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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

Desire to open Medical Billing Company-Any Advice?

Hello All,
I am finally getting an opportunity to start my own medical billing company in GA and possibly SC and wanted to know what advice that anyone has that has started their own company? Any regulations/rules/policies that someone may have overlooked. What rate is everyone charging? Are you doing a % per claim or flat rate?

Any information is welcome. Would love to network and possibly hire a few billers and coders as contractors.

If you don’t want to reply her you can send me an email at [email protected]

Medical Billing and Coding Forum

Advice on rulees and regulations

Hi everyone,
I have been asked to help with the take over of the coding/billing for a private owned addiction medicine clinic. Here’s the problem… The crew that was in charge of this prior had originally told the front desk to collect patient copays for commercial insurance patients as they were not credentialed yet. So, just last week they came and told the front desk lady that they were not going to credential to charge $ 275 cash for all commercial insurance patients. Is this legal? because I’m having a problem with that, it just seems so sketchy to me. If anyone could help guide me I would be greatly appreciative. I just want to have my facts before I present anything to the doctor about how things should be done going forward.

Medical Billing and Coding Forum

New at the industry need advice


I am a makeup artist and a mom of a smart, vibrant boy. In the search for a better life for my son, I started a medical records certificate. I am three classes away from completing my Medical Records Certificate. I have to admit that now that I can see the end of this journey I am incredibly anxious about how to enter the industry and start a stable job that helps me provide for my son and me. I plan to get my CPC immediately after finishing my certificate. I have no experience in this field, and I will appreciate any advice on what to do to accomplish my goals. Ultimately, I will love to be a medical coder and be able to work remotely, giving me some flexibility to take care of my son and being able to support him. Please help!!

Medical Billing and Coding Forum

Couple E/M question gray aeas to me. Advice please?!

My first question is in regard to the 95 and 97 guidelines and when Medicare -RAC does an audit.
Will they use the guidelines that suits THEM or will they always use the guidelines that benefits the physicians?

Also, if it’s an established patient and you need 2 out of 3…history and exam are perfect-comprehensive but MDM lacks complexity, can you still do a moderate using the history and exam, and not MDM?

And if I’m in a urology specialty but the patient has diabetes, CHF, COPD, basically things that the dr doesn’t necessarily treat, but might need to make medical decisions around that, can I bill those diagnoses? Or is it a matter of IF they put it in the assessment and plan? What if they put it there and list it. Can I count those as a point for established problem?
Do they actively have to be treating it on that encounter date? Where I’m struggeling is that they are not ‘treating’ the diabetes, etc. but it could be a factor in decision making.

Medical Billing and Coding Forum

Looking for advice for beginners!

I am currently (today), completing my medical coding certification program at my local community college. I completed the program in Colorado Springs, Colorado but am moving back to Kentucky (my home state) on December 22nd, (so, in just a couple of weeks!). I plan to take the National Exam soon. I purchased the study guide through AAPC and intend to take the National Exam if I do well on the practice test. If not, I plan to keep studying and taking more practice exams until I do well enough to feel confident about the actual Exam. I would like to obtain employment in the coding field in KY as soon as possible. I am worried that it may take longer than I am hoping because I do not yet have any on the job experience. I do however, have many years of experience in the court system, as an office administrator. Can anyone please advise me, or provide some leads to medical coding jobs in KY? I’m not even sure where to start. Any help will be much appreciated! Thanks!

Medical Billing and Coding Forum

Serious Advice Needed!

After working a month and a half, with 3 weeks closed for building renovations, I have uncovered quite a large number of issues with the practice I was hired to manage, so much so I was doubting myself until I conferenced with the newly hired manager at our satellite location. Does anyone know of a reputable healthcare compliance attorney in the Southern Tier of NY or even Northeastern PA? At this point I just need to make sure I am covered and not going to suffer legal repercussions from the issues I am uncovering. The issues have been, from what I can tell so far, going on for years. I have heard that when issues had been brought to the physicians attention in the past, those people were let go due to insubordination. I have brought numerous issues to the attention of the physician and then have been avoided for meetings pertaining to possible fixes and met with "you need to document this is the first time I am ever hearing of this issue." Somehow I don’t believe it one bit. I need to get something in writing from the physician stating that I am not responsible for any past wrongdoings, but I don’t think I’ll get it, so I’m thinking I may need an attorney sooner rather than later. I was misled completely and gave up a job that I loved for this one just because it was closer to home. Any advice would be greatly appreciated. Thanks in advance!

