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

California Physician and Practice Settle Case Involving False Claims

On December 20, 2018, Michael Jadali, D.O., and the Center for Pain & Rehabilitation Medicine (collectively, “Dr. Jadali”), San Jose, California, entered into a $ 60,406.30 settlement agreement with OIG. The settlement agreement resolves allegations that Dr. Jadali submitted claims to Medicare for Healthcare Common Procedure Coding System codes 80500 (clinical pathology consultation; limited, without review of patient’s history and medical records) and 80502 (clinical pathology consultation, comprehensive, for a complex diagnostic problem, with review of patient’s history and medical records), where no consultation request had been made, no written narrative report by a consultant pathologist was produced, and no exercise of medical judgement by a consultant pathologist was required. Senior Counsels Geoffrey Hymans and Kenneth Kraft represented OIG.

The post California Physician and Practice Settle Case Involving False Claims appeared first on The Coding Network.

The Coding Network

California Physician and Practice Settle False and Fraudulent Claims Case

On April 12, 2019, Complete Women Care, Inc., and Miriam Mackovic-Basic, M.D. (collectively, “CWC”), with multiple locations in Los Angeles County, California, entered into a $ 258,045 settlement agreement with OIG. The settlement agreement resolves allegations that CWC submitted claims to Medicare for items or services that it knew or should have known were not provided as claimed and were false or fraudulent. Specifically, OIG contended that CWC submitted claims for: (1) diagnostic electromyography services using CPT Code 51784 and diagnostic anorectal manometry (ARM) services using CPT Code 91122 when therapeutic, not diagnostic services, had been provided; (2) ARM services using CPT Code 91122 that were not performed according to CMS guidelines; (3) pelvic floor electrical stimulation that was not preceded by a four-week course of failed pelvic muscle exercise training; and (4) in 13 instances, evaluation and management services using CPT Code 99214 that did not meet the criteria for billing under that code. OIG’s Division of Data Analytics and Office of Counsel to the Inspector General, represented by Senior Counsels David Traskey and Michael Torrisi, with the assistance of Program Analyst Mariel Filtz, collaborated to achieve this settlement.

The post California Physician and Practice Settle False and Fraudulent Claims Case appeared first on The Coding Network.

The Coding Network

California medicaid (medi-cal) progress note — start / end time

Good morning,

Does anyone know where exactly that I could find any literature on clinical documentation requirements (verbatim) regarding the "start and end" time for Mental Health services (Individual / Family) rendered to a Medi-Cal (California Medicaid) Beneficiary?

Thank you in advance.

Medical Billing and Coding Forum

CMS Authorizes Blanket Waivers for California

The Centers for Medicare & Medicaid Services (CMS) issued several blanket waivers, Nov. 13, for those who are evacuated, transferred, or otherwise displaced as a result of  the California wildfires. These waivers are retroactive to Nov. 8, and allow healthcare providers to continue caring for Medicare patients affected by the emergency without having to apply […]

The post CMS Authorizes Blanket Waivers for California appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

California Physician and Practice Settle False and Fraudulent Claims Case

On June 11, 2018, James S. Dunn, Jr., MD, d/b/a Auburn Urogynecology and Women’s Health (collectively, “Dr. Dunn”), Auburn, California, entered into a $ 419,578 settlement agreement with OIG. The settlement agreement resolves allegations that Dr. Dunn submitted claims to Medicare for items or services that he knew or should have known were not provided as claimed or were false or fraudulent. Specifically, OIG contended that Dr. Dunn submitted claims for:

  1. diagnostic electromyography services using CPT Code 51784 and diagnostic anorectal manometry using CPT Code 91122 when therapeutic, not diagnostic, services had been provided;
  2. pelvic floor electrical stimulation that was not preceded by a four-week course of failed pelvic muscle exercise training; and
  3. pelvic floor physical therapy services that were provided by an unqualified individual.

It was reported that the OIG’s Consolidated Data Analysis Center collaborated on this settlement which might mean the issues were identified through data analytics.

Compliance officers reading these summaries can see how implementing some of the best practices of an effective compliance program might have been able to prevent these problems. For example, regular performance of exclusion checks might have identified the excluded individuals employed by some of the organizations which some of the billing and claims issues might have been identifiable through regular auditing and monitoring programs.

