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

Allergy Test CPT Codes Limitation for Florida Blue

Reimbursement for allergy testing is based on the number of each type of test performed by the same physician and is subject to the following limitations when the coverage criteria are met

Reimbursement Information:

Reimbursement for allergy testing services includes the following components,

  • Supplies (e.g., sterile diluents, syringes, needles)
  • Monitoring the physical status of the patient during testing 
  • Observation, recording, and interpretation of the test results

Reimbursement for “allergy testing” is based on the number of each type of test performed by the same physician and is subject to the following limitations when the above coverage criteria are met,

Limitation:

Reimbursement for “allergy immunotherapy” is based on the number of procedures performed and is subject to the limitations below,


Coding Ahead

SC BCBS Blue Essentials 00811 Denials

Hello,

We bill for CRNA’s for anesthesia in South Carolina . We recently have been getting denials for SC BCBS Blue Essentials when we bill 00811 (When screening colonoscopy procedure turns diagnostic) as the reason "Benefit Plan does not cover this service." Is anyone else experience this issue/ have a remedy? We have reviewed the medical policy on BCBS website for our state, asked provider services, and used the Snat Chat option without getting a direct answer if policy has changed. We don’t have access to any of the Blue Essentials policy details.

Thank you!

Medical Billing and Coding Forum

Billing 45385 and 45381 to Blue Cross Medicare packages

I really need some help!
Lately I am having difficulty getting 45381 paid when coded with 45385. I have sent supporting documentation as well as "clear Connect" screen shot from Web Dennis showing this code combination is allowable. On one of my appeals it was stated to reference the CMS processing manual chapter 12 section 40.6. This section states that 51 modifier should be attached to the lesser of the two codes. I sent in a corrected claim and complied and received a denial stating bundled service. I have billed this code combination in the past and did not have a problem.
Is anyone experiencing this problem? if so, what have you done to remedy this.
Thank you in advance for your help!

Medical Billing and Coding Forum

Capital Blue Cross – Colonoscopy

When billing Capital Blue Cross – what CPT code do you use to bill a screening colonoscopy? I used ICD 10 Z12.11 as primary code for Colorectal Cancer Screening and CPT code 45378 for Colonoscopy/Screening. It’s been 10 years since his last one.

Patient is saying that anesthesia sent him a bill – when it should have been covered 100% as screening – our part of the bill was! He called the insurance company and they are saying that because we billed as diagnostic so did anesthesia. We got paid as a preventive service – HOW WOULD the anesthesia know how we billed? THe OP report clearing says it was for a screening.

Any advice is appreciated.

Medical Billing and Coding Forum

Laboratory Billing For Blue Cross Blue Shield

This is a general question that I hope someone can help me with.

We have a patient in which we drew a blood sample for testing. The specimen is being sent to an out of state lab for testing and results. I assume that we bill the state in which the specimen was being tested in, but I have a colleague stating that we bill the state in which the sample was actually drawn in. I’m new to this part of billing, so any feedback would be appreciated! Thank you!

Medical Billing and Coding Forum

Patients Take Control of Their Health Data with Blue Button 2.0

The Centers for Medicare & Medicaid Services (CMS) announced a new government-wide initiative, MyHealthEData, that provides patients with control of their health data. MyHealthEData is a response to the Executive Order to Promote Healthcare Choice and Competition Across the United States, issued by President Trump last year. The initiative’s aim is to: Empower patients, so every American […]
AAPC Knowledge Center

2018 Payment Policy for Blue Light Cystoscopy

In the 2018 Outpatient Prospective Payment System (OPPS) final rule, the Centers for Medicare & Medicaid Services (CMS) finalized their proposal, without modification, to allow for a complexity adjustment when blue light cystoscopy is reported on the same claim as certain cystourethroscopy CPT codes.  Rationale  Traditionally, CMS explains in the final rule, white light (or standard) cystoscopy, […]
AAPC Knowledge Center

Outpatient Detox, Florida BLue

There is an ongoing issue with Florida Blue where they will not pay for outpatient detox. It is a covered service by their home plan and it processes as biller error, but in actuality its due to Florida Blue assigning $ 0 on the fee schedule. There is no issue for Blue card plans in which the home plan prices, just when the local prices. Is there an appeal we can do? We bill S9475 under rev code 0944 or 0955.

Medical Billing and Coding Forum