Advance Care Planning 2020 Post Test – SCAFP

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Question 1 of 10

1. Question
Benefits from having “advance planning” in place for end of life care include
- Reduced cost of care because of less intensive treatments and less hospitalizations
- Better quality of life and satisfaction of care due to enhanced communication with family and caregivers
- Length of life not adversely affected by following ACP planning
- All of the above
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Question 2 of 10

2. Question
The education session mentions having a “PIMP” session with patients with ACP discussions. Which of the following is NOT part of that roadmap?
- Prepping the patient for this discussion can be triggered by a life event or could occur as part of the natural conversation that occurs during a wellness encounter
- Informing the patient of your insight into their condition, but, also seeking their understanding of their condition is important along this journey
- A patient may show a mix of moods during this process
- Push the patient to decide what next steps have to happen to complete the POLST
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Question 3 of 10

3. Question
This is a signed legal document authorizing another person to make medical decisions on a patient’s behalf in the event the patient loses decisional capacity
- Living Will
- Durable Power of Attorney for Healthcare
- Physician Order for Life-Sustaining Treatment
- Last Will and Testament
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Question 4 of 10

4. Question
This document is used to summarize the patient’s preference for future medical care. This usually outlines a wish to withhold “heroic measures”. These can vary state by state as with any legal document
- Living Will
- Durable Power of Attorney for Healthcare
- Physician Order for Life-Sustaining Treatment
- Last Will and Testament
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Question 5 of 10

5. Question
A document that states the condition and provides medical orders in line with the patient’s wishes in case of medical emergency (like CPR preference, assisted nutrition, medical intervention, etc.) is called a
- Living Will
- Durable Power of Attorney for Healthcare
- Physician Order for Life-Sustaining Treatment
- Last Will and Testament
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Question 6 of 10

6. Question
A “Do Not Resuscitate” (DNR) status is in place for a patient. That means that
- EMS staff must not do CPR ONLY IF there is no pulse OR respirations present. Otherwise, standard of medical care practices should be followed
- CPR should not be started regardless of the condition
- Tube feedings are off limits
- A POLST, Living Will, and Durable Power of Attorney for Healthcare are not needed
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Question 7 of 10

7. Question
Which of the following is FALSE with respect to Advance Care Planning?
- There are no frequency limits
- Form completion time counts, same day
- Critical care billing and ACP are allowed on same day ONLY
- It is OK to bill ACP in the same month as CCM, but the time allotted for ACP should not be counted as part of the CCM
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Question 8 of 10

8. Question
Which of the following is TRUE with respect to Advance Care Planning?
- If performed in context of the Initial Preventive Physical Exam (the IPPE, or “Welcome to Medicare” visit) then the co-pay and deductible is waived (so, “free”)
- If performed in context of the Medicare Annual Wellness Visit (initial/subsequent), then the co-pay and deductible is waived
- Use a -25 modifier to allow the ACP codes to be billed correctly
- No frequency limits as long as billed with higher level E/M codes (99213 and higher)
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Question 9 of 10

9. Question
You do a 99213 encounter and spend an additional 11 minutes discussing end of life issues with the patient. She wishes to go home and call you to make sure her daughter is on board with her wishes. That occurs over lunch today for an additional 14 minutes. You can optimally bill (assuming documentation supports)
- 99214 due to E/M plus time
- 99497 because it was under 30 minutes
- 99498 because if was above the 16 minute threshold of 99497
- 99213 + 99497 because we spent more than 16 (of the required 30) minutes dealing with ACP-specific issues
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Question 10 of 10

10. Question
The same encounter above occurs, but you also spend an additional 20 minutes reviewing the ADs on the chart and filling out the POLST form after the discussion with the family earlier that day. The billing now can be
- The 99211 as this qualifies as a “form completion” fee
- Bill the ACP lower code and CCM
- 99213 + 99497 (first 30’) + 99498 (> 15 minutes of the next 30’)
- 99214
- Not to be billed on same day as adult or pediatric critical care services
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Advance Care Planning 2020 Post Test – SCAFP

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