Click here for more sample CPC practice exam questions with Full Rationale Answers

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What makes a good 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

Anesthesia and Epidural Blood Patches

One of our patients had an epidural blood patch done after her C-section. The headache did not clear up right away and the patient stayed in the hospital for two days after the blood patch. Our anesthesiologists did pain rounds on this patient every day after her blood patch until she was discharged from the hospital. Can I charge for the subsequent pain management days after the blood patch? If so, what CPT code should I use?

Medical Billing and Coding Forum

ICD-10 for blood on toilet paper

Good Morning, I am looking for recommendations for an ICD-10 code for blood on toilet paper, patient stated he had a small amount on the toilet paper after a BM. The rectal exam was negative for blood. The provider gave Hemorrhage (R58), I am recommending Other fecal abnormalities (R19.5) or Hematochezia (K92.1). Any information to clarify will be helpful. Thank you,

Medical Billing and Coding Forum

D68.32 Won’t Get You Paid for Blood Clotting Factor

Medicare Part A claims that include ICD-10-CM diagnosis code D68.32 Antiphospholipid antibody with hemorrhagic disorder will be denied after June 30, 2018, when the code is terminated. Per the Inpatient Hospital Billing Manual, Chapter 3, Section 20.7.3, Payment for Blood Clotting Factor Administered to Hemophilia Inpatients, effective July 1, 2018, payment may be made for […]
AAPC Knowledge Center

Blood Draw to Office Visit

The patient came in just for a blood draw but fainted at the sight of the blood (vasovagal syncope). PA was called to check up on the patient because of this and the PA did a physical exam. Can we bill an office visit for this encounter? We hope someone can help us on here as we couldn’t find any information on the web. Thank you!

Medical Billing and Coding Forum

How to Lower Your Blood Pleasure Without Taking Medical Treatment

A common way for people with high blood pressure is taking medecines in order to control it. However, sometimes, these medecines are not enough strong to lower high blood pressure to normal levels. Lowering to healthy levels also needs some additional measures.

 

Prolonged and Uncontrolled high blood pressure can result in some serious complications like stroke, heart attack or even kidney failure. It is for this reason that you need to do everything you can to control it to normal levels.

 

We are listing some natural ways which could help you immensely to lower your BP and these are easy for you to include in your normal daily routine.

 

1. Have a piece of dark chocolate daily. As per the recent report on Hypertension in the Journal of AHA (American Heart Association), when a person eats small amounts of dark chocolates in daily routine, it contributes to some chemical changes in human body which contributes in dilation of blood vessels thus lowering blood pressure.

 

2. Potassium: It is a magic mineral. It is an important nutrient essential for maintaining electrolyte balance which regulates the muscle and heart’s contraction. It also helps maintain the fluid balance in the body.

 

You can get your daily requirements of potassium from foods like apples, avocados, bananas, oranges, pears, carrots, pears and sweet potatoes.

 

3. Water: It is the miracle medicine given by Mother Nature. When your body goes in the state of dehydration, your BP can shoot up dramatically. When body mechanism begins to retain water instead of allowing it a natural flow, the blood pressure could rise. This action of body is however preventive to save the body cells from dehydrating.

 

Make it a habit to drink good amounts of water daily. It will not only lower your blood pressure but would help to improve your other body functions.

 

4. Walking Is Good For You. Sedentary lifestyle is a bane and cause of many diseases. Over a period of time our inactivity could lead to lot’s of health complications in us. Regular exercise would help us in lowering our blood pressure. The good news is that you need not go for vigorous exercises but just moderate ones to achieve maximum gains.

 

A most recent study which was published in Journal of Epidemiology and Community Health informed us that just 35 minutes of daily walk just three days a week is all that is needed for good health and heart.

 

The above mentioned 4 ways are in fact simple and yet proven ones to lower your blood pressure. But maintaining consistency while practicing them is the only way to gain maximum benefit in long run. You should try making them a part of your daily routine to gain a healthy heart and a fully normal blood pressure.

 

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Related Medical Coding Articles

Medical importance of blood sucking flies

The blood sucking flies are important as intermediate hosts in the transfer of leishmaniasis, trypanosomiasis, Onchocerciasis and loa loa. What really do we need to know?

 

There are different classes in this category which are: Phlebotonus, Smulium, Chrysops and the Glossina flies.

 

Phleotonus (sandfly, moth fly and Owl midge)

There general morphology is as follows: Thorax is hump-backed; small sized (3mm), body and wings are quite hairy, their wings are devoid of scales, when wings are at rest, they are held in ‘v’ at 60 degrees angle, wings are veined in parallel lines, mouth parts are structured for piercing and biting and finally they are yellow-buff colored.

