E/M
It's a Toss Up
TCM
Modifier Mania
ICD-10
100

In what year were the E/M guidelines changed? 

What is 2021

100

This chapter has sequencing priority over codes from other chapters.

What is Chapter 15 - Pregnancy, Childbirth, and the Puerperium (O00-O9A). 

100

How many calendar days after discharge must the patient receive a face-to-face visit with a provider? 

What is 14 days

100

What modifier indicates a significant, separately identifiable E/M service on the same day?

What is modifier 25.

100

What does content enclosed in brackets [ ] mean in the ICD-10 guidelines? 

What are synonyms, alternative words, or explanatory phrases? 

200

What is the lowest level E/M a physician can bill for a new patient? 

What is 99202?

200

What does CPT code 93000 represent?

What is an electrocardiogram, routine ECG with at least 12 leads; with interpretation and report.

200
What discharge location does not qualify a patient for a TCM? 

What is a SNF?

200

This modifier identifies a bilateral procedure performed during the same session.

What is modifier 50?

200

What does an Excludes1 note mean?

What are two conditions that cannot occur together, such as a congenital form versus an acquired form of the same condition.

300

What are the three elements of medical decision making (MDM)?

What are: problems, data, and risk.

300

What CPT range includes anesthesia codes?

What is CPT range 00100-01999.

300

This is the primary driver for determining the appropriate level of TCM.

What is the decision making?

300

A surgeon performs a second, unrelated procedure during the patient's global period. This modifier should be appended.

What is modifier 79?

300

What does "with" or "in" mean in the ICD-10 guidelines?

What are words that should be interpreted to mean “associated with” or “due to” when it appears in a code title, the Alphabetic Index (either under a main term or subterm), or an instructional note in the Tabular List. 

400

Is the E/M level of service based on time or MDM?

What is both time or MDM - whichever is advantageous. 

400

CPT code 45378 is described as what?

What is a Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure).

400

These are the two CPT codes used to report TCM services.

What are 99495 and 99496?

400

This modifier is often overused and audited because it bypasses NCCI edits by indicating procedures are distinct.

What is modifier 59?

400

If a diagnosis is documented as "rule out pneumonia" in outpatient coding, what do you code?

What is the sign and/or symptoms.

500

What risk level is associated with prescription drug management?

What is moderate.

500

This common global surgical package length applies to most major procedures and includes pre-op, intra-op, and post-op care.

What is a 90-day global period?

500

This type of contact must be made within 2 business days of discharge for TCM services.

What is interactive contact (phone, email or in-person)?

500

This modifier indicates that a procedure was discontinued due to extenuating circumstances or patient safety concerns.

What is modifier 53?

500

These official coding guidelines are updated on this schedule each year, aligning with the start of the federal fiscal year.

What is annually (every October 1)?