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What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

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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

Here’s Why You Need Old Medical Code Sets

Staying up to date is essential to the business of healthcare, but current codes aren’t always the answer. When you’re responsible for an audit, working an appeal, or researching proper code use for a previous encounter, knowing the code descriptors and guidelines that applied in the past can make all the difference to your job. […]

The post Here’s Why You Need Old Medical Code Sets appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Here’s What You May Not Know About Artificial Intelligence

Find out why “machine learning” is the most important part of the AI puzzle. Artificial intelligence (AI) is an ever-expanding field within the world of healthcare. While the possibilities for future expansion are seemingly endless, AI has already made an imprint on everything from coding and billing automation to the harnessing of patient data for […]

The post Here’s What You May Not Know About Artificial Intelligence appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Limit Your CPT® Code Set Updates to January? Here’s Why That’s a Bad Idea

CPT Code Updates January

Guest Post from Deborah Marsh, JD, MA, CPC, CHONC, a senior content specialist for TCI SuperCoder.

Payers don’t accept deleted CPT® codes, so your claims can’t succeed if your medical procedure codes are out of date. But do you know how often you need to update your CPT® code set? It may be more often than you think. Here are some pointers to keep in mind to give your claims their best chance at accurate payment.

Make the Biggest Transition with January Updates

Each year, a new CPT® code set is effective on January 1. For instance, for CPT® codes, 2018 codes will give way to the 2019 code set on Jan. 1, 2019.

If you use an online CPT® code search product, you’ll want to be sure that the updates are searchable January 1. It’s also helpful if the CPT® lookup includes deleted codes (marked with the deletion date) because you use the code set based on the date of service. You may need access to previous code sets to finish filing claims and for working on appeals.

Plan for These Other Regular CPT® Code Set Releases, Too

The AMA, which owns and maintains the CPT® code set, implements certain types of codes more than once a year. You should be aware of these updates and have a strategy for ensuring you have them when you need them. All specialties may see CPT® updates throughout the year, but path/lab coders need to watch for a few special categories that apply to them.

Category III and vaccine codes: Category I vaccine codes and Category III codes (temporary codes for emerging technology and services) are implemented January 1 and July 1. You’ll typically find them posted on the AMA site six months before the codes are effective, giving you time to learn how to apply them.

Category II: Category II codes are tracking codes that you may use for performance measurement programs, like MIPS. The AMA site indicates you may see release March 15, July 15, and November 15, with implementation three months after release.

Molecular pathology tier 2 codes: To help with reporting MoPath procedures, these codes go from approved to effective fairly quickly. After approval by the CPT® Editorial Panel, codes are released to the AMA site March 1, September 1, and December 1. The effective date may be as soon as one month after the release.

Administrative MAAA codes: Similar to the MoPath codes, Multianalyte Assays with Algorithmic Analyses (MAAA) see a quickened schedule. After Panel approval, the codes are released to the AMA site March 1, September 1, and December 1. The effective date is typically one month after release, although some codes are held until the major January 1 update.

PLA: The schedule for proprietary laboratory analyses (PLA) code changes is quarterly, but publication and effective dates have varied as this new-ish type of code got off the ground. For 2018, the effective dates are January 1, April 1, July 1, and October 1.

Tip: This schedule of updates throughout the year is one reason why having an online CPT® code lookup resource is a good idea. Whether it’s in addition to your paper manual or an alternative to it, automatically updated CPT® codes online ensure you have the correct codes available to you.

And Don’t Forget Corrections May Happen Any Time

The AMA posts an Errata and Technical Corrections file on its site, and you need to be sure you check it regularly or make sure your online code-lookup provider incorporates any corrections. Often the AMA posts corrections before code set implementation as people report issues they find while preparing for the transition. But updates and corrections may occur at any point in the year, so don’t assume you can let down your guard early in the year.

Bottom line: Healthcare providers need access to up-to-date CPT® codes to ensure their claims are accurate for the date of service reported. Keeping codes current isn’t as simple as updating once a year in January. Make a plan to update your coding resource or keep an eye on your online coding solution to be sure it’s doing the update work for you.

