EXAM 2025 QUESTIONS AND ANSWERS
What modifier is commonly used if a provider performs an unrelated office visit during a post
operative period? - ANS 24
PQRS measure G8477 refers to what? - ANS Patient encounter documented using a certified
EHR system
What are radially arranged natural fibers in the eye that suspend the crystalline lens from the
ciliary body and hold it in position? - ANS Zonules
Prone - ANS face down/ palm down
For an E&M service, what is the minimum number of elements required by the Documentation
Guidelines for a Detailed Physical Exam? - ANS Nine
Does Medicare have standard guidelines physicians must follow for the "written interpretation
of medical findings?" - ANS No
Is it a federal requirement to do self audits of patient charts and coding in private practices? -
ANS No
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, -endo - ANS within
coronal - ANS vertical body plain, divides the body into front & back sections
-oid - ANS like
supine - ANS face up/palm up
What is an e-claim clearing house? - ANS A company that a provider contracts with to
transmit claims legally and safely between the provider and the insurance companies
What are surgically implanted plastic half rings that change the shape of the cornea? -
ANS Intacs
What is medical insurance? - ANS A written policy between the individual (policy holder) and
health plan (payer)
What is "QMB" Medicaid? - ANS Qualified Medicaid Beneficiary- limited benefits
What are the four "E" modifiers used for? - ANS For indicating which lid is involved. E1=
Upper left eyelid, E2= Lower left eyelid, E3= Upper right eyelid, E4= Lower right eyelid
How many "E" modifiers are there? - ANS 4
On the CMS 1500, what box is designated to provide additional information to the payer? -
ANS 19
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, -retro - ANS behind, back
The documentation of each patient encounter should include which items(s): - ANS Reason
for the encounter and assessment, medical plan and date, and legible identity of the observer
trans- - ANS across, through
Is it acceptable for a staff person to correct a CPT or ICD-10 code on a route slip or claim
without the consent of the doctor? - ANS No
What are the Key Components of E and M Coding? - ANS Medical Decision Making,
Examination, and History
What modifier is used if two non bundled surgical procedures are performed on the same eye
at the same visit? - ANS 51
What modifier should you use on the office visit if a patient comes in with allergic conjunctivitis
during their global post-op period? - ANS 24
What does RBRVS stand for? - ANS Resource-Based Relative Value Scale
List the Contributory Factors of E and M Coding - ANS Counseling, Coordination of Care,
Presenting Problem, and Time
When billing for post cataract eyewear through Medicare, what is the date of service? -
ANS The date the eyewear is dispensed
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anterior or ventral - ANS at or near front surface of the body
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