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

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CPC Practice Exam and Study Guide Package

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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

Full Recovery Of Medical Safety Issues As “prevention”

A material display, Zhejiang has 200 children in a kindergarten there the phenomenon of abdominal lymph nodes.

Just be exposed the Acanthopanax injection to cause death, followed by anesthesia in a hospital in Fujian Province took place, “Ma” death and several incidents; the First Affiliated Hospital of Xi’an Jiaotong University for nosocomial infections caused by eight neonatal death row Event has just concluded, and now 200 “lymph child” has a collective “stage.”

The moment, there are thousands of “Stone Baby” did not discharge.

Recently be described as one trouble following another.

Objectively speaking, we do not have enough evidence to come to public health and safety incidents are more conclusive than before?? In fact, from all over the world to see, such issues have always been impressive, due to lack of information developed before or , or for information not transparent in many cases not known to the public. It should be recognized, high-speed development, we really are experiencing a high rate of public health safety frequently stage.

Sense, in social transformation, public health and safety incidents associated with certain properties. Imagine living in a blind worship of diffuse large GDP, “site” on the scene in full swing under the colors and pollution everywhere in the sharp decline in environmental quality, unless King, body, how can do it vulnerable to the attack?

From 5 years ago, “SARS” Start, health and safety incidents in recent years experienced, people can see the media an open, transparent reporting, see the Government brainer positive “response.” In this sense, the public informed of significant information in a timely, accurate, comprehensive, government departments, the emergency response of fast, efficient, can be said to the best period in history. Although these are not sufficient to eradicate hidden dangers, but expressed the government’s attitude and determination.

But no matter how good the response afterwards, some consequences are irreversible?? Mortality in the “stone” and “infected” children never grow up opportunities, died of Acanthopanax and anesthesia in patients can no longer wake up … … a heavy price in human lives to remind us that public health and safety incidents to curb the momentum of frequent, only emergency response is not enough; the work forward, firmly grasp the “prevention first” and hold the accident nipped in the bud, so no chance from the “likely” to “facts”, this is really solve the problem.

If the change concept of development, management and repair the environment, thereby reducing the food, pharmaceutical exogenous pollution, but also a very long time; then to strengthen routine health, medical supervision and law enforcement, especially against such as kindergartens, schools the hospital that some of concentrated population, prone to place health and safety incidents to increase law enforcement efforts to increase the frequency of law enforcement, it is realistic and necessary choice.

Admittedly, this operation would be difficult to be sure, at least faced the practical challenges of increased workload, the scheduling of resources will also inevitably need to make the layout again. But of greatest difficulty is not slack off even for a moment, because we can no longer try to life “poison” and rely on life alarm. If only because of the difficulties and dread not the former, then later even if there is another positive “remedial” actions, are able to escape suspicion “show” the questions and accusations.

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Experts On The Safety Of Medical Ultrasound Domestic Issues – Ultrasound, Medical Equipment,

Institute of Acoustics, Chinese Academy of Sciences
researchers, the National Acoustic Standard Ultrasound Technology Committee – acoustic branch of the Secretary-General, Professor Niu Fengqi a recent interview, repeatedly stressed that clinicians should know about ultrasound safety regulations, knowledge and operating skills, and actively used with caution, and to prohibit application of non-medical purposes; the safety of diagnostic ultrasound is conditional, its technical progress is a benefit and Risk Coexisting double-edged sword.

Ultrasound diagnosis of the safety concept
80 years since the last century since the ultrasound was seen as a safe sound technology is widely used in China, and even become a routine pregnancy check means.

But now, the situation has changed. Bovine Fengqi told reporters, Ultrasonic wave Clinical diagnosis as information carriers must have certain safety limits in order to ensure that no parts were irradiated produce harmful biological effects. To biological effects of ultrasound on the fetus, for example, Expert Most concerned about fetal ultrasonography in the temperature, that is, the impact of thermal effects, because a large number of studies have demonstrated a teratogenic effect fever. Therefore, the focus of the study shall seek to define the possible biological effects caused by temperature and exposure time, and then determine the cause of such a temperature rise of the ultrasonic output level, and then based on these data to establish the scope or standard security applications.

