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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

Turn The Cessation of Elective Surgeries Into an Opportunity to Educate

Under normal circumstances, the biggest difficulty practices encounter when trying to engage in physician education is timing.  Coordinating everyone’s schedules, pulling providers out of the operative and visiting rooms, and capturing a practice’s attention during the work day (or worse, during lunch) can be incredibly challenging.  We all understand that physicians are always busy and fitting in additional work, even documentation training to improve their performance, is a challenging feat.

With Shelter-At-Home ordinances and a cessation of elective services around the country, most providers find themselves with only telemedicine visits to fill their dockets.  Covid-19 has substantially slowed down many practices that provide elective services.  Instead of wasting this time waiting for normal life to resume, utilize this opportunity to take care of the tasks that are typically difficult to coordinate.

Most training sessions are able to be done remotely so the providers can login from their own homes.  In fact, this might allow for the most engagement with your providers in a training session as they do not have a full schedule dragging them in a million different directions.  Remote physician documentation training will help keep your providers involved with the practice and their specialty during a period of prolonged downtime.  Better yet, it will help to improve their skill sets so that when they do return to the operating room, their enhanced documentation will allow for optimized reimbursement and fewer denials ensuring that your practice’s revenue stream is healthier than ever.

The post Turn The Cessation of Elective Surgeries Into an Opportunity to Educate appeared first on The Coding Network.

The Coding Network

BCBS – New Reimbursement Guidelines for Smoking Cessation effective from September 26, 2019


Effective September 26, 2019, Horizon BCBSNJ will change the way consider certain professional claims for smoking cessation services provided September 26, 2019.

In accordance with CMS guidelines, Horizon BCBSNJ shall consider for reimbursement smoking and tobacco cessation counseling visits (99406 or 99407) for asymptomatic patients when billed with an approved diagnosis code.

Approved Diagnosis Codes:
  • Nicotine dependence (F17.21-F17.299)
  • Personal history of nicotine dependence (Z87.891)
  • Initial encounter, toxic effect of tobacco and nicotine (T65.211A, T65.212A, T65.213A, T65.214A, T65.221A, T65.222A, T65.223A,  T65.224A, T65.291A, T65.292A, T65.293A, T65.294A)

Evaluation and management (E&M) services shall be considered for reimbursement on the same day as smoking and tobacco-use cessation counseling services (99406 or 99407) only when medically necessary, as indicated by appending Modifier 25 to the E&M service.

Limitation: 

Horizon BCBSNJ shall limit smoking and tobacco-use cessation counseling (99406 or 99407) in any combination to eight times within a one-year period.

Reference:BCBSNJ



Coding Ahead

Billing smoking cessation counseling with E&M and EKG

My cardiologists have recently started billing the tobacco cessation counseling codes 99406 and 99407. I know when billing these codes with a separate E&M, we need the 25 modifier on the E&M. Sometimes, an EKG 93000 is also done. My question is, do we need a 59 modifier on the EKG when billing all three codes together? I’ve found one online source that specifically says we do need the 59 in this scenario, but nothing else addressing billing the three services on the same date by the same doctor. Any help with this would be appreciated!

Medical Billing and Coding Forum

Smoking Cessation billing

Hi!

I’m hoping some of you have experience with billing and reimbursement for CPT 99406/99407 smoking cessation counseling. We are an internal medicine practice (pcp) and are looking for some guidance on billing requirements. I read that Medicare covers 8 cessation counseling sessions per year (not per provider) so that part I understand.

When are we allowed to bill for it? Can it be billed at the same time as a annual physical (for non Medicare) or at the same time as a Medicare Wellness visit G0438/G0439? Do we just need to add modifier 25 to the E/M?

I would greatly appreciate any feedback. THANKS!!

Medical Billing and Coding Forum

Smoking cessation treatment-HELP!!!!!!!!!!!!!!!!!!!!!!!!!

Hi all! Does anyone know if CPT 99407-Smoking and tobacco use cessation counseling visit can be billed by a Psychologist? The code psychologists used to report was S9075, but it has now expired and according to Optum encoder, the crosswalk is now 99407. Unfortunately, 99407 falls under the E&M section and psychologists can’t report E&M’s. Is there an alternative code, or is it okay to report 99407 since S9075 is crosswalking to that code?

S9075 Smoking cessation treatment
99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes

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

Smoking Cessation Question

I am extremely good at coding for this and I have much knowledge in what should be notated in order for this to be billed (99406 & 99407). I know that time MUST be notated, however I have a provider who suddenly started notating "spent 3-10 minutes performing smoking cessation counseling". Is this acceptable? I have never encountered this as my providers have always been specific with time. I think I know that the answer is "no" but I just want confirmation as I could be wrong. As with all counseling codes, I never go by a range of time spent, but an accurate amount of time spent and I feel this should be the case in ANY kind of counseling, including smoking cessation. Any thoughts on this?

Medical Billing and Coding Forum

Smoking Cessation Documentation

Looking for feedback from other auditors. Is there any formal criteria or guidelines for documenting smoking cessation? Obviously "counseled patient not to smoke" wouldn’t support 99406, but how much more information is needed than "counseled patient not to smoke for 5 minutes"?

Looking for something authoritative, even if just guidelines from a particular payor.

Thank you!

Medical Billing and Coding Forum