437- True or false: A vasectomy which has a 90-day global period is considered a
major procedure. - Assuming adequate documentation, what determines picking a level 4 or 5 visit
when making a decision for surgery? - In regard to billing on time, which is correct?
(a) Time spent reviewing a patients’ chart and films outside the clinic room is
counted.
(b) Time spent discussing the case with a colleague for an inpatient is counted.
(c) The time threshold for a level 3 consult is the same as a level 3 new patient.
(d) When billing on time, only one of the three core billing elements is required.
(e) For a clinic visit, 50% of the total time must be face-to-face. - The difference between new patient and consult documentation is:
(a) History documentation requirement by coding level.
(b) Medical decision-making documentation requirement by coding level.
(c) An increase in 16% revenue (RVUs) for C3 versus N3.
(d) Other than a reference to the consulting MD for a specific diagnosis and
proof of consult request and correspondence, there is no documentation
difference.
(e) This question is irrelevant since the majority of payers no longer honor
consults.
Key:
- History, physical exam, medical decision-making (trump core element)
- Diagnoses, data, and risk (trump element)
- Only two of the three pillars required for established patients, three of the three
required for new patients - True
- False
- False
- True
- Surgical risk factors that increase chance for complication (e.g., obesity)
- B
- D
References
- Adiga K, Buss M, Beasley BW. Perceived, actual, and desired knowledge regarding Medicare
billing and reimbursement. A national needs assessment survey of internal medicine residents.
J Gen Intern Med. 2006;21(5):466–70. - Howell J, Chisholm C, Clark A, Spillane L. Emergency medicine resident documentation:
results of the 1999 American board of emergency medicine in-training examination survey.
Acad Emerg Med. 2000;7(10):1135–8.
23 Evaluation and Management Documentation, Billing, and Coding