Cattle Fengqi that the ultrasonic sound is nothing wrong with the early publicity, “which is based on the low output in terms of sound intensity.” Today, echocardiography (M Ultra), pulsed wave spectral Doppler, color flow imaging, the realization of many new features, often is to enhance the sound intensity for the pre-conditions and the thermal effects and mechanical effects, etc. they simply repeating what exacerbated by strong increases. The higher the sound intensity, the greater the depth imaging, image more clear, the higher signal to noise ratio when collecting information. There is no doubt enjoying the benefits of such high-tech, while the potential risk of ultrasonic irradiation is also increasing. Because of this, the international ultrasound medical sector ALARA principle of “necessary in the clinical diagnostic information can be obtained under the premise to be used at the lowest possible sound output.” This principle provides that the power output should be done with a suitable detection; If in doubt, should be low output, only when necessary, improve them; when used in obstetrics, the operating mode of each key should be placed in the lowest output adjustment state until the probe by the operator when necessary to improve the sound power.

Should keep abreast of changes in international norms
Then our clinical application of ultrasound to whether strict compliance with the relevant provisions of the security risk does not exist? Niu Fengqi not think so.

He pointed out that clinical application of color Doppler ultrasound and other high-end equipment, almost all produced in the United States and other Western countries. Published in 1985, FDA “for medical ultrasound diagnostic equipment acoustic output measurement and reporting guidelines” set forth in the body parts of the diagnostic space peak – average sound intensity (Ispta) (the most closely linked with the temperature parameters) expressed the greatest sound output: Ophthalmology , 17 mW / mm; fetus and others (including the abdomen, Pediatrics , Small parts), 94 mW / mm; heart, 430 mW / mm; peripheral, 720 mW / mm. The U.S. government in 1991 liberalized the output value of ultrasonic sound, FDA again in 1993 to achieve safe way to do Ultrasound significant changes on the one hand While the diagnosis of the biggest parts of the field restrictions remain the original value of sound intensity, but the actual product the maximum output capacity to 720 milliwatts is all relaxed / square cm; the other hand, to avoid patients suffering from high intensity irradiation of the calamity, attached prerequisites: diagnostic equipment required to install the corresponding acoustic output display system, that additional thermal index (TI ) and (or) mechanical index (MI) screen display, and provides two indices allowed limit in clinical adjustment by the operator to control the buttons on. This regulation will be greater and the ultimate responsibility to the doctor (or medical physicists), they must understand the acoustic output measurements and used to guide clinical exploration, based on differences in the clinical target selection is safe without excessive sound output level.

Ultrasound diagnostic equipment to enhance the acoustic output of the control, the International Electrotechnical Commission (IEC) in 1992 established “acoustic output of medical ultrasound diagnostic equipment disclosure requirements” (IEC61157-1992) provides the host with the probe for all the combinations work mode, the acoustic output (in water measured value), the spatial peak – average sound intensity (Ispta)

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OIG Reports Hospital Billing Issues – Adding Modifier 59 for RHC when Heart Biopsy is performed on the same day


In one of the recent reports, the Office of Inspector General (OIG) cites significant issues in which hospitals are making coding errors on Medicare claims. Correct coding of claims is important for hospitals to avoid improper payments, which can lead to recoveries of overpayments. The Centers for Medicare & Medicaid Services (CMS) encourages hospital billing and coding personnel to review the OIG reports and take steps to avoid the problems identified in those reports. It is also very important that claims submitted are supported by documentation in the beneficiary’s medical records. 

