Click here for more sample CPC practice exam questions with Full Rationale Answers

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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

Revised guidelines for E&M When Performed with Superficial Radiation Treatment effective from January 1, 2019


CR11137 revises Chapter 13 of the Medicare Claims Processing Manual to allow providers to bill E/M codes 99211, 99212, and 99213 for Levels I through III, when performed with superficial radiation treatment delivery (up to 200 kV), when performed for the purpose of reporting physician work associated with,

  • Radiation therapy planning
  • Radiation treatment device construction
  • Radiation treatment management when performed on the same date of service as superficial radiation treatment delivery.

According to Current Procedural Terminology (CPT) guidance, providers should not report superficial radiation (up to 200 kV) with CPT codes for planning and management.

Billing of these E/M codes with modifier 25 may be necessary if National Correct Coding Initiative (NCCI) edits apply.

Source: Revised E/M Guidelines for Superficial Radiation Treatment


Coding Ahead

Prophylactic Appendectomy performed by a separate provider

Help! I can’t find anything anywhere about this situation. It is my understanding that for facility charges, NCCI editing can be overridden when 2 separate providers are performing procedures that normally unbundle to each other. Is this true when one provider performs a procedure like a hysterectomy and then a separate provider performs a prophylactic appendectomy? Normally the appy wouldn’t be paid as it wasn’t medically indicated, but can it be in this case since it was performed by a separate provider?

Thanks in advance.

Medical Billing and Coding Forum

OB Coding delivery performed by residents

I have a CNM at the practice I code for who supervised a delivery performed by a resident. I can’t locate any guidelines on this and am not sure if supervision of a resident can only be done by an MD. Our MD does supervise most and I use Modifier GC, but again, unsure about the CNM supervising. Any help and/or resources would be appreciated.

Medical Billing and Coding Forum