E/M Coding Exam 2026-2027: 100
Questions & Answers for CPT Medical
Coding Certification Success
Description:
Master Evaluation & Management coding for 2026-2027 with 100 exam-style questions
covering office visits, hospital care, critical care, telehealth, MDM, and modifiers.
Perfect for CPC, CCS, CIC, and COC certification prep.
Download the complete practice exam with answer explanations now and pass your medical
coding exam on the first try!
, E/M Coding Exam 2026-2027 (100 Q&A)
Section 1: Evaluation and Management Subcategories and Patient Status
Question 1
A patient is seen by Dr. B, who is covering on-call services for Dr. A. The patient is an
established patient with Dr. A but has not been seen by Dr. B previously. Which E/M
subcategory is appropriate to report the services provided by Dr. B?
A. New patient office visit
B. Established patient office visit
C. Consultation
D. Confirmatory consultation
Answer: B
Explanation: When a covering provider (Dr. B) sees an established patient of another
provider (Dr. A) in the same group practice and same specialty, the service is reported using
the established patient E/M code subcategory. The patient's relationship with the practice, not
the individual provider, determines new versus established status.
Question 2
A primary care physician transfers a patient to a cardiologist for management of the patient's
congestive heart failure. The cardiologist examines the patient, discusses treatment options,
and schedules a stress test for this new patient. A report is sent to the PCP detailing the
findings of the office visit, results of the stress test, and intent to manage and treat the
congestive heart failure. An E/M code would be selected from what subcategory for the
cardiologist?
A. Established patient office visit
B. Consultation
C. New patient office visit
D. Confirmatory consultation
Answer: C
Explanation: The cardiologist is seeing the patient for the first time in a different specialty
and group practice. Since the cardiologist has not provided any face-to-face services to this
patient within the past three years, the service is reported using the new patient office visit
subcategory. The transfer of care does not automatically qualify as a consultation.
,Question 3
What category of codes should be used to report an evaluation and management service
provided to a patient in a psychiatric residential treatment center?
A. Inpatient hospital services
B. Nursing facility services
C. Psychiatric facility services
D. Home services
Answer: B
Explanation: Residential treatment centers are classified under nursing facility services for
E/M coding purposes. The CPT code set includes nursing facility services (99304-99318) for
patients in skilled nursing facilities, long-term care facilities, and residential treatment
centers.
Section 2: History of Present Illness (HPI) Elements
Question 4
Which elements of the History of Present Illness (HPI) are met in the following statement?
"Patient complains of headache and blurry vision for the past 3 days."
A. Location, severity, and duration
B. Location, quality, and duration
C. Quality, timing, and context
D. Duration, modifying factors, and associated signs
Answer: B
Explanation: The statement includes location (headache and blurry vision—head is the
location for headache, eyes for vision), quality (blurry describes the quality of the vision
disturbance), and duration (past 3 days). No severity, timing, context, modifying factors, or
associated signs are documented.
Section 3: E/M Coding Tools and Resources
Question 5
Where are clinical examples for evaluation and management codes found in the CPT code
book?
A. Appendix A
B. Appendix B
C. Appendix C
, D. Appendix D
Answer: C
Explanation: Appendix C of the CPT code book contains clinical examples for evaluation
and management codes. These examples illustrate typical patient presentations and
documentation requirements for each level of E/M service.
Section 4: Emergency Department and Observation Services
Question 6
EMS brought a 31-year-old motor vehicle accident patient to the Emergency Department.
After a comprehensive history, a comprehensive examination, and medical decision making
of high complexity, the provider determines the patient has multiple internal injuries and
needs immediate surgery. What level ED code is reported?
A. 99283
B. 99284
C. 99285
D. 99291
Answer: C
Explanation: Emergency department code 99285 represents the highest level of ED service,
requiring comprehensive history, comprehensive examination, and high complexity medical
decision making. This level is appropriate for patients with life-threatening or severe
conditions requiring immediate intervention.
Question 7
A soccer player hits his head during an indoor game and is admitted to observation to watch
for head trauma. Admit date/time: 01/21/20XX 8:12 PM. Detailed History, Detailed Exam,
Low MDM. Discharge date/time: 01/22/20XX 8:15 AM. Discharge time: 20 minutes. What
CPT code(s) is/are reported for the admission and discharge to Observation Care?