 

habits and distribution

Active nocturnal feeders, females alone are bloodsuckers cosmopolitan in tropical and subtropical climates. Breeding places hard to find; under stones, in masonry cracks, poultry houses, hollow trees, breeding places are generally non aquatic.

 

Symptoms of bite

Rose-colored papule at site of bite, with 10-20mm zone of erythema stinging pain and itching Nausea, fever, and malaise in sensitive individuals.

 

Parasite and disease transmitted

Leishmania donovani (kala-azar), Leishmania tropica (oriental sore), L.braziliensis (American leishmaniasis), Phlebotomus fever (pappataci fever), Bartonella bacilliformis (Oroya fever, carrison’s disease).

 

simulium (Black fly, Buffalo gnat)

There general morphology is as follows: Small size (2-3mm); body is black, body is sturdy, legs are short, conspicuous compound eyes, short proboscis with blade-like cutting organs, wings are broad and usually clear, body appears longitudinally striped due to fine silver.

 

Habits and distribution

Cosmopolitan in distribution, breeds along shaded watercourses or woodland streams. Females bite in the day time.

 

Symptoms of bite

Bite is initially painless; wound bleeds profusely; pain, itching, and swelling develops later.

 

Parasite and disease transmitted

Onchocerca volvulus (onchocerciasis)

 

Chrysops (Deer fly Tabanid Mangrove fly

There general morphology is as follows: Highly colored yellow banded abdomen with dark stripes; mouth parts fitted for stabbing and cutting; wings clear with dark band along anterior margins; wings held spread away and horizontal to body.

 

Habits and distribution

Cosmopolitan, but more common in America. Female bite in early morning or late afternoon. Breeds in woodlands, marshy ponds or roadside ditches.

 

Symptoms of bite

Several thrusts of cutting mouth parts leave an unsightly puncture wound pain and swelling develop within a few hours. Loa loa pasteurella tularensis (tularemia).

 

Glossina (Tse tse fly)

Its morphology is as follows: Slightly larger than housefly, its brownish in color, resting wings overcrossed like scissor blades, slender proboscis held horizontal to ground.

 

Habits and distribution

Found in equatorial africa, G.Palpalis: hot dump areas along borders of rivers, lakes, and streams in West Africa Males and females bite in the day. Bite have minor significance. The parasite responsible is the Trypanosoma rhodesiense, Trypanosoma gambiense (African sleeping sickness).

 

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43255 Good Bet For Coding For Excessive Blood Loss

When you are coding for excessive blood loss, modifier 22 may not be what you are looking for. The answer may depend on more appropriate CPTs such as 43255 and critical care codes.

Think about endoscopy with injection as option

Scenario 1:

The physician injects epinephrine into a duodenal ulcer to control active bleeding during endoscopy with biopsy. 43239, Upper gastrointestinal endoscopy including esophagus, stomach and either the duodenum and/or jejunum as apt; with biopsy, single or multiple).

Previously, you may opt to use 43239 appended with modifier 22 (Increased procedural services) if the doctor required effort to control the patient’s bleeding.

However this option would need you to submit additional paper documentation to support your modifier 22 claim. Instead of submitting yourself to potential hassles, you can accurately describe the session by reporting 43239 for the biopsy and 43255 for the control of bleeding provided that the bleeding was not caused by the biopsy.

As is obvious from 43255’s descriptor, this procedure describes control of bleeding by any method including injection.

Requirement: On your claim, you should append modifier 59 to 43255, and then report 43239. Omitting the modifier would give payers the impression that the biopsy (or physician) caused the bleeding and bundle 43255 into 43239.

Extraordinary bleeding requires critical care coding

Scenario 2: When the gastroenterologist is about to carry out an upper GI endoscopy, the patient experiences gastrointestinal bleeding so severe that the doctor must suspend the endoscopy and spend 40 minutes lavaging blood from the gastro-intestinal tract before continuing.

Code it: This time, the critical code 99291 is your best choice.

Here’s why” If the gastroenterologist caused the bleeding, you cannot bill for the control of bleeding procedure. You should call on control-of- bleeding codes only when treatment is required to control bleeding that occurs spontaneously, or as a consequence of traumatic injury (noniatrogenic), and not as a result of another type of operative intervention, the CPT Assistant states.

Remember that the time spent at the bedside carrying out services including lavage of gastric blood isn’t included in the performance of a subsequent endoscopic procedure and is not part of the E&M service that might be carried out on the same day.

Nevertheless, you should not report a critical care code carelessly for an excessive bleeding situation that’s not out of the ordinary. Additional time for emergency bedside services less than 30 minutes does not count as billable critical care service. For prolonged critical care services, the physician should specifically note the amount of time in his notes.

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