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

RAP Diagnosis Code, Service Date Instructions Change

Other claims system glitches fixed, with one still waiting. The Centers for Medicare & Medicaid Services (CMS) continues to issue new rules to accommodate no-pay Request for Anticipated Payments (RAPs) and Patient-Driven Groupings Model (PDGM). Principal Diagnosis CMS has reissued Change Request (CR) 11855 and added a few new instructions about requests for anticipated payments. […]

The post RAP Diagnosis Code, Service Date Instructions Change appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Code Change for Influenza Season 2020-2021

The 2019-2020 influenza season is winding down, so now is a good time to start preparing for the 2020-2021 influenza season. Let’s start with a new CPT® code for the flu vaccine. Flu Activity Report The Centers for Disease Control and Prevention (CDC) reports that viral activity is decreasing in the United States. According to […]

The post Code Change for Influenza Season 2020-2021 appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

What Happens When E/M Guidelines Change?

Medical coders, billers, auditors, and other healthcare business professionals started Day 2 of AAPC’s Regional Conference in New York City getting the scoop on the proposed changes to evaluation and management (E/M) services coding and guidelines. E/M Guidelines Changes Are About Time Conference attendees were eager to hear Raemarie Jimenez, CPC, CDEO, CIC, CPB, CPMA, […]

The post What Happens When E/M Guidelines Change? appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Change to National Drug Code (NDC) Reimbursement Policy for Outpatient Facilities in UHC


For dates of service on or after Nov. 1, 2019, the National Drug Code (NDC) policy for UnitedHealthcare Medicare Advantage plans, including all UnitedHealthcare Dual Complete plans, will be revised for drug-related codes in outpatient facilities.


With this policy change, care providers who are contracted with us who submit claims for drug-related Healthcare Common Procedure Coding System (HCPCS) and CPT codes in an outpatient facility will be required to include the following information on the claim,


• A valid NDC number

• Quantity
• A unit of measure

If the required information isn’t included, the claim may be denied. The NDC requirement will apply to all claims submitted on the CMS-1500, Electronic Data Interface (EDI) 837p, CMS UB-04 and EDI 837i claim forms. 


Reason for Changes:


As the industry standard identifier for drugs, NDCs provide full transparency to the medication administered. They accurately identify the manufacturer, drug name, dosage, strength, package size and quantity.


Will keep you posted list of CPT codes at the earliest


Reference: https://www.uhcprovider.com/content/dam/provider/docs/public/resources/news/2019/network-bulletin/August-Network-Bulletin-2019.pdf#page=27


Click here for Revised Moh’s Surgery Guidelines 


Coding Ahead

Let Us Know When You Change Proctors

Occasionally officers get exams scheduled and then changes must be made to the proctors. When this happens, it is imperative to contact AAPC immediately to report the names of the new proctors. First, it may impact where the exams are being sent, but also if AAPC needs to contact the proctors before the exam, the […]

The post Let Us Know When You Change Proctors appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Change to RT and LT Modifier Use

The Durable Medical Equipment Medicare Administrative Contractors (DME MAC) are changing the requirement that medical coders to use the right (RT) and left (LT) modifiers for certain HCPCS codes, and that the modifiers be used when billing two of the same item or accessory on the same date of service and the items are being […]

The post Change to RT and LT Modifier Use appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

CMS PTP Edit Change

Has anyone else seen the CMS MLM Matters # MM11168?

Effective July 1, 2019, "Modifiers 59, XE, XS, XP, and XU are among the NCCI-associated modifiers. The Multi-Carrier System (MCS) currently requires that modifiers 59, XE, XS, XP, or XU be appended to the column two code of a PTP edit to bypass the edit. With the implementation of CR 11168, Medicare will allow modifiers 59, XE, XS, XP, or XU on column one and column two codes to bypass the edit."

https://www.cms.gov/Outreach-and-Edu…ds/MM11168.pdf
https://www.cms.gov/Regulations-and-…ds/R4266CP.pdf

Waiting for the quarterly PTP edit file effective July 1, 2019 to be release to see if there are any changes to the format. Would anyone have any more information than this?

Medical Billing and Coding Forum

Trach change – code 31502

I am looking for some clarification regarding trach change. I found some literature that states that you can only bill the 31502 code if the trach change occurs before the tract is fully established which is usually after about 7 days. If the trach change is performed after the fistula tract has been established, the trach change is part of the E/M and isn’t billed separately. Our doctor thought that we were allowed to bill the 31502 for the first trach change period. Does anyone have any info on this that can help me? Thank you in advance for your help!
Sherry

Medical Billing and Coding Forum

Trach change – code 31502

I am looking for some clarification regarding trach change. I found some literature that states that you can only bill the 31502 code if the trach change occurs before the tract is fully established which is usually after about 7 days. If the trach change is performed after the fistula tract has been established, the trach change is part of the E/M and isn’t billed separately. Our doctor thought that we were allowed to bill the 31502 for the first trach change period. Does anyone have any info on this that can help me? Thank you in advance for your help!
Sherry

Medical Billing and Coding Forum

Pediatric ECMO Coding for a circuit Change

Hello, my clinician and I are disagreeing on what CPT code should be used for an ECMO Circuit Change. I am leaning towards CPT 33949-Extracorporeal membrane oxygenation (ECMO/extracorporeal life support (ECLS) provided by physician; daily management, each day, veno-arterial.
Here is the scrubbed documentation; PROCEDURE: This procedure was done at the bedside in the NICU. We prepped and draped the cannula sites in the usual fashion. We prepared the venous and arterial lines from the new circuit and these were held in place in a sterile fashion. We then made incisions in the cannula at the connector sites. We then clamped the venous and arterial cannulae on the patient’s side and on the circuit side, therefore coming off ECMO and at that very moment, the patient was put on rescue settings on the conventional ventilator. We then disconnected the old ECMO circuit by detaching the circuit tubing from the venous and arterial cannnula and these were moved away. We then brought the new venous and arterial lines and attached them to the cannulas, ensuring that we did not introduce any air into the circuit. We then went back on ECMO with good flows and achieved an immediate improvement in the pressure gradient across the membrane oxygenator. I was present for the duration of the procedure. The circuit change took approximately 90 seconds.

Any direction anyone can provide will be greatly appreciated.
C. Waddock, CPC

Medical Billing and Coding Forum