CPT Coding Scenarios Study Guide Test.
A patient who was on observation status for 48 hours is discharged from the hospital. The patient was
being observed after a motor vehicle accident for subdural hematoma, which was subsequently ruled
out. Code only the discharge services and diagnosis.
CPT Code: ________. - CORRECT ANSWER 99217
A 16-year-old female is being admitted by her family practice physician with a 2-week history of fatigue
and fever. It has been progressively getting worse. She is suffering from dehydration. The physician
performs a comprehensive history to look for explanations for her fatigue, including recent activity level
and recent sleep habits. A detailed examination is performed and she is diagnosed with mononucleosis
and admitted for treatment.
CPT Code: ________. - CORRECT ANSWER 99221
The patient is a 34-year-old established patient seen in the clinic by her dermatologist. She is followed
for extensive psoriasis involving her scalp, trunk, and arms. It has now worsened and spread to her
palms, and she is now also complaining of joint pain. The spread to her hands has made it difficult to do
many of her day-to-day tasks. A detailed history and examination are performed. The examination
includes inspection of the affected areas in addition to bending and rotation of joints. A long discussion
took place regarding a change in her medications to try to gain better control of her psoriasis and slow
down the systemic progression. Topical and systemic treatment was decided on.
CPT Code: ________. - CORRECT ANSWER 99214
The patient is a 52-year-old male from out of state visiting his daughter. He left his medications for his
benign hypertension at home and is now here in the clinic in need of a prescription. A problem focused
history and examination is performed and a prescription is given to the patient.
CPT Code: ________. - CORRECT ANSWER 99201
, A 38-year-old female has severe low back pain due to a trauma injury she experienced as a factory
worker 4 years ago. The chronic pain has become almost unbearable, and her internal medicine
physician cannot go any further with her treatment. An initial outpatient consultation is requested and
the patient is sent to see the pain management specialist for suggestions to control the chronic pain. A
comprehensive history is taken, including all of the pertinent information regarding her injury. During
the comprehensive examination the patient's gait and movement were observed. Moderate-complexity
decision making is performed, including different treatment options. A separate note is dictated to show
the requesting physician what results were found during the visit, and the decision on treatment of her
pain.
CPT Code: ________. - CORRECT ANSWER 99244
A 46-year-old male is admitted to the hospital with a progressive staphylococcal pneumonia that is not
responding to treatment. A request is made for the infectious disease physician on staff to render his
opinion for treatment. The patient is seen in initial inpatient consultation. An expanded problem focused
history and examination are performed. After looking at the sputum cultures, the physician decides on
the most effective antibiotic for treatment. The decision making is straightforward.
CPT Code: ________. - CORRECT ANSWER 99252
A 44-year-old patient, with chronic mastoiditis, was seen in consultation by the ENT specialist in the
office. Her physician was inquiring as to the advantages of surgery versus continued antibiotic treatment
when an acute flare comes on. The ENT specialist recommends surgery because of the increasing
severity with each acute flare. She is fearful of the surgery because of the need to go under general
anesthetic and a fear of permanent hearing loss. The physician performs an expanded problem focused
history to include the duration of this problem and how many acute flares a year the patient
experiences. An expanded problem focused examination and straightforward decision making is
completed. It is determined that with the number of acute flares a year and the increasing severity of
each case that surgery is recommended. The patient's fears are laid to rest and the patient decides to go
ahead with the surgery.
CPT - CORRECT ANSWER 99242
An 83-year-old patient is seen at the local nursing home. The patient suffers from severe COPD. Routine
labs were drawn on the patient by her primary doctor and her blood sugar came back abnormal. Fasting
glucose was then taken and was high. The endocrinologist was asked to render an opinion on a possible
diagnosis of diabetes. A problem focused history and examination and straightforward decision making
A patient who was on observation status for 48 hours is discharged from the hospital. The patient was
being observed after a motor vehicle accident for subdural hematoma, which was subsequently ruled
out. Code only the discharge services and diagnosis.
CPT Code: ________. - CORRECT ANSWER 99217
A 16-year-old female is being admitted by her family practice physician with a 2-week history of fatigue
and fever. It has been progressively getting worse. She is suffering from dehydration. The physician
performs a comprehensive history to look for explanations for her fatigue, including recent activity level
and recent sleep habits. A detailed examination is performed and she is diagnosed with mononucleosis
and admitted for treatment.
CPT Code: ________. - CORRECT ANSWER 99221
The patient is a 34-year-old established patient seen in the clinic by her dermatologist. She is followed
for extensive psoriasis involving her scalp, trunk, and arms. It has now worsened and spread to her
palms, and she is now also complaining of joint pain. The spread to her hands has made it difficult to do
many of her day-to-day tasks. A detailed history and examination are performed. The examination
includes inspection of the affected areas in addition to bending and rotation of joints. A long discussion
took place regarding a change in her medications to try to gain better control of her psoriasis and slow
down the systemic progression. Topical and systemic treatment was decided on.
CPT Code: ________. - CORRECT ANSWER 99214
The patient is a 52-year-old male from out of state visiting his daughter. He left his medications for his
benign hypertension at home and is now here in the clinic in need of a prescription. A problem focused
history and examination is performed and a prescription is given to the patient.
CPT Code: ________. - CORRECT ANSWER 99201
, A 38-year-old female has severe low back pain due to a trauma injury she experienced as a factory
worker 4 years ago. The chronic pain has become almost unbearable, and her internal medicine
physician cannot go any further with her treatment. An initial outpatient consultation is requested and
the patient is sent to see the pain management specialist for suggestions to control the chronic pain. A
comprehensive history is taken, including all of the pertinent information regarding her injury. During
the comprehensive examination the patient's gait and movement were observed. Moderate-complexity
decision making is performed, including different treatment options. A separate note is dictated to show
the requesting physician what results were found during the visit, and the decision on treatment of her
pain.
CPT Code: ________. - CORRECT ANSWER 99244
A 46-year-old male is admitted to the hospital with a progressive staphylococcal pneumonia that is not
responding to treatment. A request is made for the infectious disease physician on staff to render his
opinion for treatment. The patient is seen in initial inpatient consultation. An expanded problem focused
history and examination are performed. After looking at the sputum cultures, the physician decides on
the most effective antibiotic for treatment. The decision making is straightforward.
CPT Code: ________. - CORRECT ANSWER 99252
A 44-year-old patient, with chronic mastoiditis, was seen in consultation by the ENT specialist in the
office. Her physician was inquiring as to the advantages of surgery versus continued antibiotic treatment
when an acute flare comes on. The ENT specialist recommends surgery because of the increasing
severity with each acute flare. She is fearful of the surgery because of the need to go under general
anesthetic and a fear of permanent hearing loss. The physician performs an expanded problem focused
history to include the duration of this problem and how many acute flares a year the patient
experiences. An expanded problem focused examination and straightforward decision making is
completed. It is determined that with the number of acute flares a year and the increasing severity of
each case that surgery is recommended. The patient's fears are laid to rest and the patient decides to go
ahead with the surgery.
CPT - CORRECT ANSWER 99242
An 83-year-old patient is seen at the local nursing home. The patient suffers from severe COPD. Routine
labs were drawn on the patient by her primary doctor and her blood sugar came back abnormal. Fasting
glucose was then taken and was high. The endocrinologist was asked to render an opinion on a possible
diagnosis of diabetes. A problem focused history and examination and straightforward decision making
