Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

Practice Exam

2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

How To Flip To the Codes Faster in the Medical Coding CPC exam

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www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep Well for the ICD Manual, I’ll start with that. One of the frustrating things for me is I don’t think there’s any version of a manual out there that has the true Table of Contents. And most versions are volumes 1 and 2 and one spiral bound book. And if you’re into Inpatient Hospital Coding, you have 3 volumes in it and it’s very hard when you’re brand new at using it to figure out you know, where to even start. So what I recommend to my students is that at the top of the manual, not on the sides, that they get those hard tabs and put them where all the main sections of their manual are. So obviously, where each volume starts when you have volumes 1 through 3.

More here: http://www.cpcmedicalcodingcertificationexamprep.org

Watch Laureen Jandroep show you her proprietary “Bubble and Highlighting Technique”

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For more CPC Exam study techniques, visit Laureen’s official site here at www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

You can also get access to Practice CPC Exam Questions which comes with full rationale answers at www.cpcmedicalcodingcertificationexamprep.org

 

How To Prepare For Your CPC Exam and How To Pass It On Your First Try

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Medical Coding Certification CPC Exam Review

Watch Laureen Jandreop show you her special “Bubbling and Highlighting Technique” and how you can practice it in your coding manual too (The CPC exam is an open book exam so you can bring in your coding manual with you to your exam)

Feeling stressed studying for your CPC exam? Maybe overwhelmed by the amount of studying involved?

Maybe you are not sure whether you are well prepared for the CPC exam questions, or maybe you have a hard time planning and managing your study time, maybe you’re worried that you can’t finish the CPC exam paper in the five and a half hours time.

Fear not, I’ve been there too and this was exactly how I felt. I was especially worried about the 5 and a half hours alloted time frame which always seems too short.

Maybe this is your first time studying for the CPC exam. Or maybe you are re-sitting the CPC exam. Either way, as the date draws nearer you might be getting desperate for a method to help you study for and pass the CPC exam.

Good news! Laureen Jandroep (CPC) has put together the highly result driven Medical Coding Certification Review Blitz Videos that you cna watch online from the comfort of your own home. It shows 12 hours of CPC exam review and CPC exam tips that you wouldn’t wanna miss! And as a bonus, a full set of 7 DVD’s of these video course will be delivered to your home or office!

This Medical Coding Review Program prepares you for the Certified Professional Coder (CPC) exam by the American Academy of Professional Coders (AAPC) and also the Certified Coding Specialist-Physician Based (CCS-P) exam by the American Health Information Association (AHIMA).

This is a two in one program where the program will guide you in the review of the subject matter, as well as guide you in doing well on the CPC exam. The video course will guide you through an exhaustive review of all the diagnostic and therapeutic procedures covered in the exam, and also teaches you how to make the best use of the time alloted in the CPC exam, which is only five anda half hours! And since the CPC exam is an open-book exam, Laureen Jandroep’s proprietary bubbling and highlighting technique will greatly save time and enable you to locate the important points quickly and efficiently during the CPC exam. This Bubbling and Highlighting Technique actually teaches you how to mark and highlight your coding manual, making it easier to choose the correct answer for any question in the CPC exam. It will also teach you how to manage more difficult questions.

The online video program and the DVD program is identical. This is what they will cover:

01 Introduction to the program

02 Medical Terminology CPC Exam Prep

03 HCPCS CPC Exam Prep

04 Modifiers CPC Exam Prep

05 ICD-9 CPC Exam Prep

06 E&M Section CPC Exam Prep

07 Anesthesia Section CPC Exam Prep

08 Radiology Section CPC Exam Prep

09 Path & Lab Section CPC Exam Prep

10 Medicine Section CPC Exam Prep

11 Integumentary System CPC Exam Prep

12 Musculoskeletal System CPC Exam Prep

13 Respiratory System CPC Exam Prep

14 Cardiovascular System CPC Exam Prep

15 Digestive System CPC Exam Prep

16 Urinary System CPC Exam Prep

17 Genital System CPC Exam Prep

18 Endocrine/Nervous System CPC Exam Prep

19 Eye/Ear System CPC Exam Prep

Laureen Jandroep has been teaching medical coding 12 years ago since 1999. She has personally taken all the certification exams so she could understand the format of the exams and thus prepare her students for what was gonna be covered in the exams. The video course was created when her students begged her to help them prepare for the following weeks exam and therefore she reviewed the whole CPC training program in two days. Since then, Laureen has been teaching this CPC review program and has helped many students successfully pass the CPC exam.

Click here to visit the official site now!

