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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

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

Medical nutrition therapy

Hello All~
Can someone please direct me to where I can find a policy or information on billability requirements for MNT for a NON-MEDICARE patient who is SELF-REFERRED? I see a lot on Medicare requirements and that we are unable to bill for MNT services WITHOUT a Provider referral and covered diagnosis.

This non-medicare patient of mine is SELF-REFERRED and doesn’t want regular insurance co billed. (No PROVIDER referral!) Are we allowed to bill the patient WITHOUT a provider referral if they want the services? What if they also sign a waiver of payment responsibility? Or even if they are a Medicare patient, knowing they don’t cover MNT for non-DM diagnoses and sign an ABN or waiver? Again, all of this is in regards to the referral issue.
My company is stating that ALL MNT services require a provider referral whether self-pay, signed waiver, or not, but I feel that if anyone wants this service and is willing to pay out-of-pocket for it, it shouldn’t need one. Please help if you can. Thank you so much!!!

Sue

Medical Billing and Coding Forum

BCBA incident-to services for ABA therapy

Are there any ABA therapy billers or practice managers who can help me? I am working with an ABA practice who would like to bring on a psychologist to work with our patients and our BCBAs. Is anyone billing incident-to services? I would really like to chat about how you are doing this.

I have reached out to the insurance companies we work with and the reps are not giving me information on incident to services.

Any help or knowledge would be appreciated.

Medical Billing and Coding Forum

Pelvic Floor Therapy

Hello all!

I’m reviewing some records and need some help on how the visits should be coded. Multi-practice group, and some Doctors are billing differently for the same services. (I can’t tell which one is actually accurate.) I’ve researched Google, Encoder, AAPC Coder, etc and it appears there is lots of confusion out there on how to bill the procedures in question.

Does anyone have any resources that show what would be documented for the following when being done for PFT: 91122, 51784, 97750, 97032, 64566?

Medical Billing and Coding Forum

Physical Therapy supervised (untimed codes) question

Hello,

I have a question regarding PT supervised code 97010 being billed with another supervised code 97014 in the same 15 minute time period. The information I have found says:

Billing Two CPT Codes for Same 15 Minute Time Period
*Only when one of the services is a supervised service that does not require the presence of the therapist (97010 – 97028)
*One or more supervised modalities may be billed in the same 15 minute time period with any other CPT code requiring constant attendance or direct one-on-one patient contact.

Does this mean since they are both supervised codes and neither are timed codes that they should not both be billed? The office notes say there was 32 minutes of Therapeutic Exercises with 15 minutes of concurrent care for the Cold Pack and EStim for a total of 47 minutes. 2 units of 97110 was billed with 1 unit of 97010 and 1 unit of 97014. Is this correct and all 4 units should be allowed?

Thank you in advance for any advice you can give!

Medical Billing and Coding Forum

Therapy Services Get a Workout in Medicare Final Rule

The 2019 Physician Fee Schedule (PFS) final rule doesn’t hold a lot of surprises for physical therapists, as the Centers for Medicare & Medicaid Services (CMS) finalized most of what they proposed for therapy services in July. To the relief of many commenters, however, there is one provision CMS didn’t follow through on — at least […]

The post Therapy Services Get a Workout in Medicare Final Rule appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Well woman exam with hormone therapy

Hello,

52 years old Established Patient come for Gynecological Exam
HPI: Patient doing well except she is getting some flushes and flashes on the lower dose of estrogen
…..
…..

& for A/P : Well woman exam, Menopausal woman, On HRT with now some symptoms, once to evaluate the doses
"Discussed options with hormone therapy versus decreasing dose versus nothing versus how long she can take it and risks. I discussed the risks, benefits and alternatives to hormone replacement therapy with Heather. We discussed the results of the Women’s Health Initiative and the guidelines for HRT from ACOG. Some of the risks include stroke, clot, dvt, PE and she understands these risks and wants to take HRT". And Medication ordered: progesterone (PROMETRIUM) 200 mg capsule, Estradiol (DIVIGEL) 0.5 mg/0.5 gram (0.1 %) Gel in Packet.

Can we code extra 99213 with 99396?
Hormones review is included annually WWE?

Thanks
Helen

Medical Billing and Coding Forum

Therapy codes denial for SNF

Just got a denial from UHC on outpatient therapies i.e occupational and speech, The reason code stated that it is not billed according to the Medicare guidelines. The codes in question are 92526 and 97535 both of em had GN and GO modifiers appended to em respectively but the 92526 also had KX modifier. Adding to that I had the same bill for the same patient for the same procedures but different dates and that one got paid and the only difference was it didn’t have any KX modifier with 92526.

Medical Billing and Coding Forum