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

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

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Practice Exam

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

Code Changes Could Undermine Quality Reporting

Many quality measures in the Quality Payment Program include ICD-10-CM codes in either the numerator, denominator, exclusions, or exceptions, and used to determine patient eligibility. The accuracy of any measure, and the ability for eligible clinicians to meet data completeness, risk being compromised when ICD-10 codes are updated (October 1). Workflows that are not automatically updated, such as claims and registries, are particularly vulnerable. […]
AAPC Knowledge Center

Reporting Multiple Injections 96372

When billing for professional services, you should report 96372 Therapuetic, prophylactic, or diagnostic injection, specify substance, or drug; subcutaneous or intramuscular for each medically appropriate injection provided, as instructed in CPT Assistant (May 2010; Volume 20: Issue 5): Question: What is the appropriate CPT code to report when a patient receives two or three intramuscular […]
AAPC Knowledge Center

99024 Reporting for Post-Op Visits in 2018

In July 2017, the Centers for Medicare & Medicaid Services (CMS) began requiring medical offices with 10 or more practitioners in nine states (Florida, Kentucky, Louisiana, New Jersey, Nevada, North Dakota, Ohio, Oregon, and Rhode Island) to report claims data on post-operative visits furnished during the global period of specified procedures using CPT® 99024 Postoperative […]
AAPC Knowledge Center

Time-Based Code Reporting

When calculating time spent performing a time-based procedure or service, include only those items specifically detailed in the code descriptor. For example, when reporting critical care services (e.g., 99291-99292), you may include the time spent interpreting cardiac output measurements or chest X-rays, performing ventilator management or vascular access, and other services enumerated within CPT® as […]
AAPC Knowledge Center

Reporting Endobronchial Ultrasound (EBUS)

Endobronchial ultrasound (EBUS) combines a bronchoscope with ultrasound to visualize the bronchi and adjacent structures, and to obtain tissue for biopsy. Sampling by EBUS differs from transbronchial lung biopsy(s) (+31632) or transbronchial needle aspiration biopsy(s) (+31633), neither of which includes an ultrasound component. Two codes describe EBUS to obtain transtrtacheal and transbronchial sampling: 31652 Bronchoscopy, […]
AAPC Knowledge Center

Q&A: Prepare for requirements when reporting biosimilars

Q: Last week, you said there is a code for reporting the biosimilar for filgrastim. How is CMS going to pay for the drugs and are there any “surprises” that we should look out for?
A: CMS has initiated the same type of payment that we are familiar with under the OPPS. For those who receive payment under the Medicare Physician Fee Schedule (MPFS) for drugs, it is a bit of a new concept. CMS will assign a single HCPCS code for the biosimilar, and all biosimilars for the same biological will be reported with the same HCPCS code. For example, cyclophosphamide is manufactured by more than 20 different companies. Regardless of the manufacturer, the drug is reported with HCPCS code J9070 (cyclophosphamide, 100 mg) and reimbursed under APC 1408 based on the average sales price information. This same concept will apply for biosimilars, which are eligible for pass-through payment, as well as subject to the same packaging and separately payable considerations as other drugs/biologicals.
As additional manufacturers begin providing filgrastim biosimilar, HCPCS code Q5101 (injection, filgrastim [G-CSF], biosimilar, 1 microgram) will be reported with the appropriate number of units for the dose ordered and administered, and will be reimbursed at the same rate under APC 1822 for 2016.
There is another reporting requirement for biosimilars. Based on discussion in the MPFS final rule, beginning January 1, 2016, CMS is going to issue manufacturer-specific modifiers that must be appended to the HCPCS code for the biosimilar based on which manufacturer supplied the product administered to the patient. Transmittal 1542 describes the process and notes that once the modifiers are communicated, it is a mandatory that the modifiers be reported on the claim. The first modifier is -ZA for Sandoz, which is the current manufacturer for filgrastim biosimilar.
As the number of biosimilars grows, and the number of manufacturers providing the biosimilars increases, this will be a huge operational consideration as the modifier will be specific to the product provided to an individual patient. It is a great idea to be proactive and begin working on how to operationalize this requirement.


Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Revant Solutions,in Fort Lauderdale, Florida, answered this question. – APCs Insider

External cause codes for professional reporting

I’m in a situation where I need to advise an billing company that does professional claims only whether they need to report external cause codes for Emergency Department claims. It’s my understanding that e-code reporting requirements differ by state and/or by payer., but I’m having difficulties finding this information.

Could someone point me in a good direction to find more information about professional coding of external cause codes? :confused: I’d really appreciate this.


Medical Billing and Coding Forum

Exceptions and Exemptions from MIPS Reporting for 2017: What Radiologists Need to Know

In the August 4, 2017 edition of its Advocacy in Action eNews the American College of Radiology (ACR) reported on the Centers for Medicare and Medicaid Services (CMS) announcement regarding the manual application process for a significant hardship exception under the Advancing Care Information (ACI) category of MIPS

Radiology Billing and Coding Blog