WP-Procedure Coding Ch 16 Review p 2

The use of the HCPCS coding manual is to:

• Assign codes for medical procedures and services

• Record patient vital signs

• Schedule patient appointments

• Prescribe medications

The purpose of an E&M audit is to:

• Evaluate the accuracy of coding and documentation for Evaluation and Management services.

• Determine patient eligibility for insurance coverage.

• Assess the quality of medical equipment used in a facility.

• Monitor the number of patients seen by a provider.

The medical office should prepare for an audit by:

• Organizing and reviewing all relevant records and documentation

• Ignoring previous audit findings

• Delaying the audit process as much as possible

• Only preparing financial documents

Describe what Evaluation and Management (E&M) codes are used for.

• They describe patient encounters with a physician for evaluation and management of a health problem.

• They are used to code surgical procedures only.

• They are used exclusively for laboratory tests.

• They are used to bill for medical equipment.

The most frequently used Evaluation and Management (E&M) codes begin with which numbers?

• 10

• 50

• 99

• 75

Where is the E&M section located in the CPT manual?

• The E&M section is the first section at the front of the CPT manual.

• The E&M section is located in the middle of the CPT manual.

• The E&M section is found at the end of the CPT manual.

• The E&M section is in the appendix of the CPT manual.

What is an audit in the context of Evaluation and Management (E&M) coding? An audit is a detailed process that verifies that every detail of E&M code is ________ documented.

• clearly

• rarely

• partially

• vaguely

Which of the following best describes an internal audit?

• Conducted by an outside organization, such as an insurance company or Medicare

• Conducted within the medical office

• Conducted by the patient

• Conducted by the government

Which of the following best describes an external audit?

• Conducted within the medical office

• Conducted by an outside organization, such as an insurance company or Medicare

• Conducted by the patient

• Conducted by the government

Which of the following is a step in preparing for an audit?

• A) Access the patient’s record

• B) Schedule a patient appointment

• C) Prescribe medication

• D) Discharge the patient