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”

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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

Revised Payment Indicator for Flu Vaccine (CPT 90689)

CPT- 90689 Influenza virus vaccine, quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25 mL dosage, for intramuscular use.


Guidelines:


The provider injects 0.25 mL of a four–strain influenza virus vaccine into a patient’s muscle to provide immunity to four forms of influenza, a severe and infectious respiratory disease; the vaccine is free of preservatives and derived from cell cultures of a killed virus and contains a substance that increases the patient’s immune response.


Payment Indicator for ASC:


CMS is revising the status indicator from “E1” to “L1” Influenza vaccine; pneumococcal vaccine. Packaged item/service; no separate payment made for CPT code 90689 retroactive to Jan. 1, 2019.


Currently, CPT code 90689 is assigned to status indicator “E1” in the OPPS to indicate that the vaccine is not paid by Medicare when submitted on outpatient claims. This policy is also applicable to ASCs. 


However, as noted in Change Request 10871 (Quarterly Influenza Virus Vaccine Code Update – January 2019), Transmittal 4141, dated September 27, 2018, effective for claims with dates of service on or after January 1, 2019, CPT 90689 will be payable by Medicare.


The vaccine is packaged in the ASC payment system; therefore, CMS revising the status indicator to “L1” (L1:Influenza vaccine; pneumococcal vaccine. Packaged item/service; no separate payment made.) for CPT code 90689 retroactive to January 1, 2019.


Please note that packaged codes should not be separately billed by ASCs



Coding Ahead

Assistant Surgeon Status Indicator 2

Hernia repair done with an assistant surgeon. Assistant surgeons’ name is indicated at the top of the report but nowhere else in the document is indicated the work done by the assistant and nowhere in the document is demonstrated the need for the assistant surgeon. What are the documentation requirements for an assistant surgeon for procedure with status indicator 2? Is it enough to just document the assistants name at the top?
Thanks!

Medical Billing and Coding Forum

Add on codes with N1 payment indicator in an ASC

If anyone can help me with this question I would very much appreciate it!!

Is it right or wrong to bill the add-on codes that have an N1 payment indicator for the ASC to Medicare? Good example is 64490 which is paid at a higher rate because the additional levels, 64491 & 64492 are included in the "package" rate for 64490.

Does anyone else bill the additional levels even though they won’t get paid? I have read that you should bill them for future rate calculations and I’ve also read that Medicare does not want them billed. I feel it is not unbundling because they are add-on codes and some commercial payers do pay.

:confused: Thanks everyone!

Medical Billing and Coding Forum

Product of the week: Clinical Documentation Improvement Tips to Identify Patient Safety Indicator Targets webcast

Clinical documentation improvement (CDI) programs need to expand their focus beyond CC/MCC capture reviews. New reimbursement methods are punishing facilities that cannot prove they meet certain quality standards. That proof often lies within what is (or isn’t) documented in the medical record.
 
Join us at 1 p.m. (Eastern) Tuesday, January 19, for the 90-minute webcast. During this program, expert speakers Michelle McCormack, RN, BSN, CCDS, CRCR, and Mark LeBlanc, RN, MBA, CCDS, will discuss how traditional reviews can be expanded to include investigations into Patient Safety Indicators and how to work cohesively with their quality departments to improve the overall capture of these important statistics.

 

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HCPro.com – JustCoding News: Inpatient

Indicator For Medical Operations – Assessing the Performance

An indicator for medical operations is a system that is especially designed to deal with the management structure in medical organizations. This assists clinics as well as the doctors so that they can assess well the performance in relation to the procedures. Most organizations including the health care industry implement a particular form of administration system which is usually about the inventory, accounting and sales systems. There may be other aspects included here but the most important thing is that there is consistency in every process to accomplish most favorable care excellence.

Typically the medical KPIs are incorporated into the system so that they can be some sort of software application. Generally, medical service focuses on four different areas which involve emergency services, monetary aspects, patient approval and facilities. There are a number of key indicators that can be used here depending on the factor that is considered as the central point. You can include the indicator for the cutback in the number of deaths brought about by medical abandon, elimination of demise after surgery and decrease in number of patients that are readmitted as a result of lacking care quality.

Even though these areas are considered as minute by many people, you can hypothesize that by taking them one by one, a company will be able to achieve its purposes. When it comes to patient satisfaction indicator for medical operation, the focal point here is given to the clinic’s relationship with the customers. To ensure that the company will reach its goal of becoming the prime choice of customers, it is imperative that the personnel and everyone behind the organization should work hard to build up the credibility.

When it comes to the emergency services, this pertains to the ability of the clinic or the medical institution to respond to different kinds of emergencies. This way, the people will continuously support the efforts of the organization because it is apparent that they are concerned about the importance of their clients. Actually, there is a great need for organizations to prioritize their patients and their needs since this is what medical firms are all about. They are created to cater to the demands of the public by providing quality service especially when it is called for.

Monetary aspects are also important since the clinic will not be able to survive without money. However, it is important for institutions to ensure that every activity that they perform is organized and well planned. With this, they can save from the expensive issues that they have to deal with. Lastly, the facilities that they are offering should be first rate and usable. A hospital should bear in mind that they are helping people live and thus, they have to consider the amenities that they provide.

The performance of the medical companies should prove to be very effective so that the care that they provide will be deemed as quality service. The indicator for medical operations is believed to be a great help in the mission of the organization to be a good service provider.

If you are interested in Indicator for Medical, check this web-site to learn more about medical KPIs.

ED J1 Indicator – CA defaulting to Status Indicator “V”

Hello,

(Ignore message header… it should read "J2" not "J1")

When does an Emergency Department visit, for example, 99283, a status indicator "J2" default to a Status Indicator "V?"

I have seen this status indicator re-assignment (from J2 to V) from quite a few Claims Administrators.

Any guidance to the right regulations (links, ect.,) for this would be appreciated.

Thanks!

Medical Billing and Coding Forum