About the Author

Deborah Marsh, JD, MA, CPC, CHONC, is a senior content specialist for TCI SuperCoder, working on everything from online tool enhancements and data updates to social media and blog posts. Deborah joined TCI in 2004 as a member of TCI’s respected Coding Alert editorial team.

— This post Limit Your CPT® Code Set Updates to January? Here’s Why That’s a Bad Idea was written by Manny Oliverez and first appeared on CaptureBilling.com – Medical Billing Services. Capture Billing is a medical billing company helping medical practices get their insurance claims paid faster, easier and with less stress allowing doctors to focus on their patients.

CaptureBilling.com – Medical Billing Services

Here’s What Wise Officers Will Do Right Away

Step #1 – Hold an officers’ meeting right away: Get acquainted with one another. The most successful chapters have leaders who work as a team and communicate openly. Together, review the responsibilities and general expectations of each officer as outlined in the 2020 AAPC Local Chapter Handbook. Allow each person to fulfill his or her […]

The post Here’s What Wise Officers Will Do Right Away appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Here’s What You Need for Colonoscopy Coding Prep

March is national colorectal cancer awareness month, and a perfect time to check your colonoscopy coding. Colorectal cancer is the third most common cancer in men and women in the United States, the Centers for Medicare & Medicaid Services (CMS) reminds us in this week’s MLN Connects (March 14, 2019). Getting screened for colorectal cancer […]

The post Here’s What You Need for Colonoscopy Coding Prep appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Limit Your CPT® Code Set Updates to January? Here’s Why That’s a Bad Idea

CPT Code Updates January

Guest Post from Deborah Marsh, JD, MA, CPC, CHONC, a senior content specialist for TCI SuperCoder.

 

Payers don’t accept deleted CPT® codes, so your claims can’t succeed if your medical procedure codes are out of date. But do you know how often you need to update your CPT® code set? It may be more often than you think. Here are some pointers to keep in mind to give your claims their best chance at accurate payment.

 

Make the Biggest Transition with January Updates

Each year, a new CPT® code set is effective on January 1. For instance, for CPT® codes, 2018 codes will give way to the 2019 code set on Jan. 1, 2019.

If you use an online CPT® code search product, you’ll want to be sure that the updates are searchable January 1. It’s also helpful if the CPT® lookup includes deleted codes (marked with the deletion date) because you use the code set based on the date of service. You may need access to previous code sets to finish filing claims and for working on appeals.

 

 

Plan for These Other Regular CPT® Code Set Releases, Too

The AMA, which owns and maintains the CPT® code set, implements certain types of codes more than once a year. You should be aware of these updates and have a strategy for ensuring you have them when you need them. All specialties may see CPT® updates throughout the year, but path/lab coders need to watch for a few special categories that apply to them.

 

Category III and vaccine codes: Category I vaccine codes and Category III codes (temporary codes for emerging technology and services) are implemented January 1 and July 1. You’ll typically find them posted on the AMA site six months before the codes are effective, giving you time to learn how to apply them.

Category II: Category II codes are tracking codes that you may use for performance measurement programs, like MIPS. The AMA site indicates you may see release March 15, July 15, and November 15, with implementation three months after release.

Molecular pathology tier 2 codes: To help with reporting MoPath procedures, these codes go from approved to effective fairly quickly. After approval by the CPT® Editorial Panel, codes are released to the AMA site March 1, September 1, and December 1. The effective date may be as soon as one month after the release.

Administrative MAAA codes: Similar to the MoPath codes, Multianalyte Assays with Algorithmic Analyses (MAAA) see a quickened schedule. After Panel approval, the codes are released to the AMA site March 1, September 1, and December 1. The effective date is typically one month after release, although some codes are held until the major January 1 update.

PLA: The schedule for proprietary laboratory analyses (PLA) code changes is quarterly, but publication and effective dates have varied as this new-ish type of code got off the ground. For 2018, the effective dates are January 1, April 1, July 1, and October 1.

 

Tip: This schedule of updates throughout the year is one reason why having an online CPT® code lookup resource is a good idea. Whether it’s in addition to your paper manual or an alternative to it, automatically updated CPT® codes online ensure you have the correct codes available to you.

