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 Sorry, that is Incorrect Try Again 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] Continue 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 Sorry, that is Incorrect Try Again 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. < Back Continue 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 Sorry, that is Incorrect Try Again Congratulations, that is Correct! New Medicare enrollees must schedule their IPPE within 12 months of Medicare Part B enrollment. < Back Continue Click the Correct Choice The Medicare IPPE requires A. Chest X-ray B. Electrocardiogram C. End of life planning D. Bone mineral density test Sorry, that is Incorrect Try Again Congratulations, that is Correct! 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. < Back Continue 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 Sorry, that is Incorrect Try Again Congratulations, that is Correct! 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. < Back Continue 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 Sorry, that is Incorrect Try Again 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.