms Sthe Sphy Ssical. SHe Salso Sperforms Sa Shistory Sand Sexam Sand Streats Sthe Spatient Sfor Sa SURI Swith
Slow Smedical Sdecision Smaki Sng. SWhat SCPT® Scoding SisZreported Sfor Sthis Svisit? S- Scorrect Sanswer-Correct
SAnswer:
a. 99393, S 99213-25
Response SFeedback:
Rationale: SThe Sphysical Sexam Scode Sis Sselected Sfrom Sthe SPreventive SMedicine SServices Sand Sselected
Sbased Son Swhether Sthe Spatient Sis Snew Sor Sestablished Sand Sby Sage. SThe Spediatrician Salso Sevaluates Sand
Streats Sthe SU SRI. SThe Sadditional Swork Sfor Sthe SURI Sallows Sus Sto Sreport San Sestablished Spatient Soffice
Svisit. SModifier S25 Sis Sap Spended Sto Sthe Soffice Svisit Sto Sshow Sit Sis Sa Ssignificant Sand Sseparately Sidentifiable
Sservice Sfrom Sthe Spreventive Svisit.
Dr. SJones Sdocuments SMrs. SSmith's Scondition Shas Simproved Sduring Shis Sthird Svisit StoZher Shospital Sroom.
SUpo Sn Sentering Sthe Sroom, She Sfinds Sher Ssitting Sup Sin Sbed, Swatching Stelevision Sand Seating Sbreakfast. SDr.
SJones Sper Sforms Sa Sproblem Sfocused Sexam Sand Slow Smedical Sdecision Smaking. SWhat SCPT® Scode Sis
Sreported? S-
correct Sanswer-Correct SAnswer:
c. S99231
Response SFeedback:
Rationale: SThisZis Sa Ssubsequent Shospital Scare Svisit. SSubsequent Shospital Scare Scodes Sare S99231-
99233. SCodes Sin Sthis Ssection Srequire S2 Sof S3 Skey Scomponents Sbe Smet. SA Sproblem Sfocused Sexam Sand
Slow Sme Sdical Sdecision Smaking Ssupports Sa S99231.
A Ssoccer Splayer Shits Shis Shead Sduring San Sindoor Sgame Sand Sis Sadmitted Sto Sobservation Sto Swatch Sfor
Shead Stra Suma.
Admit Sdate/time: S01/21/20XX S8:12 SPM
S Detailed SHistory, SDetailed SExam, SLow
MDM SDischarge Sdate/time: S01/22/20XX
S
8:15 SAM
S
MANAGEMENT - REVIEW EXAM 2025
WITH CORRECT ANSWERS
A provider admits Mrs. Smith to the hospital. She is there for five days. The provider sees her each day sh
e's in the hospital. What subcategory of E/M codes would be used for days two, three and four? -
correct answer-Correct Answer:
c. Subsequent Hospital Care
Response Feedback:
Rationale: Codes from the Subsequent Hospital Care subcategory would be used for days two, three and f
our. The code for the first day would be from the Initial Hospital Care subcategory. Day five could be repor
ted with either subsequent hospital care or hospital care discharge depending on the role of the provider.
What modifier is used to report an evaluation and management service mandated by a court order? -
correct answer-Correct Answer:
c. 32
Response Feedback:
Rationale: Modifier 32 is used for services related to mandated consultation and/or related services by a
third-party payer, governmental, legislative or regulatory requirements.
What category of codes should be used to report an evaluation and management service provided to a p
atient in a psychiatric residential treatment center? - correct answer-Correct Answer:
c. Nursing facility services
Response Feedback:
Rationale: The guidelines for NursingZFacility ServicesZstate, "These codes should also be used to report e
valuation and management services provided to a patient in a psychiatric residential treatment center."
A patient is seen by Dr. B who is covering on call services for Dr. A. The patient is an established patient wi
th Dr. A. but she has notZbeen seen by Dr. B. before. Which E/M subcategory is appropriate to report the s
ervices provided by Dr. B? - correct answer-Correct Answer:
,c. SEstablished Spatient Soffice Svisit
Response SFeedback:
Rationale: SAccording Sto Sthe SE/M SGuideline Sfor SNew Sand SEstablished SPatient, Swhen Sa Sprovider Sis Son Scall
Sor Sc SoveringZfor Sanother Sprovider, Sthe Spatient's Sencounter Swill Sbe Sclassified Sas Sit Swould ShaveZbeen Sby
Sthe Sprovi Sder Swho Sis Snot Savailable. SIn Sthis Sinstance, SDr. SB Swould Sreport San Sestablished Spatient
Soffice Svisit.
A SPCP Stransfers Sa Spatient Sto Sa Scardiologist Sfor Smanagement Sof Sthe Spatient's Scongestive Sheart Sfailure.
