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

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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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

Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme

Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme.

Two owners of Guam Medical Transport (GMT) were sentenced to prison terms today for their roles in a health care fraud and money laundering scheme that resulted in a loss to the United States of approximately $ 10.8 million, one of the largest single Medicare ambulance fraud cases ever prosecuted by the Justice Department.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Shawn N. Anderson of the Districts of Guam and the Northern Mariana Islands, Special Agent in Charge Eli S. Miranda of the FBI’s Honolulu Field Office, Special Agent in Charge Justin Campbell of IRS Criminal Investigation (IRS-CI) Seattle Field Office and Special Agent in Charge Timothy DeFrancesca of the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) Los Angeles Regional Office made the announcement.

According to their admissions at the plea hearing, from approximately March 11, 2010, to approximately March 21, 2014, the defendants engaged in a conspiracy to defraud Medicare and TRICARE by submitting claims for reimbursement for medically unnecessary ambulance services that GMT provided to patients with ESRD.

As part of the scheme, the defendants directed GMT employees to remove from internal documents references to GMT patients’ ability to walk because they knew that Medicare and TRICARE would not provide reimbursement for the patients.

The post Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme appeared first on The Coding Network.

The Coding Network

Nebulizer Tips for Providers and Their Coders

If your provider is ordering nebulizers and the drugs used in them for their patients, here are things  in the documentation that will help prevent a resubmission to Medicare and ease medical coding. CMS Wants Nebulizer Necessity The Centers for Medicare & Medicaid Services (CMS) recently released an MLN fact sheet that helps clarify what’s […]

The post Nebulizer Tips for Providers and Their Coders appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Proper coding for patients seen by a specialist during their observation stay

I just wanted to confirm with the panel the correct way to bill for an exhisting pateint who was seen in the hospital during the observation stay portion prior to being formally admitted as an inpatient. We are an oncology practice and one of our oncologist was asked to consult on a patient for Hematology reasons, while the patient was still registered as being in observation. The physician obliged and saw the patient, but marked teh encounter as an initial inpatient visit (99221-99223).

Per CMS guidelines (PUB 100-04 Claim Processing Manual, Transmittal 2282, section 30.6.8 Payment fo Hosptial Observation Services and Observation of Inpateint Care Services (including admission and discharge), "Payment for an initial observation care code is for all the care rendered by the ordering physician on the date the patient’s observation services began. All other physicians who furnish consultations or additional evaluations or services while the patient is receiving hospital outpatient observation services must bill the appropriate outpatient service codes."

Unfortunately, it does not go into detail on how to code if the patient being seen was already and exhisting patient of the consulting physician. Since we are told to use the appropriate outpatient codes (99211-99215, 99201-99205), the question was asked which would be the more appropriate code type of code, exhisting or new patient? I think an argument could be made for both code types, but my gut feeling is that we are bound by the 3yr rule when using the outpatient codes. Is this the more prudent way to approach these scenarios?

Greg Quinn, CPC, CPPM, CHONC

Medical Billing and Coding Forum

Millennials and Their Healthcare Access

Millennials, those born between 1980 and around 2000, access healthcare differently. Are you aware of their habits? Here’s an example. Millennials look for convenience and price transparency along with the fast service. This challenges the traditional primary care medicine office care delivery model. As a result of having a difficulty in getting convenient appointments, knowing […]

The post Millennials and Their Healthcare Access appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Physician delegates to sign off their charts notes

I need help!

Since our physicians are so busy they suggested that we assign delegates to sign off their charts notes. The CMS guidelines for signature requirements does not really mentioned delegates, is this even legal to assign someone to sign off their chart notes? I do not really agree with their suggestions but if there are guidelines out there that I do not know please share them with me.

Thank you in advance

Josephine

Medical Billing and Coding Forum

Pathology Key Words for Correct Coding: Know Their Differences

Diagnosis code choice relies on a thorough understanding of the four classifications of abnormal cell growth severity. The good news about cancer coding is that it is generally straightforward. If you can familiarize yourself with a few key pathology words, you’ll be headed in the right direction. Stages of Cancer Cancer is not a disease […]
AAPC Knowledge Center

Parents Making Appointments For Their Adult Children

I believe that it’s a HIPAA violation to allow a parent to make a medical appointment for their adult child (over 18). We are a pediatricians office so this happens regularly – and usually a month or two after the child turns 18. I’m getting pushback and would like to gather other feedback. Please advise.

Medical Billing and Coding Forum

MIPS Eligible Clinicians Learn Their Fate for 2019

Eligible clinicians can now see the results of their 2017 performance in the Merit-based Incentive Payment System (MIPS). Feedback includes performance category scores, final scores, and 2019 MIPS payment adjustments. The Centers for Medicare & Medicaid Services (CMS) is mandated under MACRA to adjust payments for professional services furnished to Medicare patients provided by MIPS […]
AAPC Knowledge Center