Evaluation and management:
How does the CPT Professional Edition define a new patient?
A. A new patient is one who has not received any professional services from the physician or another
physician of the same specialty who belongs to the same group practice, within the past two years.
B. A new patient is one who has not received any professional services from the physician or another
physician of the same specialty who belongs to the same group practice, within the past three years.
C. A new patient is one who has received professional services from the physician or another
physician of the same specialty within the last two years for the same problem.
D. A new patient is one who has received hospital services but has never been seen in the clinic by
the reporting physician.
2. James, a 35-year-old new patient, received 45 minutes of counselling and risk factor reduction
intervention services from Dr. Kelly. Dr. Kelly talked to James about how to avoid sports injuries.
Currently, James does not have any symptoms or injuries and wants to maintain this status would
you report this. This was the only service rendered. How service?
A. 99213
B. 99203
C. 99385
D. 99403
3. Andrea, a 52-year-old patient, had a hysterectomy on Monday morning. That afternoon, after
returning to her hospital room, she suffered a cardiac arrest. A cardiologist responded to the call and
delivered one hour and 35 minutes of critical care. During this time the cardiologist ordered a single
view chest x-ray and provided ventilation management. How should you report the cardiologist’s
services?
A. 99291, 99292
B. 99291, 99292, 71010, 94002
C. 71010, 94002, 99231
D. 99291, 99292, 99292-52
4. Brandon was seen in Dr. Shaw’s office after falling off his bunk bed. Brandon’s mother reported
that Brandon and his sister were jumping on the beds when she heard a “thud.” Brandon
complained of knee pain and had trouble walking. Dr. Shaw ordered a knee x-ray that was done at
the imaging center across the street. The x-ray showed no fracture or dislocations. Dr. Shaw had
seen Brandon for his school physical six months ago. Today, Dr. Shaw documented a detailed
examination and decision-making of moderate complexity. He also instructed Brandon’s mother that
if Brandon had any additional pain or trouble walking he should see an orthopedic specialist. How
should Dr. Shaw report her services from today’s visit?
A. 99204
B. 99394, 99214
C. 99214
D. 99203
5. Adam, a 48-year-old patient, presented to Dr. Crampon’s office with complaints of fever, malaise,
chills, chest pain, and a severe cough. Dr. Crampon took a history, did an exam, and ordered a chest
x-ay. After reviewing the x-ray, Dr. Crampon admitted Adam to the hospital for treatment of
pneumonia. After his regular office hours, Dr. Crampon visited Adam in the hospital where he
dictated a comprehensive history, comprehensive examination, and decision-making of moderate
complexity. How would you report Dr. Crampon’s services?
A. 99214
B. 99222
C. 99204, 99222-51
D. 99223, 99214-21
6. Why are the following codes not reported with continuing intensive care services (99478–99480):
36510, 36000, 43752, 51100, 94660, or 94375?
A. These codes are deleted from the 2008 edition.
B. These codes are included with continuing intensive care services.
C. These codes are only add-on codes and should be reported with a modifier -51
D. These codes are Category III Codes and should never be reported with Category I codes.
7. Larry is being managed for his warfarin therapy on an outpatient basis. Dr.Nancy continues to
review Larry’s INR tests, gives patient instructions, dosage adjustment as needed, and ordered
additional tests. How would you report the initial 90 days of therapy including 8 INR measurements?
A. 99363
B. 0074T
C. 99214
D. This services is bundled with evaluation and management services
8. Dr. Jane admitted a 67-year-old woman to the coronary care unit for an acute myocardial
infarction. The admission included a comprehensive history, comprehensive examination, and high
complexity decision-making. Dr. Jane visited the patient on days two and three and documented
(each day) an expanded problem focused examination and decision-making of moderate complexity.
On day four, Dr. Jane moved the patient to the medical floor and documented a problem focused
examination and straightforward decision-making. Day five, Dr. Jane discharged the patient to home.
The discharge took over an hour. How would you report the services from day one to day five?
A. 99213, 99232, 99231, 99239 x 2
B. 99221, 99222,99223, 99238
C. 99231, 99232, 99355, 99217
D. 99223, 99232, 99232, 99231, 99239
9. Which code range would describe services for a critically ill patient who is 23 days oldas a out
patient?
A. 99291–99292
B. 99293–99294
C. 99295–99296
D. None of the above