You can also download Laureen’s CPC Exam Study Guide at www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

Practice CPC Exam Package Review – 150 Question CPC Practice Exam, Answer Key, With Full Rationale, Medical Coding Certification Study Guide

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What I like most about this CPC Practice Exam Package is that the full answers and rationales are given for all 150 questions. It also refers you to the relevant part of your textbook. They also provide the answer keys to each CPC exam question, so you can go through each one and see if your rationale is correct when testing yourself. I also found the CPC Exam Study Guide very helpful as it summarizes the whole textbook for you. As the CPC exam is an open book exam, you can actually mark your book or highlight the important texts or codes to help you search for the codes faster during the test. Do practice answering all 150 questions of the practice test within 5 and a half hours, make it to 5 hours if you can so you will have time to go back and check your answers.

The CPC Medical Coding Practice Exam is delivered as an electronic download (in the PDF format), which means it’s instantly accessible after purchase. The good news is that ut’s priced at only $37.

This Price Includes:

What is included in this package?

  • The Full 150 Question CPC Practice Exam
  • Answer Key, With Full Rationale
  • Scan Tron Bubble Sheets
  • The Exam Study Guide, including:
    Common Anatomy Terminology Handouts
    Common Medical Terminology Prefix, Root Word, and Suffix Handouts
  • The Official AAPC Proctor-to-Examinee Instructions (read out loud on the day of the CPC exam)

Download the full CPC Practice Exam Package here and receive your bonus at www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

You can also get the latest CPC Exam updates at www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

Best Compilation Of Sample CPC Exam Questions – Followed With Full Answer And Rationale

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Sample CPC Exam Question 3: ICD-9-CM

Jim was at a bonfire when he tripped and fell into the flames. Jim sustained multiple burns. He came to the emergency room via an ambulance and was treated for second and third degree burns of his face, second degree burn on his shoulders and forearms, and third degree burns on the fronts of his thighs.

a. 941.20, 841.30, 943.25, 943.21, 945.36, 948.42, E897
b. 941.30, 943.29, 945.36, 948.42, E897
c. 941.09, 943.09, 945.09, 948.64, E897
d. 941.30, 943.29, 945.36, 948.64, E897

Rational

Answer: B

Burn codes always have no less than three codes: A burn code, a total body surface area code (948.XX), and an E code. You can have more than three codes but never less. Burn codes have the following rules (which can be found at the beginning of the ICD-9 book under general guidelines), always code one location to the highest degree (Ex. 1st and 2nd degree burns on the arm, only code 2nd degree). When sequencing burn codes always list the highest degree first (Ex. 1st degree burns to the face and 3rd degree burns to the arm. List the arm burn first and then the face burn). Answer B is the answer because its codes describe the highest degree burn to each anatomical location, it sequences the burn codes in order of highest to lowest degree burns, the 948 (TBSA code) has the correct calculation, and the E code correctly describes the bonfire incident.

Sample CPC Test Questions 4: Anesthesia

When does anesthesia time begin?

a. After the induction of anesthesia is complete
b. During the pre-operative exam prior to entering the OR
c. When the anesthesiologist begins preparing the patient for the induction of anesthesia
d. Once the supervising physician signs over the patient’s care to the anesthesiologist

Rational

Answer: C

The answer to this question can be located in the anesthesia coding guidelines under the title “Time Reporting”

Go Through more of these Sample CPC Test Questions with full answers and explanation at www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

Get the latest updates on the CPC Exam at www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

More CPC Sample Exam Questions – Comes With Correct Answer And Full Rationale For Each Question

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Sample CPC Exam Question 2: Musculoskeletal

OPERATIVE NOTE

PREOPERATIVE DIAGNOSIS: myelopathy secondary to very large disc herniations at C4-C5 and C5-C6.

POSTOPERATIVE DIAGNOSIS: myelopathy secondary to very large disc herniations at C4-C5 and C5-C6.

PROCEDURE PERFORMED:
1. Anterior discectomy, C5-C6
2. Arthrodesis, C5-C6
3. Partial corpectomy, C5
4. Machine bone allograft, C5-C6
5. Placement of anterior plate with a Zephyr C6

ANESTHESIA: General
ESTIMATED BLOOD LOSS: 60 mL
COMPLICATIONS: None

INDICATIONS: This is a patient who presents with progressive weakness in the left upper extremity as well as imbalance. He has a very large disc herniation that came behind the body at C5 as well and as well as a large disc herniation at C5-C6. Risks and benefits of the surgery including bleeding, infection, neurologic deficit, nonunion, progressive spondylosis, and lack of improvement were all discussed. He understood and wished to proceed.