 

And Don’t Forget Corrections May Happen Any Time

The AMA posts an Errata and Technical Corrections file on its site, and you need to be sure you check it regularly or make sure your online code-lookup provider incorporates any corrections. Often the AMA posts corrections before code set implementation as people report issues they find while preparing for the transition. But updates and corrections may occur at any point in the year, so don’t assume you can let down your guard early in the year.

 

Bottom line: Healthcare providers need access to up-to-date CPT® codes to ensure their claims are accurate for the date of service reported. Keeping codes current isn’t as simple as updating once a year in January. Make a plan to update your coding resource or keep an eye on your online coding solution to be sure it’s doing the update work for you.

 

About the Author

Deborah Marsh, JD, MA, CPC, CHONC, is a senior content specialist for TCI SuperCoder, working on everything from online tool enhancements and data updates to social media and blog posts. Deborah joined TCI in 2004 as a member of TCI’s respected Coding Alert editorial team.

 

— This post Limit Your CPT® Code Set Updates to January? Here’s Why That’s a Bad Idea was written by Manny Oliverez and first appeared on CaptureBilling.com – Medical Billing Services. Capture Billing is a medical billing company helping medical practices get their insurance claims paid faster, easier and with less stress allowing doctors to focus on their patients.

CaptureBilling.com – Medical Billing Services

Charge Entry in the Medical Practice: Here’s How to Optimize

Charge entry should be done frequently. The process requires attention to detail and accurate data entry. When charges are entered, all insurance and demographic information should be in the billing system. After the service is performed and properly documented and coded, the procedure and diagnosis codes need to be entered for the appropriate patient, with […]
AAPC Knowledge Center

Your Phone is Super Gross – Here’s How to Clean It

Cleaning a Cell Phone with UV Light
You probably clean your bathroom every week and your kitchen counters usually get a wipedown every day. Even your oven gets a once-over every so often. But what about your cell phone?

We spend hours and hours on our smartphones and tablets every day without thinking about all the germs that are on those devices. And what we touch gets transferred to those screens—and how! Smartphones are particularly dirty: Over 90 percent of them had bacteria present, and 1 in 6 tested positive for the presence of fecal matter (that’s poop).

Fortunately, smart devices are small and easy to take care of so keep your smartphone as clean as possible; that will minimize the germs that you transfer in the first place.

The reason I am even sharing this thought is because one of our billers here at Capture Billing got a UV cell phone cleaner for their birthday. We all lined up to have our phones cleaned. Worked great . . . I think.

Anyway, I went online to look for some info on cleaning my phone. I found this infographic that shows some easy steps you can take to keep your phone clean.

Is your cell phone germ-free or gross? How do you clean your phone? Leave me a note below.

— This post Your Phone is Super Gross – Here’s How to Clean It was written by Manny Oliverez and first appeared on Capture Billing. Capture Billing is a medical billing company helping medical practices get their insurance claims paid faster, easier and with less stress allowing doctors to focus on their patients.

Capture Billing

Zika Virus – A Q&A Primer – Info on Zika is changing quickly – here’s what I know as of today (03/02/2016)

This is the most current article that I wrote for Justcoding.com.  It is also free to access on their website.  However, I suggest becoming a full-subscription member, as they have a huge amount of resources and information available.  :) 


