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

Capture Chronic Conditions in the Outpatient Setting With Confidence

Know when to assign diagnosis codes for chronic conditions. While assigning diagnosis codes for chronic conditions may seem straightforward, some confusion remains regarding which conditions should be coded in the outpatient setting. Medical coders are responsible for assigning ICD-10-CM codes for all diagnoses made by a healthcare professional that affect the patient’s care. These codes […]

The post Capture Chronic Conditions in the Outpatient Setting With Confidence appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Hypertensive Chronic Kidney Disease

Check your diagnosis coding for this patient encounter. A patient presents today for a follow-up for her hypertension. At her last visit, she was complaining of swelling in her feet and ankles, back pain, trouble sleeping, and having to get up at night to urinate. She has a family history of chronic kidney disease (CKD). […]

The post Hypertensive Chronic Kidney Disease appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

OIG Uncovers Medicare Overpayments for Chronic Care Management Services

Chronic care management (CCM) services are services that do not involve face-to-face patient/provider contact. The Centers for Medicare & Medicaid Services (CMS) implemented Medicare coverage for CCM in Jan. 1, 2015. There are very specific guidelines providers need to follow to be reimbursed for CCM services rendered to Medicare patients, but it appears CMS is […]

The post OIG Uncovers Medicare Overpayments for Chronic Care Management Services appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Chronic Care Management (CCM) Benefits and Guidelines


Chronic care management (CCM) is a critical component of primary care that contributes to better outcomes and higher satisfaction for patients.

CHRONIC CARE MANAGEMENT (CCM):

Medicare initially provided payment for CPT code 99490 beginning January 1, 2015 to separately identify and value clinical staff time and other resources used in providing CCM.

CMS adopted 3 additional billing codes (G0506, CPT 99487, CPT 99489)

The Centers for Medicare & Medicaid Services (CMS) recognizes CCM takes time and effort.

ELIGIBLE BENEFICIARIES:

Patient have two or more chronic conditions expected to last at least 12 months or until death, that place them at significant risk of death, acute exacerbation, or functional decline .

PATIENT CONSENT:

A practitioner must obtain patient consent before furnishing or billing CCM. Consent may be verbal or written but must be documented in the medical record, and includes informing them about:

The availability of CCM services and applicable cost-sharing

Only one practitioner may be paid for CCM services for a given calendar month. This practitioner must only report either complex or non-complex CCM for a given patient for the month (not both)

The right to stop CCM services at any time (effective at the end of the calendar month)

ELIGIBLE REPORTING PRACTITIONERS:
  • Physicians
  • Physician Assistants,
  • Clinical Nurse Specialists,
  • Nurse Practitioners,
  • Certified Nurse Midwives

CPT CODES AND PAYMENT FOR CCM:

  1. CPT G0506 (Add -on code to CCM initiating visit ($ 64 )
  2. CPT 99490 Non complex CCM($ 43)
  3. CPT 99487 (Complex CCM 60 mins ($ 94)
  4. CPT +99489 (Complex CCM ) additional 30 mins ($ 47)

PATIENTS BENEFIT FROM CCM:

  • Spend more time focusing on health and help work towards your health and Quality of life goals
  • Don’t always have to come into the office to get help; you can also make a call.
  • Patients will receive a comprehensive care plan.

CCM SUPPORTS OUR PRACTICE:

  1. Improve care coordination.
  2. Improve patient satisfaction and compliance, and decrease hospitalization and emergency department visits.
  3. Increased payment to practice for the coordinated CCM services we provide outside of face to face visits


Coding Ahead

Chronic renal insufficiency w/ inproved/stable blood work

Hoping someone can advise me. I have a note which indicates patient has Chronic renal insufficiency w/ stable blood work. My inclination is to still code as N18.9 but I’m not 100% sure so I thought I’d ask. Anyone have a recommendation? Thank you

Medical Billing and Coding Forum

Chronic illnesses. MDM. CEMC exam

I am studying for CEMC exam (E/M) via Study Guide. In some rationals, they consider illnesses as chronic without documented ‘chronic.” I wonder if it’s correct in a coding world to assume they are chronic? Below I type some examples and thank you for your help in advance.
Case 5:
Atrial Fibrillation: the pt is with history of chronic AF who is…
Obesity: Pt is working on this but has continued to have problems.
Hypertension: Blood pressure today was.. She will be followed conservatively.
[I]Rational:[/I] Medical decision making level is :Moderate ( pt has multiple chronic illnesses that the cardiologist is following during the hospital stay)
Case 6:
Atrial fibrillation: Pt with a history of AB….
Mild cardiomyopathy: Pt has mild.. clinically stable.
Hyperlipidemia: This will be followed by Dr.X.
Rational: MDM is Moderate (… due to the number of chronic illnesses treated)

Medical Billing and Coding Forum

Chronic conditions reporting in abortion cases ?

Patient is 13 weeks pregnant admitted for missed abortion and underwent D&C, she also has ovarian cyst, asthma etc.would I code the other conditions to pregnancy related first trimester? Any official reference or coding clinic for this please suggest me ?

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Anugu Srinivas
Medical Coder
Bachelor of pharmacy,CCS
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Medical Billing and Coding Forum