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

Infusion coding in an outpatient setting

When a patient receives multiple drugs during an infusion session, including both chemotherapy drugs and immunotherapy drugs, do I code Z51.11 and Z51.12 for all drugs or only the corresponding Z code for the corresponding/approriate drug? When looking over old codes, completed by others, I have seen it both ways, and I would like clarification.

Thanks,

Julie

Medical Billing and Coding Forum

Physician Infusion Services, CHONC Practice Exam Clarification.

Hello,

I was hoping for clarification on a topic that has me torn as to the true and correct coding method. The below scenario and rationale comes directly from the CHONC Specialty Practice Exam.

Image 1.jpg
Image 2.jpg
Image 3.png

Prior to this I have previously been taught that we can only bill a IV push as primary to a hydration infusion (Facility Hierarchy rules), but per the AAPC rationale provided because I am in a physician practice (not a facility) I can bill a 96360 and 96375 in a real life scenario.

Has anyone ever tried this? Or do hey have any experience with physician infusion guidelines being different than facility guidelines?

The AMA CPT Guidelines for hydration and therapeutic infusions do state that “When these codes are reported by the physician or other qualified healthcare professional, the “initial” code that best describes the key or primary reason for the encounter should always be reported irrespective of the order in which the infusions of injects occur.”

Any input is greatly appreciated!!

Thank you,
Asia

Attached Images

Medical Billing and Coding Forum

Billing E&M with IV infusion with extra liter

Good afternoon all,

Just had a question in regards to billing out a certain claim and am having trouble finding the answers through forum search. We had a patient in a doctor’s facility come in with flu like symptoms, patient had a shot of antibiotics, and then an IV infusion with an additional hour of IV afterwards. Now the problem I am having is all of the codes I am trying to bill out conflict, and I’m trying to figure out how to properly bill.

The codes I currently have are:

Code:

99213 mod 25 - E&M fee
96372 - injection fee
J0696,XGR1 - rocephin injection
96360 - IV infusion for 1 hr only which includes 1 bag
96361 - add'l 1 hr IV infusion
A4217 - supply code for add'l liter of IV


Even by adding a mod 25 on 99213, I still get an error thrown up on 96360 or the 96372. Am I overbilling one too many codes or is there a more appropriate modifier that I am not using correctly?

Thank you for your time!

Medical Billing and Coding Forum

Physician E&M service same day Facility Infusion

I hope I can get someone to shed some light on this issue.

physician E&M service and facility infusion on the same day-

So in peds, often times, the physician ends up seeing the patient on the same day as infusion therapy that is billed by the facility.

Since the clinic and infusion suite is hospital owned, there is conflict on how the physician services should be billed.

following CPT guidelines, if there is a significant and separate identifiable E&M it should be billable, however, since both the infusion suite and physician clinic is hospital based/owned the POS for both location i believe would be 22. I know the facility is reporting an E&M + infusion codes, but would the physician E&M also be billed? If so, is it with modifier 25 or w/o? If not, is it because there is already an E&M code the facility is billing?

Medical Billing and Coding Forum

Medicare Denials – Infusion Coding Guidelines

Recently, Medicare has denied some infusion, injection, and hydration charges on our observation claims due to not having an initial service billed for each date of service on the claim. Our HIM Dept is stumped because we have always followed the coding guidelines that only 1 initial service can be reported PER ENCOUNTER rather than PER DOS. Is anyone else experiencing a similar issue or can anyone provide an update to the coding guidelines that we may have missed?

Thanks!

Medical Billing and Coding Forum

Billing E/M codes with an infusion

I know this is an old question. But, we are getting push back from some Medicare Advantage plans (Medicare Part C) and Medicaid (payors) on billing for E/M on the same day as an infusion every 91 days. Has the rule changed? I have been researching for a while now and I cant find any specific rule stating we no longer bill and E/M codes for an infusion patient every 91 days. Furthermore aren’t Medicaid plans obligated to follow the primary payors rule (traditional Medicare in this instance)?
The secondary is United Health Care Medicaid.
I would appreciate any info on this.

Martha Aragon CRHC

Medical Billing and Coding Forum