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Zika Virus –  A Q&A Primer
by Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP
What is Zika?
According to the Center for Disease Control (CDC)  this is the officialdefinition:
The Zika virus is a mosquito-transmitted infection related to dengue, yellow fever and West Nile virus. It was discovered in the Zika forest in Uganda in 1947 and is common in Africa and Asia.  It did not begin spreading widely in the Western Hemisphere until last May, when an outbreak occurred in Brazil.
A bit of clinical background
This is information direct from the American Congress of Obstetricians and Gynecologists (ACOG)  and the Society of Maternal and Fetal Medicine  (SMFM)
The virus spreads to humans primarily through infected Aedes aegyti mosquitoes. Once a person is infected, the incubation period for the virus is approximately 3-12 days. Symptoms of the disease are non-specific but may include fever, rash, arthralgias, and conjunctivitis. It appears that only about 1 in 5 infected individuals will exhibit these symptoms and most of these will have mild symptoms. It is not known if pregnant women are at greater risk of infection than non-pregnant individuals.
Zika during pregnancy has been associated with birth defects, specifically significant microcephaly. Transmission of Zika to the fetus has been documented in all trimesters; Zika virus RNA has been detected in fetal tissue from early missed abortions, amniotic fluid, term neonates and the placenta. However, much is not yet known about Zika virus in pregnancy. Uncertainties include the incidence of Zika virus infection among pregnant women in areas of Zika virus transmission, the rate of vertical transmission and the rate with which infected fetuses manifest complications such as microcephaly or demise. The absence of this important information makes management and decision making in the setting of potential Zika virus exposure (i.e. travel to endemic areas) or maternal infection, difficult. Currently, there is no vaccine or treatment for this infection.
The ACOG and SMFM put forth guidelines for testing of pregnant women, and the laboratory tests are being done exclusively though the guidance of the CDC at the level of the local and state health departments.  Many states in the US are developing guidelines to help in identifying who has been exposed, and where an outbreak may take place. 
Currently the testing being done is a “Zika” serology IgM testing assay.  The reports have been being reported out as “likely positive”, “Inconclusive” and “likely negative”  .  Unfortunately, the labs do not know and gannot guarantee the sensitivity of the IgM assay.
Symptoms of Zika
 Below is a listing of all the known symptoms of Zika virus as put forth by the CDC, however, there may be more that are noted as the Zika Virus becomes more studied in all individuals. Zika is still a virus, and not a bacterial infection, and currently there is not vaccine to prevent it, or a specific medication or antibiotic to treat it with. 
• About 1 in 5 people infected with Zika virus become ill (i.e., develop Zika).