A. 99218 only
B. 99217 only
C. 99218, 99217
D. 99221, 99238
Answer: C
Explanation: Observation care requires separate reporting of admission and discharge
services when the patient stays less than 24 hours. Code 99218 represents observation
Questions & Answers for CPT Medical
Coding Certification Success
Description:
Master Evaluation & Management coding for 2026-2027 with 100 exam-style questions
covering office visits, hospital care, critical care, telehealth, MDM, and modifiers.
Perfect for CPC, CCS, CIC, and COC certification prep.
Download the complete practice exam with answer explanations now and pass your medical
coding exam on the first try!
, E/M Coding Exam 2026-2027 (100 Q&A)
Section 1: Evaluation and Management Subcategories and Patient Status
Question 1
A patient is seen by Dr. B, who is covering on-call services for Dr. A. The patient is an
established patient with Dr. A but has not been seen by Dr. B previously. Which E/M
subcategory is appropriate to report the services provided by Dr. B?
A. New patient office visit
B. Established patient office visit
C. Consultation
D. Confirmatory consultation
Answer: B
Explanation: When a covering provider (Dr. B) sees an established patient of another
provider (Dr. A) in the same group practice and same specialty, the service is reported using
the established patient E/M code subcategory. The patient's relationship with the practice, not
the individual provider, determines new versus established status.
Question 2
A primary care physician transfers a patient to a cardiologist for management of the patient's
congestive heart failure. The cardiologist examines the patient, discusses treatment options,
and schedules a stress test for this new patient. A report is sent to the PCP detailing the
findings of the office visit, results of the stress test, and intent to manage and treat the
congestive heart failure. An E/M code would be selected from what subcategory for the
cardiologist?
A. Established patient office visit
B. Consultation
C. New patient office visit
D. Confirmatory consultation
Answer: C
Explanation: The cardiologist is seeing the patient for the first time in a different specialty
and group practice. Since the cardiologist has not provided any face-to-face services to this
patient within the past three years, the service is reported using the new patient office visit
subcategory. The transfer of care does not automatically qualify as a consultation.
,Question 3
What category of codes should be used to report an evaluation and management service
provided to a patient in a psychiatric residential treatment center?
A. Inpatient hospital services
B. Nursing facility services
C. Psychiatric facility services
D. Home services
Answer: B
Explanation: Residential treatment centers are classified under nursing facility services for
E/M coding purposes. The CPT code set includes nursing facility services (99304-99318) for
patients in skilled nursing facilities, long-term care facilities, and residential treatment
centers.
Section 2: History of Present Illness (HPI) Elements
Question 4
Which elements of the History of Present Illness (HPI) are met in the following statement?
"Patient complains of headache and blurry vision for the past 3 days."
A. Location, severity, and duration
B. Location, quality, and duration
C. Quality, timing, and context
D. Duration, modifying factors, and associated signs
Answer: B
Explanation: The statement includes location (headache and blurry vision—head is the
location for headache, eyes for vision), quality (blurry describes the quality of the vision
disturbance), and duration (past 3 days). No severity, timing, context, modifying factors, or
associated signs are documented.
Section 3: E/M Coding Tools and Resources
Question 5
Where are clinical examples for evaluation and management codes found in the CPT code
book?
A. Appendix A
B. Appendix B
C. Appendix C
, D. Appendix D
Answer: C
Explanation: Appendix C of the CPT code book contains clinical examples for evaluation
and management codes. These examples illustrate typical patient presentations and
documentation requirements for each level of E/M service.
Section 4: Emergency Department and Observation Services
Question 6
EMS brought a 31-year-old motor vehicle accident patient to the Emergency Department.
After a comprehensive history, a comprehensive examination, and medical decision making
of high complexity, the provider determines the patient has multiple internal injuries and
needs immediate surgery. What level ED code is reported?
A. 99283
B. 99284
C. 99285
D. 99291
Answer: C
Explanation: Emergency department code 99285 represents the highest level of ED service,
requiring comprehensive history, comprehensive examination, and high complexity medical
decision making. This level is appropriate for patients with life-threatening or severe
conditions requiring immediate intervention.
Question 7
A soccer player hits his head during an indoor game and is admitted to observation to watch
for head trauma. Admit date/time: 01/21/20XX 8:12 PM. Detailed History, Detailed Exam,
Low MDM. Discharge date/time: 01/22/20XX 8:15 AM. Discharge time: 20 minutes. What
CPT code(s) is/are reported for the admission and discharge to Observation Care?
A. 99218 only
B. 99217 only
C. 99218, 99217
D. 99221, 99238
Answer: C
Explanation: Observation care requires separate reporting of admission and discharge
services when the patient stays less than 24 hours. Code 99218 represents observation
