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

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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

Remote billing/coding full time

Elisha Bedford
[email protected]
559-904-5655
Billing Follow-Up Associate

Seeking a rewarding, full time position as a remote associate.

Caring and compassionate medical professional, with a proven determination to consistently excel at all assigned duties, seeking to turn medical professional skills into continuation of a rewarding career with a dynamic organization.

WORK EXPERIENCE

Billing Follow-Up Associate
Government Adventist Health Physicians Network
Hanford, CA – October 2015 to Present •
Responsible for daily processing of the patient account following discharge in order to submit a timely and accurate bill. ◦ Reviews all information for accuracy, completeness and compliance. ◦ Prepared and submit clean claims to various insurance companies either electronically or by paper ◦ Work with other departments of the hospital in conjunction with the PFS Billing Supervisor to improve the quality of information directly related to submitting a compliant bill. ◦ Resolves credit balances by requesting refunds to the Accountants by region to refund patients and/or insurances ◦ Answered questions from patients, clerical staff and insurance companies ◦ Identified and resolved patient billing complaints. ◦ Processed payments from insurance companies and prepares a daily deposit. ◦ Communicates any/all potential concerns clearly and timely to department management, offering suggestions to resolve &/or avoid any negative impacts. ◦ In cooperation with the PFS Leadership team, coordinates and ensures adherence to hospital financial and department policies. • Promotes positive relationships with patients, coworkers, physicians and the community. • Portrays a positive image for the hospital and PFS department • Participated in educational activities and attended monthly staff meetings. • Maintained strictest confidentiality • Adheres to all HIPAA guidelines/regulations.

Lead Authorization Coordinator
Foundation For Medical Care/Key Medical Group – Visalia, CA – October 2005 to September 2015 •
Verify eligibility and benefits through the health plans web portal. • Identify and provide accurate CPT/ICD-9/ICD-10 codes during authorization check and/or authorization request. • Maintain all authorizations/notifications related faxes from physicians, and/or health plans. • Received incoming documentation from providers in order to support the appeals process if a claim is denied. • Communicates professionally and timely to the patient, physician, and clinical staff regarding authorization status or authorization delays. • Processed 100 plus referrals in one business day. • Handles difficult situations in a professional demeanor • Trained new employees to on process ◦ Request for authorization ◦ Check claim status ◦ Follow up on claim denial/ appeal/grievance ◦ Verify Eligibility Status • Operate multi-line phone systems with ease

Accounting Clerk Accountemps – Visalia, CA
August 2004 to September 2004
Processed and reported on debit/credit transactions and total accounts on excel documents and databases, and using specialized accounting software. • Operate 10-key calculators, typewriters, and copy machines to perform calculations and produce documents. • Comply with federal, state, and company policies, procedures, and regulations. • Perform financial calculations such as amounts due, interest charges, balances, discounts, equity, and principal. • Perform general office duties such as filing, answering telephones, and handling routine correspondence, etc.

Customer Care Representative/Department Secretary-Appeals Grievance
San Diego, CA – February 2003 to August 2004 • Operate office equipment, such as voice mail messaging systems • Worked daily with MS word processing, spreadsheet, or other software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records. • Answer telephones and directed calls to appropriate staff. • Schedule and confirm patient appointments, surgeries, medical consultations, pharmacy authorization. • Transmit medical records by mail, e-mail, or fax. • Provide claim status to patients. providers, and hospitals. • Process referrals by incoming fax.

EDUCATION
Certification in Medical Billing and Coding Ultimate Medical Academy – Tampa, FL 2014 to 2015
Patient Care Assistant Technician Maric College – San Diego, CA 2001 to 2002
Hanford High School – Hanford, CA 1995
Medical Billing and Coding-Associates Degree Grantham University – Lanexa, Kansas 2016

ADDITIONAL INFORMATION SKILLS
CPT coding courses, HCPCS, Analytical and Critical Thinking, ICD-10 CM, ICD-9 CM, Payment Poster, EZ-CAP, Cerecons, IDX, Medical Billing and Coding, Customer Service, Multi-Line Phone System, Problem Solving, 10-key, Microsoft Word, Excel, Outlook, PowerPoint, Spreadsheet 50 WPM, Power Chart, SSI, MS4/AS400, RCI, Medical Terminology, Collections

Medical Billing and Coding Forum

FQHC facility billing/coding 36415

I recently starting working for an FQHC facility and have been doing some research on how to properly bill/code for our facility. We have a lot of patients who will see a provider one day, then the following day come back JUST for a blood draw. From what I have been reading, the reimbursement we receive for the initial provider visit is an all inclusive rate which includes payment for the NV for just the blood draw. Some articles I have read, say we can code 36415 on the previous encounter with the provider or the following visit with the provider. Is that true? If so, what documentation is needed? Example, specifying date of actual blood draw.

