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

Practice Exam

CPC Practice Exam and Study Guide Package

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

CPC Exam Review Video

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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

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

Add-on to What? Finding Primary Procedure Codes

CPT® add-on codes, such as +10004 Fine needle aspiration biopsy, without imaging guidance; each additional lesion (List separately in addition to code for primary procedure), describe procedures always provided “in addition to” a more extensive, primary procedure code (there is one exception). Often, a parenthetical note will identify the primary code(s) with which the add-on code […]

The post Add-on to What? Finding Primary Procedure Codes appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

3D strain echocardiogram add-on code 0439T

My practice has acquired a 3D strain echocardiogram equipment and we can’t find the reimbursement anywhere. Would anyone be able to help in this matter or lead us in the right direction. We know that we have to put an add-on code to 93306 which is 0439T. We are located in Southern MA.
Thank you,
Louise CPC medical coder

Medical Billing and Coding Forum

CMS Proposes Add-on Codes

CMS includes in the proposed rule some new Part B specific add-on codes that are to be used specifically with E/M codes which create the single rate of $ 93 for established patients 99212-99215 and a single rate for new patients 99202-99205 of $ 135. The add-on codes are designed to provide for an additional payment to primary […]
AAPC Knowledge Center

Add-on Billing coding

Hi! I have recently taken on a lot more of our billing at my lab and am wanting to know how to bill add-on codes. This has been a problem for us in the past.
Example would be that we received a urine sample and ran the initial screening and basic confirmation testing. The doctor comes back a day or 2 later and wants something else ran on the sample based on the initial results. Since the initial claim has most likely gone out the door, how or can you bill for an add-on test without creating what seems like a duplicate claim. (Pt’s insurance would take the G-code and so another G-code would show up for same DOS….)

Is there a modifier that can be used?

thank you!

Medical Billing and Coding Forum

Add-On Code Usage

I have a simple question about the usage of add-on codes and I feel I should know the answer. Is there any rule that limits the number of add-on codes per CPT code? This question came up at work during an audit. A vascular surgeon billed primary procedure code 37228 (unilateral one vessel leg angioplasty) with two add-on codes, 37232 (additional vessel) and 76937-26 (US guidance for vascular access). Thank you in advance to those who respond.

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Medical Billing and Coding Forum

Reimbursement for add-on codes and the corresponding primary procedures

We are having a dilemma with one of our payers with regards to codes new to 2017 (CPT 36901-36909). CPT 36907 – 36909 are add-on codes with 36901-36906 the possible primary codes. The problem is that some of the add-on codes have a higher allowable rate and higher RVU value than the primary procedure. Therefore, one of our payers is using this as a reason to pay the add-on code as the primary procedure and reduce the actual primary procedure and citing multiple procedure rule. For example, when billing 36902 and 36908 together they are paying 36908 as primary and reducing 36902 by 50%. I disagree with this. How can an add-on code be considered the primary procedure when by definition it is not? Noridian, our Medicare MAC has been paying them correctly, allowing both codes at 100%. When I pointed this out to our payer, their response was that perhaps Medicare was paying the claims incorrectly and would be recouping the money once they do an audit. Can I please get other’s thoughts on this topic?
Thank you!
Gina, CPC

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