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

Inspect Coverage for HBO Therapy for Radiation Proctitis

Look at diagnosis history changes and Medicare’s national and local coverage determinations for greater insight into denied claims. Coverage determinations for hyperbaric oxygen therapy (HBOT) for radiation proctitis make getting paid for physician services tricky. A review of historical diagnosis code changes, and the effect these changes have had on Medicare coverage determinations is necessary […]

The post Inspect Coverage for HBO Therapy for Radiation Proctitis appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

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

Neurosurgeon radiation treatment planning with a radiation oncologist physcian.

Hi All,

I am new to auditing and have a question. I appreciate any feed back I can get as well as reference materials (if possible).
I have a neurosurgeon who at times will resect a spinal metastatic tumor then partner up with the radiation oncologist to obtain a radiation treatment plan for the patient. He insists on billing 63620. However, my understanding is, if he has already performed the surgical resection the planning is already included in this code. Can this code be billed in this case?
Second scenario is if he does not perform a surgical resection, however, is part of the radiation planning, can he bill this code in this scenario. Again, I am very appreciative and grateful for any assistance/advice.

Thank you
Deborah Torres CPC, CPMA

Medical Billing and Coding Forum

Bilateral Panniculectomy for radiation damage

Can I bill for a bilateral Panniculectomy by using:

15830
15830-59

The dr documents that he performed surgery on either side of the abdomen (different locations) both of the same size, and is medically necessary for post abdominal wall radiation damage and to help with abdominal closure. This is NOT a cosmetic procedure, the patient is in global now from a recent abdominal skin graft from a recent aggressive abdominal wall debridement. However, the panniculectomy procedure is not related and was done on the left/right side of the abdomen away from the graft, I know you can bill 15734 that way for bilateral myocutaneous flap reconstruction with incisional hernias by doing 15734, 15734-59.

Any advice would be appreciated! Thank you in advanced!

Medical Billing and Coding Forum

Avoid Overpayments for Intensity Modulated Radiation Therapy

Maintain appropriate documentation and reporting for this valuable tumor treatment option. A recent Office of Inspector General (OIG) review found $ 25.8 million in hospital overpayments for intensity modulated radiation therapy (IMRT) planning, which suggests a need for greater education around reporting of these services. This article will provide insight into what IMRT is, its uses, […]

The post Avoid Overpayments for Intensity Modulated Radiation Therapy appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Radiation Oncology Barium Sulfate (Berry Smoothie)

Hello,

I am new to Radiation Oncology coding. My department is using code 61904 for barium sulfate (Berry Smoothie) but I can’t locate this code anywhere.
The following is from the simulation note. Can anyone help me on coding for this please and where to find the information on it if possible ?

Pelvis. supine. pillow. Vaclock. hands on chest holding O-ring. full bladder. shoes off. 30 ml of Barium in rectum. 5 cc of omnipaque in bladder

Thanks

Medical Billing and Coding Forum

Radiation Oncology CPT 77263

Hi All,

I have a physician who believes that for a patient receiving brachytherapy you can charge CPT 77263 at each brachytherapy visit. I am not seeing any information that this can be done. 77263 is for complex therapeutic radiology treatment planning. I believe that this can be charged anytime there is a change in the treatment planning, not each time a brachytherapy session is performed.

Is there any new information that states a new treatment planning can be charged at each brachytherapy visit? If so, can you give me any information on a website? Or, if not can you advise on how I can explain to the doctor that he cannot code this out?

Any help would be appreciated!

Denise Turner, CPC

Medical Billing and Coding Forum

Hospitals Improperly Bill Medicare Millions for Radiation Therapy

An OIG review shows Medicare overpaid outpatient hospitals as much as $ 25.8 million for complex simulations billed during audit period. Between 2013 and 2015, Medicare paid 1,193 hospitals $ 109,197,933 in bundled payments for intensity modulated radiation therapy (IMRT) — about $ 25,754,171 more than they should have, according to the Office of Inspector General (OIG). The […]
AAPC Knowledge Center

Radiation Oncology E/M

Good Morning,
I’m wondering if there are any resources out there to help with E/M coding for radiation oncology that someone can share. More specifically, I’m looking for examples of what the documentation would look like and the reasoning behind the E/M codes selected.

One of my most pressing conundrums is deciding on an accurate Risk score. I’m coming across many patients that are being seen for a follow up, nothing is noted to be getting worse and seems stable. No documentation to assume otherwise. Nothing more is being done currently, pt either has completed radiation tx or will begin after chemo, but I can’t decide if the risk for this would be low or moderate. Any advise or direction would be much appreciated.
Thanks
Laura

Medical Billing and Coding Forum

Immediate need for Radiation Oncology Coder!

Position: Full Time- Onsite in our Jersey City office or Remote Medical Coder
Requirements:
AAPC- CPC or equivalent
Minimum Experience: 5+ Years in Radiation Oncology Coding
Compensation:Based on experience
Benefits:Medical, Dental, 401K, Vacation Time & Personal Time off
Please send your resume to [email protected].
This is an immediate opening and you will receive a response within 24 hours with additional information and to set up a time for an interview by phone.

Medical Billing and Coding Forum