SThe Sc Sardiologist Sexamines Sthe Spatient, Sdiscusses Streatment Soptions Sand Sschedules Sa Sstress StestZfor
Sthis Snew Spati Sent. SA Sreport Sis Ssent Sto Sthe SPCP Sdetailing Sthe Sfindings Sof Sthe Soffice Svisit, Sresults Sof Sthe
Sstress Stest Sand Sintent Sto Smanage Sand Streat Sthe Scongestive Sheart Sfailure. SAn SE/M Scode Swould Sbe
Sselected Sfrom Swhat Ssubcategor Sy Sfor Sthe Scardiologist? S- Scorrect Sanswer-Correct SAnswer:
a. New Spatient Soffice Svisit
Response SFeedback:
Rationale: SThe SPCP Stransferred Sthe Spatient Sto Sthe Scardiologist Sto Smanage/treat Sthe Scongestive Sheart Sfailur
e. SThe Scardiologist Saccepted Sthe Stransfer Sof Scare Sof Sthe SpatientZand Ssent Sa Sletter Sto Sthe SPCP Swith
Sfindings So Sf Sthe Sfirst Svisit Sand Sstress Stest. SThis Swould Sbe Scoded SasZa Snew Spatient Ssince Sthe
Scardiologist Saccepted Sthe Sp Satient Sand SisZtaking Sover Sthe Scare Sof Sa Sspecific Sproblem.
WhatZICD-10-CM Scode SisZreported Sfor Snausea Sand Svomiting? S- Scorrect Sanswer-Correct SAnswer:
b. R11.2
Response SFeedback:
Rationale: SLook Sin Sthe SICD-10-
CM SAlphabeticZIndex Sfor SNausea/with Svomiting Sreferring Syou Sto SR11.2. SVerify Scode Sselection Sin Sthe
STabula Sr SList.
AZpatient Sis Sdiagnosed Sas Shaving Sboth Sacute Sand Schronic Stonsillitis. SHow Sis Sthis Sreported Sin SICD-10-
CM? S- Scorrect Sanswer-Correct SAnswer:
d. SThe Sacute Stonsillitis Sis Sreported Sfirst; Sthe Schronic Stonsillitis Sis Sreported Ssecond.
Response SFeedback:
, Rationale: SCoding Sacute Sand Schronic Sconditions Sin SICD-10-
CM SfollowsZthe Scoding Sguidelines SI.B.8. SIf Sthe Ssame Scondition Sis Sdescribed Sas Sboth Sacute S(subacute) Sand Sch
Sronic, Sand Sseparate Ssubentries Sexist Sin Sthe SAlphabetic SIndex Sat Sthe Ssame Sindentation Slevel, Scode Sboth
Sand Ssequence Sthe Sacute Sor S(subacute) Scode Sfirst.
A S10-year-
old Sgirl Sis Sscheduled Sfor Sher Syearly Sphysical Swith Sher Spediatrician. SAt Sthe Stime Sof Sthe Svisit, Sthe Spatient
Scomp Slains Sof Swatery Seyes, Sscratchy Sthroat Sand Sstuffy Snose Sfor Sthe Spast Stwo Sdays. SThe Sprovider
Sperforms Sthe Sphy Ssical. SHe Salso Sperforms Sa Shistory Sand Sexam Sand Streats Sthe Spatient Sfor Sa SURI Swith
Slow Smedical Sdecision Smaki Sng. SWhat SCPT® Scoding SisZreported Sfor Sthis Svisit? S- Scorrect Sanswer-Correct
SAnswer:
a. 99393, S 99213-25
Response SFeedback:
Rationale: SThe Sphysical Sexam Scode Sis Sselected Sfrom Sthe SPreventive SMedicine SServices Sand Sselected
Sbased Son Swhether Sthe Spatient Sis Snew Sor Sestablished Sand Sby Sage. SThe Spediatrician Salso Sevaluates Sand
Streats Sthe SU SRI. SThe Sadditional Swork Sfor Sthe SURI Sallows Sus Sto Sreport San Sestablished Spatient Soffice
Svisit. SModifier S25 Sis Sap Spended Sto Sthe Soffice Svisit Sto Sshow Sit Sis Sa Ssignificant Sand Sseparately Sidentifiable
Sservice Sfrom Sthe Spreventive Svisit.
Dr. SJones Sdocuments SMrs. SSmith's Scondition Shas Simproved Sduring Shis Sthird Svisit StoZher Shospital Sroom.
SUpo Sn Sentering Sthe Sroom, She Sfinds Sher Ssitting Sup Sin Sbed, Swatching Stelevision Sand Seating Sbreakfast. SDr.
SJones Sper Sforms Sa Sproblem Sfocused Sexam Sand Slow Smedical Sdecision Smaking. SWhat SCPT® Scode Sis
Sreported? S-
correct Sanswer-Correct SAnswer:
c. S99231
Response SFeedback:
Rationale: SThisZis Sa Ssubsequent Shospital Scare Svisit. SSubsequent Shospital Scare Scodes Sare S99231-
99233. SCodes Sin Sthis Ssection Srequire S2 Sof S3 Skey Scomponents Sbe Smet. SA Sproblem Sfocused Sexam Sand
Slow Sme Sdical Sdecision Smaking Ssupports Sa S99231.
A Ssoccer Splayer Shits Shis Shead Sduring San Sindoor Sgame Sand Sis Sadmitted Sto Sobservation Sto Swatch Sfor
Shead Stra Suma.
Admit Sdate/time: S01/21/20XX S8:12 SPM
S Detailed SHistory, SDetailed SExam, SLow
MDM SDischarge Sdate/time: S01/22/20XX
S
8:15 SAM
S
