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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CPC Practice Exam and Study Guide Package

Practice Exam

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

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

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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

Finding Revenue Cycle Inefficiencies Is a Team Effort

Coding clean-up crew lays the groundwork to improve healthcare reimbursement through denial management. In large healthcare business offices, medical billers and coders are often in separate departments, with separate leadership. Although the medical billers are largely responsible for denial management, they often don’t have the necessary coding expertise required to properly work coding denials. This […]

The post Finding Revenue Cycle Inefficiencies Is a Team Effort appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

AAPC Certified experienced coder READY TO JOIN YOUR TEAM!

SHEELA SHIVRAMAN
11322 Wishing Well Lane, Clermont FL 34711
248-787-3942 • [email protected]

PROFESSIONAL SUMMARY
AAPC trained CPC Certified. Hard working and fully certified and two years of experience. Medical Coding Specialist has a full understanding of ICD-10-CM and CPT coding procedures. Fully proficient with
medical terms and procedures.
CORE QUALIFICATIONS
 Strong understanding of ICD-10-CM and CPT codes
 Extensive knowledge of medical terminology across a broad range of medical practice areas
 Excellent data entry skills
 Good multi-tasking abilities
 Good interpersonal skills and the ability to function as a team member
 Experience with fast-paced medical care environments
PROFESSIONAL EXPERIENCE
Synapse Neurology, Clermont, FL 2014 – 2019
Medical Office Coordinator
 Worked in a fast-paced medical office and reviewed patient charts and assign diagnosis codes (ICD-10) for
insurance billing
 Utilized knowledge of CPT and ICD-10-CM to properly translate performed services into numerical code
for insurance billing
 Interpreted medical terminology and pharmacological information for translation into the coding system.
 Obtained authorizations for the EMG, EEG and Botox injections
 Resolved patient issues in regards to patient care satisfaction
 Reconciled patient records and invoices
ST. MARY MERCY HOSPITAL, Livonia, MI, 2005-2013
Certified Nuclear Medicine Technologist
 Successfully performed general and specialized Nuclear Medicine procedures while exercising initiative,
judgment, problem solving, and decision-making. Daily Cardiology/EKG systems experience.
 Gained proficiency in radiation safety, protection, regulations, JACHO, HIPPA, MQSA and ACR
guidelines.
 Proficient with medical applications, Radnet, Powerchart, HealthStream and McKesson PACS.
 Medical billing performed using ICD-9-CM codes, CPT codes, and HCPCS codes.
 Took the initiative to improve patient care and safety standards.
EDUCATION
AAPC Trained Certified Professional Coder, 2019
William Beaumont Hospital School of Nuclear Medicine Technology, Royal Oak, MI 2007
Associate Degree in Nuclear Medicine Technology, Oakland Community College, Southfield, MI 05/08
Bachelor of Science, National College, Bangalore, India 1993
References Available Upon Request

Attached Files

Medical Billing and Coding Forum

G0390 (Trauma Team Response) denied when billed with CPT 99291 & ER Services

We have several claim that are being denied payment for G0390, Trauma Team Response with the correct Rev Code 689 billed on the same day as CPT 99291, Critical Care. The EOB always says that the CPT/HCPCS is not valid/ correct or that services were not performed. The payer is WV Health Plan Medicaid. I have reviewed the CMS guidelines and it looks like it is being billed/coded correctly. Is anyone else having an issue getting G0390 paid?

Medical Billing and Coding Forum

To Use A Set Of Coding Techniques, Memos And Research Team Conversations

Three iterations of Tween Day were completed by the research team with three unique tween samples. The locations chosen were Juicy Couture Jewellery a university campus in the city (hereafter “University”), a faith-based ministry in a culturally diverse urban neighborhood (“Ministry”), and an elementary school in a middle-class suburb twenty miles from the city (“School”). In total, thirty-four tweens participated: sixteen at University (ten females and six males; average age 11 years), five at the Ministry (two females and three males; average age 12 years), and thirteen at the School (seven females and six males; average age 11 years). The University tweens were Caucasian; the Ministry tweens were African American; and the School tweens were a mix of Caucasian, African American, Native American, and Asian/Pacific Islander. Although the participants were recruited conveniendy at each location, the combined sample of thirty-four tweens represented a diverse range of socioeconomic and ethnic groups, one roughly equivalent to the study’s geographic region, which was broadly situated in a large urban-suburban area with a population in excess of 3 million.

