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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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Feds and U.S. Attorneys Continue to Crack Down on Telemedicine Fraud

Medical practitioners in Michigan are held responsible for their role in Medicare fraud scheme. On Aug. 24, U.S. Attorney Andrew B. Birge announced criminal and civil enforcement actions against four Michigan medical practitioners for their role in perpetuating a telemedicine scheme to defraud Medicare. The practitioners signed off on illegitimate orders for medical braces and […]

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AAPC Knowledge Center

CMS Seeks to Improve Healthcare Outcomes and Drive Down Costs

CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity. On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) announced new proposed actions to address the health equity gap, decrease mounting healthcare costs, and increase medical accessibility and patient quality of care. […]

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Right axillary artery cut down with impella placement

Procedure:
#1 right axillary cutdown with insertion of percutaneous left ventricular assist device ( Impella CP)
#2 Placement of in to side 6 mm Dacron graft to the right axillary artery
#3 TEE with visualization and interpretation
#4 Fluoroscopy with intraoperative visualization and interpretation

Intraoperative findings:
TEE showed severe left ventricular dysfunction with global hypokinesis. Aortic valve was a trileaflet valve with no insufficiency or stenosis. Limited TEE was performed for the purposes of placement of the ventricular assist device. After placement of the device, the device was positioned appropriately across the aortic valve.
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On fluoroscopy, the final resting position of the percutaneous left ventricular assist device had the elbow of the device positioned at the level of the aortic valve. Device was functioning appropriately.
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Procedure in detail:
The patient had his history and physical updated prior to the procedure. He was transferred to the operating suite and placed on the operating table where he underwent general anesthesia. The patient was already endotracheally intubated.the right shoulder and chest were prepped and draped in usual sterile fashion using DuraPrep solution after TEE probe was inserted by anesthesia. Timeout was used confirm patient identity as well as the surgery to be performed. Antibiotics given prior the incision. Next

The right axillary artery cutdown was performed by Dr. X. Once this was completed, the right actually artery was exposed and proximal distal vessel loops were placed. I then took over the operation. The patient was anticoagulated with ACT greater than 250 seconds after giving heparin. Proximal distal control of the axillary artery was performed. A longitudinal arteriotomy was then made and extended with angled scissors. A 6 mm Dacron graft was then beveled and anastomosed using 6-0 Prolene. Once this was completed, the graft was de-aired.
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The introducer sheath was then placed within the 6 mm graft and secured. The dilator was removed. The graft was de-aired and then carefully flushed with hep saline. J-wire was then introduced and advanced into the Aortic arch under fluoroscopic guidance. The pigtail catheter was inserted over the wire and positioned within the aortic arch, then used to manipulate the wire into the aortic root. The pigtail catheter was then positioned within the aortic root and the wire was carefully advanced across the aortic valve under fluoroscopic and TEE guidance. Pigtail catheter was advanced into the left ventricle. The J-wire was removed and the 018 guidewire was then placed within the left ventricle. Next
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The ventricular assist device then placed over wire and advanced in position within the left ventricle using fluoroscopic and TEE guidance. The wire was removed. The device was started, with excellent flows, improvement in the mean arterial pressure,as well as good motor current. The 6 mm graft was then trimmed to just above the level of the skin. The peel-away sheath was removed. The positioning sheath was then inserted and secured with 0 Ethibond and 0 silk. The Impala device was then secured with final fluoroscopic Evaluation used to pull the Impala back slightly as it had advanced during these maneuvers. Once this was completed, the soft tissues reapproximated with 0 Vicryl. The skin was closed with 4-0 Monocryl in running subcuticular manner. Dermabond was placed over the wound. The patient tolerated procedure well was transferred to CVRU in critical condition.

IMPELLA 33990
axillary cutdown by DR X?
axillary graft?
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Medical Billing and Coding Forum

Practicode Still Down?

I know they were doing an update to it, but I was told it would be back up this afternoon. I have been trying to log in this evening, but I keep getting a message that either my login is wrong or the session has expired. I purchased in August, so I know my time in the course has not expired (you have 18 months to complete all modules). I did send an email, but was hoping to get some insight before tomorrow.

Medical Billing and Coding Forum

EHR Interoperability Got You Down?

Be a part of the solution: Comment on a draft strategy for reducing regulatory administrative burdens. Do the practitioners in your organization complain about the administrative burden associated with the use of electronic health records (EHR) and other health information technology (IT)? You may be sick of hearing it, but the Office of the National […]

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Ideas for Spending Money Down at the End of the Year

If your chapter is fortunate enough to have extra funds at this time, now might be a good time to purchase a laptop, an I-pad for checking in members at meetings, other necessary A/V equipment, or even an application for presenting virtual meetings. (This would be a great way to have an officer meeting.) Be […]

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DOJ Takes Down Father and Son Opioid Kickback Scheme

We’ve seen a surge of Department of Justice (DOJ) takedowns of doctors who committed prescription fraud and abuse of opioid drugs. As prescription opioid addiction grows, so does the crackdown on abuse of federal dollars funding physicians who are feeding patient addiction. On March 9, 63-year-old Jerrold N. Rosenberg, MD, of Rhode Island was sentenced […]
AAPC Knowledge Center

HHS-OIG Cracks Down on Healthcare Fraud in 2017

The Office of Inspector General (OIG) was busy in 2017. In the video, Eye on Oversight – 2017 Year in Review, released Dec. 20, the agency charged with protecting the integrity of U.S. Department of Health and Human Services (HHS) healthcare programs reflects on its accomplishments throughout the year. Summarizing the video, the OIG reports for […]
AAPC Knowledge Center

OIG Takes Down the Largest Bribery Ring of Medical Professionals

Lately it seems that the Office of Inspector General’s (OIG) focus is on fraud and abuse of federal healthcare dollars via the False Claims Act; however, a case in Newark, N.J., has proven that the Anti-Kickback Statute also is being enforced in a big way. A Staten Island doctor, Ahmed El Soury, has been sentenced […]
AAPC Knowledge Center