Aapc Chapter 19 - Evaluation And Management -
Review Exam 2025/2026 With Correct Answers
A vprovider vadmits vMrs. vSmith vto vthe vhospital. vShe vis vthere vfor vfive vdays. vThe vprovider vsees vher
veach vday vsh ve's vin vthe vhospital. vWhat vsubcategory vof vE/M vcodes vwould vbe vused vfor vdays
vtwo, vthree vand vfour? v-
correct vanswer-Correct vAnswer:
c. vSubsequent vHospital vCare
Response vFeedback:
Rationale: vCodes vfrom vthe vSubsequent vHospital vCare vsubcategory vwould vbe vused vfor vdays vtwo,
vthree vand vf vour. vThe vcode vfor vthe vfirst vday vwould vbe vfrom vthe vInitial vHospital vCare
vsubcategory. vDay vfive vcould vbe vrepor vted vwith veither vsubsequent vhospital vcare vor vhospital vcare
vdischarge vdepending von vthe vrole vof vthe vprovider.
What vmodifier vis vused vto vreport van vevaluation vand vmanagement vservice vmandated vby va vcourt
vorder? v- vcorrect vanswer-Correct vAnswer:
c. v32
,Response vFeedback:
Rationale: vModifier v32 vis vused vfor vservices vrelated vto vmandated vconsultation vand/or vrelated
vservices vby va vthird-party vpayer, vgovernmental, vlegislative vor vregulatory vrequirements.
What vcategory vof vcodes vshould vbe vused vto vreport van vevaluation vand vmanagement vservice vprovided
vto va vp vatient vin va vpsychiatric vresidential vtreatment vcenter? v- vcorrect vanswer-Correct vAnswer:
c. vNursing vfacility vservices
Response vFeedback:
Rationale: vThe vguidelines vfor vNursingZFacility vServicesZstate, v"These vcodes vshould valso vbe vused vto
vreport ve vvaluation vand vmanagement vservices vprovided vto va vpatient vin va vpsychiatric vresidential
vtreatment vcenter."
A vpatient vis vseen vby vDr. vB vwho vis vcovering von vcall vservices vfor vDr. vA. vThe vpatient vis van
vestablished vpatient vwi vth vDr. vA. vbut vshe vhas vnotZbeen vseen vby vDr. vB. vbefore. vWhich vE/M
vsubcategory vis vappropriate vto vreport vthe vs vervices vprovided vby vDr. vB? v- vcorrect vanswer-Correct
vAnswer:
,c. vEstablished vpatient voffice vvisit
Response vFeedback:
Rationale: vAccording vto vthe vE/M vGuideline vfor vNew vand vEstablished vPatient, vwhen va vprovider vis
von vcall vor vc voveringZfor vanother vprovider, vthe vpatient's vencounter vwill vbe vclassified vas vit vwould
vhaveZbeen vby vthe vprovi vder vwho vis vnot vavailable. vIn vthis vinstance, vDr. vB vwould vreport van
vestablished vpatient voffice vvisit.
A vPCP vtransfers va vpatient vto va vcardiologist vfor vmanagement vof vthe vpatient's vcongestive vheart
vfailure. vThe vc vardiologist vexamines vthe vpatient, vdiscusses vtreatment voptions vand vschedules va
vstress vtestZfor vthis vnew vpati vent. vA vreport vis vsent vto vthe vPCP vdetailing vthe vfindings vof vthe
voffice vvisit, vresults vof vthe vstress vtest vand vintent vto vmanage vand vtreat vthe vcongestive vheart
vfailure. vAn vE/M vcode vwould vbe vselected vfrom vwhat vsubcategor vy vfor vthe vcardiologist? v-
vcorrect vanswer-Correct vAnswer:
a. New vpatient voffice vvisit
Response vFeedback:
Rationale: vThe vPCP vtransferred vthe vpatient vto vthe vcardiologist vto vmanage/treat vthe vcongestive vheart
vfailur
e. vThe vcardiologist vaccepted vthe vtransfer vof vcare vof vthe vpatientZand vsent va vletter vto vthe vPCP
vwith vfindings vo vf vthe vfirst vvisit vand vstress vtest. vThis vwould vbe vcoded vasZa vnew vpatient vsince
vthe vcardiologist vaccepted vthe vp vatient vand visZtaking vover vthe vcare vof va vspecific vproblem.
WhatZICD-10-CM vcode visZreported vfor vnausea vand vvomiting? v- vcorrect vanswer-Correct vAnswer:
b. R11.2
, Response vFeedback:
Rationale: vLook vin vthe vICD-10-
CM vAlphabeticZIndex vfor vNausea/with vvomiting vreferring vyou vto vR11.2. vVerify vcode vselection vin
vthe vTabula vr vList.
AZpatient vis vdiagnosed vas vhaving vboth vacute vand vchronic vtonsillitis. vHow vis vthis vreported vin vICD-
10-CM? v- vcorrect vanswer-Correct vAnswer:
d. vThe vacute vtonsillitis vis vreported vfirst; vthe vchronic vtonsillitis vis vreported vsecond.
