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

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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

CMS Proposes to Extend Medicare Coverage of Immunosuppressive Drugs for Kidney Transplant Recipients

Coverage would continue after 36 months. On April 22, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule under the Consolidated Appropriations Act, 2021 (CAA) that would, in part, extend Medicare coverage of immunosuppressive drugs for kidney transplant recipients. Section 402 of the CAA proposes to extend immunosuppressive drug coverage under […]

The post CMS Proposes to Extend Medicare Coverage of Immunosuppressive Drugs for Kidney Transplant Recipients appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Inhalation Drugs Make It On OIG’s Hit List

Does your provider’s nebulizer and inhalation drug documentation pass this OIG audit test? “Since 2010, the Centers for Medicare & Medicaid Services’ (CMS’) Comprehensive Error Rate Testing (CERT) program has identified nebulizers and related drugs (i.e., inhalation drugs) among the top 20 durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items with the highest improper […]

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AAPC Knowledge Center

TV Ads for Drugs Must Show Prices

To help drive drug prices down, the Centers for Medicare & Medicaid Services (CMS) will require direct-to-consumer television advertisements for prescription drugs covered by Medicare or Medicaid to include the list price – the Wholesale Acquisition Cost – if that price is equal to or greater than $ 35 for a month’s supply or the usual […]

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AAPC Knowledge Center

Multiple Pass-through drugs used during IOL surg – will Medicare pay

We are going to start using Dexycu (J1095) and Omidria (C9447) during IOL surgery (66984) done in an ASC, both of these drugs are approved for pass-through status with Medicare. Will Medicare apply any additional adjustments to J0195/C9447 when both drugs are used during the same surgery? Thank you

Medical Billing and Coding Forum

Civica Rx Adds 250 Hospitals, Plans 14 Drugs

Civica Rx announced that 12 new health systems representing 250 hospitals nationwide, have joined the not-for-profit generic drug company as founding members. That brings the number of hospitals that have joined the project designed to make generic drugs more accessible and less expensive to 750. Civica Rx to Solve Supply, Cost Problems Spotty supply and […]

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AAPC Knowledge Center

Billing Chemotherapy Drugs

I have 2 questions I would like some clarity on based on correct billing guidelines for Chemotherapy drugs:

1. Is there a payable HCPCS chemotherapy drug list anywhere? I have searched high and low. I am trying to find out the payable drugs codes for administration code 96416
2. When billing an add-on code admin code (96411 and 96417), is it required to bill a separate distinct drug code from the primary admin code in order for it to pay.

Any guidance would be appreciated.

Medical Billing and Coding Forum

no drugs administered, is this still MAC?

Per ASA statement of "Position on Monitored Anesthesia Care", During monitored anesthesia care, the anesthesiologist provides or medically directs a number of specific services, including but not limited to:
1. Diagnosis and treatment of clinical problems that occur during the procedure
2. Support of vital functions
3. Administration of sedatives, analgesics, hypnotics, anesthetic agents or other medications as necessary for patient safety
4. Psychological support and physical comfort
5. Provision of other medical services as needed to complete the procedure safely.

There was no anesthetic agent administered.
Does this still qualify for MAC?

Thank you.

Medical Billing and Coding Forum

Modifiers for 340B-acquired drugs

CMS established two Healthcare Common Procedure Coding System (HCPCS) Level II modifiers to identify 340B-acquired drugs:

Modifier “JG” Drug or biological acquired with 340B drug pricing program discount.

Modifier “TB” Drug or biological acquired with 340B drug pricing program discount, reported for informational purposes.

When applicable, providers are required to report either modifier “JG” or “TB” on OPPS claims (bill type 13X) beginning January 1, 2018. Though modifier “TB” is an informational modifier, reporting is mandatory for applicable providers.

For more information: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Downloads/Billing-340B-Modifiers-under-Hospital-OPPS.pdf


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