AAPC Chapter 19 Review Exam

Evaluation and Management (E/M) Codes

• Subsequent Hospital Care is applicable when a provider sees a patient for multiple days during hospitalization.
• The Quality component of the History of Present Illness (HPI) details how pain is experienced (sharp, stabbing, dull).
• Modifier 32 is utilized for E/M services required by a court order.
• The initial step for selecting an E/M code involves determining the appropriate category and subcategory per CPT® guidelines.
• Emergency Department Services are used to report visits made by patients in acute situations, as in the case of uninitiated patients in the ED.

Specific CPT® Coding

• For prostate cancer screening, the appropriate code is G0102, used when a digital rectal examination and PSA are performed.
• For a patient with an established diagnosis seeking a comprehensive check-up, CPT® code 99397 applies.
• A home care visit to a hemiplegic patient generates a CPT® code of 99348 due to the expanded problem-focused examination.
• A consult for persistent allergies involves reporting E/M code 99242 after a detailed assessment and management discussion.
• For patients with Hodgkin's lymphoma, the combined appropriate codes are 99213 and 99354, reflecting the complexity of ongoing care and discussions.
• The ICD-10-CM code for vertigo is R42, while other common codes include R11.2 for nausea and vomiting, and I20.1 for angina pectoris with spasm.

Health Visit Scenarios

• An annual check for a 10-year-old girl with URI symptoms leads to CPT® codes 99393 and 99213-25.
• Critical scenarios in pediatrics, such as a 3-year-old with respiratory failure, are reported with code 99475.
• For new patients reporting a right inguinal hernia, the coded services are defined by CPT® 99203 and ICD-10-CM K40.90.
• Discharge visits for patients, such as an individual post-splenectomy, are captured under CPT® code 99238.

Follow-Up Care and Counseling

• Established patients reporting severe dizziness and related symptoms align with CPT® code 99214 after a detailed history and moderate MDM.
• E/M visit assessments for children include checkups coded as 99391.
• When patients return with recurrent conditions, like bursitis, specific injection codes such as 20610-50 can be used for the treatment rendered.

Medication Management and Recommendations

• Counseling and prescriptions provided for smoking cessation during an initial visit to Dr. Lung should be reported as 99203.
• Upon discharge, the care plan and complex decisions made during patient interactions justify codes such as 99239 for follow-ups and 99304 for subsequent admissions.
• Nystatin suspension and creams for conditions like thrush and diaper rash are important facets of the treatment plan that may accompany the E/M coding for pediatric visits.