DESCRIPTION OF PROCEDURE:
The patient was brought to the operating room and placed in the supine position. Preoperative antibiotics were given. The patient was placed in the supine position with all pressure points noted and well padded. The patient was prepped and draped in standard fashion. An incision was made approximately above the level of the cricoid. Blunt dissection was used to expose the anterior portion of the spine with carotid moved laterally and trachea and esophagus moved medially. I then placed needle into the disc spaces and was found to be at C5-C6. Distracting pins were placed in the body of C6. The disc was then completely removed at C5-C6. There was very significant compression of the cord. This was carefully removed to avoid any type of pressure on the cord. This was very severe and multiple free fragments noted. This was taken down to the level of ligamentum. Both foramen were then also opened. Part of the body of C5 was taken down to assure that all fragments were removed and that there was no additional constriction. The nerve root was then widely decompressed. Machine bone allograft was placed into C5-C6 and then a Zephyr plate was placed in the body C6 with a metal pin placed into the body at C5. Excellent purchase was obtained. Fluoroscopy showed good placement and meticulous hemostasis was obtained. Fascia was closed with 3-0 Vicryl, subcuticular 3-0 Dermabond for skin. The patient tolerated the procedure well and went to recovery in good condition.

a. 22554, 63081, 63082, 20931, 22845
b. 22551, 63081, 20931, 22840
c. 22551, 63081, 63082, 20931, 22845
d. 22554, 63081, 20931, 22840

Rational:

Answer: A

Per. Paul Cadorette and the American Medical Association article titles, “Coding Guidance for Anterior Cervical Arthrodesis”, “When a spinal fusion (arthrodesis) is performed, the first thing a coder needs to recognize is the approach or technique that was utilized. With an anterior (front body approach)to cervical fusion the incision will be made in the patient’s neck, so the key terms to look for are platysma, esophagus, carotid, and sternocleidomastoid. These structures will be divided and/or protected during dissection down the vertebral body. After dissection, the procedure can proceed on one of three ways:

1) When the interspace is prepared (minimal discectomy, perforation of endplates) then 22554 would be reported.

2) When a discectomy is performed to decompress the spinal cord and/or nerve root(s) report 22554 for the arthrodesis along with 63075 for the discectomy procedure.

3) When a partial corpectomy (vertebral body resection) is performed at C5 and C6 report CPT code 22554 for the arthrodesis with 63081 and 63082. Two codes are reported because the corpectomy procedure is performed on two vertebral segments (C5 and C6). CPT codes 63081-63091 include a discectomy above and/or below the vertebral segment, so code 63075 (discectomy) would not be reported if performed at the C5-C6 interspace.

Once the decompression procedure has been completed, a PEEK cage can be placed within the interspace or a structural bone graft can be fashioned to fit the vertebral defect created by the previous corpectomy. Insertion of the PEEK cage would be reported with a biomechanical device code 22851. This code is only reported one time per level even if two cages are placed at C5-C6. When a structural bone graft is used, determine whether it is an allograft (20931)) or an autograft (20938). The bone graft codes are only reported one time per procedure and not once for each level. Finally, the physician will place an anterior plate with screws (22845) across the C5-C6 interspace to stabilize the area fusion”.

Some guidance on coding such procedures can also be located in the Spine (vertebral column) coding guidelines (above code 22010).

Learn more of these CPC exam questions with full answers and explanation at www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

Get the latest CPC Exam Updates at http://www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

CPC Sample Exam Questions – Comes With Correct Answer And Full Rationale For Each Question

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Example Of Sample CPC Exam Question 1: Medical Terminology

The term “Salping-Oophorectomy” refers to

a. The removal of the fallopian tubes and ovaries
b. The surgical sampling or removal of a fertilized egg
c. Cutting into the fallopian tubes and ovaries for surgical purposes
d. Cutting into a fertilized egg for surgical purposes

Rational

Answer: A

The term “salp” means tube, the term “ooph” refers to the ovary, and the suffix “ectomy” means to surgically remove. Some CPT books (like the professional edition put out by the AMA) contains pages with common medical terms like these in the beginning of the book (prior to the coding guidelines)

Learn more of these CPC exam questions with full answers and explanation at www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

Get the latest Medical Coding Certification and CPC Exam Updates at http://www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

Practice CPC Exam Questions And Answers And Time Yourself To Finish It In 5 Hours

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AAPC’s CPC exam is 150 questions long. Questions range from true and false, to 1-2 sentences, to full page operative notes.

Questions on the CPC exam do not cover just specific medical codes. Questions can be very diverse, testing the examinees knowledge on:

  • Coding Guidelines
  • Understanding of Conventions
  • Correct Modifier Use
  • Bundling and Global Packages
  • Medical Terminology and Gross Anatomy

We have taken into account the wide spectrum of diversity the CPC exam offers and have constructed the questions on our CPC Practice Exam to reflect those on the actual exam as closely as possible.

In addition to our well constructed questions we are also providing a full rationale for each question.

These rationales provide the correct answer for each question as well as a full explanation as of why this option is correct, why the other three options are incorrect, and where in the medical coding books the answer can be located.

Studying the rationale of an answer may very well be the easiest and most efficient way to learn how to pass the CPC exam.

Download and practice the CPC Exam Questions with Answers at http://www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

Get the latest Medical Coding Certification and CPC Exam Updates at http://www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

What Medical Coding And Billing Questions Are Good For The CPC Practice Exam?

