Click here for more sample CPC practice exam questions with Full Rationale Answers

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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

chronic care management

I have a question on doing the CCM. We are part of an ACO and they are doing our CCM for our patients. They are telling our providers that some of our patients are too sick to be part of CCM. I do not think they can be too sick for that from what I am reading. Does anyone else know?

Also we are being told that we have patients that are too sick to be part of the ACO. Who makes that decision? Medicare or the ACO?

Medical Billing and Coding Forum

Chronic Osteoporosis Fractures

My osteoporosis specialist will often treat patients who have what he calls "chronic vertebral fractures" caused by osteoporosis. These fractures frequently are very old, but still apparently causing the patient pain. The patient is coming in to receive a Prolia injection and I need an osteoporosis diagnosis code to be the primary code for the Prolia injection. Can I code this situation with M81.8, M54.5 and M8088XS, since the pain is a sequela of the fracture, even though the fracture is not technically current? Or would I just use the M80.88XS as the primary code just on the injection?

Medical Billing and Coding Forum

Chronic Care codes in Pediatric coding and billing

I am a Coder and Biller at a pediatric Practice I have a question regarding CHRONIC CARE code 99358 for our Patients ( who are Complex care kids)
Here is my question:
Our complex care Patients if they come for WCC we bill once a year with Complex care code 99358 with their WCC as our Dr are reviewing their Charts before they come and managing their whole health.

So I put age based WCC with 25 Mod and 99358 code if the review time is 30-74 min on a complex care Patient.

My question is ANTHEM doesn’t pay 99358 code so as discussed with you and my manager we add 99213/99214 ( whatever level) with their WCC code
to get paid on Chronic/complex care kids.

Please advise is that right? as one of our Pt mom complain that when they are bringing their child for WCC why do they have to pay a copay as we billed WCC and E/M code ( instead of 99358) to Anthem. What should we do in these scenario.

Medical Billing and Coding Forum

coding chronic condition icd10 from problem list

Scenario: Patient comes in for a visit with his FP doc to discuss his chronic cough. The MD just notes the discussion of the cough but the patient has diabetes, HTN, etc in his problem list and he refills his HTN meds and DM meds that day both of which are documented in his note for that day. Can HTN and DM be coded for that days visits along with dx for cough?

Medical Billing and Coding Forum

Chief Complaint/Status of Chronic Conditions

Does the chief complaint need to be separate from the HPI? There has been information out there that says that the chief complaint can listed under its own header or as the first sentence of the HPI (as long as it is clear). At my facility, many providers are split when doing this and I am trying to find out which is the correct way because it would alleviate a lot of extra work on both ends.

IF the chief complaint can be the first sentence of the HPI, would this suffice for chief complaint and status of one chronic condition? Example: Patient presents for follow up on hypertension and states he is doing well and offers no complaints.

Please let me know your input. Thank you very much.

Medical Billing and Coding Forum