CCA Evaluation & Management Practice Questions
Evaluation & Management makes up 2 of every 50 questions on a Tigertest CCA practice test. Here are 8 of the 8 questions on it, each with the answer and the reason.
Updated by the Tigertest team. Weighted to the AHIMA CCA Exam Content Outline. Original questions on coding guidelines and concepts; not affiliated with AHIMA.
1. Under the 2021 office E/M rules, history and examination are:
- A.No longer documented
- B.Done as appropriate
- C.Counted to set the level
- D.Required at a fixed depth
Answer: B. History and exam are performed and documented as medically appropriate but no longer set the level. Office visit levels are chosen by MDM or total time.
2. Which activity does NOT count toward E/M total time on the date of the visit?
- A.Ordering tests and drugs
- B.Documenting in the record
- C.Reviewing outside records
- D.A separately billed procedure
Answer: D. Total time includes face-to-face and non-face-to-face work by the physician or other qualified professional on that date, but not time spent on separately reported services.
3. In MDM, ordering and reviewing tests belongs to which element?
- A.Data reviewed
- B.History of present illness
- C.Problems addressed
- D.Risk of management
Answer: A. MDM has three elements: number and complexity of problems addressed, amount and complexity of data reviewed and analyzed (tests, records, independent historians) and risk of management.
4. A patient seen 2 years ago by Dr. B now sees Dr. A, same specialty and same group. The patient is:
- A.New, for a new problem
- B.Established to Dr. B only
- C.Established
- D.New
Answer: C. A patient is established when seen by the physician or another physician of the exact same specialty and subspecialty in the same group within the past 3 years.
5. A patient seen last year by the group's cardiologist now sees its dermatologist. To the dermatologist, the patient is:
- A.Established, same group
- B.New only if insurance changed
- C.New
- D.Established
Answer: C. The 3-year rule applies within the same specialty and subspecialty. A visit to a physician of a different specialty in the same group is a new patient visit.
6. Office prolonged service add-on codes are based on:
- A.Total time on the date
- B.Number of diagnoses
- C.Face-to-face time only
- D.Medical decision making
Answer: A. Prolonged services with office E/M are reported only when the level was chosen by total time and the time goes past the threshold for the highest level.
7. Under CMS rules, a split or shared facility visit is billed by the practitioner who:
- A.Signed the note first
- B.Is the physician, always
- C.Is the NPP, always
- D.Did the substantive part
Answer: D. CMS bills a split or shared visit under the practitioner who performed the substantive portion: more than half the total time, or a substantive part of the MDM, with modifier FS.
8. A patient comes for a scheduled minor procedure and no other problem is addressed. The E/M is:
- A.Reported with modifier 24
- B.Not reported separately
- C.Reported with modifier 25
- D.Reported with modifier 57
Answer: B. The decision to perform a minor procedure is included in it. Modifier 25 applies only to a significant, separately identifiable E/M beyond the usual pre-procedure work.
Practice all 8 evaluation & management questions, and the rest of the 200-question bank, in the free CCA training sets. Questions you miss come back until you have mastered them.
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