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A good practice exam should fully prepare its examinee for the real exam. Knowing what to expect and not being surprised on exam day are important.

AAPC’s CPC exam is 150 questions and must be completed in 5 hours and 40 minutes or less.

There are three main sections to the CPC exam:

1. Medical Concepts
2. Surgery and Modifiers
3. Remaining CPT codes
Each of these three sections are then further divided into the following smaller headings.

1. Medical Concepts:
**The following sub-divisions are each assigned 5-10 category specific questions**
Guidelines
Payment management
Medical terminology
Anatomy
ICD-9-CM codes
HCPCS codes

2. Surgery And Modifiers:
**This section is mainly sub-divided to reflect the surgery section of the CPT book and assigns 5-10 category specific questions to each of the following sub-divisions**
Integumentary
Musculoskeletal
Respiratory
Cardiology
Hemic/Lymphatic systems
Mediastinum/Diaphragham
Digestive
Urinary
Male and Female reproductive organs
Maternity/ Endocrine system
Nervous system
Eyes/Ears

3. Remaining CPT Codes:
**This portion of the exam focuses on the remaining CPT codes and assigns 5-10 category specific questions to each of the following sub-division**
Evaluation and Management
Anesthesia
Radiology
Pathology
Medicine

Our 150 question CPC practice exam was created using the structure listed above in order to emulate the actual CPC exam as closely as possible. We felt that by doing this examinees would know exactly what to expect on examination day. By utilizing this structure examinees can better prepare for the exam by focusing on category specific questions and identifying areas of weakness. Knowing what to expect in detail also tend to help calm pre-test anxiety.

Get the latest Medical Coding Certification and CPC Exam Updates at http://www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

Practice CPC Exam Questions And Answers For Your Exam Preparation – This Is The Best Way To Learn Medical Coding And Pass Your CPC Exam

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Are you about to take the AAPC exam for Certified Professional Coder for the first time?

Or are you one of the many people who FAILED the exam the first time, and are now looking to retake the test, perhaps for the third or fourth time?

It’s Time To STOP Doing What’s Not Working, And Get The CPC Practice Exam!

CONTENTS OF THE PRACTICE EXAM:

CPC Practice Exam Questions

CPC Practice Exam Questions

  • 150 Question CPC Practice Test
  • Answer Key, With Full Rationale
  • Scan Tron Bubble Sheets
  • The Exam Study Guide, including:
    Common Anatomy Terminology Handouts
    Common Medical Terminology Prefix, Root Word, and Suffix Handouts
  • The Official AAPC Proctor-to-Examinee Instructions (read out loud on the day of the exam)

Download your copy of the CPC Exam Practice Questions And Answers at http://www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

Get the latest Medical Coding Certification and CPC Exam Updates at http://www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

Medical Billing And Coding At Home Jobs – How to pass the CPC Exam and become a Certified Professional Medical Coder

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Download your CPC Practice Exam Questions at http://www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

A good practice exam should fully prepare its examinee for the real exam. Knowing what to expect and not being surprised on exam day are important.

AAPC’s CPC exam is 150 questions and must be completed in 5 hours and 40 minutes or less.

Contents of the CPC practice exam:

* 150 Question CPC Practice Exam

* Answer Key, With Full Rationale * Scan Tron Bubble Sheets

* The Exam Study Guide, including: Common Anatomy Terminology Handouts Common Medical Terminology Prefix, Root Word, and Suffix Handouts

* The Official AAPC Proctor-to-Examinee Instructions (read out loud on the day of the CPC exam) AAPC’s CPC exam is 150 questions long. Questions range from true and false, to 1-2 sentences, to full page operative notes.

* Coding Guidelines

* Understanding of Conventions

* Correct Modifier Use

* Bundling and Global Packages

* Medical Terminology and Gross Anatom In addition to our well constructed questions we are also providing a full rationale for each question.

These rationales provide the correct answer for each question as well as a full explanation as of why this option is correct, why the other three options are incorrect, and where in the medical coding books the answer can be located.

Studying the rationale of an answer may very well be the easiest and most efficient way to learn how to pass the CPC exam. Download your FREE “Medical Coding From Home eBook” at http://www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

How These Videos Will Help You Pass the CPC Exam – CPC Exam Video Review

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 Download your FREE “Medical Coding From Home eBook” at http://www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

CPC Practice Exam Questions at http://www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

Elimination of AAPC Apprentice Credential – Medical Coding Certification

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For the latest updates, visit www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

( Enclosed is the article)

Letter from the Chairman and CEO (Jan 2012)

Elimination of “A” Designation

The Apprentice designation is not needed anymore.

