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

Billing 99213, 11721 & 11055 Humana

I am having a hard time getting the any office visit code (99212, 99213, 99214) 11721 & 11055 all paid by Humana. I have always had trouble with this insurance bundling these services and only paying for the lower dollar amount item (this example 11055 was the only one paid). This is how I billed the original claim to Humana:

99213 25 Modifier M20.5X2, M21.6X9, E11.40, M20.41
11721 59, Q9 Modifiers E11.40, I73.9, M79.675, M79.674
11055 LT, 59 Modifiers L85.1, M79.675, E11.40

What am I doing wrong? 2018 I only had a few problems with Humana bundling the codes, this year its all up in the air. Please help me so I can get my provider paid. Thank you in advance! :)

Medical Billing and Coding Forum

Pairing Corn/Callus Codes 11055, 11056, 11057

So I have a dermatologist that does a pairing of corn/callus on patient’s hands. However some insurances deny the code stating that it is not covered. Because what I have been finding is that it’s mainly used as Podiatry. I try to fight it using the clinical policies, for example, Medicare’s clinical policy states foot care. Is there another code any other doctors are using to pare the lesion of the hand?

This is an example of one patient’s notes:
Plan: Paring Hyperkeratotic Lesion.
A total of 4 lesions located on the right distal dorsal middle finger, right mid dorsal index finger, right ring distal interphalangeal joint, and right distal radial thumb were pared with a 15 blade scalpel. This procedure was medically necessary because the lesions that were treated were: inflamed and irritated.

Any suggestions?

Medical Billing and Coding Forum

Billing for CPT 11055

I have a provider that is billing CPT 11055. It is hitting an Edit that "this code is only allowed 1 time per 60 days." Medicare is the Primary Payor. The diagnosis used are correct per the LCD.

Procedure:

Debridement/Procedure Level: Excision callus
Instrument Used: Curette
Anesthesia 2% lidocaine jelly
Bleeding: Small
Bleeding Control: Pressure
Added Pain Control: none
Specimen Taken: None
Total Surface Area of Debridement: 0.1 cm2

I’m having a difficult finding any information on this edit. If anyone has any information where I can look for this.

Thank you

Medical Billing and Coding