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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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Click here for more sample CPC practice exam questions and answers with full rationale

80305 maximum frequency denial.

Getting the denial CO-151 (Payment adjusted because the payer deems the information submitted does not support this many/ frequency of services).

We run the 80305 dipstick test once a month for patients and quarterly send out a 80307 which test the same thing and more. I have called around and cant get a good answer, and the info I am reading is saying that it is a test that we should be able to run once daily and even if we run the 80305 and send out 80307 on the same date, we should be able to bill the 80305 in house and the lab bill 80307 due to different ID.

Now am I Missing some thing? Does anyone have any info on why I would be getting this error? Do you know if their is a limit to how often we can run a test like this in a year period, cause I cant get any info from the insurances themselves.

Medical Billing and Coding Forum

Frequency denials for foot care

1. When a patient comes in for foot care before the 61st day, can you bill an E&M in place of the foot care code?

2. Patient has 11055 performed on June 4th on right sub #5 and 11055 performed on June 28th on right sub #1. Can you bill 11055 for both visits since they are different callus’ even though not within 60 days of last callus treatment? We received a denial for this scenario, can this denial be appealed?

OHIO-CGS Medicare

Medical Billing and Coding Forum

billing frequency for RFA

Hello,

I am trying to get some clarification on the frequency limitations for RFA’s. both myself and my billing supervisor are interpreting the guidelines differently than our provider. Our provider keeps ordering unilateral RFA’s if its more than one level. One side first, then two weeks later the next side. But the guidelines are stating that you cannot perform these procedures within 6 months of eachother. Our provider thinks its based off of joint levels so it shouldnt matter, but my billing supervisor says they are basing it off the codes. So regardless if they are billing 64635, then if we bill another 64635 two weeks later, then they will not pay for the 2nd even if its the same level. If anyone has any resources that they can share to clarify this.

thank you.

