Click the Correct Choice
Modifier -25 is used when
A. Payment is requested for E&M services significant and
separately identifiable from concurrently submitted procedure
services
B. Payment is requested for E&M services performed during the
operative “global period”
C. Payment is requested for follow-up consultation services
D. Payment is requested for E&M services provided in an
emergency setting
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Congratulations, that is Correct!
“if a provider performs an E/M service on the same
day as a procedure that is significant, separately
identifiable, and above and beyond the usual
preoperative and postoperative care associated with
the procedure, modifier 25 may be attached to the
claim to allow additional payment for the separate E/M
service.” [OEI - 0 7 - 0 3 - 0 0470]
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Click the Correct Choice
Which statement is NOT true regarding coding for
smoking cessation?
A. Medicare covers cessation counseling for all smokers
B. Smoking cessation can be billed if at least 2 minutes are spent
on cessation counseling
C. Medicare will pay for counseling during up to two quit
attempts per year
D. Smoking cessation may be billed with a -25 modifier
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Congratulations, that is Correct!
Medicare covers smoking cessation counseling. Up to 2
cessation attempts are covered yearly, with up to 4 counseling
sessions per attempt. Codes exist for 3-10 minutes of
counseling or over 10 minutes of counseling. Cessation
counseling codes may be combined with E&M codes using -25.
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Click the Correct Choice
The “welcome to Medicare” initial preventive physical
exam (IPPE) must be completed within how many
months of Medicare Part B enrollment?
A. 3
B. 6
C. 9
D. 12
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Congratulations, that is Correct!
New Medicare enrollees must schedule their IPPE
within 12 months of Medicare Part B enrollment.
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Click the Correct Choice
The Medicare IPPE requires
A. Chest X-ray
B. Electrocardiogram
C. End of life planning
D. Bone mineral density test
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The Medicare IPPE requires BMI assessment,
visual acuity assessment, safety/function
screening and provision of information on end of
life planning, if the patient is willing. ECG
“screening” is optional at an IPPE.
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Click the Correct Choice
You are an experienced 3rd year resident in clinic. You see an
established patient for a multiproblem care visit. You perform a
detailed history, complete physical exam, and high level medical
decision making. You review the patient’s needs with your
preceptor, who believes your presentation reflects sufficient
understanding that direct confirmation of your findings is not
required. The maximal submitted CPT code should be
A. 99213-GE
B. 99213-GC
C. 99214-GC
D. 99215-GE
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The documentation
otherwise supports 99215,
but care was not directly
provided by the attending.
“–GE” supervision allows a
maximum 99213-GE code.
To have received
appropriate 99215 payment
for this complex service,
direct faculty confirmation
was required.
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Click the Correct Choice
You spend 30 minutes in the exam room with a return patient,
discussing their recent difficulties caring for their diabetes. You
spend 20 minutes of the visit time counseling the patient on diet,
medication adherence, and exercise. How would you bill the patient
based on time rules?
A. 99212
B. 99213
C. 99214
D. 99215
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Congratulations, that is Correct!
At least 25 minutes was spent with the patient, over half of
which was spent on counseling. This supports level 4 coding of
an estblished patient visit.
CPT code
Time
(Counseling)
99211 99212 99213
(RN)
5
10
15
99214
99215
25
40
You’ve completed Quick Quiz #3.