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2016 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

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

Medical Care For Onychomycosis

Onychomycosis, a superficial fungal infection that destroys the entire nail unit, has become a rather prevalent malady. Once contracted, it is extremely difficult to remove completely. Treatment of onychomycosis depends on the clinical type of the onychomycosis, the number of affected nails, and the severity of nail involvement.

A systemic treatment is always required in proximal subungual onychomycosis and in distal lateral subungual onychomycosis involving the lunula region. White superficial onychomycosis and distal lateral subungual onychomycosis limited to the distal nail can be treated with a topical agent. A combination of systemic and topical treatment increases the cure rate.

The use of topical agents should be limited to cases involving less than half of the distal nail plate or for patients unable to tolerate systemic treatment. They may be useful as adjunctive therapy in combination with oral therapy or as prophylaxis to prevent recurrence in patients cured with systemic agents.

Topical treatments alone are generally unable to cure onychomycosis because of insufficient nail plate penetration. Agents include amorolfine, ciclopirox olamine 8% nail lacquer solution, and bifonazole/urea. Ciclopirox and amorolfine solutions have been reported to penetrate through all nail layers but have low efficacy when used as monotherapy.

The newer generation of oral antifungal agents (itraconazole and terbinafine) has replaced older therapies in the treatment of onychomycosis. They offer shorter treatment regimens, higher cure rates, and fewer adverse effects. Fluconazole offers an alternative to itraconazole and terbinafine. Derivatives of fluconazole may also be available soon.

The efficacy of the newer antifungal agents lies in their ability to penetrate the nail plate within days of starting therapy. Evidence shows better efficacy with terbinafine than with other oral agents. To decrease the adverse effects and duration of oral therapy, topical treatments and nail avulsion may be combined with oral antifungal management.

The epidermis has 7 layers which protect and surrounds the true skin. Because the true skin is the reservoir of nourishment, it is the area where many dermatological problems exist, including fungal infections. This is why chemical solutions are often caustic and rather invasive, and usually more ineffective than effective.

Because the rate of recurrence remains high, even with newer agents, the decision to treat should be made with a clear understanding of the cost and risks involved, as well as the risk of recurrence. As most standard treatments for fungal infections are not effective against fungus which has worked its way under the nails, the antifungal effects of natural plant medicine are of increasing interest.

AntiNailFungus-Rx is concentrated with a wide spectrum of powerful antifungal plant extracts exhibiting a curative effect against nail fungus, as demonstrated by a wealth of scientific and clinical studies. AntiNailFungus-Rx helps end nail fungus infections by directly attacking and destroying fungus population infecting nails and nail beds.

Clinical evidence supports laboratory tests which show that theses extracts have penetrating antifungal actions which destroy fungi without causing tissue damage. However, this treatment is very potent and therefore only to be applied to finger/toe nails where skin and nails are hardened and less sensitive.

The mode of action of AntiNailFungus-Rx as an anti-fungal agent is particularly interesting not only in consideration of its ability to destroy fungus at very low concentrations, but is non toxic when applied topically, and represents a perfectly safe and effective nail fungus eliminator. It is ideal for eradicating fungus infections occurring in the nails of fingers or toes.

Results achieved with these products are more than convincing especially in view of the poor efficacy and side effects of treatments using classic synthetic medications. The use of medicinal plants is taking an increasingly greater role in the treatment of nail fungus as conventional medicine has few effective solutions.

Powerless, and faced with treatment failures, some doctors are actively seeking alternative effective treatments to resolve this inadequacy. Created by competent scientists, this nail fungus treatment provides real opportunities to safely eliminate nail fungus with encouraging measurable results. To learn more, please go to http://www.naturespharma.org.

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CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 


Radiology Billing and Coding Blog

CPT 95827 at home for insomnia

I have a sleep provider that wants to begin using something called the "Sleep Profiler". It is an at home overnight EEG device to help diagnosis patient perception problems with sleep. The manufacturer says we can bill it using CPT 95827 with POS 12. I am trying to find information to confirm this is appropriate and am coming up empty. I’ve tried searching for NCD’s, LCD’s and policies and can’t find any. Any leads are much appreciated. Thank you, Staci

Medical Billing and Coding Forum

Add-On Codes & EAPG Framework

Greetings!

Did a search but could not find an answer to these questions.

Fact Pattern:
An ASC bill has three CPT Codes on it – 29823, 29825-59 and 29826.
They all share EAPG Code 37, and all are Level I Arthroscopy.

29823 is paid at 100% of its value, and 29825-59 is paid at 50% of its value due to Mod 59.
That leaves me with two questions regarding 29826, our wonderful add-on code.

1) Does 29826 require Modifier 59 to be reimbursed within the EAPG framework, despite the fact that it is an add-on code?
2) Assuming 29826 is reimbursable – Modifier 59 or not – would it be reimbursed at 50% or 100%, because this is an ASC subject to EAPG?

And if people have links to sources or authorities on these issues, I would GREATLY appreciate it!

Thanks in advance everyone!!

Medical Billing and Coding Forum

CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 


Radiology Billing and Coding Blog

When to use CPT 43270 or 43255

Below are two questions that I received from one of my providers. I would say to use 43270 but wanted to see if anyone else had any input. I have not coded GI in quite some time so I am a little rusty but they still send me questions, periodically.

1. If during an endoscopy for a patient( who presented with bleeding), we find an ulcer with a vessel and we treat the vessel, the ulcer is clearly the source of bleeding, but it was not bleeding during the endoscopy. Do we bill for EGD with "control of bleeding" ?

2. during and egd for a patient with anemia, I find an arteriovenous malformation in the stomach and treat it with argon plasma coagulation to ablate it (this arteriovenous malformation is the source of chronic bleeding, but was not actively bleeding during the egd)
how do you bill for that?

Thanks in advance

Medical Billing and Coding Forum

CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 


Radiology Billing and Coding Blog

CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 


Radiology Billing and Coding Blog

CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 


Radiology Billing and Coding Blog