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

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

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

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

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

Tag Archives: primary

HELP…. i have billing primary and secondary question(s)

Posted on by
Hello All,

I could really use some help. I’m confused when billing primary and secondary. Question. What do you do when a secondary pays as primary but when you call the secondary they say they paid as secondary but now your computer show an insurance refund. Who gets the refund? how would you enter the secondary’s payment? What (if there is a) balance would be the patient balance? Example: total billed amount $ 5,949.00 primary eob states allowed $ 4,242.34 Coinsur $ 848.47 adjustment $ 1706.66 Paid $ 3393.87 …. Secondary’s eob states allowed $ 5354.10 deduct $ 421.98 adjustment $ 594.90 Paid $ 3945.70 ….
Do I refund the primary’s full pymt and base the claim payment on just the secondary’s payment?
THANKS :)

Medical Billing and Coding Forum

Billing Primary Care E/M and LICSW same day

Posted on by
We are integrating a new LISCW in our Pediatric Practice, and we don’t have any experience in billing for a Behavior Health Specialist. Both provider and LISCW are billed with the same group TIN. I have a pretty good handle on psychotherapy coding in general, however, I do have questions regarding billing when a patient has an office visit with a primary care provider (not psychiatrist), but also has psychotherapy with the LISCW in the same day? I know the add-on codes 90833, 90836, and 90838 are used with E/M, but is this only when a Psychiatrist provides the E/M and psychotherapy? Is there a way to bill for both Primary Care and LISCW?

Medical Billing and Coding Forum

Allowable amounts for primary and secondary

Posted on by
Hi, I am hoping somebody can help with this scenario and also provide somewhere were I can find the proper documentation to support the decision:

Patient has commercial insurance A as primary, commercial insurance B as secondary. Provider is in network with both A and B.

Insurance A shows an allowable amount of $ 65, pays $ 55, patient responsibility is $ 10.
Insurance B shows an allowable amount of $ 100, pays $ 0 (applies to deductible), patient responsibility is $ 100.

Is provider supposed to bill the patient for the $ 10 per Insurance A patient responsibility,
or $ 100-$ 55 paid by insurance A=$ 45 per Insurance B.

Any help would be appreciated – as well as where I can find the documentation regarding this.

Thank you,

Susan Wood, CPC-A, CPB

Medical Billing and Coding Forum

98point6 Wants to be Amazon Prime of Primary Care

Posted on by

A Seattle company looks to make primary care as easy as buying something from Amazon. 98point6 is a Seattle start-up brain child of Rob Schwietzer who scaled Amazon Prime from thousands to millions and CEO Robbie Cape from Microsoft.  98point6 is focusing on “Direct Primary Care”, which involves charging the patient a subscription fee for […]

The post 98point6 Wants to be Amazon Prime of Primary Care appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Primary Care Exception in Brief

Posted on by

Under the “primary care exception,” a medical resident may perform (and bill for) limited, specific evaluation and management services without the presence of a teaching physician. Here’s what you need to know when reporting these resident services. When the Primary Care Exception Applies Ordinarily, services furnished by medical residents are excluded from Medicare payment because […]

The post Primary Care Exception in Brief appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Billing with primary and secondary insurances

Posted on by
Looking to verify the proper patient responsibility to bill them in the following scenario as well as the proper rationale.

Primary insurance is a high deductible plan through BCBS and allows $ 3000.00 to the patient’s deductible for a patient’s surgery on the $ 5000.00 billed charges. We do not participate with the primary insurance. It’s a PPO plan. They were covered by the out of network benefits on the plan. BCBS says the patient’s responsibility is the $ 5000.00.

Secondary insurance is Medicare and we do participate. Medicare allows $ 1000.00, pays out $ 800 with $ 200 coinsurance. Patient responsibility on remit says $ 200.00.

Do you bill the patient only the 20% coinsurance for $ 200?

Or do you bill the patient for $ 4200.00 ($ 5000.00 minus $ 800.00 paid by Medicare)

Medical Billing and Coding Forum

Add-on to What? Finding Primary Procedure Codes

Posted on by

CPT® add-on codes, such as +10004 Fine needle aspiration biopsy, without imaging guidance; each additional lesion (List separately in addition to code for primary procedure), describe procedures always provided “in addition to” a more extensive, primary procedure code (there is one exception). Often, a parenthetical note will identify the primary code(s) with which the add-on code […]

The post Add-on to What? Finding Primary Procedure Codes appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Need help with Primary Diagnosis for AWV G0402,G0438,G0439, Ran into a Conundrum.

Posted on by
Hey everyone, I had a rather interesting webinar that was provided by Humana regarding Medicare AWV’s and in the webinar the presenter states that Z0000 and Z0001 should’nt be used, and threw me off, and I was wanting to know everyones thought’s on this, is right or wronge?

Medical Billing and Coding Forum