By systematically collecting data from three sites using identical instruments, protocols, and time frames, the research team was able to perform a thorough, cross-site analysis of the qualitative data. All data collected were Juicy Couture Necklaces rigorously checked for validity. To ensure trustworthiness, we implemented several measures as recommended by Yvonne Lincoln and Egon Cuba [49]. Dependability (or reliability) was ensured through:
Consistent note-taking and the use of multiple researchers
Using multiple, triangulated methods
Comparing emergent themes with findings from related studies
Audiotaping and transcribing interviews
Employing intercoder checks
Analyzing the data for incidents of observer effect
We addressed different forms of validity as follows:
Face validity: asked whether observations fit an expected or plausible frame of reference Criterion/internal validity: (1) pretesting instruments, (2) peer debriefing, and (3) participant verification (i.e., member checks)Construct validity: examined data with respect to the various theoretical constructs represented in the literature and pertinent to different aspects of the study (e.g., information grounds)

The qualitative data set was analyzed using a set of coding techniques, memos, and research team conversations. Major themes emerged from the data, which, at a high level, guided the analysis and permitted the team to break an enormous data set into manageable portions. These themes (e.g., information grounds, social types, affect, and information needs) or first-level codes were mapped onto the instruments’ questions to create thematic “sets” that could be analyzed using iterative pattern-coding techniques. The researchers utilized the coding and querying features of Atlas Ti 5.0 (Knowledge Workbench, Inc.) to parse the data into these thematic sets. Repeated reading of the interview transcripts, memos, and group discussions allowed the researchers to identify patterns (second-level codes) of behavior within these sets. Some patterns appeared in multiple themes, which permitted thematic bridging. Select questions that provided particularly rich data were further analyzed independent of the themes, using third-level coding schemes specific to those smaller analytic sets. The complete methodology (including instruments and techniques) is explained in detail in Meyers, Fisher, and Marcoux [50]. The resulting data amassed from fourteen focus groups and twenty-five interviews were analyzed using the aforementioned frameworks and principles, yielding unique insights into the information worlds of tweens and its social, affective, and cognitive dimensions.

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Put Your Virtual Team to Work

Build an optimal remote team that contributes to your organization’s success. In the 2016 Membership Survey, 26 percent of coders and billers said they work from home some of the time, and 8 percent said they worked from home all of the time. As information and communication technology continues to advance, more remote coding and […]
AAPC Knowledge Center

I Bring a “Never Give Up” Attitude to Your Coding Team!

Motivated CPC-A seeking an internship opportunity or coder trainee position. I have several years of administrative support experience, including time spent working with sensitive records. As a Medical Records volunteer, I am entrusted with access to patient’s medical charts for review. I also have a strong background in customer service. Please see the attached resume. Thank you.
Attached Files

Medical Billing and Coding Forum

Looking for HCC Team leading position in Port St. Lucie area

Tehmina S. Irfan, CPC_________________________
1435 N.W. 22nd Ave, Delray Beach, Florida 33445, E-Mail: [email protected] Phone: (561) 843-8978

CAREER SUMMARY

• MRA Dept. team leader
• Train billers/coders, general staff, and PCPs for documentation, E&M, MRA, HEDIS, & PQRS (for original Medicare) guidelines
• Continue EHR experience: Practice Fusion, MD 2000, Soap Notes, E-clinical works, Kareo, Medisoft, GPRO, & Athena
• Possess the combination of years of organizational and administrative skills coupled with expertise in medical coding and instructing physicians and their staffs in compliance.
• Earned various certifications including in A+, CPC, and ICD-10 Proficiency certifications (currently pursuing CPMA) which make for a valuable asset to every team.
• Contribute to the workplace major strengths: critical thinking skills, problem solving, maintaining target goals and completing projects while accommodating path adjustments, a determined thirst for knowledge, excellent interpersonal skills and customer service.
• Master essential communication and technical areas while possessing and an eye for detail.
• Embrace the challenge of data integrity through planning, maintenance, and employee training, which is (Humana) and has been relevant throughout my professional career.
• Perform secretarial duties along with mentoring new members as the Secretary of AAPC Palm Beach Chapter

Work History

Medical Specialists of the Palm Beaches, Inc.
HCC CODER/Auditor/Educator
January ‘9th – Current

• Reviewed medical records and practice management code data to determine if the medical record is complete, accurate, and in support of individual patient risk adjustment score accuracy.
• Sequenced and assigning codes from ICD-10 methodology based on the code which most accurately describes each documented diagnoses.
• Educated providers and their practice staff in Medicare coding guidelines, focusing on revenue enhancement opportunities.
• Collaborated with other departments to develop plans and materials that support education and system changes to meet practice and revenue goals.

Humana
MRA Coder/Auditor
March ‘15 – December 21st 2016

• Reviewed medical record information to identify all appropriate coding based on CMS HCC categories.
• Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
• Provided support, education, and training related to the quality of documentation, level of service, and diagnostic coding consistent with established coding guidelines and standards.
• Extended real time support and coordination with Primary Care Providers and Care Coordinators for MRA coding, HEDIS, and STARS.
• Coordinated with clinical leadership in the development of provider training plans and for active support in the training process.
• Organized and schedule periodic training as indicated from chart review results, and/or as requested by medical leadership or CBO management.
• Monitored coding modifications to ensure that the most current information is available.
• Facilitated coding support to CBO as requested.

Outcomes Health Information Solutions
December ‘14- May ‘15: Remote HCC Coder/Auditor
• Auditing/Coding charts for Compliance/MRA

TSI Billing & Coding of USA
February ‘12- /current: Medical Billing / Internal Auditing services
• Medical Billing and Auditing records for local Physicians

Primus Health Network Inc., LLC
September ‘12- November ‘14: Coding Specialist/Auditor
• Audited charts for MRA, HEDIS, & PQRS for G-PRO
• Trained physicians & staff in documentation compliance
• Assisted physician & staff capturing HEDIS measures
• Supervised billing staff with the coding process

American Academy of Professional Coders (AAPC)
January ’17 – Current: Secretary of Palm Beach Chapter
• Perform secretarial duties along with mentoring new members
March ‘12- January ’13: New Member Development Officer of Palm Beach Chapter
• Performed duties as a mentor

Dr. Saleem A. Haq, M.D
November ‘98 – April ‘12: Office Manager/ Medical Biller & Coder
• Managed all office matters
• Medical billing and coding for all types of payers
• Referral Coordinator
• MD credentialing
• Assisted in hiring process
• Maintained all office computer systems
• , maintenance, and employee training, which is (Humana) and has been relevant throughout my professional career.

PROFESSIONAL SKILLS/ PREVIOUS JOB RESPONSIBILITIES
• Knowledge of Share point and clouds
• Auditing Humana, BCBS, United HealthCare, and Medicare, among other major insurance companies
• Earned certification from FHIMA for inpatient coding (Advanced ICD-10- CM & ICD-10 PCS)
• In depth knowledge of coding guidelines (ICD-9-CM, ICD-10-CM & PCS, CPT, and HCPCS), CMS regulations, state provider licensure and certification requirements, commercial insurance clinical and reimbursement policies, and audit and appeal techniques
• Flexible, detail-oriented ability to be a positive influence on others, skilled at working independently, willingness to take ownership of responsibilities, quality conscious, dependable, and ability to adapt well to change
• Proficiency with Microsoft Office Suite, including Word/Power Point/Excel
• Strong interpersonal and presentation skills
• Proficient in written and oral communication skills at all corporate levels
• Multilingual: English, Hindi, and Urdu
• 18+ years of billing and coding experience in outpatient settings
• Member of American Health Information Management Association (AHIMA) & American Academy of Professional Coders (AAPC)

EDUCATION/TRAINING
• CPMA (in progress)
• ICD-10 Proficiency Certification
• CPC
• 18+ years of coding and auditing experience in HCC & HEDIS and outpatient office setting
• BA in general studies