The National Advisory Board (NAB) has recommended, and the AAPC leadership team has discussed and agreed, that the Certified Professional Coder-Apprentice (CPC-A®) credential has outlived its usefulness. The objective of the apprentice (A) designation was to show others—primarily prospective employers—an individual had passed the CPC® exam, but did not yet have one or two years of on-the-job experience. Instead, it was too often preventing most CPC-As® from getting interviews for potential jobs and hurting their prospects.

We believe the résumé indicating the experience level of an individual should speak for itself. Whether the individual has great aptitude, a terrific work ethic, good people skills, or any other desirable attribute is often never discovered because an interview was unable to be obtained. While we still believe experience is needed to become a good coder, we think it should be the employer’s decision who to hire.

Accordingly, AAPC is accepting comments through Jan. 31, 2012 on the following proposal:

Effective July 1, 2012, the CPC-A® credential will no longer be granted. All current CPC-As® would have their “A” removed by doing one of the following:

Getting at least one year of on-the-job experience no later than Dec. 31, 2013 (helpful to those with a job and currently working towards that end), or

Successfully passing a clinical exam consisting of coding 20 operative/office notes

Thus, no current CPC-A® would be “grandfathered” into the CPC® credential.

Those taking the CPC® exam after July 1, 2012 will have two ways to get their CPC® credential.

They can have one year of coding experience prior to taking the CPC® exam (proof given at time of exam application), and then pass the CPC® exam, or

They can pass both the current CPC® exam and clinical exam by successfully coding 20 operative/office notes. On-the-job experience after taking the CPC® exam will not be required.

It does not matter in which order the two exams are taken; if lacking prior experience, both are required to become a CPC®.

The pass rate for the CPC® exam will stay the same and a 90 percent pass rate on the clinical exam will be required. The 90 percent will be determined by correctly coding 18 of the 20 notes (and most will require multiple codes). The clinical exam will not be multiple choice; it will be free form and hand graded.

The clinical exam will include a sampling of office visits, surgical notes, evaluation and management (E/M) coding, ancillary services, modifier usage, and diagnosis coding.

The clinical exam would be taken at any AAPC proctored exam site. The same five hours and 40 minutes time restriction and code books will be allowed into this exam. If additional resources beyond code books are needed to properly code the notes, that information will be provided as part of the exam.

Both exams will be paid for at the same time and the cost for both exams will increase by $35. Applicants may still take each exam twice to pass it. If the examinee has one year experience, then he or she would pay only the CPC® exam price. If one exam is passed after two attempts, but not the other, then the fee for the exam not passed would be paid to re-take it.

Of course, current CPCs® are not affected by this change. As stated above, we would appreciate comments to this important change to our credentialing program through Jan. 31, 2012. You may go to www.aapc.com/cpc-acomment to submit your comment. From those comments we will either proceed ahead, make modifications that strengthen the change, or slow down the change due to legitimate concerns that AAPC has not properly considered.

For the latest updates, visit www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

How to study for the CPC exam paper? More important tips to help …

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A strategy that has been adopted by many, it might work out better for you to start answering the questions from back to front. Start the CPC exam paper from the end to the front may work for you because the questions are generally more advanced at the end, while the front questions are somewhat simpler. Therefore you may not need to spend as much time on the front questions.

Also, do not worry if you’re unsure of the answers to some questions. Just skip those questions and mark them. You can come back to them later. Work on those that you are sure of, as there is a higher chance of you getting more questions correct this way, and you can be sure that you’ve got time to cover every question. After you have gone through the whole paper, return to those marked questions to work on them. If you are really running out of time, just pick an answer randomly, this way you will at least have a chance of choosing the correct answer as opposed to leaving the question blank.

Confirm and check out the CPC examination venue beforehand if possible. This will help you feel prepared and less stressed out on the actual CPC exam date. Confirm the examination venue on the website, and always arrive early just in case. This is very important as you may be forbidden from taking the CPC exam if you are late.

On the day of the CPC exam, take a breakfast rich in protein and low in greasy fat. Take some carbohydrates too. Two half-boiled or poached eggs taken with some toast would be perfect. Taking a glass of milk would be good too as it is full of protein and natural sugars and vitamins that will nourish you, your brain and your body. Refrain from eating fried or oily food for breakfast as you may feel sluggish later. Never ever sit for your CPC exam with an empty stomach. That is the biggest mistake anyone can make as you are not operating with your full potential with low blood sugar and an empty stomach. Remember, this CPC exam is 5 and a half hours long. It’s a long time to fast.

Things to bring along to the CPC exam:

Bring along a bottle of water with you into the CPC exam venue. You will need water for optimal function of your body and brain. Also, bring a watch with you to keep track of the time. Plan your time accordingly. For example, 2 and a half hours into the test, you should be halfway through the questions. Lastly, bring along a jacket or sweater to keep you warm and comfortable if needed during the test.

