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

CPC Exam Review Video

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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

Comparing 2023 E/M MDM and Table of Risk

Side by side, the 1995 and 1997 Documentation Guidelines and the 2023 CPT® E/M Services Guidelines aren’t so different. Some hospitals and coding and billing entities are under the impression that the new 2023 CPT® evaluation and management (E/M) services guidelines and code changes make things much easier for coding, billing, and auditing processes. It […]

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AAPC Knowledge Center

Unravel the Complexity of Risk Adjustment

AAPC’s RISKCON virtual conference prepares healthcare professionals for the future of reimbursement. What is risk adjustment? It’s a methodology that the Centers for Medicare & Medicaid Services (CMS) uses to compensate Medicare Advantage (MA) plans for the added costs of insuring people with chronic conditions. Sounds simple enough, but it’s not. Risk adjustment is complicated. […]

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AAPC Knowledge Center

How Telehealth Services Factor Into Risk Adjustment

2020 has proven to be one of the most complex, busiest times in healthcare — in the 21st century, anyway. In January, we were preparing for a new chapter in ICD-10-CM, Chapter 21: Vaping-Related Disorders. On January 30, the World Health Organization announced a Public Health Emergency of International Concern (i.e., pandemic) for coronavirus. In […]

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AAPC Knowledge Center

OIG to Audit Risk Adjustment Coding

Consistent with previous reporting, the Office of Inspector General (OIG) has added to its 2020 Work Plan a targeted audit of Medicare Advantage (MA) programs for risk adjustment diagnosis codes. This is not the first time federal agency has targeted risk adjustment data. The OIG stated back in 2017, “We will review the medical record […]

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AAPC Knowledge Center

Compliance Week: Managing Telecommuter Risk

Many healthcare organizations are seeking to reduce expensive physical office space, improve employee morale, and offer flexible options for the workforce; telecommuting has emerged as a commonplace solution for many of us. How can a compliance officer embrace these more prevalent and relevant offsite employee worksite opportunities while still demonstrating they are managing risks to […]

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AAPC Knowledge Center

Guideline I.A.15: The One that Makes  Risk Adjustment Coders Happy

Providers no longer need to link documentation to diabetes mellitus for certain related conditions for coding; it’s implied. Medicare risk adjustment (MRA) coders identify active diagnoses that determine a patient’s level of risk (the likelihood of that patient needing medical care). This helps health plans project the cost of caring for their patient population. That […]

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AAPC Knowledge Center

Does anyone know where to find general updated CDPS (Medicaid) risk adjustment info?

I am studying and starting to work with the CDPS Medicaid risk adjustment model and just cannot find much information explaining the model and the ICD-10-CM codes that are included. Nothing in cms.gov. I found two papers but the most recent is from 2002!!

Can anyone point me in the right direction?

Thanks!

Medical Billing and Coding Forum

high risk sexual behavior

I work for a family practice facility. They say they have standing orders for certain diseases (HIV, HEPATITIS C, ETC) for certain patient in between ages 20 something to their 40’s or 50’s. They are giving them high risk sexual behavior diagnosis. I don’t think this should be used especially if their notes state they aren’t sexually active or have only had 1 partner in the last 5 to 10 years. Can someone help me with this?

Medical Billing and Coding Forum

Global OB -Complications or if at higher risk

We have some colleagues debating on this. If most of your patients are seen for complications or are at higher risk and most of their visits are billed to insurance with an E/M (some cover these and don’t require you to bill out at time of delivery) how are you handling global? Since some of these patients have zero routine visits at the time they deliver because their complications or high risk visits were billed and paid are you splitting the global since there are no routine visits? ex 59410, 59515 etc… or are you counting the high risk visits as prenatal even though they were paid to equal the 10-13 visits allowed by most carriers.

Medical Billing and Coding Forum