Response vFeedback:
Review Exam 2025/2026 With Correct Answers
A vprovider vadmits vMrs. vSmith vto vthe vhospital. vShe vis vthere vfor vfive vdays. vThe vprovider vsees vher
veach vday vsh ve's vin vthe vhospital. vWhat vsubcategory vof vE/M vcodes vwould vbe vused vfor vdays
vtwo, vthree vand vfour? v-
correct vanswer-Correct vAnswer:
c. vSubsequent vHospital vCare
Response vFeedback:
Rationale: vCodes vfrom vthe vSubsequent vHospital vCare vsubcategory vwould vbe vused vfor vdays vtwo,
vthree vand vf vour. vThe vcode vfor vthe vfirst vday vwould vbe vfrom vthe vInitial vHospital vCare
vsubcategory. vDay vfive vcould vbe vrepor vted vwith veither vsubsequent vhospital vcare vor vhospital vcare
vdischarge vdepending von vthe vrole vof vthe vprovider.
What vmodifier vis vused vto vreport van vevaluation vand vmanagement vservice vmandated vby va vcourt
vorder? v- vcorrect vanswer-Correct vAnswer:
c. v32
,Response vFeedback:
Rationale: vModifier v32 vis vused vfor vservices vrelated vto vmandated vconsultation vand/or vrelated
vservices vby va vthird-party vpayer, vgovernmental, vlegislative vor vregulatory vrequirements.
What vcategory vof vcodes vshould vbe vused vto vreport van vevaluation vand vmanagement vservice vprovided
vto va vp vatient vin va vpsychiatric vresidential vtreatment vcenter? v- vcorrect vanswer-Correct vAnswer:
c. vNursing vfacility vservices
Response vFeedback:
Rationale: vThe vguidelines vfor vNursingZFacility vServicesZstate, v"These vcodes vshould valso vbe vused vto
vreport ve vvaluation vand vmanagement vservices vprovided vto va vpatient vin va vpsychiatric vresidential
vtreatment vcenter."
A vpatient vis vseen vby vDr. vB vwho vis vcovering von vcall vservices vfor vDr. vA. vThe vpatient vis van
vestablished vpatient vwi vth vDr. vA. vbut vshe vhas vnotZbeen vseen vby vDr. vB. vbefore. vWhich vE/M
vsubcategory vis vappropriate vto vreport vthe vs vervices vprovided vby vDr. vB? v- vcorrect vanswer-Correct
vAnswer:
,c. vEstablished vpatient voffice vvisit
Response vFeedback:
Rationale: vAccording vto vthe vE/M vGuideline vfor vNew vand vEstablished vPatient, vwhen va vprovider vis
von vcall vor vc voveringZfor vanother vprovider, vthe vpatient's vencounter vwill vbe vclassified vas vit vwould
vhaveZbeen vby vthe vprovi vder vwho vis vnot vavailable. vIn vthis vinstance, vDr. vB vwould vreport van
vestablished vpatient voffice vvisit.
A vPCP vtransfers va vpatient vto va vcardiologist vfor vmanagement vof vthe vpatient's vcongestive vheart
vfailure. vThe vc vardiologist vexamines vthe vpatient, vdiscusses vtreatment voptions vand vschedules va
vstress vtestZfor vthis vnew vpati vent. vA vreport vis vsent vto vthe vPCP vdetailing vthe vfindings vof vthe
voffice vvisit, vresults vof vthe vstress vtest vand vintent vto vmanage vand vtreat vthe vcongestive vheart
vfailure. vAn vE/M vcode vwould vbe vselected vfrom vwhat vsubcategor vy vfor vthe vcardiologist? v-
vcorrect vanswer-Correct vAnswer:
a. New vpatient voffice vvisit
Response vFeedback:
Rationale: vThe vPCP vtransferred vthe vpatient vto vthe vcardiologist vto vmanage/treat vthe vcongestive vheart
vfailur
e. vThe vcardiologist vaccepted vthe vtransfer vof vcare vof vthe vpatientZand vsent va vletter vto vthe vPCP
vwith vfindings vo vf vthe vfirst vvisit vand vstress vtest. vThis vwould vbe vcoded vasZa vnew vpatient vsince
vthe vcardiologist vaccepted vthe vp vatient vand visZtaking vover vthe vcare vof va vspecific vproblem.
WhatZICD-10-CM vcode visZreported vfor vnausea vand vvomiting? v- vcorrect vanswer-Correct vAnswer:
b. R11.2
, Response vFeedback:
Rationale: vLook vin vthe vICD-10-
CM vAlphabeticZIndex vfor vNausea/with vvomiting vreferring vyou vto vR11.2. vVerify vcode vselection vin
vthe vTabula vr vList.
AZpatient vis vdiagnosed vas vhaving vboth vacute vand vchronic vtonsillitis. vHow vis vthis vreported vin vICD-
10-CM? v- vcorrect vanswer-Correct vAnswer:
d. vThe vacute vtonsillitis vis vreported vfirst; vthe vchronic vtonsillitis vis vreported vsecond.
Response vFeedback:
