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

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

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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

I would like some input on TCN -The Coding Network

I am researching this company as I applied to 3 positions and received 2 separate emails with links to take their proficiency tests. I’ve seen some very mixed reviews concerning the tests (including the fact that many do not even hear back from them with an offer to test) and would love some recent insight into the process and the company if anyone has dealt with them. The test does seem unprofessional & unclear, and from what I have been reading unfairly graded. I want a remote position and I plan to be very picky about who I choose, so before I stress over these tests, I wanted to reach out here. Any input is appreciated!

Tina Smith COC, CPC

Medical Billing and Coding Forum

Can some one please help with this coding

Pre & post Dx: Symptomatic lymphedema of the right upper inner thigh.

Procedure performed: Excision of lymphedema pocket of right upper inner thigh with multiple layer reconstruction and wound VAC application.

Indication: This pt is a female who has developed lymphedema on bilateral lower extremities and on the medical aspect of her right inner thigh had developed a pocket which had significant entrapment of lymphatic fluid with irreversible changes and hypertrophy. The pt developed the pocket of tissue approximately the size of a bowling ball which hung from the upper inner distal medial right thigh and did hang on the ground. It severely impacted her lifestyle and limited her ability to exercise and ambulate and after seeking consultation from multiple doctors finally agreed to allow for excision of this area. Details,risks, and benefits of the operation were gone over with her. All of her questions were answered. All pertinent informed consents were gone over and signed. Medial clearance was obtained preoperatively.

Procedure: the patient was brought into the operative suite and placed in the supine position with all dependent portions carefully padded. After successful induction of general endotracheal anesthesia, was prepped and draped in usual fashion. Incision was made on the anterior and posterior surface of this massive lymphatic contained extravasation from the distal inner right thigh. Dissection was carried down through the skin and subcutaneous tissue with Bovie electro cautery. Once the lymphatic channels were encountered, harmonic scalpel was then used in order to coagulate and cuaterize the lymphatic channels, Meticulous treatment of the lymphatic channels with the Harmonic scalpel was able to accomplished full thickness from anterior to posterior. The superficial and deep venous system of the leg was kept intact, and a significant amount of skin and lymphatics was able to be removed and debulked from this area. The required free ties were placed, and after perfect hemostasis was obtained, chromic suture was used in the depths of the wound to close off the deep layer. Chromic suture were also used in the deep and subdermal layer in interrupted fashion in hopes of causing some inflammatory changes and provide for closure of this area. Metallic staples were placed to re approximate the skin loosely with multiple areas of separation to allow for lymphatic egress. All soft tissue appeared to be pink, healthy and viable at the termination of procedure. A wound VAC was then applied to account for this lymphatic egress. This served as the only dressing required, but a circumferential Ace wrap was applied for gentle compression of the lower extremity. The pt tolerated the procedure well with an estimated intraoperative blood
loss of 100 mL. she was taken from the operating room, extubated in stable condition to the recovery room. She will be admitted for pain control and wound care.

Thanks in advance

Medical Billing and Coding Forum

Hoping for some input on a procedure

Hello. I am kind of new to vascular coding but am determined to learn it.
I do have a question on the procedure noted below.

Ultrasound guidance was used to gain access to the right common femoral artery using needle puncture and seldinger technique. A 5-french sheath was placed. A diagnostic catheter was advanced to the aortic bifurcation and oblique images of the left iliofemoral system were then obtained. The catheter was then advanced into teh left common femoral artery and left lower extremity angiography was performed. There seemed to be obvious thrombus within the superficial femoral artery as well as some distal tibial disease that may also represent a small level of embolization. The sheath was then placed over the aortic bifurcation such that the distal tip way in the proximal superficial femoral artery. An infusion thrombolytic wire was then advanced such that the infusion ports lay encompassing the area of thrombosis/embolism. Thrombolytic agent will be infused through the infusion wire overnight while a small amount of heparinized saline will be infused through the sheath. Sterile dressings were applied and the patient taken to the recovery room in stable condition.
Any suggestions on the codes for this procedure is greatly appreciated. Also, any suggestions for study helps to get more familiar with vascular would be greatly appreciated.

Thank you

Medical Billing and Coding Forum

Anesthesia preop eval some days before the procedure

We are about to bill for a new group… who seem to think we can bill an e/m for the standard preop eval if it was done over 72 hours before the procedure.. as a standard practice. I said absolutely not.. to me that Is outright unbundling. Because the visit would be the pre anesthesia eval and not done for a separate unrelated illness. Just had to share this silliness.

Medical Billing and Coding Forum

Medical malpractice New York – Some facts and trends

Medical malpractice is an act which is attempted by a doctor in which he diagnosed the patient improperly that ultimately leads to the wrong treatment of the patient. So to avoid such harmful acts you must be familiar with some facts and trends of present scenario which are being discussed below as-

Fact related to the medical malpractice act in New York-
Patients generally sue the doctors and hospitals in the court of New York as they have to sacrifice a lot due to the improper treatment given by the professional and just because of committing this act of medical malpractice; victim has to suffer from a permanent injury. That is a fact but the trend going on these days appears to be completely different from the fact.

Another fact which would be quite strange to know that various victims of medical malpractice New York are not even aware of this as they have not been told about this type of practice.

In spite of the fact, trend provides a unique picture-
As there are ample of people in New York who are suffering because of the negligent act committed by a doctor but only few of them are able to identify that they are the victim of medical malpractice act and hence they are not compensated for the act due to their unawareness about the fact that it is the result of doctor’s ignorance in treating the patient.

Fact about the result of a lawsuit-
Even when the victims realize that they should file a lawsuit against the negligent party i.e. the doctors, most of the cases filed for medical malpractice New York are being settled out of court before the turn of its trial in the court.

Trend of these cases are quite different from the described facts-
As the victims of medical malpractice case have the authority of suing the concerned doctors and hospitals in court to get the justice in terms of compensation. Among all the cases which go for trial in New York, majority of the cases filed results in to the defeat of victims of around 66% to 80%. As the doctors manipulate the juries by proving that the case occurred due to the normal complications faced by the patient. There are some more reasons which compels the judges to give final decision in favor of doctors as-

· Doctors have a reputed image in the mind of juries as compared to the victims.
· As the jury trust the doctors and nurses for their treatment so they cannot suspect on their profession easily until the misdeed is correctly proved in the court by the lawyer.
· Insurance companies have manipulated the opinion of juries by saying that all the cases are being filed on false information to grab the compensation from the doctors.
· The last but not the least reason is that sometimes jury is not in favor of providing compensation amount to the victim as they believe that by giving this amount their insurance rates would be raised.

George Turner gives advice to clients who are looking for attorneys to handle injury related cases. To know more about the services of medical malpractice, medical malpractice lawyer new york, medical malpractice lawyers new york, medical malpractice law firm, visit www.nbrlawfirm.com

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Some Ways to Keep Your Electronic Medical Records Plan Moving Ahead

The most common question I get writing this column is: ‘Why is it taking so long to implement electronic medical records?’ Our initial 18-mo project turned out in about three years, instead. Though this seems a bit cautious to some colleagues, people in IT and project management industries commended our careful approach to the situation. It’s well-known that Internet Technology system implementations (such as EMR) fail up to 50 percent of the time. A solid plan must be in place, taking into account any unforeseeable circumstances which could change the time frame. For example, our journey included two new associates, two hurricanes, and a departure of an associate.

Your electronic medical records vendor should be able to refer someone to guide you through implementation. However, this person can be either a person with EMR experience or someone who knows about the system itself, though not so much about roll-out at a medical office. I strongly recommend taking on the services of a certified PM (Project Manager). One important thing a PM can do is turn your project into a dynamic process which can take a series of setbacks or delays. The standard calendar can’t really do much to ensure this sort of follow-through.

We first implemented a Project Manager to plan the location for our new office. Our employees could use what was learned from the process, which includes how to use mind-mapping software. We have used these techniques for all major projects at our practice since then, including implementation of the electronic medical records (EMR).

For meetings and other minor projects I recommend Getting Things Done by David Allen.

The primary advantage of using a work breakdown structure is that any glitches that pop up don’t completely ruin your goal to successfully implement the EMR system. Of course, at a small practice there is more schedule flexibility. A hard deadline should most certainly be set, as part of the plan for EMR roll-out. However, with a proper plan structure your plan can roll on with the punches instead of simply rolling over.

When we finally arrived a a place when staff had training, we posted the hard deadline to go live. There was a simulation date on a Saturday which occurred two days before launch; both dates were mandatory to attend.

Although theoretically we could have pushed the launch date back, these dates helped to keep us working together and exposed risks that were faced. Now we’re about 5 months into our roll-out. The stress levels have begun to settle a bit, and we’re now tweaking our templates and getting ready for the next wave of patients to introduce to electronic medical records.

Peter J. Polack, M.D., F.A.C.S., is founder of emedikon, a medical practice management consulting firm and president of Protodrone, a software development company specializing in medical practice applications. He is managing partner of Ocala Eye, a large multi-specialty ophthalmology practice. Find more useful articles and podcasts at http://www.medicalpracticetrends.com

Related Medical Coding Articles

Remote Job for a CPC-A, I need some help

So I recently passed my test! (Yayyy) and I have some experience with coding, but not enough to get out of the apprentice status. I also have ton of healthcare experience and education. However, I live in a small town and I am having trouble finding a coding position, I know its best to start an actual coding job before you do a remote job, but I’m struggling.

Is there any companies that will hire a remote coder with little experience? I worked so hard to get my CPC now I can’t find a job that doesn’t require a ton of experience.

