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

Secrets Revealed for Passing an AAPC Exam

There is more to passing your credentialing exam than studying. There aren’t really any secrets to passing an AAPC credentialing exam. We advertise what you’ll need to know on our website. For the Certified Professional Coder (CPC®) exam, for example, we recommend the following steps: Step 1: Take the online medical terminology and anatomy courses. […]

The post Secrets Revealed for Passing an AAPC Exam appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Top Claim Error(Denial) Revealed

The No. 1 claim error for June in 11 states plus the District of Columbia was for non-covered charges, according to Novitas Solutions, Medicare Administrative Contractor for Jurisdictions H (Arizona, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas) and L (Washington DC, Delaware, Maryland, New Jersey, and Pennsylvania).

This error is identified by Explanation of Benefits (EOB) message code 96. Noncoverage has been the No. 1 claim error for some time in these states, which is hard to believe because there’s a known cause and cure.

Non-coverage Denials-Cause and Cure:

Explanation of Medicare Benefits (EOB) error message 96 Non-covered charge was the No. 1 reason for claims denials in all of “Prior to performing or billing a service, ensure that the service is covered under Medicare,Medicare Jurisdiction H, according to the region’s Medicare Administrative Contractor (MAC).

Please verify “Prior to performing or billing a service, ensure that the service is covered under Medicare,”
This should be a no brainer, but there are quite a few services you would think are covered by Medicare that aren’t.

For example, according to Medicare Benefit Policy Manual Pub. 100-02, Chapter 16, Section 10, “No payment can be made under either the hospital insurance or supplementary medical insurance program for certain items and services, when the following conditions exist, 

  • Not reasonable and necessary
  • No legal obligation to pay for or provide
  • Paid for by a governmental entity
  • Not provided within United States
  • Resulting from warPersonal comfort
  • Routine services and appliances
  • Custodial care
  • Cosmetic surgery
  • Charges by immediate relatives or members of householdDental services
  • Paid or expected to be paid under workers’ compensation
  • Non-physician services provided to a hospital inpatient that were not provided directly or arranged for by the hospitalTop Claim Error Revealed
  • Services Related to and Required as a Result of Services Which are not Covered Under Medicare
  • Excluded foot care services and supportive devices for feet or,Excluded investigational devices (See Chapter 14) 


Coding Ahead

Top Claim Error Revealed

The No. 1 claim error for June in 11 states plus the District of Columbia was for non-covered charges, according to Novitas Solutions, Medicare Administrative Contractor for Jurisdictions H (Arizona, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas) and L (Washington DC, Delaware, Maryland, New Jersey, and Pennsylvania). This error is identified by Explanation of […]

The post Top Claim Error Revealed appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Cost Benefits of Medical Tourism Revealed

There is a good number of reasons that motivate Americans to go the medical tourism route and travel offshore to get health care, but the primary reason is to save money. To a lesser extent, they may get overseas sugary because the procedure they need is not available in the USA, or because they want to preserve their anonymity and wish to ensure their friends and neighbors back home do not know about their surgery, but the vast majority of American medical tourism patients do it for financial reasons.

According to the Medical Tourism Association, it is problematic to calculate precisely how much the savings would be to have health care performed abroad not because of the difficulty in learning how much the offshore treatment costs, but rather it is hard to pin down domestic doctors and hospitals about how much their fees would cost. Despite this challenge, we can state some comparison costs in round numbers, and these figures may be astonishing at times.

Dr. Michael D. Horowitz published a study in the journal of the Medical Tourism Association which included a comparison of the costs for a unilateral hip replacement operation between hospitals in India, Costa Rica and the United States. According to his figures, to have the surgery performed in the USA would carry a price tag of a minimum of $ 40,000. The same procedure done in India would cost $ 5,400 (all numbers are in US dollars) and to have the hip surgery done in Costa Rica would be priced at $ 6,600.

Of course, these numbers do not tell the complete story. First of all, there is the cost of travel from one’s home in the United States to India or Costa Rica. Most often the patient will not go alone but rather will take a companion along, so the price of those airline tickets should probably be doubled. Next, there are the costs of hotel accommodations, meals, travel insurance, etc.

Dr. Horowitz calculated the extra non-medical expenses for two Americans going to India at $ 4,600, and for Costa Rica it would be $ 3,250. This brings the total price for the India medical tourism care to be $ 10,000, or 75% less than American treatment. For Costa Rica, the total of $ 9,850 is 75.4% less than if the patient had stayed home.

The travel figures are based on the air flights being economy and not business class, and for flying from Atlanta to New Delhi, India, and San Jose, Costa Rica. Even if the patient had to miss a few extra days of work due to the extra time off needed for overseas travel, the savings of $ 30,00 or $ 30,150 are very significant.

One benefit upon which it is even harder to put a price tag is the life experience value of a trip to India. Surely the extra few hundred dollars it would cost to go from New Delhi to the Taj Mahal pale into insignificance when weighed against the opportunity to tick this wonder of the world off of one’s “bucket list” of things they are dreaming of doing.

Most travel agents are not trained to accommodate overseas surgery clients, so anyone wanting to arrange medical tourism is advised to have their procedure coordinated by an accredited specialist such as http://globalsurgerynetwork.com