-Ellen

Medical Billing and Coding Forum

Nyquist Frequency – Medical Seat Cushions – Medical Wedge Pillow Manufacturer

The aliasing problem
In principle, a Nyquist frequency just larger than the signal bandwidth is sufficient to allow perfect reconstruction of the signal from the samples. However, this reconstruction requires an ideal filter that passes some frequencies unchanged while suppressing all others completely (commonly called a brickwall filter). Such a filter is both unattainable in practice and, even in theory, introduces unwanted time domain artifacts such as ringing artifacts.
Signal frequencies higher than the Nyquist frequency will encounter a “folding” about the Nyquist frequency, back into lower frequencies. For example, if the sample rate is 20 kHz, the Nyquist frequency is 10 kHz, and an 11 kHz signal will fold, or alias, to 9 kHz. However, a 9 kHz signal can also fold up to 11 kHz in that case if the reconstruction filter is not adequate. Both types of aliasing can be important.
When attainable filters are used, some degree of oversampling is necessary to accommodate the practical constraints on anti-aliasing filters: instead of a brickwall, one has flat response in the passband up to a point called the cutoff frequency or corner frequency, (pass all frequencies below there unchanged), then gradual rolloff in a transition band, finally suppressing signals above a certain point completely or almost completely in the stopband. Thus, frequencies close to the Nyquist frequency may be distorted in the sampling and reconstruction process, so the bandwidth should be kept below the Nyquist frequency by some margin (frequency headroom) that depends on the actual filters used.
For example, audio CDs have a sampling frequency of 44100 Hz. The Nyquist frequency is therefore 22050 Hz, which is an upper bound on the highest frequency the data can unambiguously represent. If the chosen anti-aliasing filter (a low-pass filter in this case) has a transition band of 2000 Hz, then the cut-off frequency should be no higher than 20050 Hz to yield a signal with negligible power at frequencies of 22050 Hz and greater.
To avoid aliasing, the Nyquist frequency must be strictly greater than the maximum frequency component within the signal. If the signal contains a frequency component at precisely the Nyquist frequency then the corresponding component of the sample values cannot have sufficient information to reconstruct the Nyquist component in the continuous-time signal because of phase ambiguity. In such a case, there would be an infinite number of possible and different sinusoids (of varying amplitude and phase) of the Nyquist frequency component that are represented by the discrete samples: see Sampling theorem: Critical frequency.
Other meanings
Early uses of the term Nyquist Frequency, such as those cited above, are all consistent with the definition presented in this article. Some later publications, including some respectable textbooks, call the signal bandwidth or twice the signal bandwidth the Nyquist frequency; still others refer to the Nyquist rate (twice the signal bandwidth) as Nyquist frequency; these are distinctly minority usages.
References
^ Ulf. Grenander (1959). Probability and Statistics: The Harald Cramr Volume. Wiley. http://books.google.com/books?id=UPc0AAAAMAAJ&q=%22nyquist+frequency%22+date:0-1965&dq=%22nyquist+frequency%22+date:0-1965&as_brr=0&ei=R0LsRtqLN6HApgLT8726Dw&pgis=1. “The Nyquist frequency is that frequency whose period is two sampling intervals.” 
^ Harry L. Stiltz (1961). Aerospace Telemetry. Prentice-Hall. http://books.google.com/books?id=cro8AAAAIAAJ&q=%22nyquist+frequency%22+date:0-1965&dq=%22nyquist+frequency%22+date:0-1965&as_brr=0&ei=R0LsRtqLN6HApgLT8726Dw&pgis=1. “the existence of power in the continuous signal spectrum at frequencies higher than the Nyquist frequency is the cause of aliasing error” 
^ B. V. Korvin-Kroukovsky (1961). Theory of Seakeeping. Society of Naval Architects and Marine Engineers. http://books.google.com/books?id=W7Q8AAAAIAAJ&q=%22nyquist+frequency%22+date:0-1965&dq=%22nyquist+frequency%22+date:0-1965&as_brr=0&ei=R0LsRtqLN6HApgLT8726Dw&pgis=1. “The Nyquist frequency is often called the folding frequency or cut-off frequency” 
^ Michael J. Roberts (2004). Signals and Systems: Analysis Using Transform Methods and MATLAB. McGraw-Hill Professional. ISBN 0072499427. http://books.google.com/books?id=c2oN_GozNPoC&pg=PA503&dq=highest-frequency-present-in-a-signal+nyquist-frequency&lr=&as_brr=0&ei=aNGWR5vPN56ktgON2_jnBA&sig=c2t2D_p_8eYTSpQh_AkV1FG1hLo#PPA503,M1. 
^ Uwe Windhorst and Hkan Johansson (1999). Modern Techniques in Neuroscience Research. Springer. ISBN 3540644601. http://books.google.com/books?id=cjCnNtIhjMQC&pg=PA630&dq=bandwidth+nyquist-frequency&lr=&as_brr=0&ei=8c6WR6G1LqLstAOsqPjnBA&sig=vVqDAkDdIdrcoirjCWZdPTIOpHQ. 
^ Jonathan M. Blackledge (2003). Digital Signal Processing: Mathematical and Computational Methods, Software Development and Applications. Horwood Publishing. ISBN 1898563489. http://books.google.com/books?id=G_2Zh7ldQIIC&pg=PA93&dq=intitle:digital+intitle:signal+intitle:processing+nyquist-frequency&lr=&as_brr=0&ei=EsiWR8GAIYOUtgO865HoBA&sig=0nPyEIzaULnMF_UsY6TjPI6SN6w. 
^ Paulo Sergio Ramirez Diniz, Eduardo A. B. Da Silva, Sergio L. Netto (2002). Digital Signal Processing: System Analysis and Design. Cambridge University Press. ISBN 0521781752. http://books.google.com/books?id=L9ENNEPbZ8IC&pg=PA24&dq=intitle:digital+intitle:signal+intitle:processing+bandwidth+nyquist-frequency&lr=&as_brr=0&ei=8MmWR8DJF6CQtwOu4_znBA&sig=JFC3km12VpmWY6RyusmB594ZTQQ. 
See also
Nyquist rate
Kell factor
Sampling frequency
Superoscillation
Signal
Categories: Digital signal processing

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Please help – Medicare Denial Procedure code 86038 due to frequency

I have been on the CMS website, the Noridian website and I am struggling to find any updates on if CPT code 86038 limitations for frequency have changed. It used to be every 3 months the patient could have this done, but as of November 1st I have received 8 denials for this procedure due to frequency
. Any recommendations as to where to find an update on this code or any lab procedure codes that may have new limitations on them? 86038 is the Antinuclear antibodies (ANA) lab testing.

Any help would be greatly appreciated.
Thank you,

Medical Billing and Coding