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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

OIG Performs Audit on Psychotherapy Services

Findings reveal Medicare compliance amidst the psychotherapy surge during the pandemic. The COVID-19 public health emergency (PHE) drastically changed the way we lived in 2020 and 2021, especially the way we received healthcare. During the nationwide shutdown, the Centers for Medicare & Medicaid Services (CMS) temporarily expanded access to health services via telehealth to meet […]

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AAPC Knowledge Center

Meet Documentation Requirements for Psychotherapy Services

Here’s what the OIG is looking for, and Medicare carriers will be too. Did healthcare providers meet Medicare requirements and guidance when billing for psychotherapy services during the public health emergency (PHE) for COVID-19? The Office of Inspector General (OIG) conducted a nationwide audit to find out, and recently published their findings. It is not […]

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AAPC Knowledge Center

Telehealth Services After the PHE: Part 2

After learning that the public health emergency (PHE) for COVID-19 was to end May 11, the healthcare industry wondered what telehealth services would remain covered. What regulations under the Consolidated Appropriations Act, 2023 (CAA) would extend coverage? Which provisions in the Medicare Physician Fee Schedule Final Rule be enforced? And which of the Centers for […]

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AAPC Knowledge Center

Billing a PA’s Services Incident to a Physician’s

Use midlevel providers to maximize productivity and reimbursement in your physician office. Physician assistants (PAs) are a type of nonphysician practitioner (NPP) who may bill Medicare under their own national provider identifier (NPI). As of Jan. 1, 2022, PAs can bill and be reimbursed directly from Medicare where previously reimbursement could only be made to […]

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AAPC Knowledge Center

CMS Corrects Time Thresholds for Prolonged Services

What a difference 15 minutes can make when billing E/M services. The Centers for Medicare & Medicaid Services (CMS) issued a notice March 14 correcting several errors in the 2023 Medicare Physician Fee Schedule (MPFS) final rule. Most notably, CMS is correcting technical errors in the calculations of the time thresholds for reporting evaluation and […]

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AAPC Knowledge Center

Overpayments for Definitive Drug Testing Services Cost Medicare Millions

OIG audit finds Medicare could have saved up to $ 215.8 million over 5 years. Drug testing is generally performed to detect the presence or absence of drugs in patients undergoing treatment for pain management or substance use disorders. There are two types of drug testing: presumptive and definitive. A presumptive drug test identifies whether drugs […]

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AAPC Knowledge Center

Billing Multiple Behavioral Services

Is modifier 95 required on every code furnished via telehealth? After reading “Take the Complexity Out of Behavioral Health Coding” in the June 2022 issue of Healthcare Business Monthly, a reader asked: “If billing 96130, G0396, and 90791, would I use modifier 95 on all three of these procedure codes in addition to the U4?” […]

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AAPC Knowledge Center

Check Out All the New Codes for Reporting Services and Supplies to Medicare

Don’t assume the codes you’ve been using to report drugs and biologicals still apply. The January 2023 update to the HCPCS Level II code file from the Centers for Medicare & Medicaid Services (CMS) includes 184 new codes for reporting services and supplies. Approximately 36 of the new codes were created to separately identify products […]

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AAPC Knowledge Center

Coding Inpatient and Observation Services in 2023

AAPC leadership answers your questions about reporting and auditing hospital inpatient and observation services in 2023. Attendees at AAPC’s AUDITCON, Nov. 3-4, 2022, came loaded with questions about the coding and guideline changes for evaluation and management (E/M) services in CPT® 2023. The conference offered several sessions on the subject, including “Audit Approach for Hospital […]

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AAPC Knowledge Center

OIG: Feds Lack Oversight of Telehealth Services

More safeguards are needed to strengthen program integrity. The U.S. Department of Health and Human Services’ (HHS’) Office of Inspector General’s (OIG) Pandemic Response Accountability Committee (PRAC) Health Care Subgroup issued a report, December 2022, revealing telehealth use and integrity risks in six federal agencies during the first year of the COVID-19 public health emergency (PHE). […]

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AAPC Knowledge Center