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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

Preventive or problem-focused visit, this is a different scenario

Not sure how to code this visit. 9 year old patient had a well child visit on 07/30/2018, but would not let the female provider perform the genitourinary exam due to history of sexual abuse. Returned on 08/08/2018 to have this exam performed by a male provider. Male provider also explained puberty and physical changes the patient would be experiencing in the next few years. Does this warrant a preventive visit or problem-focused? Can we code a preventive visit that soon? Can I code a problem focused e/m with Z00.3 and Z62.010. Any thoughts would be greatly appreciated.

Medical Billing and Coding Forum

Coding for Waste in a Unique Scenario

The rules for coding for waste are clearly documented. You can charge up to the SDV if the waste is documented and actually wasted.

I’m not able to find standards for coding if a drug is used for multiple patients in batch processing under the hood.

For instance: Drug X comes in a 500mg single dose vial. HCPCS description says 100mg/unit or 5 units per SDV. Say you batch process two IV’s under the hood with a single entry into an SDV. Common practice in high volume hospital pharmacy IV rooms.

But say the POS is an office setting: Pt. #1 gets 150mg, Pt. #2 gets 250mg. Waste is 100mg. (150+250+100=500mg or 5 units) I can see Pt. #2 could be billed for 4 units.

But does Pt. #1 get billed for 2 units, 1 unit, or 1.5 units? Then does Pt. #2 get billed for 4 units or 3.5 units? If you round the 150mg to 2 units and the 250mg+100mg waste to 4 units, you just billed 6 units for a vial that only contains 5 units.

The 837p SV104 segment allows decimal places. 837P version 5010:Field allows a decimal point in SV104.The field length of eight digits does not include the decimal point. If a decimal is used, the maximum number of digits allowed to the right of the decimal is three. Source:https://www.optum360coding.com/uploa…E%20Sample.pdf

Medical Billing and Coding Forum

Incident to Scenario- Please help

Hi,

We need guidance on the below scenario. Our doctor evaluates patient at first visit, second visit the NP follows treatment plan with same dx (bills incident to), then a psychologist treats patient with a new dx, then the NP follows up with patient after psychologist and adds the new dx code given by the psychologist. Can the first doctor add an addendum onto the psychologist note stating that she has reviewed the treatment plan? Would that allow the NP to bill incident to with the new diagnosis that the psychologist has given because the first doctor reviewed and did an addendum to the doctor psychologist note? Or can the doctor do a separate note stating that she has reviewed the psychologist note and agrees/decides on the new dx code as a revised plan of treatment? Any advice would be helpful.

Thank you in advance.
Micki

Medical Billing and Coding Forum

Lab Tier-2 codes coding Scenario

Hi,

Not sure if this is the correct thread to ask this question but I’m in a dilemma how to code this.

If multiple genes are evaluated on a single date of service using Tier 2 code 81408 ( for example if DMD and PKDH1 full gene sequence was analysed), what should be the MUEs for this code?

Thank You in advance for your help.

Nidhi

Medical Billing and Coding Forum

Coding scenario – postpartum mother with hydronephrosis and renal calculus

Since there is no code for "incidental postpartum status", how would you code this?

Assessment/final dx: patient is 12 days postpartum with hydronephrosis and renal calculus

The ICD-10 guidelines state: “a postpartum complication is any complication occurring within the six-week period”. It doesn’t specifically state pregnancy-related complication.

Would you code this as O99.89 & N13.2? Should coders always use the O code series when the patient is in the postpartum period?

Medical Billing and Coding Forum

Incident to billing scenario

A nurse practitioner sees a Medicare patient for the initial visit and sets up a treatment plan, billing under them at 85%, because there was no supervising physician on-site. The patient returns for a second visit to see the nurse practitioner, but this time there is a supervising physician on site. Can that second visit be billed as incident to even though the patient has never seen the physician and the NP set up the initial treatment plan? Thanks.

Medical Billing and Coding Forum

Is there any billable charges in this scenario? Need assistance please

Hi,

I’m hoping someone can assist with this issue. I have a provider that has gone to a skilled nursing facility to review a patients records, discuss patient care with the SNF, and download information from a BIPAP machine. Is there any billable charges in this scenario?

Also, is there any billable charges when the provider has a phone conversation/encounter with the SNF to discuss patient care?

If this is a billable situation. Can you please tell me what codes should be used and what documentation needs to be done. Our provider is not affiliated with the skilled nursing facility.

Thank you in advance for any advice and assistance you can give.
Micki

Medical Billing and Coding Forum

Medical Recruitment Scenario in Canada

According to a recent survey conducted by the Royal College of Physicians and Surgeons of Canada, the College of Family Physicians of Canada and the Canadian Medical Association, there has been a crisis in the medical profession, a lack of suitable doctor jobs in Canada. The crisis is apparent as patient needs are not been adequately met. This crisis can be attributed to a number of issues.

 

The healthcare system clearly suffers from a lack of proper financing. In order to make it function appropriately, it is necessary that additional funds are put into the system. The second issue that needs immediate attention is definitely the lack of physicians. The onus should be on getting students to adopt medicine as a career option as there are not many medical graduates.

 

The physicians who are currently a part of the system have to deal with several other issues apart from their own work. This includes a lot of paperwork as well. There are not many doctors out there who have embraced technology to get rid of all the paperwork.

 

Sizable sections of the workforce are on the verge of retirement or have cut down on their professional engagements considerably. The numbers are not balanced as there are not many who can replace them.

 

All these issues need to be dealt with; however, their immediate resolution seems to be a distant possibility. The local areas need to address an immediate issue determining an appropriate level of service with regard to accessing doctors. There has been an attempt to providing recruitment incentive which may include subsidised housing facilities, signing bonuses and reimbursement of relocation costs.

 

Though these efforts are largely undertaken to increase recruitment in medical establishments, the efforts have been boosted by the services offered by medical recruitment agencies, also known as a Locum Support program. This program offers medical practitioners interested in filling up temporary medical practitioner jobs, an opportunity to work with some of the best medical establishments in the country. The funds that are poured into the industry are used up for the sake of identifying the locums, helping them with issues such as travel and accommodation and doing away with the obstacles that may come up in the path. These include any outstanding professional dues or additional licensing problems that the practitioner might face.

 

The program is aimed at providing continuous support in the form of filling up vacant medical positions. The program offers doctors with coverage during their practice days when they are unable to work for reasons such as illness, extended vacation, maternity leave and continuing medical education. The program is intended towards doing away with the crisis that has arisen out of a lack of a trained workforce required to tackle medical emergencies. This ensures that the doctors have a congenial work environment and also have sufficient time on their hands to manage other activities. They can afford to take it a bit easy and work as per their own convenience. The pay structure is also quite good and therefore they need not be concerned about the remuneration package.

 

 


 

 

 

Daniel Smith is a recruitment consultant and has actively worked with locums that specialise in doctor recruitment Canada. He has in-depth industry knowledge which is apparent through his publications that focus on medical doctor jobs Canada. He recommends a visit to the website http://www.globalmedics.com/ for further information.

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