Medical Billing and Coding Forum

Staying Positive – Some Thoughts For Job Seekers (And Also, Employers)

I began applying for jobs in August, right before I started training. Based on advice from my friends in the medical field, and experienced coders, I’ve applied for every entry level, "foot in the door" position I could find. Jobs like document scanning, data entry, reception desk, phone switchboard, and even housekeeping. Positions that specifically stated in their postings, "no experience necessary" or "at least one year of customer service", "must have working knowledge of computers", etc. Basic jobs. Between then and now (my training has been complete for about a month) I have applied to nearly 60 different positions, with a strong resume, cover letter, references, and a clear objective. Out of all of those jobs, I have received maybe 40 responses, with some variation of "You are not qualified" or no response at all. I even pushed back the date of my CPC exam, to focus on trying to lock down entry level work. I have posted in the forum before, about how I have two decades of retail management experience. And, anyone who has ever been in that particular field can tell you, you have your hands in everything. From banking, to dealing with sensitive information, HR, taxes and payroll, hiring/training personnel, doing paperwork, taking meetings, scheduling, running office equipment, using every computer software program known to man, answering phones. And, complicated things, like supervising packed stores, dealing with hostile customers, assisting large numbers of people at once, managing a staff of 20+ people sometimes, alone. And yes – housekeeping. It’s a role that always kept me on my toes. A role where customer service was always the biggest component, thus, the main priority. Yet, in the eyes of hiring reps for healthcare jobs, at least in my area, I am not qualified to answer a phone, process a payment, file papers/records, or deal with clients/patients in a customer service related position. As I prepare to finally sit for my CPC exam – which I am very confident about – I do remain concerned about my chances in the job market. I’ve heard horror stories from people with 30 years in billing, who couldn’t find coding work. And, I’ve heard horror stories from people like myself and others on this forum, who are new, and genuinely wanted to make a career change, but were not being considered for one reason or another. I’m trying to fight through the doubt and remain optimistic. The bottom line is, you can’t get that 3-5 years of experience that most employers are looking for, unless someone gives you a chance. And everyone deserves that chance. Especially if they are serious and legitimately care about being in this industry. And, I’d say 99% of us are! I spent nearly 20 years interviewing, hiring, and training people, and while I took their resumes into consideration, I also looked at their potential. I understood that if someone was applying to work for me, it was because they wanted to, and felt as if they had something to contribute. I always hired people who were motivated, willing to learn, and ready to jump in with both feet, no matter how new or scary it may have been for them. More importantly, I always had respect for people who were trying to make a positive change in their lives, by taking on a new challenge. I hope that anyone in my position, who is struggling, certified yet or not, will keep pushing. Knock on doors, apply to everything, until someone finally says "Yes." And, for anyone looking to hire new coders – be it for actual coding, or for an entry level, "foot in the door" job (because we WANT to work, we WILL take it if it’s the right fit!), don’t judge them solely on their background. Look at their experiences, see where they’ve been, where they want to go, and what they could bring to the table. You might come to find out that an ex retail manager, a stay at home mom, or a McDonald’s cashier could be a great addition to your team. Newbies, don’t ever lose sight of the fact that we have all worked hard to train and earn our certifications. Keep going!

Medical Billing and Coding Forum

Some Medical Alerts For Kidney Stones

Many people are not aware of it but there are actually different types of kidney stones that some individuals suffer from. Among those types, the most common that most people develop is called “calcium oxalate stone.” While others are called ‘struvite stones,” “uric acid stones,” and “cystine stones.” These types vary depending on what cause them and their characteristics.

People who are prone to kidney stones must familiarize themselves with the different types as early as possible so they would know what to adjust. Aside from setting lifestyles changes, knowing what type of kidney stones develop in the body is also important because it will help you do the things that will prevent their existence in your body system.

The symptoms of kidney stones

To be able to address the condition properly, it a must for people who are prone to having kidney stones to familiarize themselves with the condition. In order to determine if one is suffering from kidney stones, here are some medical alerts or symptoms to be noted:

1. Pain in all levels. As vague as it is, pain in varying levels is one of the major medical alerts of kidney stones. Considered as a common symptom for kidney stones, pain may vary depending on the size of the kidney stone and the length of time that it remains undiagnosed. Experts say that pain-which can be mild or extreme-is normal for people who suffer from kidney stones. This is because as the stone increases in size and weight, the more discomfort it brings especially during urination. Another form of pain that can be experienced due to kidney stones is from renal colic, which brings waves of severe pain that lasts for more than 10 minutes and can even last for an hour depending on the location of the kidney stone.

2. Blood in the urine or “hematuria.” The presence of blood in the urine is quite disturbing but this is one of the most common medical alerts of kidney stones.

Other symptoms of kidney stones include nausea or vomiting, pain with urination, and at times, the urgent need to urinate which are usually characterized among children and adults.

The importance of diagnosis

Did you know that almost 50 percent of the people who suffer from kidney stones would likely have them again in the next 10 years or so? This is because many of the sufferers do not continue medication and they cease from maintaining healthy diet and lifestyle.

People who are likely to suffer from kidney stones can go to any hospital’s Emergency Room or “ER”. Here, you can ask the attending physician or the hospital clerk on duty to undergo testing. It is advantageous for you to go straight in the ER because hospital people will attend to you directly. In most cases, it would take a long time before one can actually set at check up with a specialist. So it would be best if you go directly to the ER and get the prompt attention that you need.

Diagnosis can be done through an assessment of the person’s clinical history, a physical examination, laboratory evaluation, and x-ray for follow up. Having early diagnosis can definitely help you determine which type of kidney stone is present and would lead to faster and reliable treatments.

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