Click here for CPC practice exam questions and the CPC exam study guide

You can also download the CPC Exam Practice Questions which come with the answer keys and full rationale at http://www.cpcmedicalcodingcertificationexamprep.org/cpcpracticeexam

Or if you’d like to learn more about Laureen Jandroep’s CPC exam study guide and her special Bubbling and Highlighting technique, you can visit http://www.cpcmedicalcodingcertificationexamprep.org/cpc-exam-prep

CMS Adds 11 Codes to Telehealth List

Physicians can now offer more services via telehealth and get paid. The Centers for Medicare & Medicaid Services (CMS) is adding 11 codes to the list of telehealth services payable under the Medicare Physician Fee Schedule (MPFS). Coverage is retroactive to March 1, 2020, and is effective for the duration of the public health emergency […]

The post CMS Adds 11 Codes to Telehealth List appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Provider Relief Fund to Dole Out Add-On Payments

Billions more available to beleaguered providers. Add-on payments are available for healthcare providers “on the frontlines” of the coronavirus (COVID-19) pandemic. The Department of Health and Human Services (HHS) announced Oct. 1 an additional $ 20 billion under a Phase 3 General Distribution allocation of the Provider Relief Fund (PRF). Who Qualifies for Add-On Payments? The […]

The post Provider Relief Fund to Dole Out Add-On Payments appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

When to Apply Modifiers 26 and TC

Modifiers 26 and TC are unique coding tools that may be used in specific circumstances. It can be easy to become perplexed trying to keep the components of a procedure straight and remembering when these modifiers should be applied. To dispel some of the confusion, this article will explore common uses of modifiers 26 and […]

The post When to Apply Modifiers 26 and TC appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Limit Your CPT® Code Set Updates to January? Here’s Why That’s a Bad Idea

CPT Code Updates January

Guest Post from Deborah Marsh, JD, MA, CPC, CHONC, a senior content specialist for TCI SuperCoder.

Payers don’t accept deleted CPT® codes, so your claims can’t succeed if your medical procedure codes are out of date. But do you know how often you need to update your CPT® code set? It may be more often than you think. Here are some pointers to keep in mind to give your claims their best chance at accurate payment.

Make the Biggest Transition with January Updates

Each year, a new CPT® code set is effective on January 1. For instance, for CPT® codes, 2018 codes will give way to the 2019 code set on Jan. 1, 2019.

If you use an online CPT® code search product, you’ll want to be sure that the updates are searchable January 1. It’s also helpful if the CPT® lookup includes deleted codes (marked with the deletion date) because you use the code set based on the date of service. You may need access to previous code sets to finish filing claims and for working on appeals.

Plan for These Other Regular CPT® Code Set Releases, Too

The AMA, which owns and maintains the CPT® code set, implements certain types of codes more than once a year. You should be aware of these updates and have a strategy for ensuring you have them when you need them. All specialties may see CPT® updates throughout the year, but path/lab coders need to watch for a few special categories that apply to them.

Category III and vaccine codes: Category I vaccine codes and Category III codes (temporary codes for emerging technology and services) are implemented January 1 and July 1. You’ll typically find them posted on the AMA site six months before the codes are effective, giving you time to learn how to apply them.

Category II: Category II codes are tracking codes that you may use for performance measurement programs, like MIPS. The AMA site indicates you may see release March 15, July 15, and November 15, with implementation three months after release.

Molecular pathology tier 2 codes: To help with reporting MoPath procedures, these codes go from approved to effective fairly quickly. After approval by the CPT® Editorial Panel, codes are released to the AMA site March 1, September 1, and December 1. The effective date may be as soon as one month after the release.

Administrative MAAA codes: Similar to the MoPath codes, Multianalyte Assays with Algorithmic Analyses (MAAA) see a quickened schedule. After Panel approval, the codes are released to the AMA site March 1, September 1, and December 1. The effective date is typically one month after release, although some codes are held until the major January 1 update.

PLA: The schedule for proprietary laboratory analyses (PLA) code changes is quarterly, but publication and effective dates have varied as this new-ish type of code got off the ground. For 2018, the effective dates are January 1, April 1, July 1, and October 1.

Tip: This schedule of updates throughout the year is one reason why having an online CPT® code lookup resource is a good idea. Whether it’s in addition to your paper manual or an alternative to it, automatically updated CPT® codes online ensure you have the correct codes available to you.

And Don’t Forget Corrections May Happen Any Time

The AMA posts an Errata and Technical Corrections file on its site, and you need to be sure you check it regularly or make sure your online code-lookup provider incorporates any corrections. Often the AMA posts corrections before code set implementation as people report issues they find while preparing for the transition. But updates and corrections may occur at any point in the year, so don’t assume you can let down your guard early in the year.

Bottom line: Healthcare providers need access to up-to-date CPT® codes to ensure their claims are accurate for the date of service reported. Keeping codes current isn’t as simple as updating once a year in January. Make a plan to update your coding resource or keep an eye on your online coding solution to be sure it’s doing the update work for you.

