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

Choosing diagnosis codes for PT/OT/ST? – physician referral vs therapist’s evaluation

I work for a therapy company that provides services in various settings (via contracts) and am working toward my CPC certification (been in billing for years all over the specialty spectrum). I notice that some locations code encounters strictly based off of the physician’s referral. Is this an accurate practice? In reviewing the orders versus the therapist’s evaluations, I see a difference quite often as there is usually a medical diagnosis and then also a treatment diagnosis. I guess you could say I’m thoroughly confused at how therapy encounters are supposed to be coded because of what I am seeing compared to what I am studying in the books and guidelines.

Any advice or guidance would be much appreciated!

Thank you,
Lynn

Medical Billing and Coding Forum

99211 for xray referral?

Our patient came in for an allergy shot.
While with our Medical Assistant, she told her that her foot was sore, which our MA then relayed to our MD.
Our MD then advised patient, through our MA, to go get an xray. The xray was performed elsewhere, but the results were given to us as a fracture.
The patient did not see the MD, but did see our Medical Assistant (MA)
Are we entitled to bill a 99211 for all of the above (plus the allergy shot)
thanks

Medical Billing and Coding Forum

Bill diagnostic test for TC alone from outside referral?

We have outside physicians refer patients to our clinic for the sole purpose of using our diagnostic equipment. Can we bill for the TC of the test(s) performed? If so, a technician is the one that performs the service (with no interpretation), who would we list as the rendering provider on our claims? Any insight is appreciated!

Medical Billing and Coding Forum

Referral Specialist Supervisor

Here at Neighborcare we are starting a new position. This is a good position for those who want to make the next leap from lead to supervisor.

The Referral Specialist Supervisor works alongside the Referral Specialists. The Supervisor will direct the day-to-day work, be the referral expert, and mentor the Referral Specialists. The Supervisor is responsible for receiving, analyzing and processing all referrals and authorization requests for patients according to specific insurance requirements. The Referral Specialist Supervisor ensures patients have been cleared for specialty service office visits and certain procedures. The Referral Specialist Supervisor will provide support to clinical staff in order to facilitate the administrative components of clinical referrals for various services.

The Mission of Neighborcare Health is to provide comprehensive health care to families and individuals who have difficulty accessing care, respond with sensitivity to the needs of our culturally diverse patients, and advocate and work with others to improve the overall health status of the communities we serve. Please apply at Neighborcare.org

Medical Billing and Coding Forum

Billing patient when referral not obtained

My understanding (correct me if I’m wrong) is that if our office fails to obtain a required referral, we have to write off the visit; we can’t bill the patient.

But what about a situation in which the patient requests to be seen right away without waiting for the referral, and states that if we don’t get it, he will pay out of pocket?

Medical Billing and Coding Forum

How to Research a Medical Specialist Referral

If you have a condition that is referred to a medical specialist by your primary physician, you may be wondering how to check the credibility of that specialist.

 

Make Sure You Are Seeing the Right Specialist

 

Many people are shocked to find that they are seeing the wrong specialist, someone who focuses on only one body system. This mistake can prevent an accurate diagnosis and subsequent treatment. Specialists are experts in their field. If they are unable to figure out what your problem is, they do not always think about referring you to another specialist. To make sure you are seeing the right specialist, carefully monitor and research your symptoms, and take them to your primary care doctor. He or she can help refer you to the right person to treat your condition.

Focus on Trustworthy and Credible Sources

With so much information online, it has become easier and faster to research potential specialists. You can do everything from verifying a physician’s license to checking the board certification through trusted organizations like the American Board of Medical Specialties(ABMS).

Research cautiously, as the growth of online information also means the prevalence of misleading or confusing information. Be wary of websites based in other countries and information alongside products that are for sale.

Here are some tips for obtaining specialist information online:

Locate your state’s licensing board to research basic credential information such as board certification.

Additional information about your doctor may be found at one of the reputable credential sites.

If board certification is not listed on those sites, check separately to make sure your doctor is board-certified in the type of specialty you seek. (Note: some doctors are board certified in one area, but practice in another. You should confirm that the certification is in the right area for you).

Directories and ratings websites may or may not contain useful information, so use your best judgment or ask friends and family members for their advice.

Research Malpractice and Disciplinary Actions

It is also a good idea to check your potential specialist’s history of medical malpracticesuits or any disciplinary actions. In this kind of search, you should look for any unusual, legal or newsworthy information by:

Selecting a specific doctor to research.

Visiting your state’s local licensing board and searching for your specialist by name or location. 

The results will give you some basic information that you can use to learn more. You may discover that your medical specialist has a clean record, or he or she has settled one or many lawsuits. Chances are that this information is not current, so you will probably want to dig further. 

Use this basic information in a search engine by typing “Dr. John Doe” in quotations to keep the phrase intact and add the words malpractice lawsuit or something related to find any news reports. You can also add the word “blog,” as this may turn up additional information, including other states in which your potential specialist may have held a previous license.

Research Your Specialist’s Credentials

Credentials are an important for determining your specialist’s ability. Once you have narrowed your search, look up where they have attended school and make sure he or she specialized in the medical service you need.

Also research where they completed their fellowship program and whether this person has is continuing his or her education. You can visit your potential specialist’s website or contact their office to find out if they are affiliated with certain organizations and inquire whether they stay up-to-date with the latest innovations in their field through publications and seminars.

If you live in the Dallas, Texas area and want to learn more about how our medical malpractice lawyerscan help you, please visit the website of the medical malpractice law firm of Polewski & Associates today.