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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

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

Admitted for other conditions found to have pregnant and underwent abortion

25 yr old female patient with metastatic biliary cancer admitted to inpatient for neoplasm related pain and after 10 days of admission patient suddenly developed severe vaginal bleeding and gyn consultation was done, ordered labs . Labs shows high BHCG levels 1,6770 IU/L. Gyn consultant documents —found to have pregnant and underwent miscarriage. how would i code this encounter ?

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Anugu Srinivas
Medical Coder
Bachelor of pharmacy,CCS

Medical Billing and Coding Forum

Admitted for other conditions found to have pregnant and underwent abortion

25 yr old female patient with metastatic biliary cancer admitted to inpatient for neoplasm related pain and after 10 days of admission patient suddenly developed severe vaginal bleeding and gyn consultation was done, ordered labs . Labs shows high BHCG levels 1,6770 IU/L. Gyn consultant documents —found to have pregnant and underwent miscarriage. how would i code this encounter ?

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Anugu Srinivas
Medical Coder
Bachelor of pharmacy,CCS
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Medical Billing and Coding Forum

ER visit for contractions admitted and delivered same day – Physician

I was following the practice of billing the ED visit 99283 POS 23 (ED) for a patient who presents in labor to the ED. If she delivers same day that code is under 59409 POS 21 (Inpt) and billed. I cannot find anything on this site in writing so I can verify/prove what is correct to the billing dept. They state POS should be 22 (Observation) on the ED code. I disagree.

Thanks for any help

Medical Billing and Coding Forum

Nurs practitioner sent pt to ER/supervising doc admitted

WE have a patient that was seen at our Rural Health Clinic by a nurse practitioner who sent the pt to the ER. This was not technically a direct admit. Nurse practitioner is supervised by Dr. M. at rural health clinic. Later that day, ER doc calls Dr. M to admit the pt to the hospital. Naturally Dr. M’s charge for the admit is being denied. My question is … since Dr. M bills with a different tax id for hospital charges and technically he wasn’t the treating doc for the OV, do we have a reason to appeal the admit code? We started to just write it off, but feel this really should be considered.
Thanks for any input on this.

Medical Billing and Coding Forum

ER visit that spans midnight and pt is admitted

We have claims that are being denied due to outside the span of dates. The patient comes to the ER on 9/1/18 and is admitted after midnight to Observation on 9/2/18. Our admit date is going to be 9/2/18, but all charges for the ER, labs, and x-rays from 9/1/18 are being denied for outside the span of dates. Does anyone have any suggestions?

Medical Billing and Coding Forum

Er visit that spans midnight then admitted to obs

When a patient comes into the ER on 9/1/17 and it spans midnight then the patient is admitted to Observation with the admit date 9/2/18. Medicare is denying all charges (labs,x-ray) on 9/1/17 due to outside span dates. Is there something that we can do to get the services done on 9/1/17 paid?

Medical Billing and Coding Forum

Admitted a day after consult

Hello,

Our Doctor saw a patient in the hospital for a stroke evaluation. The evaluation was done on 1/16/18, but admission date is 1/17/18. Our doctor wanted to bill 99222. This is incorrect as the pt was not admitted as of yet. So, we should file as POS 22, with appropriate outpatient E/M code. Correct? We saw the patient on 1/17/18 and 1/18/18, those were filed as 99232.

Thanks!

Medical Billing and Coding Forum

ICD10 coding when a pt is admitted to the hospital-but billed by a private physician

Hi,
i work in a group practise doctors office. we also have doctors that we bill for, that see pts in the hospital/ER.
Our hospitalist admit pts, do subsequent visits and discharge pts. We were having a discussion on the ICD10 coding though.

if a pt is admitted to the hospital and our doctor is in charge of their care, would the ICD10 coding be based on InPatient? (meaning you CAN code "probable, possible, looks like") or because we are billing for a Hospitalist (but still coding 99221-99239 for inpatient CPTs), is the ICD10 coding considered Outpatient coding? (meaning that you CANNOT code "possible, probable" etc)?
i really need an answer/opinion on this; please help.
thank you

Medical Billing and Coding Forum

Billing for Professional fees when patients are admitted but still in the ED

Hey all,

I have an issues with a carrier telling me that I need to use (E/M) CPT codes based upon the patient’s admission statue. For example, if the patient is an inpatient, I should use inpatient E/M codes. While I understand this, I sometimes have situations where the patient is still located in the Emergency Department due to bed availability. I always thought that you have to chose codes based upon the physical location where the face to face services took place. The insurance carrier actually quoted CMS policy that stated codes should be used based upon the patient’s admission status regardless as to where the face to face encounter occurred. Does anyone have any insight into this????? Thanks!

Medical Billing and Coding Forum