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

Industry Standards for Amount of Providers to 1 Auditor?

I’m looking for some information on what are the industry standards for how many providers 1 auditor should have? This would be based on a standard yearly audit for each provider, as well as fixing any errors that may come across our WQs as we call them. So far the consensus is, 1 Auditor: 50 Providers. Is there information somewhere on that?

Thanks!
Krystle

Medical Billing and Coding Forum

Billing Office Visit + other and then only getting reimbursed the smaller amount

I’m trying to bill a 99213 along with an 81000. I’m getting messages from the carrier that they’re paying for the 81000 and bundling the 99213 under it (so I’m being reimbursed less than $ 10 for a service over $ 100). Is providing a modifier 25 for 81000 a way to get around this?

Thank you!!

Medical Billing and Coding Forum

Advanced Care Planning and minimum amount of time needed

Question: How long does a provider have to spend with a patient in Advanced Care Planning, such as DNR, living will, feeding tubes etc in order to bill?
I know CPT says 30 minutes, but I thought I saw on a Webinar that it’s the better part of half an hour, or 16 minutes.
Please Help.
Thanks

Medical Billing and Coding Forum

MDM- “Amount and/or Complexity of Data Reviewed”

I am in need of some advice on some records I’m reviewing. This is directly related to the "Amount and/or Complexity of Data Reviewed" of the MDM component.

If the Physician notes she performs a "Urine Toxicology Screening", checking for RX compliance, and mentions she personally "reviewed the dipstick herself which provides a preliminary result for the potential of more or more drugs", how many points does this qualify for?

One total, for the review and/or order of clinical labs?
Two total, for the independent visualization of a specimen?
Three total, for ordering/reviewing and also independent visualization?

I’ve seen many conversations about this, but no hard documentation that says truly which one. I’ve researched in Optum’s Evaluation and Management Coding Advisor and it isn’t answered for my scenario. I’ve Googled and can only find opinions, but nothing from bigger reputable sources. If anyone has something in writing I would greatly appreciate it!

Thanks so much!

Medical Billing and Coding Forum

CERT Errors Amount to Billions in Lost Medicare Revenue

The Centers for Medicare & Medicaid Services (CMS) measures the fee-for-service (FFS) improper payment rate through the Comprehensive Error Rate Testing (CERT) program. According to a 2017 CERT report, CMS had a 90.5 percent proper payment rate and a 9.5 percent improper payment rate for all claims submitted July 1, 2015, to June 30, 2016. […]
AAPC Knowledge Center

MI Auto Carrier Paying Less Than Billed Amount

I am looking for information regarding Michigan Auto Claims and how to handle the remaining balance.
Some of our claims are paid less than the billed amount with the carrier stating it is "above the usual and customary" for our area.
We do not have a contract with the auto carrier and feel that they do not have the right to pay less than our fee.
Normally, when dealing with an insurance company that we have no contract with, the unpaid portion is billed to the patient.
The auto carrier is informing me and the patient that we are not allowed to balance bill the patient for the remaining balance.
I would appreciate any input on this issue.
Thank you so much.

Medical Billing and Coding Forum