About the Author

Deborah Marsh, JD, MA, CPC, CHONC, is a senior content specialist for TCI SuperCoder, working on everything from online tool enhancements and data updates to social media and blog posts. Deborah joined TCI in 2004 as a member of TCI’s respected Coding Alert editorial team.

— This post Limit Your CPT® Code Set Updates to January? Here’s Why That’s a Bad Idea was written by Manny Oliverez and first appeared on CaptureBilling.com – Medical Billing Services. Capture Billing is a medical billing company helping medical practices get their insurance claims paid faster, easier and with less stress allowing doctors to focus on their patients.

CaptureBilling.com – Medical Billing Services

Final Rule Encourages Home Dialysis and Living Donor Kidney Transplants

Mandatory model aims to reduce Medicare expenditures for ESRD patients while improving their quality of care.

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3 New Codes for Infectious-Agent Detection

The latest changes to the CPT® code set will help clinicians distinguish seasonal infections from COVID-19 in their reporting. Three new CPT® codes have been created, Oct. 6, that will allow clinicians to distinguish the tests for influenza A, influenza B, and respiratory syncytial virus (RSV) that include SARS-CoV-2 from those that don’t. The new […]

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Billing therapy services in support of comprehensive APC services

Billing therapy services in support of comprehensive APC services

by Valerie A. Rinkle, MPA

CMS’ Transmittal 3523, issued May 13, is the quarterly July 1 OPPS update. In this transmittal, CMS briefly mentions billing physical and occupational therapy and speech-language pathology services provided in support of or adjunctive to comprehensive APC (C-APC) services under revenue code 0940 (general therapeutic services) rather than the National Uniform Billing Committee?defined revenue codes for these services (i.e., 042x, 043x, and 044x, respectively).

CMS refers to these therapy services as "non-therapy outpatient department services." In addition, CMS says that these services should not be reported with therapy CPT® codes.

These therapy services have been packaged into C-APCs since the inception of these per-encounter/per-claim payments in 2015. Initially, CMS implemented 25 C-APCs in 2015 for device-intensive procedures. In 2016, the agency expanded the concept to 33 surgical and procedural C-APCs covering almost 700 CPT/HCPCS procedure codes in nine clinical families. It also added one C-APC to pay for ancillary services in the case of inpatient-only procedures performed on a patient who dies prior to being admitted as an inpatient (billed with modifier ?CA).

Another C-APC is for observation services when billed for eight or more hours, with either ED, clinic, or direct admit codes and no surgery service performed. These C-APCs are defined with status indicators J1 and J2. On these claims, there is one payment associated with one primary CPT/HCPCS regardless of the number of days for the encounter. All of the other charges and codes are billed on the claim. There are a few exceptions, such as non-OPPS services like ambulance and preventive services such as vaccines and mammography.

While the transmittal does not provide much explanation, it is assumed that this instruction follows CMS’ comment in the 2016 OPPS final rule, where CMS stated at 80 FR 70326 (emphasis added):

Payment for these non-therapy outpatient department services that are reported with therapy codes and provided with a comprehensive service is included in the payment for the packaged complete comprehensive service. We note that these services, even though they are reported with therapy codes, are outpatient department services and not therapy services. Therefore, the requirement for functional reporting under the regulations at 42 CFR 410.59(a)(4) and 42 CFR 410.60(a)(4) does not apply.

 

Therefore, according to this statement in the 2016 OPPS final rule, CMS intended to provide administrative relief to hospitals so that they would no longer have to report functional status HCPCS G codes and modifiers when these therapy services were provided in support of C-APC services and included on the same claim.

However, since January 1, the Integrated Outpatient Code Editor (I/OCE) claim edits continue to require reporting of functional status HCPCS G codes and modifiers if therapy CPT and revenue codes are reported. Changing the reporting of these therapy services from the usual revenue codes and CPT codes to revenue code 0940 and no CPT codes will no longer trigger the claim edits that require the reporting of functional status codes and modifiers. However, there seems to be even more behind this change.

 

Defining therapy services

CMS described these therapy services provided during the perioperative period or in support of observation as not the same therapy services discussed in section 1834(k) of the Social Security Act (SSA). This distinction is an important one, because therapy services that meet the definition of therapy services performed by therapists under a plan of care in accordance with sections 1835(a)(2)(C) and 1835(a)(2)(D) of the SSA are excluded from OPPS by statute and paid under the Medicare physician fee schedule.

CMS implies that therapy services performed during the same encounter as C-APC services, even when performed by licensed and credentialed therapists, do not meet that same statutory definition of therapy, namely due to not being under a plan of care. Therefore, CMS no longer wants these therapy services in support of C-APCs to be reported with the same revenue and CPT codes as that used for therapy provided under a plan of care, which are required to be billed as repetitive services on monthly claims. C-APC services are required to be on an outpatient hospital claim that includes all the other charges and codes for services performed during the same encounter that are supportive or adjunctive to the C-APC service.