CONTINUING EDUCATION
• MRA education & Training Disease Specific
• 2017 CPT updates
• 2017 Professional Development for Officers
• Humana-based courses/certifications (a variety of skills)
• Clinical Documentation Improvement
• Experienced in coding/auditing E & M, HEDIS, MRA
• Data Breach Compliance and Response: “Preparing for the First 24 Hours of a Data Breach and Beyond”
• “How To Find Coding Info You Didn’t Know You Needed To Know”
• “Pay for Performance: Putting the Pieces Together”
• “CDI, Coding and Your Physician Relationship…Be the Pack Leader”
• “ICD-10 The Good The Bad & The Ugly”
• “E & M: Navigating the Real World Record”

References: Upon Request

Medical Billing and Coding Forum

5 Ways to Protect Your Clinical Team From Burnout

5 Ways to Protect Your Team from Burnout

The odds are high that burnout will strike every healthcare professional at some point. Health workers — as well as teachers, ministers and others in the caring professions — are at increased risk for the stress syndrome because of the intensity of their work and the emotional bonds they form with the people they’re helping.

Recognizing the signs of burnout and how to overcome it can help you and your colleagues stay healthy and motivated so you can provide your patients with the best possible care.

What Is Burnout?

Generally, burnout is caused by a person’s inability to relieve the physical and mental symptoms associated with unrelenting stress.  It can show up as poor job performance, an impersonality with patients and lack of motivation.

Health problems such as high blood pressure, insomnia, depression or addiction can also be signs of burnout. The degree of burnout and the way the syndrome appears vary widely from person to person. For some, it may include nothing more than negativity about the workplace.  In others, it might be serious enough that a health professional has no interest in ever going back to work in the field.

Burnout: The Full Assessment

Breaking down burnout will help shed light on how it may be affecting the whole person. Knowing the signs, symptoms and strategies to prevent job burnout can help you and your team give patients the best possible care.

Signs of burnout

  • Becoming cynical or critical at work
  • Do you drag yourself to work and have trouble getting started once you arrive
  • Becoming irritable or impatient with co-workers, customers or clients
  • Lacking the energy to be consistently productive
  • Lacking satisfaction from work achievements
  • Feeling disillusioned about work
  • Changes in sleep habits or appetite
  • Troubled by unexplained headaches, backaches or other physical complaints

Supportive Strategies for Managers

Here are five different ways in which managers can help their staff succeed, feel a personal investment within the organization and stay healthy.

1. Show Appreciation

One way you can help your staff’s morale is to help them feel appreciated. It’s important for managers to show appreciation for a job well done and to take an active interest in an employee’s life.  And, it doesn’t need to be complicated, a simple note of thanks can go a long way!

2. Take breaks!

Employers need to encourage breaks so that their staff doesn’t overwork themselves to the point of burnout. Breaks help us walk away from stress.  The first place to start?  Model the behavior by taking a break yourself!   See if the nurses will buddy up with each other to give each other breaks. Make your break room a calming place for the team to go. Everyone needs to get away and have a few minutes to themselves.

3. Encourage Healthy Habits

Packing your lunch can be the easiest way to eat right at work. It’s easy to go to the vending machine, but not good for your waistline, or your wallet. Set up a place to help your staff exercise. Why not promote a 10 minute walk break?  After all, patients look to clinical teams for health advice, shouldn’t we support one another in taking care of our own health?

4. Provide Learning Opportunities

Practices should promote/encourage ongoing learning and different educational situations. This allows employees to feel confident and in control of their careers. Personal development is another often overlooked arena of health and wellness.

5. Vacation time

Make sure people are taking their vacation time. It’s necessary because it promotes a healthy work-life balance. They need to feel valuable to the company at which they work, and rewards like this are good thing.

Is there a cost associated with these strategies to boost team morale? Yes. But they’re worth it when people’s passion for the company they work for is rejuvenated and reinvigorated. What strategies have you used at work to help your team feel supported and engaged?  

— This post 5 Ways to Protect Your Clinical Team From Burnout was written by Manny Oliverez and first appeared on Capture Billing. Capture Billing is a medical billing company helping medical practices get their insurance claims paid faster, easier and with less stress allowing doctors to focus on their patients.

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