Exam 38176000 Med Billing & Coding

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Ashley Kailian
1800 N.Hills Rd Apt 406
York, Pa, 17406
Student Number: 21648849

Examination: 38176000

1.List the three goals of Physician Payment Reform.
1. Decrease Medicare expenditures, Re-Distribute physicians payments more equitibly, Ensure quality health care at a reasonable rate.

2. Mr. Jones is admitted to the hospital by the orthopedic surgeon for severe hip pain. The ortho surgeon provides an
initial hospital visit during which it’s determined that Mr. Jones has a fractured hip that will require surgical intervention. Mr. Jones is taken later that day to the OR, where the
doctor performs the surgical procedure to repair Mr. Jones’ hip. Which modifier would you use for the hospital visit?
2. Modifier-57

3. List and define the three components of the relative value unit.
3.Physician work, Practice expense, and Malpractice.

4.List the three types of persons eligible for Medicare.
4 Elderly, Disabled by Social Security Administration and Renal Failure patients (ESRD).

5. Name the six basic location methods to locate main terms in the index of CPT
5. procedure/service
synonym
eponymous
anatomic site
condition of disease
abbreviations

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6. An initial inpatient consultation with a detailed history, detailed exam, and MDM of low complexity would be coded to what E/M code?
6. 99253 is the E/M code of the initial impatient consultation.

7. What are the four elements of history?
7. Problem focused, Expanded problem focused ,Detailed & Comprehensive

8. The complexity of medical decision making is based on what three elements? 8. Number of diagnoses, Risk of morbidity(complication or death., Amount of data (complexity)

9. 9. Provide the CPT code(s) for the following scenario.
A 7-year-old female established patient presents to the pediatrician complaining of ear pain for the last three days. A detailed history is then taken. She had associated fever of 101° F yesterday. Mom treated her with Tylenol. The fever this AM is 99° F. She has had some chills and cough as well as some difficulty breathing. No nausea or vomiting. No prior history of otitis. Her brother was sick earlier this week. The physician performed a detailed exam of the ENT as well as a limited exam of GI, lungs, and heart. Vital signs were taken in the office. The physician diagnosed the patient with otitis media and an upper respiratory infection and prescribed an antibiotic. The MDM is stated to be moderate.

CPT Code: ____________________
9. 99214

10. What are the three key components that are present in every patient case except counseling encounters or time-based codes, and enable the coder to choose the appropriate level of service?
10. History, Exam,MDM - Medical Decision Making

11. Provide the CPT code(s) for the following clinic note.
Clinic Note
CC: Patient presents for routine examination.
SUBJECTIVE: Sally is a 42-year-old female patient who presents today for a routine physical examination.
OBJECTIVE: BP 120/80. Pelvic exam: normal external genitalia. Vagina without discharge except for a scant amount of white discharge that appears normal. Cervix: Multiparous, clear. Bimanual exam is unremarkable. All systems are within normal limits.

ASSESSMENT:
1. Normal BP.
2. Normal pelvic exam.
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PLAN: Return in 1 year or as needed.
CPT Code: ____________________
11.CPT Code: 99396

12. Provide the CPT code(s) for the following scenario. Donald Mayors is a homebound patient who is experiencing some new problems with managing his diabetes. Dr. Martin, who has never seen this patient before, drives to Donald’s residence and spends 20 minutes examining the patient and explaining the adjustments that are to be made in the insulin dosage. The medical decision making is straightforward. CPT Code: ____________________

12. CPT Code: 99341

13. What are the four levels of history type?
13. Poblem-focused, expanded problem-focused,...
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