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

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

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

Is Your Provider Charging Patients Too Much?

Consumers overspent $ 18.5 billion on diagnostic imaging in 2017, according to a UnitedHealth Group (UHG) research brief, released May 23. The health insurer attributes the overspending to price gouging by some providers. Echocardiograms (EKGs) in 2017, for example, cost patients anywhere between $ 210 and $ 1,830, according to the brief. The average was $ 480, but UHG […]

The post Is Your Provider Charging Patients Too Much? appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Provider refer to H & P for dx

I am looking for documentation regarding a provider referring to an H & P for diagnoses. I have found very little on CMS. Is there something out there that states they can not do this? I found a few things on a stand alone note, but I am sure they are thinking since the dx are on the H & P, that is okay. Aside from the fact, that the dx changes over the course of the hospital stay.

I would appreciate any help, been looking for this for awhile.

Thanks.

Nancy

Medical Billing and Coding Forum

Lawyer General Ford Announces Sentencing of Fraudulent Medicaid Provider Business

Nevada Attorney General Aaron D. Passage declared that Moving Forward Counseling Solutions, LLC (Moving Forward), a Medicaid supplier business based out of Las Vegas, was condemned for Medicaid extortion. The misrepresentation was submitted between January 2016 and December 2016.

Read The Full Story Here!

The post Lawyer General Ford Announces Sentencing of Fraudulent Medicaid Provider Business appeared first on The Coding Network.

The Coding Network

Billing for RN services with no supervising provider in the office

I work in an outpatient medical and mental health clinic with 2 locations. My location is mainly admin staff and social workers. We do have an ANP and an RN at this location, but the ANP is moving his office to our other location. The problem is that the nurse wants to remain here and continue to perform med injections and lab draws. Is this allowed? I don’t see how we can bill for these services with no supervising provider present. This is a totally new experience for me so I am totally confused about this. Most of our patients are Medicaid and Medicare, but we do see some other insurances as well.

Medical Billing and Coding Forum

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

ASC billing for provider

Hi ,

We have a one doctor who owns the ASC (Ambulatory surgical center), he is Gastroenterologist tries to bill his asc billing services to get paid for global as well as professional services. Can we bill both global and professional service to get paid from payers. We though billing as

1 ) With Pos 24 on HCFA along with facility charges box 32 A with facility NPI and 24J with individual NPI.
2)With POS 11 on HCFA with provider group details.

Can it be paid? Please suggest.

Medical Billing and Coding Forum

Diagnosis on signed order and not documented in provider notes

When looking for medical necessity for ancillary services performed during an ED or observation encounter, if the attending provider signs his order with a medically necessary diagnosis and fails to document accordingly in the record, is it safe to assign that diagnosis to cover? Are there any Medicare guidelines I may be able to refer to about this?

Medical Billing and Coding Forum

Two E/M visits – Same Day – Same Provider

A patient of ours saw a provider for two unrelated issues (different dx) on the same day. There is separate documentation for both visits. I was going to bill the visits separately with M25 on the second E/M visit but from what I am reading online I might put the practice under scrutiny as it will raise a red flag with the carrier.

Is there anyone out there that has billed for this circumstance before that could give me some advise please?

Medical Billing and Coding Forum

Provider Seeing Pts at Substance Abuse Facility for Non Behavioral Health Issues

Hello All,
I have a provider who has been asked to see patients at a substance abuse facility. These are Ohio medicaid kids who are inpatients at the facility. She will be seeing them for routine care, sick vists etc. not related to their behavioral health. I’m trying to determine the correct POS and CPT’s to bill for these services. My thoughts are 99341-99350 with POS 55. Am I close?

Thanks for any input.

Tammie

Medical Billing and Coding Forum