Medical Billing and Coding Forum

Incident to billing/coding

At my facility we are going to start billing "incident to" for a PA that is going to be working in our urgent care and possibly eventually move into our family practice. I have been researching the guidelines and brought them to my CEO. My question is: do the guidelines only apply to Medicare patients? Also can you only bill "incident to" for Medicare patients? Or does this apply to ALL payers regardless? My management stated that we can bill "incident to" for anyone, and the only time the guidelines need to be followed is when it’s a Medicare patient.
Also is there any work that the supervising physician has to do when we are using that MD’s NPI for billing?

Any clarification on this would be helpful as I am lost and do not feel what I am being told is necessarily true.

Thank you,
Nicole Stettner, CPC
Coding Analyst

Medical Billing and Coding Forum

Billing/Coding Instructor at Empire College in Santa Rosa

Would you like to share your vast wealth of billing & coding knowledge with those who are just starting their training?
Empire College, in Santa Rosa, is looking for Adjunct Instructors for Medical Billing & Coding classes.
Both day & evening hours are available.
If interested, please send resume to: [email protected]

Medical Billing and Coding Forum

question on practice exam A for medical billing/coding, question 3

Question 3
64 year-old female who has multiple sclerosis fell from her walker and landed on a glass table. She lacerated her forehead, cheek and chin and the total length of these lacerations was 6 cm. Her right arm and left leg had deep cuts measuring 5 cm on each extremity. Her right hand and right foot had a total of 3 cm lacerations. The ED physician repaired the lacerations as follows: The forehead, cheek, and chin had debridement and cleaning of glass debris with the lacerations being closed with one layer closure, 6-0 Prolene sutures. The arm and leg were repaired by layered closure, 6-0 Vicryl subcutaneous sutures and Prolene sutures on the skin. The hand and foot were closed with adhesive strips. Select the appropriate procedure codes for this visit.
A. 99283-25, 12014, 12034-59, 12002-59, 11042-51
B. 99283-25, 12053, 12034-59, 12002-59
C. 99283-25, 12014, 12034-59, 11042-51
D. 99283-25, 12053, 12034-59

What I totally don’t understand is the rationale behind the answer. It states, "To start narrowing your choices down, the hand and foot were closed with adhesive strips. The Section Guidelines in the CPT® manual for Repair (Closure) states: “Wound closure utilizing adhesive strips as the sole repair material should be coded using the appropriate E/M code.” Eliminating multiple choice answers A and B. The lacerations on the face are intermediate repairs, because debridement and glass debris was removed. The guidelines in the CPT® codebook for Repair (Closure) states: “Single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair.” Eliminating multiple choice answer C. The intermediate repair of the lacerations to the face totaled 6 cm (12053). The right arm and left leg had cuts measuring 5 cm each which totaled 10 cm requiring intermediate repair (12034)."
The problem I have with this answer is that ALL of the answers have the same E/M code in the same place – so how can you use the rationale stated above (Guidelines… B)?

Medical Billing and Coding Forum

Help with ED billing/coding

I am not familiar with ED coding/billing (risk adjustment coder here) and wondering if someone can help. I received a bill for my son’s ED visit where he had a simple repair of a scalp laceration (CPT 12002). The procedure was billed twice, once for the professional component and once for the technical component. I don’t understand the rationale for billing a technical component for this procedure and am wondering if this is correct. The provider (PA) simply stapled the scalp laceration (nothing else was involved). When I look up CPT 12002 in the MPFSDB it has a value of 0 under TC/PC, which I understand means that it cannot be split into professional and technical components? An E/M code was also billed for both the technical and professional component. Also, what is the usual fee schedule for an ED? Does it make sense that the fee we are being charged for CPT 12002 is about 5x the Medicare fee? Thanks for any help.

Medical Billing and Coding Forum | AAPC