Wiki Today's CPC Sample Question ERROR?

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antigeekess said:
Hi there - I just joined AAPC this week & finished a coding course. I'm a little disappointed to find that the very first sample question on this site appears to have a big fat ERROR in it. Admittedly, I'm using a 2013 CPT manual at the moment, so this might be the problem, but I rather doubt it. Here's the question:

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"A patient presents to the physician?s office for the first time with nausea and vomiting. The physician performs an extended HPI, an extended ROS, and complete PFSH. Also supported by documentation is an eight organ system exam and moderate medical decision making. Physician assesses the patient with acute gastritis. What are the appropriate E/M and ICD-9-CM codes for this service?"

Select a correct answer below
a. 99205, 535.00, 787.01
b. 99203, 535.00
c. 99202, 787.01
d. 99204, 535.00, 787.01

Rationale: The provider documented an extended HPI, extended ROS and complete PFSH which supports a detailed history. An eight organ system exam supports a comprehensive exam. The medical decision making is moderate. This is a new patient with a detailed history, comprehensive exam and moderate medical decision making which supports 99203. The patient is diagnosed with gastritis. When a definitive diagnosis is determined, do not report the associated signs and symptoms. In the Index of Diseases look up Gastritis, acute. There is no mention of a hemorrhage.
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I quickly chose answer D because according to my CPT manual, 99204 is the ONLY new patient option with "moderate" complexity listed. No need to go further. Is it different in the 2014 or 2015? Thanks.
Click to expand...


The E/M guidelines have not changed--you have to look at the lowest level of the 3 elements to get the correct answer for new patient visits. Since the ROS is extended (and not complete), the overall level of the History is detailed. So Detailed History, Comprehensive Exam, and Moderate MDM = 99203 for New Patient.

HTH!
 
antigeekess said:
Hi there - I just joined AAPC this week & finished a coding course. I'm a little disappointed to find that the very first sample question on this site appears to have a big fat ERROR in it. Admittedly, I'm using a 2013 CPT manual at the moment, so this might be the problem, but I rather doubt it. Here's the question:

---------------------------------------
"A patient presents to the physician?s office for the first time with nausea and vomiting. The physician performs an extended HPI, an extended ROS, and complete PFSH. Also supported by documentation is an eight organ system exam and moderate medical decision making. Physician assesses the patient with acute gastritis. What are the appropriate E/M and ICD-9-CM codes for this service?"

Select a correct answer below
a. 99205, 535.00, 787.01
b. 99203, 535.00
c. 99202, 787.01
d. 99204, 535.00, 787.01

Rationale: The provider documented an extended HPI, extended ROS and complete PFSH which supports a detailed history. An eight organ system exam supports a comprehensive exam. The medical decision making is moderate. This is a new patient with a detailed history, comprehensive exam and moderate medical decision making which supports 99203. The patient is diagnosed with gastritis. When a definitive diagnosis is determined, do not report the associated signs and symptoms. In the Index of Diseases look up Gastritis, acute. There is no mention of a hemorrhage.
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I quickly chose answer D because according to my CPT manual, 99204 is the ONLY new patient option with "moderate" complexity listed. No need to go further. Is it different in the 2014 or 2015? Thanks.
Click to expand...
The lowest level(history in this case since ROS is only extended) will determine a new patient visit. Another indication to the correct answer is the diagnosis codes. You would not have both a definitive diagnosis and signs and symptoms (N&V) of that diagnosis.
Agree with the previous poster, b) is your answer based on CPT and diagnosis.
This is a good example of how you would approach this question in the CPC. Straight away I would go for b) based on the diagnosis alone without wasting time on figuring out the rest of the question. Time is not your friend in the CPC exam.
Hope this helps.
 
Thanks for your quick replies. Couldn't get back here fast enough to delete this once it dawned on me what I'd done. Duh. :eek:
 
twizzle said:
The lowest level(history in this case since ROS is only extended) will determine a new patient visit. Another indication to the correct answer is the diagnosis codes. You would not have both a definitive diagnosis and signs and symptoms (N&V) of that diagnosis.
Agree with the previous poster, b) is your answer based on CPT and diagnosis.
This is a good example of how you would approach this question in the CPC. Straight away I would go for b) based on the diagnosis alone without wasting time on figuring out the rest of the question. Time is not your friend in the CPC exam.
Hope this helps.
Click to expand...

Yeah, I'm trying to get in the habit of answering quickly because I already did the math & know it only works out to about 2 minutes per question. I would expect most people don't finish it. I just had a major brain fart & picked the wrong part to focus on in this case. BTW, you're British, aren't you? ;)
 
antigeekess said:
Yeah, I'm trying to get in the habit of answering quickly because I already did the math & know it only works out to about 2 minutes per question. I would expect most people don't finish it. I just had a major brain fart & picked the wrong part to focus on in this case. BTW, you're British, aren't you? ;)
Click to expand...
Yes I am...what prompted the question?
 
twizzle said:
Yes I am...what prompted the question?
Click to expand...

"Straight away." You have what poker players would call a "tell" in the above statement. ;) Had a British boyfriend for a couple of years. My two best online chat buddies are from that side of the pond, as well. Bit of an Anglophile.
 
antigeekess said:
"Straight away." You have what poker players would call a "tell" in the above statement. ;) Had a British boyfriend for a couple of years. My two best online chat buddies are from that side of the pond, as well. Bit of an Anglophile.
Click to expand...

OK, interesting response..... what would you use instead of straight away?
At the very least you've learned a tactic for approaching CPC questions, and I've learned that I cannot hide my Britishness and that I would be useless at poker.
 
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