Introduction to Medical Billing and Coding – Exam 4

What is the definition of a new patient?

Which type of visit cannot use time as the determining factor for the level of the visit?

Which answer(s) are TRUE for reporting Prolonged Service codes 99358?

The provider is performing their monthly rounds at the nursing facility. The provider performs a medically appropriate history and exam with medical decision making of moderate complexity. What code(s) are used to bill for these services?

Which services below are included in Critical Care Services?

When the patient is seen only by the nurse (99211) what is the requirement for charging this code?

Which answer is FALSE for Inpatient Consultation codes?

What is the appropriate code for a neonate (23 days of age) who weighs 2000 grams that requires continuing intensive care services (they are not critically ill but still require intensive observation and frequent interventions)?

Which answer(s) identify the correct guidelines for billing Hospital Inpatient and Observation Care Services codes 99234 – 99236?

The provider is called to the assisted living facility to see an established patient that has a severe cough. The provider performs a medically appropriate history and exam with moderate medical decision making. What code(s) are used to bill for these services?

Patient is admitted to the hospital on Sunday for chest pain and is discharged on Wednesday.
Sunday – medically appropriate history and exam, medical decision making high.
Monday – medically appropriate history and exam, medical decision making is moderate.
Tuesday – medically appropriate history and exam, and medical decision making is low.
Wednesday – medically appropriate history and exam, and medical decision making is low complexity. The provider documented 40 minutes of discharge management that they are billing for.
How would these hospital visits be charged for CPT and ICD-10 codes by the provider?

This new patient comes into the office for sinusitis and diabetes. The provider performs a medically appropriate history and exam with moderate medical decision making. The patient is a smoker and wants to quit but needs assistance in quitting. The provider also counsels the patient for 8 minutes on types of quitting methods that he has tried in the past, withdraw symptoms, and side effects of the prescription. What code(s) are used to bill for these services?

Through-out the CPT book, many codes identify services performed by “a qualified health care professional”. Which answer(s) appropriately defines the definition of a qualified health care professional?

Which statement is TRUE per CPT guidelines for Consultations?

This 42 year-old established female patient came into the office for her annual physical examination. The provider performed a comprehensive history and exam with medical decision making of moderate complexity. What code(s) are used to bill for these services?

This newborn baby was born in the birthing room at the hospital and the provider performed the history and examination on Monday. The next day the provider performed a second visit. What code(s) are used to bill for these services?

The provider documented they spent 60 minutes of critical care for 6:15am – 7:15 am with a patient for a myocardial infarction, later that day they document 42 minutes in critical care for irregular heart rates and dropping oxygen levels. Two hours later they document another 60 minutes at bedside in critical care and discussion with the family of patient de-escalation and palliative care. What code(s) are used to bill for these services?

The patient was admitted to the hospital on Monday. The provider performed a medically appropriate history and exam with medical decision making of moderate complexity. On Tuesday the provider saw the patient for a subsequent hospital visit and performed a medically appropriate history and exam with medical decision making of high complexity. On Wednesday the patient was discharged to go home and the provider spent 45 minutes preparing records and talking with the patient about their discharge and home care. What code(s) are used to bill for these services?

Which of the following are condisered a home or residence per the guidelines for services 99341 – 99345, and 99347 – 99350?

This is a new patient seen in the Emergency Department by the ED provider with chest pain. Labs, EKG, and other tests are ordered. The provider documented a medically appropriate history and exam, and medical decision making of high complexity. The ED provider calls the cardiologist to evaluate and admit the patient to the hospital. What code(s) are used to bill for these for the ED provider?