Medical Billing and Coding Forum

Any feedback or advice in job search

Dear Friends,
I got CPC in September and had "A" removed due to my current claim department job experience.
I am applying everyday online or calling doctor offices since then. I had just one interview call but they called me back that they want experienced coder in busy office.
Am I doing right so far or something better can be done??

Medical Billing and Coding Forum

Need advice regarding E&M upcode

I am in need of E&M coding advice and I would really appreciate input on this scenario:

This is regarding a routine E&M internal physician audit:

MD bills Initial Inpatient Admission – 99222

Leveled at 99221 under 97 guidelines
Leveled at 99223 under 95 guidelines

Question: Would you advise the MD to bill billed 99223 versus his selected code of 99222?

I, personally, would advise the MD to bill the initial E&M code selected of 99222. I would not advise the MD upcode to 99223, especially since case leveled at 99221 under 97. Other coders in our office think 99223 is appropriate. Will you please weight in.

(I am aware that before downcoding an E&M that you are required to audit by both 95 and 97. However, in this scenario – the physician isn’t going to be downcoded to the 99221 that leveled under 97 because he/she met (and exceeded) billed code of 99222 under 95. I just don’t think we should proactively encourage MD to change from 99222 to 99223 unless 99223 was met under both 95 and 97.

Input would be appreciated. Thank you-

Medical Billing and Coding Forum

Need advice on dealing with Mental Health providers

Hi I really need some advice on what I should do in this situation.

I code for all the mental health providers in my practice. There is one in particular who seems to end up having cases where the patient was abused in the past. Unfortunately one of these patients is a still a child. When I brought the idea to code for the abuse that the patient mentioned in the report. I was met with, my manager and her manager coming to talk to me about why I had even asked about it, and why I even need to read their progress notes. I explained the situation and legality of it. I tried to explain this to the provider when I sent the claim back to her as well. After that big attack toward me for trying to help her patient, and the provider.

The providers response was basically that she is not treating the patient for it. Which I would think is just not true. How can someone go thorough that, and have it not be a part of why they are depressed or anxious? Also considering that it is in the progress note, that seemed to convey that it happened in the past. Past victims often always become victims again, especially when they are not taught anything to prevent it from happening again. Which according to the provider she isn’t doing by stating that she is not doing treatment based on that. Also if she is basically sweeping this under the rug, she believes she is protecting the patient, which she isn’t. She is protecting the person that did this. If it were to happen again, and there is no evidence that the patient was being treated for it, and if she won’t stand up for her patient, then it’s possible to not be believed.

Also since this happened, according to her manager she got really upset at the fact that I read any of the mental health providers notes. Which I have to do because well, they are not very good at coding really at all. I had to fight to get them to even put the amount of time spent with the patient in their progress notes. Also it seems that this provider has responded by putting next to nothing in her notes, and consistently still not providing the time spent. I feel like because I brought this up that she thinks I’m a creep or something. I don’t know what to do. Because I feel like maybe she doesn’t even know that when abuse is even suspected it needs to be reported to authorities. It’s like I feel that if there was someone that came to see her because they are being abused, she wouldn’t report it and that’s a crime.

I think I am going to talk to her manager because it’s just silly that she’s acting like this. I’m trying to help her and her patient, and shes just like no.

Medical Billing and Coding Forum

Looking for advice from coders about getting first coding job.

Hi, My name is Eugene Cooper, and I just graduated from College in a Medical Coding program. Since most of you have been through this process, I was looking for advice on methods to gain employment. I have been told by coding instructor (who is also a full time medical coder) that if I have no experience in medical coding, I should look at medical office jobs to gain entry, then work my way into a coding job. I have done 2 internships working with an Electronic Medical Record database in one of them, but that is it for now. I am a member of AAPC and I will be attending my first chapter meeting on Tuesday July 18th, which I am looking forward to gaining a "live coder network". But a virtual network via computer is just as valuable to me. If anyone has any advice for me, I would appreciate it very much, and since I am so green at all this, forgive me if I show some ignorance to how to go about things, but it’s been nothing but learning how to gain valid networks, and job hunting since graduating from college. I was able to attend college because I am receiving Social Security Disability, and am going through the Social Security’s Ticket to Work program, which with my state vocational rehabilitation, helped me go back to school to receive my certificate of proficiency in medical coding, and they will also help with paying for my certification as well, but I want to become employed and gain medical experience first due to many personal reasons. I am looking forward to meeting and hearing from anyone who can give me solid advice on how to get started, because once I do become employed, my CPC-A certification is my next priority. Thank You Very much, Eugene Cooper

Medical Billing and Coding Forum