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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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

UnitedHealthcare Delays Changes in Consultation Code Policy

In August 2017, UnitedHealthcare (UHC) indicated they would no longer reimburse inpatient and outpatient consultation codes as of Oct. 1, 2017. When the implementation date came on Oct. 1, 2017, UHC indicated they delayed the consultation services revision until 2018: We previously announced that certain revisions to the Consultation Services Reimbursement Policy would become effective […]
AAPC Knowledge Center

Telephone/Internet Consultation and Inpatient Consultation Next day

I work for a specialty clinic whose physicians are on call with a local hospital for inpatient matters. Recently, a patient who was in a remote location was seen by a physician who requested a Telephone Consultation (99446). Our physician performed the Telephone/Internet consultation in accordance to CPT guidelines. The next day, the patient was flown in to the local hospital. The hospital physician requested our physician (same one) to do an Inpatient Consultation, which our physician performed. The pt. is not medicare/VA/military. The problem I am experiencing is that we’d like to bill for both services but, under the guidelines for the Telephone/Internet Consultations, it states "When the telephone/internet consultation leads to a immediate transfer of care OR OTHER face to face service (eg, a surgery, a hospital visit, or a scheduled office evaluation of the patient) within the next 14 days or next available appointment date of the consultant, these codes are not reported". Question is then, does the physician simply not bill for the telephone internet consultation and receive no reimbursement or is there something I’m missing? Thank you for your assistance.
Mike

Medical Billing and Coding Forum

Brief Mental Health Consultation Code

I have a provider (LISW) who saw a patient for basically a brief mental health consultation and was only in there for around 7 minutes. I am trying to find the CPT Code that would best fit that description but I can’t really find "BRIEF CONSULT". Does anyone have any suggestions as what might be close to this for us to bill correctly. Thanks in advance for any help!

Medical Billing and Coding Forum

Consultation and minor surgery same day

Hoping some one can help!!

Situation: Provider consulted on a patient in hospital for vomiting blood. Patient was stable at time of consult. Provider waited for patient’s hgb and labs to come back and decided to perform an EGD due to possible GI bleed. Labs were the indication for procedure at that time. EGD did not show any active bleeding, but duodenal ulcer and old blood in somach, provider ordered for the patient to be transfused. Within 3 hours, patient started to show BRBPR. Provider brought patient back into the OR, and another EGD was performed which showed bleeding duodenal ulcer and then every thing went south. How can I bill the consult along w/the two EGD’s? Many times my providers may perform minor surgery EGD or consultation on the same day of service on Inpatient or obs patient. How do I bill Consults in hospital and minor surgeries same day?

Any advice is appreciated along with any documention or websites!!! :)

Medical Billing and Coding Forum

Consultation Coding for Medicare

Medicare does not accept claims for either outpatient (99241-99245) or inpatient (99251-99255) consultations, and instead requires that services be billed with the most appropriate (non-consultation) E/M code. Report outpatient E/M services with the appropriate Outpatient Services code (e.g., 99201-99215, or 99281-99285 for patients seen in the emergency department). The service must be supported by the […]
AAPC Knowledge Center

Compliance Officer Consultation Fees

Help please!

I am looking to start consulting as a Compliance Officer.

Does anyone have ANY ideas on a fair charge amount for my services?

Such as an overall risk assessment consult maybe and developing a compliance plan and even staying on as the compliance officer – like a small monthly charge or up front charge?

Medical Billing and Coding | AAPC Forum

CPT for E/M Medicare patient consultation in Observation Status

Hello,
I do not know how to bill for a hospital consultation for a Medicare patient under observation status. Since Medicare does not pay for consult codes, and patient is not inpatient what is the correct code to use?, I was using observation codes but we got a denial because our doctor was not the admitting physician.

Our Dr. was called to see patient for a specialist consultation, please help.

Medical Billing and Coding | AAPC Forum

post op consultation

I have a surgeon who less than 30 days prior perfomed a 19125 for bloody discharge from left nipple. Excised the duct and submitted it to pathology. Now the surgeon wants a 99215 for a 45 minute, 100% consultation for DCIS.

Would the 99215 be billable with a 24 modifier? Nothing documented about carcinoma in the procedure visit, everything was nipple discharge. However, because it is the same anatomy, would that place this encounter unbillable?

Appreciate any feedback

Medical Billing and Coding Forum | AAPC