Use of the Medicare Audit Tool and An Introduction to Objective Criteria for Emergency Medicine E/M Code Choice – Part 1 Test takers should read all test instructions, and complete the Required Information fields (your name, your Organization [enter APP and your work location], and your email address. This test consists of seven questions. Please select one best answer for each test question by clicking on the square next to the answer you have selected. This test is not timed; however, the test must be taken in one sitting. When all seven questions have been answered, please click on the Submit Test button. Your score, as well as logic-reach reasoning for answers to any test questions that you missed, will be displayed immediately following completion and successful transmission of this test. For technical support for your APP webinar library subscription please call or email: Cari Laplace Webinar Technical Support Administrator BSA Healthcare Phone: 1-561-434-4740 Email: claplace@bsanda.com NameCompany NameEmailThe great majority of patients who present to the emergency department fall within which category in Table A: Diagnosis and Management Options Table: Established Problem; Worsening Establish Problem; Stable, Improving New Problem to the provider; work-up planned Self-limited or MinorWhich of the following qualifies as “additional work-up planned”: Admission of an emergency department patient, transfer of an emergency department patient, or placement of a patient in observation Order of three or more ancillary studies (i.e., EKG, lab, x-ray) Order of any special study (i.e., US, MRI, CT) All of the above.In Table B: Amount/Complexity of Data, how many points can be assigned for the review and/or order of four lab tests: Four points Two points Three points One pointIn Table B: Amount/Complexity of Data, how many points can be assigned for the independent visualization of an image, tracing or specimen? Four points Two points Three points One pointIf a provider visualizes and interprets a patient’s EKG, how many points would these efforts garner In Table B: Amount/Complexity of Data: Four points Two points Three points One pointTrue or False: Point values that can be assigned by coders for labs and ancillary studies differ from Table A: Diagnostic and Management Options Table) to Table B: Amount/Complexity of Data Table. True FalseWhich of the following ancillary studies counts as two studies: Troponin Comprehensive Metabolic Panel UA (dip or sent to lab) Liver profileRegarding the Diagnostic Procedures column in Table C: Risk Table, risk in this capacity refers to: Inherent risk of the procedure at the time of performance of the procedure itself, and after the procedure is performed. The overall severity of the patient. Both A and B. None of the above.Regarding Table C: Risk Table, a patient presenting to the ED with one stable, chronic illness requiring that no labs or x-rays are ordered, and no meds are administered in the ED or on discharge would fall under which Table C: Risk Table Level of Risk: Low Moderate Minimal HighWhich of the following scenarios is indicative of patient who falls under the Table C: Risk Table Low Level of Risk: A 40-year-old female presents to the ED complaining of dysuria with associated hematuria. The patient is given a prescription for antibiotic on discharge. An 18-year-old female presents to the ED complaining of wheezing. She is treated with a single nebulizer dose and is prescribed a bronchodilator inhaler at the time of discharge. A 30-year-old male presents with a fishhook imbedded in his finger. The finger is swollen and bruised. The fish hook is removed without incision. The patient is instructed to take an over-the-counter pain reliever. A 26-year-old female presents to the ED with a productive cough and nasal congestion. An x-ray is ordered and visualized by the clinician, and the patient is prescribed antibiotics.In Table C: Risk Table, High Moderate Risk may be defined as: A high severity case that poses an immediate threat to the patient’s life or physiologic function as defined in the CPT manual. Represents a range of patient severities from low to moderate. Two or more stable chronic conditions. A high severity case that does not pose an immediate threat to the patient’s life or physiologic function as defined in the CPT manual.Low Moderate presenting problems like chronic illnesses with mild exacerbation or undiagnosed new problems with uncertain prognoses may require: Ancillary studies like lab or x-ray. One nebulizer treatment. Oral, rectal, nasal, eye, ear or topical meds in the ED or on discharge. Any of the above.Which of the following scenarios is indicative of patient who falls under the Table C: Risk Table High Moderate Level of Risk: A 40-year-old female presents to the ED complaining of dysuria with associated hematuria. The patient is given a prescription for antibiotic on discharge. A 42-year-old female complains of a moderately severe migraine headache. The patient is provided an exam including a neurological evaluation and is given IM injections of Morphine and Zofran™. After approximately 30 minutes, she feels better and is discharged with prescriptions for pain and nausea. A 30-year-old male presents with a fish hook imbedded in his finger. The finger is swollen and bruised. The fish hook is removed without incision. The patient is instructed to take an over-the-counter pain reliever. A 26-year-old female presents to the ED with a productive cough and nasal congestion. An x-ray is ordered and visualized by the clinician, and the patient is prescribed antibiotics.Regarding Table C: Risk Table, a patient presenting to the ED with an abrupt change in neurologic status would fall under which Table C: Risk Table Level of Risk: Low Moderate Minimal HighWhich of the following Table C: Risk Table management options is included in the High Level of Risk category: IV fluids with additives Most admissions and transfers Prescription Drug Management Minor surgery