The transmittal also refers to the status indicator for this revenue code (0940) being changed from B to N. Status indicator B means codes that are not recognized when submitted on an OPPS claim. One way to remember this is that B stands for "better code." Status indicator N means items unconditionally or always packaged, or stated another way, services never separately paid. Heretofore, status indicators were preserved for CPT/HCPCS codes and APC groupings and not assigned to revenue codes.

However, CMS maintains a list of packaged revenue codes. Previously, revenue code 0940 was not included in the list of packaged revenue codes (Table 4 in the 2016 OPPS final rule at 80 FR 70320). CMS appears to be changing revenue code 0940 to be included in the list of packaged revenue codes.

If the services are no longer to be reported with CPT codes, then this revenue code will become packaged. As is the case with all packaged revenue codes, if the service is defined by a CPT/HCPCS code, and all other CPT/HCPCS coding and NCCI policies are followed, the CPT/HCPCS codes should be reported in addition to the revenue code irrespective of the fact that the revenue code is packaged.

 

Setting a precedent

This transmittal is the first time that CMS appears to suggest that services that meet the definition of CPT/HCPCS codes should not be reported at all, even when all other CPT/HCPCS coding conventions and NCCI policies are followed; it appears to be a precedent for CMS.

Once this change occurs, CMS will not use hospital therapy cost center cost-to-charge ratios from hospital cost reports to reduce the billed charges for therapy under revenue code 0940, but rather hospitals’ "other" cost center cost-to-charge ratios. It will likely result in a mismatch of revenue and expense that could adversely impact future rate setting.

It is interesting to note that rehabilitation services are optional hospital services under CMS’ Conditions of Participation (CoP) at 42 CFR 482.56, which states:

Physical therapy, occupational therapy, speech-language pathology or audiology services, if provided, must be provided by qualified physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, speech-language pathologists, or audiologists as defined in part 484 of this chapter.

 

There are a few services that CMS defines as "sometimes therapy services" which can either be performed by therapists or nurses, namely wound care services. The CoPs, which are different than conditions of payment, do not require a plan of care, but do require orders. Therefore, it appears that hospital therapy services can be provided without a plan of care, and presumably, these services are now packaged under OPPS and do not qualify for physician fee schedule payment. Requirements for therapy plan of care for coverage can be found at 42 CFR 410.61 and 42 CFR 424.24.

To implement this change, hospitals will likely have to duplicate therapy charges in the chargemaster under the different revenue code that would only be used for Medicare outpatients and not for Medicare inpatients, and commercial or Medicaid accounts that are not likely to follow this billing instruction. This implementation step will likely complicate charge capture and increase the likelihood of errors.

Providers should evaluate this CMS instruction and provide feedback to the agency. Consider the following:

  • Is this proposal more or less burdensome than continuing to report therapy under the current revenue codes and also reporting the functional status codes and modifiers?
  • Do hospitals currently develop plans of care for therapy, whether or not it is in support of a C-APC service?
  • Will it alleviate a different type of burden on therapists if plans of care are not required?

 

Providers should comment to CMS if this solution is more burdensome or creates more confusion. CMS may be able to find other ways to change the I/OCE edits for functional status codes and modifiers and allow therapy services to continue to be reported with the usual revenue codes and CPT codes.

One of the most significant impacts may be to the accuracy of future payment rates. If this instruction continues without change, then a fundamental principle of cost reporting and rate setting seems to have been changed. This new policy may create a critical precedent for future rate setting. If CMS does not hear from many providers, then it is not likely to change the requirement and providers will need to work toward implementation as of July 1.

 

Editor’s note: Rinkle is a lead regulatory specialist and instructor for HCPro’s Medicare Boot Camp®?Hospital Version, Medicare Boot Camp®?Utilization Review Version, and Medicare Boot Camp®?Critical Access Hospital Version. Rinkle is a former hospital revenue cycle director and has over 30 years in the healthcare industry, including over 12 years of consulting experience in which she has spoken and advised on effective operational solutions for compliance with Medicare coverage, payment, and coding regulations.

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Public Health Emergency Extended

Health and Human Services Secretary Alex Azar has once again renewed the public health emergency (PHE) for the coronavirus pandemic (COVID-19). Set to expire Oct. 23, the PHE is now set to expire Jan. 21, 2021 — one year after declaring a PHE for COVID-19 in the United States. The renewal has many implications, including […]

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I Am AAPC: Jamie Hanmer, CPC, COBGC

My journey to healthcare began approximately six years ago. Having dabbled in various fields, I never found the perfect fit — you know, the one that makes you want to get up and go to work every day. Someone later suggested I try a career in healthcare. I wasn’t sure where to begin. I thought […]

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