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

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

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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

Top Claim Error(Denial) Revealed

The No. 1 claim error for June in 11 states plus the District of Columbia was for non-covered charges, according to Novitas Solutions, Medicare Administrative Contractor for Jurisdictions H (Arizona, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas) and L (Washington DC, Delaware, Maryland, New Jersey, and Pennsylvania).

This error is identified by Explanation of Benefits (EOB) message code 96. Noncoverage has been the No. 1 claim error for some time in these states, which is hard to believe because there’s a known cause and cure.

Non-coverage Denials-Cause and Cure:

Explanation of Medicare Benefits (EOB) error message 96 Non-covered charge was the No. 1 reason for claims denials in all of “Prior to performing or billing a service, ensure that the service is covered under Medicare,Medicare Jurisdiction H, according to the region’s Medicare Administrative Contractor (MAC).

Please verify “Prior to performing or billing a service, ensure that the service is covered under Medicare,”
This should be a no brainer, but there are quite a few services you would think are covered by Medicare that aren’t.

For example, according to Medicare Benefit Policy Manual Pub. 100-02, Chapter 16, Section 10, “No payment can be made under either the hospital insurance or supplementary medical insurance program for certain items and services, when the following conditions exist, 

  • Not reasonable and necessary
  • No legal obligation to pay for or provide
  • Paid for by a governmental entity
  • Not provided within United States
  • Resulting from warPersonal comfort
  • Routine services and appliances
  • Custodial care
  • Cosmetic surgery
  • Charges by immediate relatives or members of householdDental services
  • Paid or expected to be paid under workers’ compensation
  • Non-physician services provided to a hospital inpatient that were not provided directly or arranged for by the hospitalTop Claim Error Revealed
  • Services Related to and Required as a Result of Services Which are not Covered Under Medicare
  • Excluded foot care services and supportive devices for feet or,Excluded investigational devices (See Chapter 14) 


Coding Ahead