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

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

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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

Unravel the Complexity of Risk Adjustment

AAPC’s RISKCON virtual conference prepares healthcare professionals for the future of reimbursement. What is risk adjustment? It’s a methodology that the Centers for Medicare & Medicaid Services (CMS) uses to compensate Medicare Advantage (MA) plans for the added costs of insuring people with chronic conditions. Sounds simple enough, but it’s not. Risk adjustment is complicated. […]

The post Unravel the Complexity of Risk Adjustment appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Interactive Complexity and Virtual Reality

Hello!

I have a behavioral health provider who is starting to use virtual reality in her treatment sessions with children. Would it be possible to bill the add-on code for interactive complexity (90785) for this service?
Does anyone have experience with insurance reimbursing interactive complexity in this scenario? Any information would be greatly appreciated. Thank you!

Medical Billing and Coding Forum

Understand the Complexity of Reporting Same Day CMT and E/M Services

In the absence of payer guidance, look to CMS and CPT® for guidance on reporting an E/M as a separate service from chiropractic manipulative treatment with modifier 25. Editor’s Note: Healthcare Business Monthly was recently asked about reporting evaluation and management (E/M) services separately from chiropractic manipulative treatment (CMT) of the spine. As with most […]
AAPC Knowledge Center

Low Complexity versus Moderate Complexity

I just finished a practice exam from AAPC and I would appreciate a bit more clarification on the answer if possible!

If the physician documented a detailed history, comprehensive examination and a medical decision making of moderate complexity, how is the correct E/M code 99221 when the description states low complexity? Is low and moderate interchangeable? I thought the correct code would be 99222.

Medical Billing and Coding Forum

MDM- “Amount and/or Complexity of Data Reviewed”

I am in need of some advice on some records I’m reviewing. This is directly related to the "Amount and/or Complexity of Data Reviewed" of the MDM component.

If the Physician notes she performs a "Urine Toxicology Screening", checking for RX compliance, and mentions she personally "reviewed the dipstick herself which provides a preliminary result for the potential of more or more drugs", how many points does this qualify for?

One total, for the review and/or order of clinical labs?
Two total, for the independent visualization of a specimen?
Three total, for ordering/reviewing and also independent visualization?

I’ve seen many conversations about this, but no hard documentation that says truly which one. I’ve researched in Optum’s Evaluation and Management Coding Advisor and it isn’t answered for my scenario. I’ve Googled and can only find opinions, but nothing from bigger reputable sources. If anyone has something in writing I would greatly appreciate it!

Thanks so much!

Medical Billing and Coding Forum

Counting checking PDMP (Prwescription Drug Monitoring Program) as Complexity of Data

Email sent to Our Medical Director:
I noticed that ‘and/or checked PDMP’ was added to <Reviewed old records…> check box for Complexity of Data for coding points.
If this is being done as part of Agency protocol, it does not count for coding purposes and should not be included as it may result in up-coding. There is no complexity in decision-making to just follow a protocol.
Unsure how this got changed as this was not the way it was set up per my prior recommendation, and my professional opinion is: this verbiage should be removed and another check box added: <PDMP checked per Agency protocol> that does not link to coding.
I have no problem educating prescribers to check <Reviewed old Records> when they check the PDMP on established patients, not on controlled meds (ie not part of protocol) and document why: “checked PDMP as client has history of Benzo abuse” or “ checked PDMP as client has a SUD Dx” or “client has been using up recent prescriptions prior to renewal date; checking PDMP for possible prescription abuse”. This does show additional ‘work’ on the part of prescribers which may allow for higher coding level.

Experienced E/M coders-please provide input as the Director disagrees with my stance

Medical Billing and Coding Forum

Wild Oregano Oil – Providing Answer To Every Medical Complexity

A product of Mediterranean region, wild oregano oil is used by people across the world for treating number of diseases in the most herbal and non-expensive way. Known as one of the strongest antibiotics to have ever germinated on the Blue Planet, this oil is fast turning into a potent alternative to commonly used pharmaceutical drugs.

This Mediterranean product possesses various body-friendly chemicals such as carvacrol, flavanoids, esters and terpenes in it that come handy in treating number of infections that can be found in human body.

Thanks to its health benefiting properties, today wild oregano oil is widely being used to treat problems like arthritis, acne, allergies, constipation, menstrual inconsistencies and many others. In addition to it, diseases like ringworm, penumonia, tuberclosis and even urinary tract infections can also be treated via it.

Discovering the score of positive effects it brings on human body even medical experts are encouraging people to use oregano oil. The reason cited behind it, is a theory that might amuse many but is believable to a large extent. Consistent usage of antibiotics helps problematic bugs present in body in developing strong immunity against it. Hence, after a while our body automatically fails to respond to the treatment being administered to it. Thus the condition deteriorates and problem stays far from getting solved. Wild oregano oil acts like morphine thus helping people in recovering from the situation they are in.

Meanwhile for those who don’t know, this oil can also be used as liquid soap. Yes, using this oil on hand kills bacteria and pathogens that are dangerous threat to the body. People complaining of bleeding gums can use the same oil for getting rid of the problem. Thanks to its edible value, wild oregano oil can be consumed along with regular food items.

However extreme caution needs to exercised when the user is a child. Yes, children below 7 years of age are advised to seek advice from a reputed physician or doctor before consuming the same.

Hence it is quite clear that wild oregano oil is need of hour for every health conscious person. Thanks to its health benefiting properties, people can now enjoy a healthy lifestyle.

Robert Henry is connoisseur in the field of medication. He has been writing some amazing articles on Cystitis , symptoms and cures of the bladder infections. His knowledgeable articles have brought amazing changes in the lives of several individuals.

For more please visit: wild oregano oil

The Complexity of Root Operations in ICD-10-PCS

As inpatient coders, we are always faced with the daunting task of the “intent of procedure” when compliantly coding for Inpatient procedures. With the inception of the 2017 updates, which became effective October 1, 2016, we are again faced with the lingering questions of the “intent of the procedure” when applying PCS codes. As we […]
AAPC Blog