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CEMC practice exam from the AAPC

  1. #1
    Default CEMC practice exam from the AAPC
    Medical Coding Books
    I just got the online exam this week. Case 28 I answered that is was a 99214, when I hit grade it tells me I am wrong. I read the rationale.

    HISTORY LEVEL IS DETAIL
    EXAMINATION LEVEL IS DETAILED
    MEDICAL DECISION MAKING LEVEL IS LOW


    Source: The E&M Documentation Guidelines can be referenced at: http://www.cms.hhs.gov/MLNEDWebGuide/25_EMDOC.asp

    That was their rationale.

    On the bottom of every note it states

    The AAPC does not ask a coder to make any final determination based on medical necessity. Decisions about what constitutes a medically necessary service should be made only by a practicing physician peer. Please code this service based solely on the elements of History, Exam and Medical Decision Making using the same rules and logics that are defined by the “Marshfield Clinic” audit tool, and CPT coding guidelines

    Ok, what am I missing?

    Thanks,

    Laura, CPC

  2. #2
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    was this a new patient level 3 - 99203? or what was their answer??
    Donna, CPC, CPC-H

  3. #3
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    They are saying 99213.

    Laura, CPC

  4. #4
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    hmm...well, I'd agree with you (given what you wrote), I would have chosen the 99214 also, although I know there's always the arguement that MDM drives the level.

    I don't have a link to where it states that but I've seen it said many times..
    *shrugs* sorry I'm not much help - but I agree with what you picked!
    Donna, CPC, CPC-H

  5. #5
    Default
    Thanks Donna.

    I just copied and pasted the rationale info they gave me. This kind of stuff makes me nervous about taking the exam next month. The fact that they gave me an audit tool to use that combines 95 & 97 history with only 95 exam doesn't make me feel any better either. I have emailed the AAPC asking why they are giving out incorrect information but I have not recieved a response. If they base scenarios in the exam on the mixing of the guidelines like the audit tool I won't be getting those questions right.

    Laura, CPC

  6. Default
    Please keep us posted about the reply you get from the AAPC.

    Sarah

  7. #7
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    Laura - I think you'll do just fine on the test nonetheless. ..BUT I do understand your frustration!!
    let us know their answer..
    Donna, CPC, CPC-H

  8. #8
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    Quote Originally Posted by katmryn78 View Post
    Thanks Donna.

    I just copied and pasted the rationale info they gave me. This kind of stuff makes me nervous about taking the exam next month. The fact that they gave me an audit tool to use that combines 95 & 97 history with only 95 exam doesn't make me feel any better either. I have emailed the AAPC asking why they are giving out incorrect information but I have not recieved a response. If they base scenarios in the exam on the mixing of the guidelines like the audit tool I won't be getting those questions right.

    Laura, CPC
    I felt your pain, I too purchased the practicum, the only thing I could think is that they put both 95 and 97 History DG is so that once you know which one your using for history you then know what exam DG's you will need. It took me some time to get used to using the audit tool they provided, but you don't have to use the audit tool they have given us you can use whichever audit tool you want, I took the one they gave plus the one I use on a regular basis but for me since I did the practice exam using the one they provided I did stick with using it for the exam too.
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  9. #9
    Default Just got a response from AAPC
    "The quick reference tool is to be used in conjunction with the 1995 and 1997 Documentation Guidelines. Since the 1997 Documentation Guidelines include the templates for the 1997 exam component, we did not reproduce them on the quick reference tool.

    The recommended resources for the exam we have posted on the website include:

    Highly Recommended References:

    E/M Audit Worksheet of your choice
    Both CMS DGs (1995 & 1997)
    If you prefer to use a different audit tool that has both 95 and 97 exam components, you can instead of using the tool we provide in addition to the exam templates included in the 1997 Documentation Guidelines. It was not our intention with the tool for you to mix and match guidelines. On the tool it is labeled as "95 exam guidelines" so that it is clear that it is not to be used for the 1997 exam component. In the one hour E/M audio, we cover that you are not to use 95 and 97 guidelines for the same note and that you should use both the 1995 and 1997 Documentation Guidelines when preparing for and sitting for the exam. There are many specialties included in the exam. It would be impossible to include the template for each specialty on the quick reference tool. That is why we instruct you to also bring both sets of guidelines with you to the exam.



    The correct E/M code selection for Case 28 is 99214. The rationale provided is correct based on the documentation in the note. The answer key was mismarked on the website. Thanks for bringing it to our attention."

    The above is the email I got back. I have not listened to any of the audio portions yet, I just took the test to see where I was. I missed 8 (1 of them was this one) out of 75. Some of the questions threw me because they really don't have anything to do with E/M they were about insurance/CMS processing and reasons for audits.

    Oh well, I guess I have a better idea what to expect.

    Laura, CPC

  10. #10
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    yup...and then there's that - .... a mistake... it happens, all the time. At least you brought it to their attention! AND more so, you were correct!

    there's always a risk of error in our books/answers that we use. So if something just doesn't sit well, doesn't make sense (like this one), it's good to question it!

    we're all human, we all make mistakes!
    Last edited by dmaec; 06-08-2009 at 12:44 PM.
    Donna, CPC, CPC-H

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