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

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”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

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

Emergency room vs hospital Ambulatory surgery center

I have a payor who is taking a UB-04 billed with a 270, 450 and 360 and paying it off of an ASC fee schedule.
this is a minor surgical procedure a minor ER visit 99283 surgical 11042. I know according to Texas Medicaid facilities are assigned a HASC number to use when billing as an ASC but I cannot find any other information I do not see that the facilities are billing with anything different then NPI etc….
I do not believe you should take an ED visit and make it ASC.
Can anyone with knowledge of Medicaid help maybe I missed something in the manual that says to apply this way?
thank you

Medical Billing and Coding Forum

Four steps to improve your hospital quality and safety rankings

For one hospital, a poor Leapfrog Hospital Safety Grade rating in 2014 became a launching pad for improved quality and safety.

“When we got a ‘D’ from Leapfrog, that was our wake-up call. We had done good patient safety work before, but it wasn’t the fanatic level that we have now,” says Leigh Hamby, MD, MHA, executive vice president and chief medical officer at Piedmont Healthcare, an integrated healthcare system with 11 hospitals and almost 100 physician and specialist offices throughout Atlanta and North Georgia.

HCPro.com – Briefings on Accreditation and Quality

Labs Through the Hospital

If you are billing lab services through the hospital, these are rural hospitals, do those services need to be billed on institutional claims or professional? These are ONLY labs for patients that are not admitted to the hospital. They are either walking in to the laboratory to get the labs done, a TOB 131 or they are having their labs drawn at their physician’s office and they are being sent to the hospital, TOB 141.

UHC and Aetna are stating they will not pay for a TOB 141 through the hospital. Thoughts? Advice? Anything?

Medical Billing and Coding Forum

Normal Newborn Hospital/Inpatiant Hospital Coding

Hello all!

A recent article was brought to my attention regarding billing for codes 99221-99233 for other than normal newborn care (also realizing this is in the CPT guidelines). I am wondering if I am able to bill for 99461 (subsequent normal newborn) with 99222 (initial encounter for hospital care)? Can the two code sets be mixed?

Thank you!

Medical Billing and Coding Forum

Clinic / Specialist / Hospital / Confused….

A Cancer specialty clinic sees patients for care/treatment for Cancer at their clinic.
These same patients often have other comorbidities where they are treated in the ER and or Inpatient stays at the hospital located on the same campus.
Scenario:
-The Clinic Physician, who is not a hospitalist, treats a cancer patient at their (outpatient) clinic.
-The same patient ends up being admitted to the hospital for an unrelated condition.
-Because of the Cancer/Diagnosis the pt. has, the hospital staff physicians are not specialized to treat these patients.
-Due to this, our Clinic Physician will be called to manage the patient’s cancer while they are inpatient at the hospital.
-Our Clinic Physician will dictate progress notes and sometimes a Discharge summary for the patient.
-Our Clinic Physician’s progress note(s)/discharge summary will sometimes be directed at care of the pt’s cancer. Other times, the Clinic Physician will treat the (non cancer related) current condition(s) the pt. has.
I’ve looked at the guidelines but I’m a bit confused on this.
Anyone care to comment?
Thank you!

Medical Billing and Coding Forum

Partial Hospital Program Billing

Any info anyone can provide regarding "Activity Therapy" and "Education/Training Sessions."

Providers are billing G0177 and G0176, along with the 90853 Psychotherapy Group code. Should the activities and education training sessions be billing separately or should be bundled with the 90853?

Thanks!!!

Medical Billing and Coding Forum

Should I wait until the pt is discharged from hospital to create and send the claim?

Hello everyone,

I need your help… I am working in a practice that have been doing the hospital billing the same way for the last couple of decades. They are very fortunate to have the same employee for almost 40 years. Now that I involved in the hospital billing I have been informed that they wait until the patient is discharged from the hospital to create the claim. I have never heard of such rule and I cannot find any documentation to prove it right or wrong either. From previous experience, this rule was not recommended. I have always created the claims on a daily basis if possible, but at the end of the month all visits were counted as part of the monthly financial report therefore all hospital claims were created and sent to the insurance companies by the last day of the month.

My questions is: How do you do it in your practice, your experience? What is your recommendation? Should we wait until the patient is discharge from the hospital to create and send the claim>

In advance, thank you for your help and the learning experience.

Isvel Bacallao CPC

Medical Billing and Coding Forum