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

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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

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Click here for more sample CPC practice exam questions and answers with full rationale

Rural Health Clinic Policies Revised

Don’t send another RHC claim until you’ve reviewed these key changes for 2022. A Rural Health Clinic (RHC) is a clinic located in a rural, underserved area with a shortage of primary care providers, personal health services, or both. Medicare pays RHCs for the provision of certain primary care and preventive health services in these […]

The post Rural Health Clinic Policies Revised appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

E&M Level Coding in a RHC (Rural Healthcare)

I need guidance please.
We have a patient that was seen in the RHC clinic. The MA documented in the chart the social history, the Vitals, an a med reconciliation. The doctor circled a level 3 on the superbill and added a diagnosis code; however, he never did any documentation himself (no dictation or entry into EHR). The superbill is signed and has the dx code on it. It also states on Superbill that it is part of the medical chart and scanned into the chart. Would this visit qualify for a Level 2 visit based on the MA documentation and the Superbill?

Medical Billing and Coding Forum

Rural Health Clinics and Federally Qualified Health Centers

Calling all RHC, CAH, FQHC coders and billers! I am a new RHC coder, and have been having a hard time finding information or resources on RHC coding and billing practices. It would be great to have our own discussion forum here, but I see very few posts pertaining to any of our unique practices.

I use the CMS RHC chapter and NARHC website for most of my questions, but if anyone knows of any other useful resources, I’ll be more than thankful to hear about them!

Thank you and please respond with any you know of.:confused::confused:

Medical Billing and Coding Forum

35 Telehealth Programs Combined to Boost Rural Care

Intermountain Healthcare recently combined 35 telehealth programs into what it calls a “virtual hospital,” touting the new service’s ability to reach underserved areas. Connect Care Pro will not only service patients directly, but cut healthcare costs for inpatients, the system says. Telehealth is Broad Solution The Utah-based system has 22 hospitals, including regional facilities in Salt […]
AAPC Knowledge Center

Telemedicine Cuts Access Time for Rural EDs

A recent study by the University of Iowa finds that rural patients find quicker access to providers in emergency departments (ED) if using telemedicine than traditional patients. Telemedicine Study The cohort study of patients seen in 1 of 14 rural hospitals in a large Midwestern telemedicine network included 127,928 encounters. Door to provider time for 2,857 […]
AAPC Knowledge Center

New Webpage Helps Small, Rural Practices Participate in MIPS

CMS announced over the weekend the launch of a new section on the Quality Payment Program (QPP) website dedicated to clinicians working in small or rural practices, as well as those treating patients in underserved areas. The new page serves as a single point of reference for these clinicians to help them prepare for and actively […]
AAPC Knowledge Center

FCC: Telehealth Not Always Available to Rural Chronically Ill

The Federal Communications Commission’s (FCC) Connect2Health task force just updated its data of on-line access for chronically ill, rural Americans, and the news isn’t very encouraging. In Mapping Broadband Health in America, the FCC identified additional rural/urban gaps in care, especially for a growing number of chronically ill  patients whose nearby medical facilities have closed. the […]
AAPC Knowledge Center

Medicare-Dependent, Small Rural Hospital Program Set to Expire

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) extended the Medicare-dependent, Small Rural Hospital (MDH) program, but like previous statutes before it, only temporarily. Beginning Oct. 1, 2017, the MDH program will no longer be in effect. The Effect on Hospitals The Centers for Medicare & Medicaid Services (CMS) explains in the 2018 […]
AAPC Knowledge Center

Payment for G0101 and Q0091 in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)


The Centers for Medicare & Medicaid Services (CMS) has determined that HCPCS codes G0101 (Cervical or vaginal cancer screening; pelvic and clinical breast examination) and Q0091 (screening Papanicolaou smear) are billable visits when furnished by a RHC or FQHC practitioner to a RHC or FQHC patient.

CR8927 instructs MACs to allow HCPCS codes G0101 and Q0091 to be billed as a standalone encounter/visit. These services will be paid the AIR on RHC and FQHC claims for 71X and 77X Types of Bills (TOBs), effective for dates of service on or after January 1, 2014. Please note that deductible and coinsurance are NOT to be applied to G0101 or Q0091. If other billable visits are furnished on the same day as G0101 or Q0091, only one visit will be paid.

G0101 or Q0091 are payable annually for women at high risk for developing cervical or vaginal cancer, and women of childbearing age who have had an abnormal Pap test within the past 3 years. It is payable every 2 years for women at normal risk. For FQHCs billing under the PPS, G0101 and Q0091 are qualifying visits when billed with FQHC payment HCPCS codes G0466 or G0467.

Please note: MAC will not search for claims that have been denied with HCPCS code G0101 or Q0091 prior to the implementation of CR8927, but will adjust any claims that you bring to their attention.

Reference: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM8927.pdf


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