MOA 193 - Current Procedural Term Coding » Spring 2023 » Digital Review & Assignment 6
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Question #1
How many key factors are there to consider when assigning the appropriate E&M code?
A.
3
B.
4
C.
2
D.
5
Question #2
What are the contributing factors to consider when assigning the appropriate E&M code?
A.
resources used by a physician to provide care to a patient
B.
counseling, coordination of care, presenting problem, and time
C.
Medicare Administrative Contractors and private payers
D.
the patient's history, examination, and medical decision making
Question #3
Why is it crucial to thoroughly document all relevant information related to the key factors in the patient's health record?
A.
to provide care to a patient
B.
to avoid confusion
C.
to assign the appropriate E&M code
D.
to self-determine which set of guidelines to follow
Question #4
What are the resources used by a physician to provide care to a patient?
A.
counseling, coordination of care, presenting problem, and time
B.
the patient's history, examination, and medical decision making
C.
Medicare Administrative Contractors and private payers
D.
portions of the 1995 and 1997 Documentation Guidelines
Question #5
Which two sets of guidelines are physicians and qualified healthcare professionals allowed to self-determine to follow when determining the appropriate E&M service level to report?
A.
the 1995 and 2005 Documentation Guidelines
B.
the 1995 and 1997 Documentation Guidelines
C.
the 1997 and 2007 Documentation Guidelines
D.
the 1995 and 1998 Documentation Guidelines
Question #6
Why did many Medicare Administrative Contractors and private payers have to create additional rules?
A.
to assign the appropriate E&M code
B.
to avoid confusion
C.
to specify that portions of the 1995 and 1997 guidelines could be combined
D.
to provide care to a patient
Question #7
How many levels of E&M services are typically found in each E&M code category or subcategory?
A.
3-5
B.
1-2
C.
6-8
D.
9-10
Question #8
What is the main point of having various levels of E&M services?
A.
to provide a range of options for patients
B.
to avoid linkage to fraudulent practices and behaviors
C.
to ensure accurate coding
D.
to reflect diversity in each healthcare professional's skills, knowledge, and effort
Question #9
What determines the level of E&M service chosen?
A.
how much time the physician spends providing the service
B.
the patient's insurance coverage
C.
how much time the patient spends with the physician
D.
how complex and detailed the medical encounter is
Question #10
What is the definition of a "new patient" according to the AMA CPT E&M guidelines?
A.
Both
B.
Neither one of the options
C.
An individual who has received professional face-to-face services within the last three years from the physician or qualified healthcare professional who is currently providing E&M services
D.
An individual who has not received any professional face-to-face services from the physician or qualified healthcare professional providing the current E&M service within the preceding three years
Question #11
What is the definition of an "established patient" according to the AMA CPT E&M guidelines?
A.
An individual who has not received any professional face-to-face services from the physician or qualified healthcare professional providing the current E&M service within the preceding three years
B.
An individual who has received professional face-to-face services within the last three years from the physician or qualified healthcare professional who is currently providing E&M services
C.
Both
D.
Neither one of the options
Question #12
What is the primary reason for accurate E&M coding?
A.
To ensure healthcare providers receive appropriate reimbursement
B.
All of the reasons listed apply
C.
To generate reliable data for healthcare analysis
D.
To avoid audits and investigations
Question #13
According to the Centers for Medicare & Medicaid Services, what is the likelihood of payment errors for E&M services compared to other Part B Medicare services?
A.
10%
B.
50%
C.
75%
D.
25%
Question #14
What is the potential consequence of failing to code E&M services correctly?
A.
Underpayment
B.
All of the reasons listed apply
C.
Denial of reimbursement
D.
Overpayment
Question #15
How can proper E&M coding help with quality improvement initiatives?
A.
By providing an accurate record of the level of care delivered to each patient
B.
By identifying trends and patterns over time
C.
By enabling the collection and comparison of data between different providers and organizations
D.
All of the reasons listed apply
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