In the report, “Hospitals Nationwide Generally Did Not Comply with Medicare Requirements for Billing Outpatient Right Heart Catheterizations with Heart Biopsies,” the OIG analyzed claims to determine if hospitals were correctly reporting modifier -59 for RHCs and heart biopsies. The OIG found that in billing for outpatient RHCs with heart biopsies, hospitals often use modifier -59 inappropriately, which leads to significant overpayments and overpayment recoveries on claims for these services. 

For detail information on OIG audits & findings, visit: https://oig.hhs.gov/oas/reports/region1/11300511.pdf


Coding Ahead

CMS immediate jeopardy follows possible restraint, seclusion issues

This September, a Missouri hospital found out the hard way that when not addressed quickly, restraint and seclusion deficiencies can threaten a hospital’s ability to remain open, as well as who keeps their job.

HCPro.com – Briefings on Accreditation and Quality

Denial issues: No ROS and PEG tube placement

Good morning!

I have a claim I am struggling with.

This claim was initially billed to UHC as:
02/05/17 99223
02/06/17 99233 – 57
02/07/17 31600
02/07/17 43246 – 59

I have several issues with this claim/denial:

1. Line 02/05/17 99223 was denied for level of service. We sent the medical records, but they didn’t deem them sufficient for this level of service. I am having a hard time determining the level due to the information provided. Here is what I was given:

HPI:
The HPI that was listed on the intake form is:
67F presented to X Facility on 01/28 after found down by husband at home. She was AO with left sided weakness on arrival but progressively worsened. She became less responsive, GCS 8 and was unable to protect her airway. She was remained intubated since that time. She was found to have a ICH due to a small AVM. No neurosurgical intervention is planned at this time. Off of all sedation she is only able to follow simple commands and oopens eyes to pain. General surgery has been consulted for trach and peg.

History:
Med history: GERD, hyperlipidemia, hypertension, Osteoarthritis
Surg history: appendectomy, hysterectomy
Social history: lives with family, married
Family history: Father – Diabetes

ROS: Unable to obtain due to ventilator; ams

It also states under the Diagnosis, Assessment & Plan:
– Will plan for trach and PEG this week
– Procedure explained and all questions answered with husband and daughter

2. Line 02/06/17 99233 – 57 was denied for improper use of modifier.

The decision for surgery was made on 02/05/17 so this mod doesn’t apply. I think it needs to be removed, my co-worker disagrees.

3. Line 02/07/17 43246 – 59 was denied for Medical Record does not support code.

The lines from the Op Report that pertain to this are as follows:

The guidewire was passed. It was snared and brought out through the oropharynx with the EGD scope. A PEG was then placed through the guidewire and brought back down though the oropharynx into the stomach through the abdominal wall. It was secured at 3.5 at the skin incision and placed a 2-0 nylon the around bumper and to the skin.

Is that sufficient enough info to bill the 43246?

I know this is a lot to take in. I am new to this practice and not familiar with these types of surgeries just yet. I would appreciate any help and/or suggestions with the above listed three problems.

Medical Billing and Coding Forum

TAVR Assist Surgeon issues

Medicare denying cpt code set: 33361-80,Q0 missing modifier. When condition merits 3rd surgeon ( assistant), is anyone getting past this denial of missing modifier? Cant get passed this first rejection so documentation can be submitted to validate assistant. Rep states its the modifier that is causing code set to reject. no other modifier describes Assistant ( MD ) but 80… correct?

thanks for any/all insights.
jro

Medical Billing and Coding Forum

risk for follow up visit, no further issues

Good Morning,
I’m looking for some help in determining what the risk would be for a patient returning for a followup of hand surgery 20 weeks post op. There is no further treatment, prescriptions or issues remaining. Patient is to just continue stretching exercises and return as needed. I say it would be low, but I’m second guessing myself. If you feel it would be moderate, please provide some reasoning.
Thank you in advance for your time.
Laura

Medical Billing and Coding Forum

CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 


Radiology Billing and Coding Blog

CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 


Radiology Billing and Coding Blog