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

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2016 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

PLEASE HELP-discrepancy between name on id and name on insurance card

If a new patient comes in and their ID says their name is John Bob Doe and their insurance card says their name is Bob Doe, how do you handle this? I have always billed under the name that is on their ID as this is their legal name but I keep seeing posts that say offices change their demographics to match what is on the insurance card so that they will be paid. This seems wrong but I am surprised how many patients come into my office expecting me to do this. I tell patients that if their info is wrong with an insurance company they need to call them and correct it. Am I wrong? Really need some advice, I have looked everywhere I can think of and can’t find anything specifically dealing with this issue. Thanks in advance for any input you can give!

Medical Billing and Coding Forum

Couple E/M question gray aeas to me. Advice please?!

My first question is in regard to the 95 and 97 guidelines and when Medicare -RAC does an audit.
Will they use the guidelines that suits THEM or will they always use the guidelines that benefits the physicians?

Also, if it’s an established patient and you need 2 out of 3…history and exam are perfect-comprehensive but MDM lacks complexity, can you still do a moderate using the history and exam, and not MDM?

And if I’m in a urology specialty but the patient has diabetes, CHF, COPD, basically things that the dr doesn’t necessarily treat, but might need to make medical decisions around that, can I bill those diagnoses? Or is it a matter of IF they put it in the assessment and plan? What if they put it there and list it. Can I count those as a point for established problem?
Do they actively have to be treating it on that encounter date? Where I’m struggeling is that they are not ‘treating’ the diabetes, etc. but it could be a factor in decision making.

Medical Billing and Coding Forum

what ICD 10 codes that can be used for preventative labs. Please help!

when patient comes for a yearly preventative care visit, my doctor order CBC with diff, CMP and TSH ( general health panel CPT 80050). I use ICD 10 codes : z13.0, Z13.29 to bill for these labs but BCBS does not pay. How should i bill for these labs? Please advise me what ICD 10 codes should i use for these labs. Thank you.

Medical Billing and Coding Forum

Please Clarify

Hi!

I’m creating some coding FAQs for dentist who are participating Medicare DME suppliers. They provide Oral appliance therapy for OSA. They have been told after the initial 90 day delivery of the DME device, they should bill Medicare Part B for follow-up visits. I think that’s incorrect because Medicare doesn’t recognize dentist as MDs and Medicare also doesn’t cover dental visits.

Can someone clarify that an DDS/DMD can not bill CPT e/m services to Medicare?

Thank you in advance!

Tiffany

Medical Billing and Coding Forum

Infusion coding help please!

If a patient is receiving hydration (Normal Saline 500cc) and magnesium is added into the bag, are we able to charge for the both the Magnesium (J3475) and the bag of Normal Saline 500cc (J7040) it was added to?

I realize that I can only bill the Therapeutic IV 96365 code, and not hydration administration. But as far as the J-codes I’m not sure if I can bill for both?

Thank you!
AK

Medical Billing and Coding Forum

CPT HELP Please!!

Can anyone help me with the cpt codes for this surgical visit:

Patient placed under general anesthesia. Started the procedure with cystoscopy examining the urethra and bladder. Used cone-tip Cather to inject contrast to outline the ureter and stone. Used open-ended Cather to advance a guide wire through the left ureter, regular guide wire would not go above the stone so they used a glide wire instead. Once the ureter Cather and cytoscope were removed they introduced a #12 french sheath and a #8 french flexible ureterscope up the ureter until stone was identified. Use a french laser fiber pulse to break stone and use the basket to remove fragments. The went up over the ureter up to the kidney to inspected, no more fragments found. Verified by flouroscopy and cystoscopy. No Foley left in place.

Thank you in advance for all your help!

Medical Billing and Coding Forum

Is there any billable charges in this scenario? Need assistance please

Hi,

I’m hoping someone can assist with this issue. I have a provider that has gone to a skilled nursing facility to review a patients records, discuss patient care with the SNF, and download information from a BIPAP machine. Is there any billable charges in this scenario?

Also, is there any billable charges when the provider has a phone conversation/encounter with the SNF to discuss patient care?

If this is a billable situation. Can you please tell me what codes should be used and what documentation needs to be done. Our provider is not affiliated with the skilled nursing facility.

Thank you in advance for any advice and assistance you can give.
Micki

Medical Billing and Coding Forum