The post California Physician and Practice Settle False and Fraudulent Claims Case appeared first on The Coding Network.

The Coding Network

California insurance plans help

Hi,
I currently have a billing service in Oregon. Several of my clients are Licensed Massage Therapists. One of my clients will be opening a new location in California, near Sacramento. Can anyone provide me with a list of good insurance companies that we should look into contracting with in that area? (I know not all cover MT, but we still would like some input on good companies to contract with). Or who I can contact that may provide me with that. Does California use a standard credentialing app like Oregon does?
Thanks in advance.
Traci

Medical Billing and Coding Forum

California Workers Comp Division Suspends Three Medical Providers for Fraud

The California Division of Workers’ Compensation has recently suspended 3 more medical providers from participating in the state’s system, bringing the total number of providers suspended to 245.

Click here to read the full story.

The post California Workers Comp Division Suspends Three Medical Providers for Fraud appeared first on The Coding Network.

The Coding Network

Medical Malpractice Attorneys in Lancaster, California

You need to find an experienced attorney to help you when someone you loved died because of medical malpractice. Medical malpractice is when you want to file a claim against your doctor when they made errors in the treatment of a family member that could have been preventable. It is not as simple as it may seem to be. You may suspect that the doctor made a preventable error but it takes the expertise of lawyers doing research to find out the truth.

Medical malpractice is not only the fault of a doctor but it can result in preventable errors executed by any Lancaster hospitals, nursing homes, the Veteran’s Administration, and other medical providers in the area. It takes an experience team of Lancaster attorneys to uncover the truth in a medical malpractice case. There are many different ways that a medical malpractice can happen to a person.

One of the most common malpractice procedures is that of failure to diagnose a person’s condition. The attending physician may not have provided the person proper treatment to save their life. A person may have an illness, that when properly treated, they will get better and presume their life style. When a doctor fails to diagnose a condition, or delays to long in making that diagnoses, it could mean the patient health is damaged or an avoidable death occurs.

The Lancaster attorneys need to be able to prove that the diagnoses could have been made sooner by the doctor. The doctor was negligent in not checking the patient’s tests and verifying the patient’s condition. There are more threatening signs that show the patient needed treatment immediately. It is very obvious when there are surgical errors that cause the death of a patient. Many times the patient might die because of the Anesthesia was administrated improperly.  Medical errors can occur when a patient is prescribed the wrong medicine. Lancaster attorneys need to be able to look at all the possible things that went wrong and detect a reason for medical malpractice suit.

Lancaster, California is located in Los Angeles County and the main hospital in that area has over three hundred active medical staff personnel that are responsible for the care of patients. The hospital in Lancaster has approximately 7,000 patients a year admitted to the hospital with about 11,000 out patients who come in for daily care. This is a lot of patients who need professional medical care in Lancaster alone. Lancaster medical malpractice attorneys realize with such a large group of patients who need a variety of treatment, that it is not impossible for a medical mistake to be made.

On any given day, the Lancaster hospital emergency room can be over crowed with sick people who need immediate care. The emergency room has peak periods when more accidents take place that require immediate care. The doctors who practice in the Lancaster surrounding areas must send their patients to the hospitals for tests. That is why with so many professionals on staff, that it is not impossible for a medical error to be made. Patients are seen by many people during a time period of tests and treatments.  When you notice that your family member is not getting proper treatment then you can make a complaint to the head administrator. If you find that nothing is being done, or that the wrong things are being done for your family member, then consult with a medical malpractice lawyer in Lancaster in order to get help.

RW has been performing SEO and website consulting online since 1997, and specializes in Medical and Legal consulting online. for more information regarding Lawyers in Lancaster please visit www.lawyerslancaster.com.

More Medical Coding Articles

Podiatrist billing Medi-cal California

I need help I am working for a Podiatrist that is seeing medi-cal pts for 11720 or 11721 and we can’t get paid we first billed B35.1 which is needs to be a secondary code per Medi-cal guidelines so I rebilled claim with L60.3 and B35.1 as secondary and we are still getting denied. We have the TAR approved but still Denied due to diagnosis.. Anyone else have this issue or anything I can rebill with

Medical Billing and Coding Forum