Click here for more sample CPC practice exam questions with Full Rationale Answers

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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

Practice Exam

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

2 Tips for Billing a Physician Assistant as Assistant Surgeon

A physician assistant (PA) serves as an assistant surgeon only to suture and close an incision. There is no documentation that the PA performed any other function to assist the primary surgeon during the surgery performed on the Medicare patient, such as providing extra hands needed for tasks which required more than the surgeon’s two […]

The post 2 Tips for Billing a Physician Assistant as Assistant Surgeon appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Michigan surgeon accused of $60M billing fraud

Bay City, Michigan surgeon Vasso Godiali, MD, was indicted on July 10, 2019, for allegedly orchestrating a $ 60 million healthcare fraud scheme. He is also charged with money laundering for financial transactions involving almost $ 50 million in proceeds from the scheme. The indictment comes from both the federal government and Michigan state authorities because it […]

The post Michigan surgeon accused of $ 60M billing fraud appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Pre Op H&P by surgeon preforming procedure

I have a patient who was admitted for a Pacemaker relocation procedure. The surgeon did a quick H&P the day before the surgery. From my research I have found that this should be included in the Global charge of the procedure. But what code would I use to show the H&P visit was done the day before? I do not think I can use a 99024 as that is a Post Op code.

Thank you in advance!

Medical Billing and Coding Forum

Resigned New Haven Oral Surgeon Settles False Claim Allegations

A resigned New Haven oral specialist and his training consented to pay more than $ 250,000 to settle charges that they damaged government and state false case laws.

Read The Full Story Here!

The post Resigned New Haven Oral Surgeon Settles False Claim Allegations appeared first on The Coding Network.

The Coding Network

Assistant Surgeon Status Indicator 2

Hernia repair done with an assistant surgeon. Assistant surgeons’ name is indicated at the top of the report but nowhere else in the document is indicated the work done by the assistant and nowhere in the document is demonstrated the need for the assistant surgeon. What are the documentation requirements for an assistant surgeon for procedure with status indicator 2? Is it enough to just document the assistants name at the top?
Thanks!

Medical Billing and Coding Forum

Assistant Surgeon Billing

I work for an orthopedic surgeon who does predominantly worker’s compensation billing. Recently, we have gotten denials from some of the insurance carriers denying the assistant surgery due to "the surgeon must specify what specifically the assistant performed." We have never heard of this requirement, and the surgeries are always authorized for an assist. Additionally, these are codes that have the correct Medicare indicator to receive payment for an assist. I found a blog article from 2013 written by Marilyn Holley, CPC, CPC-I, RHIT, CHISP, (https://www.aapc.com/blog/25432-prom…rgery-payment/) that contained a sentence stating the physician must include these details in their report as well, however, she did not cite the guideline that would require specifics in the documentation of what the assistant did. Due to our recent denials, I was hoping for some help…Is there a requirement for the assistant’s actions to be specifically documented in the report? If so, what is the regulation and where is this stated?

Thank you in advance for the input!

Medical Billing and Coding Forum

Assist Surgeon on C-Sec?

I have read through a bunch of threads on here, and the responses seem to be all over the place. I’m thinking maybe the answer is situational? Here is my scenario:

Provider A provides *almost* all antepartum care.
Provider B provides some antepartum care. *Pt is high risk and had more than 13 visits*
Provider A delivers, and provider B assists.
Provider A provides antepartum care.

Best billing practice for said situation?

If provider A bills 59510, can provider B bill for assisting on the c-sec?

Any help is appreciated!
Thank you!!

Medical Billing and Coding Forum

Assistant Surgeon claim denial: considered inclusive …

In GYN surgery, the primary surgeon did multiple procedures. The assistant surgeon assisted with only one of those procedures. The procedure that had the assistant was considered inclusive of the other services done by the primary surgeon. Does the assistant surgeon have any standing for appeal? I have no administration over the claims or billing of the primary surgeon. The assistant surgeon is reaching out to me to see if there is anything he can do to get paid.

Medical Billing and Coding Forum

spine surgery for assistant surgeon

Hello I have a question we have been billing spine surgeries with 22804-80 22844-80 22214-80 22216-80 X 8 units are we allowed to get reimbursed for all of 8 units for assistant at surgery for cpt 22216? we are getting denials stating that we are only allow 1 unit since is under assistant surgeon. please let me know

Medical Billing and Coding Forum

refund request for an assistant surgeon

Do we need to refund an insurance company that we do not PAR with if they paid us the whole amount for the surgery? A third party now is requesting 84% TAKE BACK of our claim that was submitted correctly with the 80 modifier. It is well over a year and we have no relationship with the insurance company. What are our options<

thank you
New Jersey

Medical Billing and Coding Forum