• The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.
• The illness is usually mild with symptoms lasting for several days to a week.
• People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika.
• Zika virus usually remains in the blood of an infected person for about a week but it can be found longer in some people.
Risks of Zika in Pregnant Women and in their sexual  partners
Normally Zika virus is transmitted through a mosquito bite, however, the Zika virus can be transmitted from a pregnant mother to her unborn fetus during the time of pregnancy and possibly around the time of birth.  It has been noted that Zika virus has been noted in all trimesters of pregnant women, and may possibly be transmitted during the birth process.  Sexual transmission of the Zika virus can also occur, however there is limited data, but the CDC has stated that if the patient fears they are infected with the Zika virus to reduce the risk of sexual transmission via abstinence and/or usage of condoms.
Women are not the only ones at risk of contracting Zika virus.  Men who have traveled to an area of active Zika virus, or who live in these areas may become infected with the Zika virus too.  The CDC has not completely determined if the Zika virus can be transmitted sexually, so the recommendation for men is if you are symptomatic or have a confirmed case of Zika virus, condoms or abstinence is still a best practice.  However, it remains uncertain if the mirus persisits in semen even if no longer  detectible in the blood.
Fetal Evaluation for possible exposure to Zika
Ultrasound exami is the primary recommendation for pregnant mothers who have been exposed to zika virus.  The Ultrasound examinations should focus on development of the fetal brain with intracranial calcifications and microcephaly.  Micocephay has been the most frequently reported adverse fetal complication  in women who have had the virus while pregnant
SMFM is recommending not only blood tests for pregnant women who have been exposed, but also consider performing serial ultrasound, as frequently as every 3-4 weeks.   By obtaining the additional ultrasounds, this would be considered ongoing surveillance.  Considering the history of Zika virus and complications to the fetus  due to this infection is not known.  In addition,  the time from exposure and infection from Zika  to  exhibiting full-blown clinical manifestations is unknown.
The CDC, ACOG and SMFM have put out a number of clinical flow algorhythms for usage with patients’ that have been exposed or live in an area where Zika as been prevalent.  However, this is so new, that these recommendations may change very quickly.   
Case Study and Coding Consideration
Case #1:
An asymptomatic pregnant woman at 19 weeks gestation, presents to her OB office for her regularly scheduled OB prenatal visit.  She informs the receptionist of the possibility she has been exposed to Zika. She has a history of travel to Mexico between 16+0 and 16+5-weeks. She has noted mosquito bites over both legs (calf area).  The bites do not appear infected, and look as if they are resolving.  Patient states they no longer itch, and does not report any other complaints but her ongoing pregnancy related fatigue.  The physician performs a comprehensive history, a comprehensive exam, and will have labs drawn for Zika to be sent to the local district health office.  In addition, the physician decides to perform a baseline screening ultrasound exam to follow up from the patient’s first trimester ultrasound anatomy exam from 1 month ago. 
Coding Consideration: 
CPT: 
99214-25 E&M  – 
76816 Ultrasound 
36415 Venipuncture/Lab Draw
ICD-10: 
O26.812   Pregnancy related exhaustion and fatigue (2ndtrimester)
Z20.828    Contact with and (suspected) exposure to other viral communicable        diseases (Zika Virus)
S80.861A  Insect bite of rt lower leg initial encounter
S80.862A  Insect bite of lt lower leg initial encounter
Z3A.19      19 weeks gestation of pregnancy
Rationale:  The  E&M visit would be coded, as it is separately identifiable  “outside” the normal pregnancy antenatal care.  (A Zika virus exposure is not considered “normal obstetric care”)  the follow-up ultrasound/baseline ultrasound is coded for comparison to the previously performed 1st trimester ultrasound.  The venipuncture is the only thing chargeable, as the blood was drawn, and sent out to the health district for testing.  The sequencing of the pregnancy diagnosis is primary based upon the ICD-10 pregnancy guidelines.
ACOG’s Quick Zika Q&A
Q1.  True or False. Pregnant women are at greater risk of infection with the Zika virus than nonpregnant women.
A:   False – According to a practice advisory from ACOG and SMFM, “It is not known if pregnant women are at greater risk of infection than non-pregnant individuals.”
Q2.  Once a person is infected with the Zika virus, what is the approximate incubation period for the virus?
A:.   3 to 12 days – Following infection with the Zika virus, the incubation period is approximately 3 to 12 days
Q3.  The Zika virus spreads to humans primarily through infected Aedes aegypti mosquitoes. Which of the following symptoms may be associated with the virus?
Fever
Rash
Arthralgia
Conjunctivitis
All of the above       
A.   Although symptoms associated with the Zika virus are non-specific, they may include fever, rash, arthralgia, and conjunctivitis. (eg all of the above)
Q4. In which trimester(s) has transmission of Zika been documented?
A. All trimesters — The transmission of the Zika virus has been documented in all trimesters
Wrap up
At this time, there are still a number of unanswered questions in regard to the Zika virus.  However, there is no vaccine currently available, so it is recommended that precaution be taken to avoid exposure to mosquito bites from areas where the Zika virus is prevalent.  In the United States and worldwide expert epidemiologists are helping to set forth useful clinical guidelines for identifying and managing patients who have been exposed and currently have the Zika virus.  At this time, clinical guidelines are calling for blood tests to be run, and screening ultrasound should be performed on pregnant patients to screen for possible fetal anomalies related to fetal brain development in infected female patients.
When coding, carefully review to see if the physician or provider is stating whether the patient truly has the Zika virus as a diagnosis, or if they are only “screening” for the Zika virus in light of an exposure to the virus. (either through mosquito bite, or sexual transmission).  
In addition, currently, ICD-10 does not have a specific code to identify Zika virus. Usage of code B33.8 Other specified viral diseases, would be appropriate.  However, If the patient is diagnosed with the Zika virus and has fever with it, then it may be appropriate to use code A92.8 – Other specified mosquito-borne viral fevers.   If the patient is pregnant, then usage of ICD-10 code 098.5X “other viral diseases complicating pregnancy, childbirth and the puerperium,” (be sure to use the most specific trimester as the additional character) would be the most appropriate. 
If in doubt about the clinical documentation, be sure to query the provider to obtain clarity on the diagnosis noted in the medical record. 
References:
www.acog.org/
www.cdc.gov/zika
Editor’s note: Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC and ICD10 cm/pcs Ambassador/trainer is an E&M, and Procedure based Coding, Compliance, Data Charge entry and HIPAA Privacy specialist, with over 20 years of experience.  Lori-Lynne’s coding specialty is OB/GYN office & Hospitalist Services, Maternal Fetal Medicine, OB/GYN Oncology, Urology, and general surgical coding.  She can be reached via e-mail at [email protected] or you can also find current coding information on her blog site: http://lori-lynnescodingcoachblog.blogspot.com/.  

Lori-Lynne’s Coding Coach Blog