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

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Practice Exam

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What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

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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

Company Carolina Physical Therapy Will Pay almost $800K to Settle False Billing Allegations

US Attorney Sherri A. Lydon made the announcement that the US Attorney’s Office for South Carolina has settled numerous claims of prolific health care fraud with Carolina Physical Therapy (also called “Carolina PT” for short).  The company in question was a chain of nearly ten physical therapy practices headquartered in and around Columbia, Irmo, Lexington, Sumter, and Mount Pleasant.

Read The Full Story Here!

The post Company Carolina Physical Therapy Will Pay almost $ 800K to Settle False Billing Allegations appeared first on The Coding Network.

The Coding Network

Physical therapy insurances that only pay for evaluation on first visit

I’m having a hard time trying to find information about which insurances will only pay for the evaluation code for the patient’s first visit with physical therapy. Does anyone know what the insurances are or where I can find that information? Thank you!

Medical Billing and Coding Forum

Coding refusals & future orders with annual physical


Patient is being seen for an annual physical. Z00.00

BUT… they refused the offer of a colonoscopy

AND… the provider is ordering a mammogram.

To include or not to include…. Z53.20 for the refusal AND/OR Z12.31 for the mammogram order.

Discuss. :confused:

Thanx!!

Medical Billing and Coding Forum

Billing for time spent counseling for Morbid obesity when done during a Physical

Provider documents
Morbid obesity – E66.01, (HCC), 50 minutes spent with the patient, with over 50% of that spent on discussion of morbid obesity, her attempts at weight loss, the risks and benefits of bariatric surgery. Patient would like to proceed with evaluation.
This was outside of the patients AW visit of 30 minutes
The excludes note for 99404 indicates not allowed with her Physical 99395
The 50 minutes fall short of a prolonged service code
Would it be appropriate to add an E/M for weight loss counsel consideration for Bariatric surgery during her Wellness visit?
Cheri

Medical Billing and Coding Forum

Physical Exam Element Extremity?

Patients exam below

Physical Exam:
General: Well developed, well groomed, in no acute distress.
Lungs: Clear to auscultation bilaterally.
Cardio: RRR; Normal S1, S2; Without murmurs, gallops, rub, or click.
GU: has small epidermal cyst in left scrotum

Extremity: no edem ** Can I count this towards the MS or Skin? Or is it just rolled in with the CV?**

Thank you,

Nichole

Medical Billing and Coding Forum

Secondary Office visit Billed with Annual Physical

I have a Physician who regularly bills an Annual Physical (99395-99397) with an Office visit E/M(99212-99215). I have tried telling him the differences as to when and how this should be done and for the most part, he has cut down on billing an office visit(99212-99215) with an Annual Physical(99395-99397).

One scenario that keeps coming up however is when a Patient comes in for an Annual Physical, had bloodwork beforehand, is found to have "Vitamin D Deficiency" and then the doctor bills for the Office visit on top of the physical for treating the Vitamin D Deficiency (same goes for B12).

I don’t necessarily think that this qualifies as a significant, separate service but I’m not sure that I have a good argument against it. This doctor’s argument is pretty much, ‘well it’s a new diagnosis and I wrote a prescription for it.’ While I think about the patient receiving a copay or a deductible bill for this and trying to explain to them why they got a bill for Vitamin D deficiency. I think most people would be upset that they got billed separately for this but I can’t tell if I’m looking at this scenario objectively or not.

Is my doctor right in billing separately for this service along with an Annual Physical or am I right in thinking that there just isn’t enough work involved in diagnosis a Vitamin deficiency to bill separately for it?

Medical Billing and Coding Forum

Physical Therapy supervised (untimed codes) question

Hello,

I have a question regarding PT supervised code 97010 being billed with another supervised code 97014 in the same 15 minute time period. The information I have found says:

Billing Two CPT Codes for Same 15 Minute Time Period
*Only when one of the services is a supervised service that does not require the presence of the therapist (97010 – 97028)
*One or more supervised modalities may be billed in the same 15 minute time period with any other CPT code requiring constant attendance or direct one-on-one patient contact.

Does this mean since they are both supervised codes and neither are timed codes that they should not both be billed? The office notes say there was 32 minutes of Therapeutic Exercises with 15 minutes of concurrent care for the Cold Pack and EStim for a total of 47 minutes. 2 units of 97110 was billed with 1 unit of 97010 and 1 unit of 97014. Is this correct and all 4 units should be allowed?

Thank you in advance for any advice you can give!

Medical Billing and Coding Forum