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

2016 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

Coding HBO Therapy Is a Gas

It may sound like something out of a sci-fi movie, but hyperbaric oxygen (HBO) therapy is real. It involves breathing pure oxygen in a pressurized room or tube, and it has long been used to treat decompression sickness from scuba diving. More recently, physicians have found it useful to treat other conditions. Medicare Coverage under […]
AAPC Knowledge Center

Medicare therapy cap

Hi! I just read something that stated that the Medicare therapy caps were REPEALED when President Trump signed the budget extension bill (through March 23rd) last week. Can anyone give me any information on this? Does it take effect immediately? And is it permanent, or might it change when we get a permanent budget signed into law? Thanks for your help!

Medical Billing and Coding Forum

G0447 Intensive Behavioral Therapy (IBT) for obesity

Hello,

I have some questions about G0447. Any resources besides Medicare’s website?

1) Documentation requirements for billing code? Time documentation required?

2) Can it be billed with an e/m? Other preventive visit?

3) Can you bill if they only discuss with the patient at one visit? Or do you have to have more visits?

Any help is greatly appreciated!!

Medical Billing and Coding Forum

Expired Medicare Legislative Provisions and Therapy Claims with the KX Modifier Rolling Hold


CMS is committed to implementing the Medicare program in accordance with all applicable laws and regulations, including timely claims processing.  Several Medicare legislative provisions affecting health care providers and beneficiaries recently expired, including exceptions to the outpatient therapy caps, the Medicare physician work geographic adjustment floor, add-on payments for ambulance services and home health rural services, payments for low volume hospitals, and payments for Medicare dependent hospitals.  CMS is implementing these payment policies as required under current law.

For a short period of time beginning on January 1, 2018, CMS took steps to limit the impact on Medicare beneficiaries by holding claims affected by the therapy caps exceptions process expiration. Only therapy claims containing the KX modifier were held; claims submitted with the KX modifier indicate that the cap has been met but the service meets the exception criteria for payment consideration. During this short period of time, claims that were submitted without the KX modifier were paid if the beneficiary had not exceeded the cap but were denied if the beneficiary exceeded the cap.

Starting January 25, 2018, CMS will immediately release for processing held therapy claims with the KX modifier with dates of receipt beginning from January 1-10, 2018.  Then, starting January 31, 2018, CMS will release for processing the held claims one day at a time based on the date the claim was received, i.e., on a first-in, first-out basis. At the same time, CMS will hold all newly received therapy claims with the KX modifier and implement a “rolling hold” of 20 days of claims to help minimize the number of claims requiring reprocessing and minimize the impact on beneficiaries if legislation regarding therapy caps is enacted.  For example, on January 31, 2018, CMS will hold all therapy claims with the KX modifier received that day and release for processing the held claims received on January 11.  Similarly, on February 1, CMS will hold all therapy claims with the KX modifier received that day and release for processing the held claims received on January 12, and so on.


Coding Ahead

Build Up Physical and Occupational Therapy Know-how

Reaffirm your knowledge of ICD-10-CM codes and the more specific E/M PT/OT codes introduced in 2017. Coding for physical and occupational therapy (PT and OT) requires an understanding of ICD-10-CM guidelines, and a firm knowledge on how to bill units of timed and untimed therapy CPT® codes. ICD-10 Considerations In therapy encounters, there is often […]
AAPC Knowledge Center

Aenta Medicare Reimbursement for Physical Therapy Code

Is anyone having any issues with Aetna Medicare reimbursing for G0283. We keep getting denials and they are stating that it is due to the LCD 35222 stating that the DX is not covered and we have used several DX that should be covered. When we look up LCD 35222 it doesn’t give us much information.

Medical Billing and Coding Forum