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

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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

There are Deadlines for Submitting Information

CEUs for chapter meetings It is recommended that CEUs be requested 30 days in advance of the meetings, but no later than two weeks before. Meetings are approved in the order they are received. CEUs will not be granted if the request was received after the meeting was held.  CEUs for chapter-sponsored seminars It is […]

The post There are Deadlines for Submitting Information appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Lenox Hill Hospital Pays $12.3 Million Settlement For Submitting Fraudulent Medicare Claims

The US Attorney for Manhattan, New York, and a Special Agent for the OIG’s New York Regional Office, announced today that the US Federal Government has settled a civil fraud suit against Lenox Hill (a Manhattan Hospital) and its corporate parent Northwell. The Government’s complaint alleges that the two Defendants violated the False Claims Act by knowingly and fraudulently billing Medicare for healthcare services that didn’t comply with Medicare law.

Read The Full Story Here!

The post Lenox Hill Hospital Pays $ 12.3 Million Settlement For Submitting Fraudulent Medicare Claims appeared first on The Coding Network.

The Coding Network

Tips for Submitting Applications for CEUs for Local Chapter Meetings

We appreciate all our chapter officers for their proficiency in submitting applications for CEUs accurately. Occasionally there is confusion, so we offer the following for clarity and to provide tips that could be implemented to help speed up the approval process: Save the Date Reminders If you are interested in publicizing a Save The Date […]

The post Tips for Submitting Applications for CEUs for Local Chapter Meetings appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

There are Deadlines for Submitting Information

CEUs for chapter meetings It is recommended that CEUs be requested 30 days in advance of the meetings, but no later than two weeks before. Meetings are approved in the order they are received. CEUs will not be granted if the request was received after the meeting was held. CEUs for chapter-sponsored seminars It is […]

The post There are Deadlines for Submitting Information appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

submitting claims to primary commercial ins and secondary ins medicaid

I have a co-worker who insists that when 99395 is submitted to the primary commercial ins and denied, that the 99395 code can be changed to a 99214 to submit to the secondary ins medicaid plan first to receive payment. I thought this was illegal but I would like to find some information to print off regarding guidelines on this.
Any help would be appreciated.

Judy in Mobile

Medical Billing and Coding Forum

Q&A: Submitting claims for observation services

Q: Did something change with the observation services Composite APC in 2016? The director of patient financial services says we no longer receive payment for it.

A: The observation services Composite APC (APC 8009) was replaced with a single comprehensive APC (C-APC 8011) for CY 2016. Along with the new C-APC comes new status indicator J2. Services assigned to J2 are considered to be adjunctive services and components of C-APC 8011, and this will result in a single payment for these services reported as part of the comprehensive observation services APC. The J2 designation and the payment are based at the claims level and not per date of service.
 
The good news is that the requirements to meet the observation services C-APC are the same as for the Composite APC (e.g., clinic/ED visit, 8 or more units of G0378, etc.). Even more good news is that the ED visit level requirement now includes all Type A and Type B ED levels and critical care; the level is no longer limited to the higher ED visit levels.
 
Be sure that all services provided continue to be reported to insure that all costs pertaining to the individual patient’s scenario are included in your claims data. CMS will continue to expect and rely on the claims data for rate setting under the OPPS.
 
For more information, see the Medicare Claims Processing Manual, Chapter 4, sections 10.2.1, 10.2.3, 10.4, 290.5.1. 290.5.2 and new section 290.5.3.
 
Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Revant Solutions,in Fort Lauderdale, Florida, answered this question.

HCPro.com – APCs Insider

submitting 90853 and 90849 during same group session?

The provider is starting a group therapy session. She is asking if she can bill 90849 for those patients when the parents come to the session and bill 90853 for the rest of the group members whose parents do not come in to the session? Do these group sessions need to be separate? One for the family and one for the patient? any help will be appreciated!

Medical Billing and Coding Forum

Billing a patient for a service without submitting to insurance

I have some providers that would like to charge a patient $ 20 for a B12 injection and not submit it to insurance at all when they are in the office for other services. I’m questioning the legality of this.

For example, a patient with insurance is seen for a sick visit and gets labs and a steroid shot. They pay their copay for this. Can we skip billing the insurance for the B12 drug and admin, and charge the patient right away for the $ 20?

The reason for this is that some plans aren’t covering B12 and the providers want to follow the same guidelines for every patient instead of having to remember which insurance is going to cover it or not.

Thanks so much in advance!
Zory

Medical Billing and Coding Forum