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

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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

Claims for Next Generation Sequencing May Have Been Denied in Error

Clinical diagnostic laboratories that fulfilled orders for targeted genomic sequence analysis panel CPT code 81455 between March 16, 2018, and March 31, 2018, may need to resubmit these claims to Medicare. Some claims may have been denied due to non-coverage for the given diagnosis. However, since the Centers for Medicare & Medicaid Services (CMS) announced […]

The post Claims for Next Generation Sequencing May Have Been Denied in Error appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Wiki Need help why Medicaid-AL been denying CPT 36902

Hello, we billed 36902 by itself and MCD-Alabama has been denying it for " M49: Missing/incomplete/invalid value code(s) or amount(s).
N59: Please refer to your provider manual for additional program and provider information." ANyone help me please…Thank you.

Medical Billing and Coding Forum

Established problem but “New” patient since it has been over 3 years

If a patient’s PCP is referring him back to our office for re-evaluation of a problem treated by us more than 3 years ago, is that worth 2 points (est. problem worsening) or 4 points (new problem, additional workup planned) under # of diagnoses or treatment options in MDM? The patient would be considered "New" since it has been 3 years, but problem is not new to the provider. Thanks.

Medical Billing and Coding Forum

G-codes G0436 and G0437 for Smoking and Tobacco cessation counseling has been deleted Effective Oct 1st, 2016


HCPCS code G0436 and G0437 has been discontinued effective for the dates of services from 10/1/2016. CPT codes 99406 and 99407 are the remaining codes for tobacco cessation counseling. The beneficiary copayment is waived for CPT codes 99406 and 99407.


The below list of HCPCS / CPT codes are the only Approved Preventive Health Services with Coinsurance and Deductible Waived


HCPCS/CPT  Short Descriptor 
G0101 Ca screen; pelvic/breast exam
G0296 Visit to determ LDCT elig
G0402 Initial preventive exam
99406 Tobacco-use counsel 3-10 min
99407 Tobacco-use counsel >10
G0438 Ppps, initial visit
G0439 Ppps, subseq visit
G0442 Annual alcohol screen 15 min
G0443 Brief alcohol misuse counsel
G0444 Depression screen annual
G0445 High inten beh couns std 30 min
G0446 Intens behave ther cardio dx
G0447 Behavior counsel obesity 15 min
Q0091 Obtaining screen pap smear


Reference: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1611.pdf


Coding Ahead

Have coders typically been responsible for implementation of MU/PQRS/MIPS?

Hello all,

I am curious if in the other physician practices out there, who typically is responsible for the implementation and participation of Meaningful Use, PQRS and now MIPS? Our practice has been participating in these programs (including eRx) since 2011. At the beginning way back in 2010 the office manager we had decided that I would be responsible for all things PQRS which made sense since we were reporting via Claims. She would take on Meaningful Use. About 6 months later she began handing over the Meaningful Use to me ("since it was really more about coding") and then she left the practice. I just attested for the 6th year for MU. I was told before our new administrator joined the group that this would be one of their responsibilities – sure I would be involved but she was going to take over. I am the only coder in our group of 4 providers, a mid-level and 2 techs, so needless to say I have my hands full.
Now that we have begun our transition to MIPS it has become quite evident that this will continue to be my responsibility. I am curious because I am coming up on my yearly evaluation and was told last year that I had "topped out" at the salary for a coder in our area and would not be eligible for a raise this year.
I really feel like I am much more than a coder – something to which I’m certain any coder in a small physician practice can relate. I believe my job title would more accurately be described as Coder/Biller/MIPS/Receptionist/Financial Counselor/Operations Manager/New Hire Trainer.

Has anyone out there been through a similar experience? I am curious if this is the norm at most physician practices?

Thanks!

Medical Billing and Coding Forum

HCPCS Codes G0431 and G0434 has been deleted for the year 2016


2016 Deleted Lab Codes List

82486 Chromatography, qualitative; column (eg, gas liquid or HPLC, analyte not elsewhere specified)

82486 has been deleted. For a qualitative column chromatography procedure, use the appropriate specific analyte code, if available, or 82542

82487 Chromatography, qualitative; paper, 1-dimensional, analyte not elsewhere specified

82488 Chromatography, qualitative; paper, 2-dimensional, analyte not elsewhere specified

82487, 82488 have been deleted. For a paper chromatography procedure, use the appropriate specific analyte code, if available, or 84999

82489 Chromatography, qualitative; thin layer, analyte not elsewhere specified

82489 has been deleted. For a thin layer chromatography procedure, use the appropriate specific analyte code, if available, or 84999

82491 Chromatography, qualitative; column (eg, gas liquid or HPLC); single analyte not elsewhere specified, single stationary and mobile phase

82491 has been deleted. For a quantitative column chromatography procedure, use the appropriate specific analyte code, if available, or 82542

82492 Chromatography, qualitative; column (eg, gas liquid or HPLC); multiple analytes, single stationary and mobile phase

82492 has been deleted. For a quantitative column chromatography procedure that detects more than one analyte, use a single specific code that represents all of the analytes, if available, or one unit of 82542 for all of the analytes.

82541 Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), non-drug analyte not elsewhere specified; qualitative, single stationary and mobile phase

82541 has been deleted. For a quantitative chromatography procedure with mass spectrometry that only detects a single specific analyte, use the appropriate specific analyte code, if applicable, or 82542

82543 stable isotope dilution, single analyte, quantitative, single stationary and mobile phase. 

82543 has been deleted. For a quantitative chromatography procedure with mass spectrometry that only detects a single specific analyte, use the appropriate specific analyte code, if applicable, or 82542

82544 stable isotope dilution, multiple analytes, quantitative, single stationary and mobile phase. 82544 has been deleted. For a quantitative chromatography procedure with mass spectrometry that detects more than one analyte, use a single specific code that represents all of the analytes, if applicable, or one unit of 82542 for all of the analytes

83788 Mass spectrometry and tandem mass spectrometry (MS, MS/MS), analyte not elsewhere specified; qualitative, each specimen. 

83788 has been deleted. For a qualitative mass spectrometry or tandem mass spectrometry procedure, use the specific analyte code, if available, or 83789

88347 Immunofluorescent study, each antibody; indirect method. 88347 has been deleted. To report, see 88346, 88350

G0431 Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter

G0434 Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter

G0464 Colorectal cancer screening; stool-based DNA and fecal occult hemoglobin (e.g., KRAS, NDRG4 and BMP3). This code has been replaced with code 81528: Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result.

G6030 Amitriptyline

G6031 Benzodiazepines

G6032 Desipramine

G6034 Doxepin

G6035 Gold

G6036 Imipramine

G6037 Nortriptyline

G6038 Salicylate

G6039 Acetaminophen

G6040 Alcohol (ethanol); any specimen except breath

G6041 Alkaloids, urine, quantitative

G6042 Amphetamine or methamphetamine

G6043 Barbiturates, not elsewhere specified

G6044 Cocaine or metabolite

G6045 Dihydrocodeinone

G6046 Dihydromorphinone

G6047 Dihydrotestosterone

G6048 Dimethadione


Coding Ahead