Use of the Medicare Audit Tool Part 2

This webinar is AAPC-approved for 1.5 CEUs. Can be used for Core A and all specialties except CIRCC and CASCC provided you score a 70% or higher on the post test. Test takers should read all test instructions, and complete the Required Information fields at the top of the test. This test consists of 15 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 15 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 Emergency Medicine Coding and Reimbursement Webinar Library subscription please call or email:
Cari Laplace
Webinar Technical Support Administrator
BSA Healthcare
Phone: 1-561-434-4740
Email: claplace@bsanda.com

Name

Company Name

Email

When selecting final E/M code choice, to reach the High Level MDM, a coder must have:

High Risk plus Table A at 4 points

High Risk plus Table B at 4 or > points

Table A at 4 points plus Table B at 4 or > points

Any one of the above

Which of the following is an example of a Low-Moderate presenting problem:

A patient presents with several uncomplicated insect bites

A patient presents with a fever = to or > 100.5°

A patient presents for removal of sutures from a well-healed, uncomplicated laceration

A patient is sent from his PCP’s office to receive a tetanus toxoid immunization

Which of the following is an example of a Low-Moderate presenting problem:

Vaginal discharge w/out abdominal pain

Vaginal discharge w/ abdominal pain

Abdominal pain w/ a pelvic exam

Abdominal cramping w/ a rectal exam

Which of the following objective criteria is an example of a Low-Moderate management option for shortness of breath:

Two or more nebulizers medications given

One nebulizer medication alone given (usually the medication is Albuterol)

Four or more ancillary studies

Two IM meds

Which of the following objective criteria is an example of a Low-Moderate exam, evaluation, or consultation:

Pelvic Exam

Any medical or surgical consultation

Psych evaluation by an ED provider with no request for a professional psych evaluation

All the above

Which of the following is an example of a Low-Moderate objective criteria for medication or IV fluids:

Two to three IM/SQ non-controlled medications

One IM/SQ controlled medication

Any prescription (Rx) on discharge

One IM/SQ non-controlled medication with an ancillary study, a lab, or an x-ray

The CPT Manual defines level four or 99284 as:

A high severity case that poses an immediate threat to the patient’s life or physiologic function

A moderate severity case

A high severity case that does not pose an immediate threat to the patient’s life or physiologic function

A case that starts as a moderate level of risk and then moves to a high level of risk during the course of treatment of the patient

Which of the following is an objective example of a High-Moderate presenting problem:

Trauma patient who presents to the ED via EMS. The patient is retrained and the patient’s cervical spine is immobilized.

A patient presents with a fever = to or > 100.5°

Pregnant patient with any complaints

Non-trauma patient who presents via EMS

Which of the following is an objective example of High-Moderate ancillary studies:

One to three lab studies

Four or more lab studies or three lab studies and one x-ray series

One isolated x-ray series

Two labs and one x-ray series

The CPT Manual defines high severity, high risk cases that are Level Five-type cases as:

A high severity case that poses an immediate threat to the patient’s life or physiologic function

A moderate severity case

A high severity case that does not pose an immediate threat to the patient’s life or physiologic function

A case that starts as a moderate level of risk and then moves to a high level of risk during the course of treatment of the patient

Which of the following is an objective example of a High risk presenting problem:

A 30-week pregnant female requiring post-traumatic uterine monitoring in Labor & Delivery

A patient on whom CPR is performed throughout the duration of the visit

Urinary retention requiring a Foley catheter insertion

Coordination of admission for a patient who was transported from another facility

True or False: Administration of medications that fall in the High risk category guarantees a Level 5 (99285) case.

True

False

Which of the following is an objective example of a High risk patient disposition:

Most patients who are placed in observation

Most admitted and transferred patients

Rape cases, and child or elder abuse cases

All of the above.

Which of the following is an objective example of High Risk ancillary studies:

Four or more ancillary studies plus IV fluids and any parenteral medication (IV, IM or subQ)

One to three lab studies

One isolated x-ray series

Two labs and one x-ray series

Which of the following is an example of a High Risk chest pain work-up:

Chest pain workup with one to three ancillary studies, an EKG, and no cardiac enzymes

Chest pain workup with an EKG alone

Chest pain workup with an EKG and cardiac enzymes (e.g, CPK isoenzymes and Troponin)

Chest pain workup with three labs and an x-ray