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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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

Managed Care Organizations and TG modifier

Public School Mental Health agency has recently been enrolled to bill FFS for Mental Health Services. The HCA has given us the green light to bill Specialized Mental Health services with modifier TG. Any reason these codes would deny when billing the any Managed Care Organizations?

EX: 90832 TG Psychotherapy 30 minutes with patient and/or family member

Thanks!

Medical Billing and Coding Forum

Help reporting co managed care!

Our physician (Provider A) is providing surgery and 45 days of post operative care. He then is transferring care to another provider (Provider B).

:confused::confused::confused:
When reporting for our physician (Provider A) I will report the claim for surgery with modifier 54 on the first line.

When reporting for our physician (Provider A) I will report the claim for post op care on a second line with the proper date span on line 2 of the claim with modifier 55.

Here is my question:

Must I wait till the ending date of our post operative care provided by our physician (Provider A) is complete before submitting my claim? And, can I send two separate claims for the surgery and post operative care or must the claim have both items reported on the same claim which would mean Provider A should wait to submit his claim till he has transferred care to Provider B?

Your help is greatly appreciated!

Medical Billing and Coding Forum

Nurses Are Perfect Candidates for Managed Care Positions

A nurse’s background and expertise makes for a great liaison between doctors and insurance companies. Experienced nurses who have held traditional nursing roles make excellent candidates for coding, corporate, and managed care positions. They have a clinical understanding of medical procedures, and appreciate how coding and provider documentation complement each other. Let’s explore how a […]
AAPC Knowledge Center

Billing for managed care services

Our clinic’s case management team routinely goes to visit patients and their families in SNFs to come up with a care plan. The head of managed care would like to start billing for this and I’m looking for a CPT code that this would fall under. The closest I’m seeing is 99366. Does "nonphysician qualified health care professional" mean an actual provider who’s just not a physician? Or would a case manager count? The requirement for a separate E/M could be met with 99490 and it’s very possible that some of these visits include a multidisciplinary team (I’d have to check to know for sure). If so, the requirements would all be met. But when I read about the code online, I get the impression that it’s for nonphysician provider time only. Does anyone know for sure? Or is there a different code you guys use for this? Thanks for any input!

Medical Billing and Coding Forum