Podcast Beta
Questions and Answers
According to CPT guidelines, which of the following activities cannot contribute to the level of service if performed on a different calendar day than the face-to-face service?
Which of the following statements is true regarding the contribution of problems to the level of evaluation and management service?
Under what condition can Social Determinants of Health (SDOH) be used to support the level of service?
What is the minimum time frame required for intensive monitoring according to the AMA definition?
Signup and view all the answers
Which of the following statements is true regarding the contribution of activities to the level of service according to CPT guidelines?
Signup and view all the answers
According to the guidelines, which of the following statements is true regarding the contribution of problems managed by other professionals to the level of service?
Signup and view all the answers
What is indicated by having more than one independent historian in medical history?
Signup and view all the answers
How is a self-limited or minor problem defined in the Medical Decision Making grid?
Signup and view all the answers
In the context of a minor illness, what should be considered when a patient is documented to have a fever?
Signup and view all the answers
How should a discussion between an Internal Medicine physician and an Infectious Disease specialist be counted towards the level of service?
Signup and view all the answers
When a patient's glucose readings are better than ever but not in the normal range, what does this suggest about the patient's condition?
Signup and view all the answers
What aspect of the patient's disease process is accounted for in the Risk element of Medical Decision Making?
Signup and view all the answers
Study Notes
CPT Guidelines for E/M Codes
- Only time spent on the date of the visit counts toward the level of service.
- Activities that contribute to the level of service must be performed on the same calendar day as the face-to-face service.
Time to Support E/M Codes
- Time spent on services not performed on the same calendar day as the face-to-face service does not count toward the level of service.
Addressed Problems
- Only problems that are addressed may contribute to the level of service.
- Notation in the patient's medical record that another professional is managing the problem without additional assessment or care coordination documented does not qualify as being addressed or managed by the physician.
Social Determinants of Health (SDOH)
- SDOH may be used to support the level of service when the physician indicates that the circumstance impacted treatment decisions.
Intensive Monitoring
- Intensive monitoring is required to be not less than quarterly, according to the AMA definition.
Medical Decision Making
- Multiple data points may be credited if history is obtained from more than one independent historian.
- Assessment requiring independent historian(s) means one or more, and additional historians would not result in any greater credit given.
Self-Limited or Minor Problem
- A self-limited or minor problem runs a definite and prescribed course, is transient in nature, and is not likely to permanently alter health status.
- A patient with a minor illness and a fever should be considered as having a self-limited or minor problem.
Internal Medicine Consultation
- Discussion of management with a specialist from the same group practice can be counted toward the level of service.
Stable Chronic Illness
- A stable chronic illness is one that is at treatment goal.
Medical Decision Making Elements
- The risk associated with the patient's disease process is accounted for in the Risk element of Medical Decision Making, which refers to the risk of complications and/or morbidity or mortality of patient management at an encounter.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Identify which items cannot be counted towards the time to support an evaluation and management code, according to CPT guidelines. Learn what activities are included in the level of service provided they are performed on the same calendar day as the face-to-face service.
